Any good resource for clients with, um, personal questions?

[doctorjen]

Not wanting to get my thread shut down, here! Anyway, as a family doc, I do a lot of well woman care. Lately (perhaps because I've been better about asking) I have been getting a lot of questions about sex - ranging from reduced libido, to pain/discomfort to unable to reach orgasm.
Now that I'm getting all these questions, I find that I don't really know much about fixing these types of issues. I practice in a small town, surrounded by small towns, and there aren't places to refer people, either.
Anyway have any favorite books - either from a health care professional point of view for me or even directed at women with an issue that I could recommend to them?

[CMcC]

Wow, I'm really surprised to find out when doctors don't know basics like these. (Don't mean to offend!) I even found out pediatricians aren't knowledgable about breastfeeding!!! That's crazy!

With that said, I recommend the book Taking Charge of Your Fertility by Toni Weschler. It's a great book for you and your patients. It covers why sometimes sex can be uncomfortable at different times, why it can be easier to reach a orgasm at a certain time in a woman's cycle, natural birth control, natural pregnancy achievement, plus a lot more useful info...

Things like reduced libido could be a hormonal imbalance that the woman can spot if she is charting...

Hope this helps. And I'm so happy there is a Dr. out there that cares enough about her patients to research this important aspect in health.

[tchatters]

Thank you so much for asking for suggestions! After my son was born, I knew something was wrong but both my nurse practitioner and family doc told me it was just post-pregnancy stuff. Turned out I had a major thyroid imbalance but it took months for me to get an answer. I so appreciate you seeking out answers for your patients!

I second the Taking Charge of your Fertility (actually tipped me off to the thyroid problem!)- well written, easy to read for most women and not over their heads or too medical.

[BetsyS]

I really like the book Intimate Issues by Dillow and Pintus. It's a Christian book, but not overly preachy. It approaches alot of sexual issues from that frame of reference, and it's easy to read, real life applicable, and down to earth.

[doctorjen]

Let me clarify. I feel quite adequately trained to rule out physical causes. I feel quite knowledgeable about potential physical problems as well. I have read TCOYF cover to cover as well as having it in my lending library for patients to borrow. I'm talking specifically about sexual questions which one might refer to sex therapy if one had one around to refer to. Like the 50 yr old woman who has never had an orgasm, or folks who are having serious libido problems without a traceable medical cause.

I'll look into that other book to PP mentioned, but would also like some non-religious sources.

[CMcC]

Didn't mean to offend!

Have you considered the emotional well being of these women? Have these women experienced sexual abuse/ trauma in their past or childhood? Many women who have been sexual abused (even in childhood and may not remember) would have to put up mental blocks to even have sex....maybe never allowing her to have an orgasm. Same with libido problems. Can't exactly get excited about something that brings flashbacks...

[doctorjen]

Originally Posted by CMcC

Have you considered the emotional well being of these women? Have these women experienced sexual abuse/ trauma in their past or childhood? Many women who have been sexual abused (even in childhood and may not remember) would have to put up mental blocks to even have sex....maybe never allowing her to have an orgasm. Same with libido problems. Can't exactly get excited about something that brings flashbacks...

Yes, of course. What I am looking for is any resources to them help these women. I have no training in sexual abuse survivor counseling/treatment or sex therapy or similar, and I have very limited resources for referral to someone more qualified. I'm hoping there will be some birth professionals around, or folks who've faced issues themselves who can suggest some good written resources or internet resources, or something to aid in treatment.

[Joyce in the mts.]

"Our Bodies, Ourselves" by The Boston Women's Health Collective

There's a few versions/titles in this series...including a menopause title as well.

Pretty detailed and accessible stuff both technically and otherwise, I think. Probably at your local librarie, Docjen, so maybe you can check it out before reccommending?

I don't know that it will serve you and your clients, Docjen, but it's worth a try.

J.

[CMcC]

Originally Posted by doctorjen

Yes, of course. What I am looking for is any resources to them help these women. I have no training in sexual abuse survivor counseling/treatment or sex therapy or similar, and I have very limited resources for referral to someone more qualified. I'm hoping there will be some birth professionals around, or folks who've faced issues themselves who can suggest some good written resources or internet resources, or something to aid in treatment.

Okay. I promise to leave you alone after this cause obviously I haven't been much help.

As for the "treatment" for sexual abuse and other abuses, all my recommendations are bible based...sorry, I know you didn't want religious stuff. With that said, I personally found them very benificial. http://www.committedtofreedom.com/ is specifically for sexual abuse.
And the books we use in www.journeytototalfreedom.com are the workbook from Committed to Freedom and My Father's Child. My Father's Child covers physical, mental and sexual abuse.

[ldsapmom]

For those who may be Christian: The Act of Marriage. This is also a great book for Christians getting married who have no real knowledge of physical intimacy.

In general: Woman's Experience of Sex: The Facts and Feelings of Female Sexuality at Every Stage of Life, by Sheila Kitzinger. Also, Women's Sexual Passages: Finding Pleasure and Intimacy at Every Stage of Life, by Elizabeth Davis.

[doctorjen]

I have an old copy of "Our Bodies, Ourselves" and like it. It's maybe a little too feminist for some of my clients. One lady with the never-had-an-orgasm issues, d copied some out of Our Bodies for her and she looked at me incredulously and said "Can't you just give me a pill?" Don't I wish. I'll took at some Christian sources, too. It would apply to a lot of my clients, just some want something more general. I personally am very comfortable with stuff written from a Christian viewpoint, but I have a lot of clients who aren't necessarily from the same background and a lot of the spiritual aspects wouldn't mesh well with their life views, you know?

Sorry if I am sounding snippy - I'm working and trying to reply quicky in between folks here. I just feel this is an area where so many of my clients are struggling, but I don't know how to help them and don't have good resources to point them too. Imagine if you were 50 years old and finally got up the nerve to tell your doctor about your orgasm issues and she was like "gee, that's too bad" so I really want some way to help!

[lolar2]

The Dr. Ruth books are accessible and non-religious. General clinical psychologists and clinical social workers are usually able to address issues of past trauma. And some physical therapists are certified in helping with pelvic floor problems, even sometimes in small towns.

[mamallama]

I like A Woman's Experience of Sex by Sheila Kitzinger.

While I was looking up the amazon link, I also noticed that Elizabeth Davis (midwife & author of Heart & Hands) also has a general sexuality book. Women's Sexual Passages: Finding Pleasure and Intimacy at Every Stage of Life. I've never read it, but it looks good & I do like Elizabeth Davis.

[birthinglau]

I think it is really a sign of a caring sensitive CP that your patients are comfortable coming to you with these issues. What a gift you are giving them by honoring that trust.

I attended some short workshops with this sex educator : www.sheriwinston.com

Sheri is also a CNM, LMT and approaches sexuality from the standpoint of humour and reverence. She has a technical background, but focuses mostly on the non-medical aspects of sexual function. She is definitely not Christian, so I would not recommend her info to someone who is offended by earth based spirtuality.

She has not published a book, though I believe she does have booklets available, articles and links on her website.

-Lau

[rnchrista]

Originally Posted by doctorjen

Yes, of course. What I am looking for is any resources to them help these women. I have no training in sexual abuse survivor counseling/treatment or sex therapy or similar, and I have very limited resources for referral to someone more qualified. I'm hoping there will be some birth professionals around, or folks who've faced issues themselves who can suggest some good written resources or internet resources, or something to aid in treatment.

If you're looking for your pregnant clients with a history of sexual abuse, there's a book called "When Survivors Give Birth" by Penny Simkin.

[sarahn4639]

i don't necessarily think this is what you are looking for but since survivors were mentioned, and i know you provide maternity care, penny simkin has a book called something like when survivors give birth. i'm not positive of the exact title and it is related to maternity/birth so it may be helpful but not with the 50 y/o i hope your patients know how lucky they are! i wish my family doc was on mdc!

[sarahn4639]

oh geez, that's what i get for hitting reply before laying dd down! but atleast i got the title right!

[rnchrista]

Originally Posted by sarahn4639

i don't necessarily think this is what you are looking for but since survivors were mentioned, and i know you provide maternity care, penny simkin has a book called something like when survivors give birth. i'm not positive of the exact title and it is related to maternity/birth so it may be helpful but not with the 50 y/o i hope your patients know how lucky they are! i wish my family doc was on mdc!

HA! That is funny, we just posted the same thing a few minutes apart. GMTA!

[doctorjen]

I'll have to look at the Penny Simkin and Elizabeth Davis books. I have other things by both authors.
We are lucky to a physical therapist skilled in pelvic floor problems at our little hospital. I've had very good luck with folks with incontinence or mild prolapse or other pelvic floor relaxation issues with her.
In many other more "lifestyle" areas of my practice - like breastfeeding, parenting, etc. I have a broad base of personal experience and lots of reading to draw from. In this area, I'm not exactly going to share any personal experience and haven't done much reading.
I learned almost exactly nothing about sex in med school or residency (other than which nervous system controls erection and ejaculation - it's the parasympathetic for the first and the sympathetic system for the second in case you are wondering, with the mnemonic being Point and Shoot)

[BelgianSheepDog]

Are we really and truly not allowed to actually discuss medical sexuality issues on MDC? That's kind of sad.

Anyhow, I think Christiane Northrup touches on issues like this a lot in her books. I remember several anecdotes about sexual dysfunction in "Women's Bodies, Women's Wisdom" and I think she also has a book out about menopause that might discuss issues specific to women in that age group. I don't agree with Dr. Northrup on a lot of things, but she's generally a little more progressive than average so it might be somewhere to start.