Sexual Health with Dr. Dani Steininger, MD, FACOG

It’s time to take the taboo out of sex. This month, we’re taking your high-school Sex-Ed class to another level with Board-Certified Dr. Dani Steininger as we discuss how to better care for your reproductive health, the importance of open communication with a sexual partner and how to protect yourself from STIs/STDs.

Ashley: When should someone get a sexual health screening?

Dani: I recommend that everyone who’s sexually active get tested for sexually transmitted infections (STIs) each time they have a new sexual partner. I recommend that people who are newly monogamous get tested at least once a year. In my experience, my patients who have been in long-term monogamous relationships decide for themselves if they want to get tested.

A: What happens at a sexual health screening?

D: It’s just a blood test and a urine sample. If a person’s already having a pap smear or another issue that requires a pelvic exam, we do a swab of cervical mucus rather than the urine specimen. Testing for sexually transmitted diseases (STDs), such as gonorrhea or chlamydia, does not require a pelvic exam, however, testing for other causes of discharge like bacterial vaginosis or vaginal yeast, does.

A: I’ve never had an orgasm during sex, is something wrong with me?

D: Not usually. Lifelong generalized female orgasmic disorder is rare, but does exist. It’s a diagnosis of exclusion and there’s no test for it. More common causes of a lack of orgasm are unhealthy relationships with your sexual partner, anxiety regarding sex, prior trauma or abuse, fears regarding body image, lack of understanding of the female anatomy and normal sexual arousal, high stress levels, lack of sleep, side effect of medications, lack of foreplay, among other things.

A: Is masturbation healthy? Is there such a thing as too much of it?

D: Yes, it’s healthy to masturbate, but there is such a thing as too much masturbation. Almost everyone has masturbated at some point in their life. Self exploration is a normal part of sexual development and usually starts in the pre-teen or early teen years. Masturbation can teach us about our own sexual arousal so that we can better experience satisfying sex lives with our partners. Masturbation is unhealthy when it detrimentally affects our relationships or starts to mirror other addictive behaviors.

A: Should I use protection with oral sex?

D: Yes, you should always use a condom while participating in sexual activity , regardless of whether it’s vaginally penetrative. Gonorrhea of the throat is a thing.

A: How do I talk to my partner about birth control options?

D: Start by talking about the risk of pregnancy and how you enjoy having sex with this person, but it’s not a good time to have a baby. That way, you’re both on the same page regarding preventing pregnancy. Many of my patients bring their partner to their appointments, especially when it’s over telehealth and in the comfort of their own home.

A: After sex, how should you properly care for your body?

D: Do not douche after having sex; vaginas are self-cleaning. If you struggle with urinary tract infections (UTIs) or urinary irritation after having sex, consider emptying your bladder after having sex to flush out any bacteria in your urethra. It’s normal to have semen come out after having sex, sometimes right after, several hours after or even a day afterwards. It’s not a sign of infection when it occurs this quickly after sex. Discharge a few days to a week later can be a sign of an infection and needs to be evaluated by a doctor.

A: Are there any vaccines I should be considering when it comes to my sexual health?

D: The HPV vaccine has been a wonderful success story in lowering the incidence of
cervical precancer and cancer in the United States and other developed countries. It’s never too late for a woman or their partner to get vaccinated against HPV as it’s FDA approved up to age 45 in women and insurance usually covers it. Even if you already have an HPV infection or precancer of the cervix, the vaccine can increase your chances of clearing the infection and preventing future precancer of the cervix.

A: What causes vaginal dryness? What can I do to lessen it?
D: Vaginal dryness is one of the most common questions I get in the clinic. Premenopausal women can sometimes experience dryness during sex. Most of the time, this is due to lack of arousal or foreplay and resolves with better body awareness and open communication within a relationship. Sometimes, it can be a side effect of medications and an adjustment is in order; other times, lubricants are helpful. In postmenopausal women, vaginal dryness is a known effect of the drop in estrogen caused by menopause. This can make sex painful even if sexually arroused, therefore, making sex less enjoyable. If the dryness is mild, I recommend using hyaluronic acid vaginal suppositories two nights a week and lubricant (water or oil based) with every sexual encounter in order to prevent pain. If the dryness is more pervasive, give us a call and let’s talk about your other options.

A: Is it normal for sexual desires to change?
D: It’s normal for sexual desire to change throughout a woman’s life. When we’re stressed or sleep deprived, lacking safety and intimacy with our partner, our hormone levels are low from childbirth or menopause are all instances that could decrease our sexual drive. When we go through these periods in our lives, good communication with our partners and our healthcare practitioners can help us maintain satisfying sexual lives.

Click the links to learn more about Dr. Dani Steininger and Adriatica Women’s Health. Follow the discussion around women’s health on social media. Then, use our contact form to ask any questions you may have.