Sexual Wellness, Explained

Concerns about sex are one of the least talked about, and most common, reasons women want to see a gynaecologist. If something is not working the way it used to, or the way you would like it to, it is a legitimate reason for an appointment.

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What women bring to us

• Pain during or after sex
• Low or absent desire
• Difficulty with arousal or reaching orgasm
• Vaginal dryness, often linked to breastfeeding, hormonal contraception, or menopause
• Changes after childbirth, surgery, or a new diagnosis
• Concerns within a relationship that feel connected to a physical or medical cause

Any of these can happen at any age and any life stage. None of them mean something is permanently wrong.

Why it happens

Sexual concerns rarely have a single cause. Physical factors (hormonal changes, infection, scar tissue, pelvic floor tension), medical factors (some medications, chronic conditions), and psychological factors (stress, past experiences, relationship context) can all play a part, often together. Working out which factors are involved is the point of an assessment, not something you are expected to diagnose yourself.

What an assessment usually involves

• A private conversation about your symptoms, history, and what you would like to change
• A physical examination, only with your consent and only if it will actually help answer the question
• Ruling out infection or a hormonal cause where relevant
• A referral for pelvic floor physiotherapy or counselling, where that is the more useful next step

You are always in control of what is examined and what is discussed. Nothing here requires you to share more than you are ready to.

What can help

• Lubricants or moisturisers for dryness
• Pelvic floor physiotherapy for pain or tension
• Hormonal treatment where a hormonal cause is identified
• Counselling or sex therapy, alone or with a partner, where that fits the picture

Treatment is matched to the cause, not applied as a blanket fix.

Your next step

This conversation is private, and it is treated that way. Talk to your care team, in your own words, in your own time. There is no version of this that is too small, too embarrassing, or too late to raise.