9 Things Your Doctor Won't Tell You About Your SexABILITY

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ABC News senior medical contributor and gynecologist Dr. Jenn Ashton said Streicher’s book, which hit bookstores last month, is “well-written, thorough and comprehensive.”

Ashton said 40 to 50 percent of her female patients are affected by dyspareunia (painful intercourse) and low libido.

“It is definitely true that women don't ask their doctors about sex, and doctors don't ask their patients,” said Ashton. “I ask every patient about their sex lives, and only feel uncomfortable when I feel that my patient is having a problem that I can't help her with. Also, the female sexual cycle is so much more complex than that of a man, that there can be numerous issues that contribute to poor sexual function in women, and these can require different diagnostic and therapeutic approaches.”

Some of the advice in Streicher’s book – specific recommendations for lubricants and other over-the-counter products – a woman can buy without seeing a doctor. Other recommendations require a doctor’s prescription. Streicher also gives women a “script” to bring up the topic with their doctors and how to ask for help.

Here are nine things your doctor may not have told you about sex:

1. You can hire a “personal trainer” for your vagina. Pelvic floor therapy can strengthen the muscles to make sex less painful and offer the “pleasure-boosting power” of kegel exercises.

2. Vaginal dryness can be corrected with “safe and effective solutions” beyond lubricants. Estrogen-based products can actually reverse vaginal atrophy.

3. Incontinence affects 30 percent of all women, says Streicher. “Women may cough or sneeze and lose urine. Some find they pee when the penis is in the vagina or when they have an orgasm. It’s horrifying, so they don’t go there.” Pelvic floor therapy can help, but so can a brand new FDA-approved vibrator device that a woman can use at home. Some even come with clitoral stimulation and can help with orgasm.

4. Women with disabilities can also have pleasurable sex.

5. Single women without partners have needs, too. “Most doctors assume if you are single, you are not having intercourse,” said Streicher, who has recommendations for sex toys.

6. Cancer patients can be helped. Chemotherapy and radiation can destroy a woman’s sex life, as can surgery after pelvic and colon cancer. “Doctors can counsel them back in to the game with local vaginal and estrogen products.”

7. Diabetes can cause nerve damage that can kill a woman’s ability to have an orgasm. Clitoral neuropathy can affect blood flow. “Even if he has the fastest fingers in the West, it’s still not enough,” she said. Vibrators, topical botanicals and even suction devices in clinical trials, can help.

8. Common dermatological conditions like lichen sclerosis, which affects the vulva, can make sex painful, but these conditions can be treated with soothing creams that are “life-saving,” she said.

9. Flibanserin, a drug currently in clinical trials and before the FDA for approval, can help a subset of women rekindle sexual thoughts and urges.

“The libido is complex,” she said. “If a woman has pain with sex or no libido or hates her husband, this won’t help her.” But for those who have pain-free, pleasurable sex and orgasms, [Flibanserin] works on the he neurotransmitters in the brain to bring back “sexual fantasy and the urge to have sex.”

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