Female Sexual Medicine

Ask Dr. Millheiser questions about female sexual function

Q: I have been using a water-based lubricant during sex with my husband for the past two years. Since that time, I have noticed that I am getting frequent yeast infections. Could this be due to the lubricant or is this just a result of getting older and a change in hormones? I thought that water-based lubricants were the safest to use.

Dr. Millheiser: You are absolutely right! Water- and silicone-based lubricants are the safest to use for two reasons: they don’t break down latex condoms (this can occur with mineral- or petroleum-based lubricants) and they will not promote vaginal inflammation. However, many of these water and silicone lubricants have glycerin as an active component. Glycerin can cause yeast infections. Therefore, if you are prone to developing yeast infections, switch to the glycerin-free version of your favorite lubricant. Most companies today make them. If you can’t find them in your local pharmacy, you can usually buy them on-line.

Q: My daughter is a teenager and wants to get the HPV vaccine. I am afraid that this will make her more likely to have sex, especially unprotected sex. Do you think it’s a good idea?

Dr. Millheiser: The human papilloma virus (HPV) vaccine protects girls from the 4 most common types of the virus that cause genital warts and cervical cancer. However, there are other less common types that are not prevented by the vaccine. Safe sex practices are essential with or without the HPV vaccine and this is where early sexual education by a parent or caregiver is imperative. Studies show that when children learn about sexuality at home, they are less likely to engage in risky sexual behavior.

Q: I am a woman in my twenties who has been married for about 8 months and I still have not had sex with my husband. In my culture, sex is not appropriate before marriage. I love my husband and we have a great relationship. Every time we have tried to have sex, he feels like he is “hitting a brick wall”. I tell my body to relax, but my vagina doesn’t seem to be listening. What’s wrong with me?

Dr. Millheiser: Although it is impossible to diagnose you without doing an examination, it sounds like you may be suffering from vaginismus, one of the sexual pain disorders. This is a very common condition seen in young women. The muscles of the lower third of the vagina will contract involuntarily. So you are correct when you say that “your vagina isn’t listening to your brain”. Vaginismus can occur for many reasons: the fear of vaginal penetration and pain, the fear of pregnancy, the inability to give up control of one’s body, relationship difficulties, or a prior negative experience associated with sex. Sometimes, it occurs for no specific reason at all. The great news about vaginismus is that it is often times very easy to treat with vaginal dilator therapy and education. Physical therapy and psychotherapy may also be recommended.

Q: I have been hearing a lot about Viagra for women. Is it safe for me to take my husband’s?

Dr. Millheiser: No!! It is not safe for a woman to use Viagra unless it is under the guidance of a physician. Viagra can be dangerous, even deadly, if used by a person with undiagnosed heart disease or who is taking certain medications, such as nitrates. Viagra should never be used recreationally. It has been shown to be effective only in women with genital arousal disorder or orgasmic disorder. However, if a woman is also experiencing low sexual desire, Viagra may not be effective.