Why Many Women Don't Get Sexual Health Care They Need

Can I get a doctor’s note so I don’t have to have sex with my husband for another six weeks?”

One of my postpartum patients recently asked this, only half-joking.

As usual, I laughed along with her at first and then got to the heart of the issue that was plaguing my 6-week sleep-deprived postpartum patient—low libido and sexual pain.  This was the beginning of an on-going treatment plan I developed that day for her sexual dysfunction.

What I have observed in my 14 years as an obstetrics/gynecologist specializing in sexual dysfunction is that while some patients can usually resume sexual relations with their significant other after the six- to eight-week postpartum check, this is a very common question. Many women are still asking it during the fourth trimester postpartum check.

Many factors impact a woman’s ability and desire to have intercourse after giving birth to a baby. These factors are often not addressed during the standard 15-minute postpartum visit. In a traditional busy OB/GYN practice, where the visit is covered under a global billing fee along with the prenatal visits, delivery and postpartum care, most clinicians have neither the time nor expertise to address significant issues with sexual function. Additionally, they do not get reimbursed from insurance companies for the extra time needed with the patients.

Unfortunately, this is a huge disservice to the patients who have multiple issues postpartum, including sexual pain and low libido or even postpartum depression. Many problems are missed or ignored and develop into much larger more complicated issues in the months to years it may take to obtain an adequate diagnosis and treatment.

Sexual health is also not given appropriate attention in all classes of women from premenopausal to postpartum to postmenopausal. According to the American College of OB/GYN, up to 40 percent of women do not even seek postpartum care.

I know. I am a recently postpartum working doctor mom. At five months postpartum, I still have not seen my OB/GYN. Like many other millions of women, we just deal with pain or lifestyle issues because we are not sure if they are abnormal.