Selected Podcast

Sexual Health: When to Start a Conversation

Our sex life isn't something that we talk openly about with many people – maybe not even our partner!

When we're not feeling satisfied with our sexual health or there is a barrier there that we don't know how to deal with, a sexual therapist may be a fit.

Dr. Lauren Fogel, a psychologist specializing in human sexuality, helps identify what sexual health is and when to start a conversation.
Sexual Health: When to Start a Conversation
Featured Speaker:
Lauren Fogel, PsyD, LP - Psychologist
Lauren Fogel is a licensed psychologist. She completed her post-doctoral training at the University of Minnesota’s human sexuality program and she is a member of the American Association of Sexuality Educators, Counselors, and Therapists.
Transcription:
Sexual Health: When to Start a Conversation

Melanie Cole (Host):  You know our sex life isn’t something that we talk openly about with many people, maybe not even our partners. When we’re not feeling satisfied with our sexual health or there’s a barrier that we don’t know about, how do we deal with that? Well, a sexual therapist may just be right for you. My guest today is Dr. Lauren Fogel. She’s a licensed psychologist at Allina Health Nicollet Mall Clinic located in downtown Minneapolis. Welcome to the show, Dr. Fogel. What is sexual health? When we use those terms, what does that mean?

Dr. Lauren Fogel (Guest):  Well, you know, I think at its roots, sexual health is when you feel good about your sex life. It’s when you feel that sense of wellbeing or that sense of wellness about your sexual behaviors and values and desires. I think it’s important for people to know that this is not realistic for those things to always be aligned a hundred percent of the time, but sexual health is when, for the most part, issues that come up are minimal and infrequent. 

Melanie:  Why would some people even have to think about this? Isn’t sex something that just comes naturally? What are some issues that would get in the way of our good sexual health? 

Dr. Fogel:  Well, I think we are taught that sex is something that we don’t talk about and that you’re just supposed to kind of go off and do it without having much guidance. It’s still an issue about whether we can teach accurate and informed sex education in the classrooms, and a lot of parents don’t feel comfortable talking to their children about sex and sexuality. I think the issue for a lot of people is that there are times where we just don’t have all the information, or when an issue does come up that’s not expected, people don’t really know exactly where to turn. There are a lot of common issues that are seen in sexual health and that can be a variety of things. I can name sexual dysfunction, which is something we’ll talk a little bit more about. Having a sexually transmitted infection can impact your sexual relationship. Having children in the house, going through menopause or other hormonal changes, a history of sexual abuse, and then there’s mental health issues that can also impair sexual function. Depression, anxiety, and then, of course, a lot of medical issues that can have impact as well, like diabetes and hypertension and those sort of issues. There are a lot of different things that can be happening that can affect sexual health and oftentimes, that can be more than one of these issues going on at any one given time. 

Melanie:  Well, I can certainly appreciate that having children at home is a real, big factor in having problems with sexual health. You get nervous the children are in the home or they might walk in. Medication as well, there are so many medications on the market today that can contribute. Let’s talk just a little bit about erectile dysfunction and things that contribute, and then I’d like you to tell us what a sex therapist does to help you. 

Dr. Fogel:  Okay. Well, speaking about erectile dysfunction, a lot of people know about medications that are out there to help with that, but oftentimes erectile dysfunction can be a product of, like we just talked about, multiple different factors. Sometimes taking medication and talking to your healthcare professional does the job and that’s just what you need. There are other times where it’s helpful to have a bit more help, and that’s where sex therapy can come in. A sex therapist is someone you’ll see who is a mental health professional, first and foremost, and it’s someone who is going to engage in talk therapy. You’re going to talk about what issues you have going on. It’s set up so that you can have a place to talk about this without feeling judged and without feeling stigma and where you can feel as comfortable as possible. In addition to doing the therapy side of things, there’s also the function of serving as an educator because though there’s a lot of access to sexual health information and though we’re more open to talking about sexual health today than we probably have been in the past, people still have questions and are still very interested to learn more about their bodies and their partners and their own sexual functioning. 

Melanie:  Dr. Fogel, as women, we generally know our bodies better than men. We have Pap smears and mammograms. We generally are more aware than men about these things, and yet we seem to have more trouble achieving orgasm than men do, for the most part, a lot of women. Why is that and how can you help women when they’ve got that low sexual desire or maybe they’re not feeling very good about their body image? What do you do in that case? 

Dr. Fogel:  Well, one of the issues that I see very often with women is where they are being influenced in terms of their sexual behaviors. When you watch movies and videos and even pornography, a lot of that is geared towards male sexuality and has sort of a lens from a male perspective. A lot of those industries and those media are missing the female perspective. Most women that I have met with in my practice are under a false assumption that if they are just engaging in vaginal penetration with their partner, that that should be producing orgasm. What we know about female anatomy is that, for most women, the way for them to be orgasmic is through clitoral stimulation. So, there seems to be a large disconnect for a lot of people, particularly women, either not knowing that or not being able to feel comfortable communicating that to their sexual partner. For a lot of men, again not knowing that or not having a good understanding of that, that is where it starts to lead to sexual experiences feeling less satisfying or less pleasurable. 

Melanie:  What does treatment involve? People have misguided views about sex therapists, Dr. Fogel. Does it involve also teaching a woman, for example, how to masturbate, how to find that spot for herself? All of these kinds of things. We don’t have a lot of time left, but tell us a little bit about treatment. 

Dr. Fogel:  Treatments – one thing to notice is sex therapy is not the same as sexual surrogacy. You’re not going to come into an office and be asked to show what you’re doing or take off clothing or anything like that. It’s done through sitting in an office and talking about these things. Absolutely, treatment involves teaching how to masturbate, teaching how to know when your body is orgasmic, seeing patients either individually or seeing them as a couple, and going over different exercises or tools or books that people might be able to add into their experience. Oftentimes, I send my patients home with something to try out between sessions and then they come back in, either alone or with their partner, and we talk about how it went. One of the things to know about sexual issues is that they’re very highly treatable, for the most part.  

Melanie:  That’s really great information. In just the last minute, kind of wrap it up for us. Give us your best advice for people that feel that they are suffering in their sexual health department and what you would tell them right away on your first visit. 

Dr. Fogel:  I think it’s important for people to know that most people have sexual problems or a sexual problem at some point in their lifetime. I think it’s really important to know that you’re not alone, that it’s a very common issue, and also, that you don’t have to accept that that’s just going to be the way it is, but that there are treatments and there are resources available to help with that. I like to instill that sense of hope for patients to know that there are some things that we can try to make some significant improvement.  

Melanie:  Thank you so much. Really great information and a great topic. You’re listening to the WELLcast with Allina Health. For more information, you can go to allinahealth.org. That’s allinahealth.org. This is Melanie Cole. Thanks so much for listening.