Barry White, pregnancy, and labor

It has been standard practice to tell healthy women who want to get labor going to turn up the volume on Barry White and get busy with their partner. However a study published this month suggests that having sex likely won't pump up the contractions.

Researchers recruited 210 women who were going to be inducted for non-emergency reasons. They assigned each women by chance to one of two groups. The first group was told to have sex to encourage labor. The second group was given no advice about sex before their induction.

They found that women who were told to have sex were more likely to do so - 60.2% compared to 39.6% in the group that was given no advice. However, they also found there were no differences between the two groups in rates of spontaneous labor - or labor starting on its own before the scheduled induction. There also were no differences between the groups in how many women had a C-section or in their babies' birth outcomes.

Bottom line: increasing sexual activity doesn't seem to promote labor. So if your libido is low, don't feel like you have to have sex to get the ball rolling. On the other hand, if sex sounds good, have at it. While an orgasm might not promote labor, it might be your last one for a while - so enjoy!

Sex after Cancer

Last week I wrote about a study that showed long-time survivors of vaginal and cervical cancers experienced sexual problems, including lack of desire, painful intercourse, and inability to have an orgasm. I'm thrilled to report there are some folks in the field who care about this issue and want to help.

In a study published this month in the Archives of Sexual Behavior, researchers developed and tested a brief (3 session) intervention to treat female sexual arousal disorder (FSAD) in women with gynecologic cancer. FSAD is characterized by the inability to maintain arousal and vaginal lubrication during sex. The one-hour sessions included educational information, cognitive and behavioral therapy, and mindfulness training in three main areas: (1) sexual arousal, (2) orgasm, sexual desire, and sexual distress, and (3) quality of life, depression, and relationship satisfaction.

The brief intervention indeed helped. The women experienced improved sexual response, including genital arousal (yes, they actually checked this with a probe, some erotica, and a locked door - see the article if you're interested in more details), orgasm, and satisfaction with sex. Additionally, the women had less depression, and greater overall quality of life.

The downside of this study is that it was small - only 22 women participated - so they need to repeat the study with larger and more diverse groups of women to ensure this positive effect was not just the result of giving the program to a group of highly motivated women. Meantime, I'm just happy that someone is taking the time, energy and effort to develop such an intervention. They've been taking care of men's sexual health after cancer for a good decade now - it's about time we catch up.

What's sex got to do with it?

Apparently a lot, according to a new study published in Gynecologic Oncology this month. In the first (!!) study of its kind, researchers examined the sexual health and functioning of long-time survivors of vaginal and cervical cancers. Compared to similar women without cancer, the cancer survivors were more likely to experience a variety of sexual problems, including lack of desire, painful intercourse, inability to have an orgasm, vaginal dryness, and anxiety about their sexual performance. Further, despite the fact that most of these women had their sexual organs removed or destroyed during their cancer treatments, only one-third of doctors actually talked to these women about their sexual health.

The lack of talking isn't for lack of wanting to talk either - at least not on the patients' part. Most of the cancer survivors surveyed believe sex is an important part of life and they want their doctors to discuss their sexual health. So why aren't they?

It's no secret that we Americans have a lot of hang-ups when it comes to sex. Just take a look at your neighborhood abstinence-only (sex) education program ("zippers closed, buttons buttoned") to see that. But we're talking about consenting adult women (average age = 49 years), nearly three-fourths of whom were married and several more who were in long-term partnerships. In my view, doctors need to step it up and take responsibility for initiating conversations about sexual health with female patients. Further, these conversations need to occur not only with cancer survivors, but with all women across the lifespan, and especially as women age and hormonal shifts affect sexual health and functioning.

While I would like to think my call to arms will inspire physicians to talk to their patients about sex and sexual functioning, it's clear from this study that women unfortunately can't depend on their doctors to initiate such conversations. Rather, women need to be proactive partners in their health care, and sometimes this means bringing up difficult conversations. ("Well, Dr. X, I'm not having orgasms when I make love to my husband.") Women deserve to enjoy sex in the same way as men - and the way that little blue pill flies off the shelves, my guess is men are enjoying it fully, doctor-approved.