Low libido, intercourse pain, orgasm problems? Sexual-health doctors are trying to help

A small number of Canadian doctors specializing in women's sexual health is trying to address what they say is a near-total lack of support for those suffering from common problems such as low libido, difficulty achieving orgasm and pain during intercourse.

"In terms of the juxtaposition with men's sexual functioning, we are behind and it's really frustrating," said Dr. Stephanie Finn of Oakville, Ont.

Finn is one of five Canadian doctors trained by the International Society for the Study of Women's Sexual Health (ISSWSH), based in Burnsville, Minn.

While help for male sexual dysfunction has been widely available since erectile dysfunction drug Viagra burst onto the scene — approved for use in Canada in 1999 — women's sexual health has remained largely shrouded in secrecy.

"When's the last time your doctor has asked you about your clitoris? Like never, and that's fascinating, right? We ask men all the time about their penises and their function, sexual functioning and such," she told White Coat, Black Art.

"I think that there is generally a lack everywhere of interest in women's sexual functioning, and I'm happy to say that I think that's beginning to change."

Originally a family doctor, Finn found that so many of her female patients needed help with sexual issues that she decided to focus on sexual medicine, opening her clinic about a year ago. 

Part of that work is simply teaching women about their bodies, she says.

"It is really common for women to have almost no understanding of their own anatomy," Finn said.

"I've had women who really haven't a good idea about where their clitoris is. I've had people say, 'Oh, I've always wondered,' and sometimes I'm slightly surprised by that response in women who are in their 50s."

Finn offers her patients the option of holding a mirror while she gives them a guided tour of their genitalia. Or she'll use a 3D model to show patients things such as how the clitoris is actually a wishbone-shaped organ, with only the clitoral bulb visible externally.

A study published in the Journal of Sexual Medicine in 2023 found that the bulb has around 10,000 nerve endings. That's compared to about 7,800 at the tip of the penis, according to a paper published in the same journal in February.

Some of that knowledge gap and reluctance among women to seek help for sexual-health issues is tied to cultural shame, says Dr. Stephanie Hart from Okotoks, Alta., another ISSWSH-trained family doctor.

"In North America, vaginas are dirty. Like, I actually had somebody say that to me yesterday," said Hart, who opened her specialized clinic in 2019.