Sexual Health: Pain, Libido, Menopause & Testing

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Pain during sex

Pain during sex (dyspareunia) is common but not something you should just live with. Causes range from not enough arousal or lubrication to infections, vaginismus (involuntary muscle tightening), endometriosis and hormonal changes. More foreplay and lube can help mild cases. Persistent or deep pain deserves a visit to an OB-GYN, and a pelvic floor physical therapist can help too.

Low libido

Desire naturally ebbs and flows. Stress, fatigue, relationship issues, some medications (including certain antidepressants and hormonal birth control), postpartum changes and hormones can all play a role. Talking to a clinician is a good first step, and telehealth now makes that easy.

Sex during and after menopause

Falling estrogen can cause vaginal dryness, thinning tissue and discomfort (called genitourinary syndrome of menopause). Vaginal moisturizers, generous lube and regular sexual activity can help. Prescription options like low-dose vaginal estrogen are very effective for many women, so it's worth asking a menopause-trained provider.

STI testing

Many STIs cause no symptoms, so regular testing is the only way to know your status. The CDC recommends yearly chlamydia and gonorrhea testing for sexually active women under 25 (and for older women with new or multiple partners), plus HIV testing at least once for everyone aged 13 to 64. At-home kits make it private and simple.