Generally, when something is wrong with our body, we seek evaluation from a healthcare provider. Some symptoms, however, are perceived as just too embarrassing to talk about to friends or even our most trusted healthcare providers.

These unmentionable symptoms have to do with bladder, bowel and sexual organ functions. Our hesitancy to seek information or solutions can deprive us of dignity and quality of life. My years of experience doing exams on women, and going through my father’s journey with prostate cancer treatment, taught me problems in these areas have a major impact on everyday life.

I found that if I didn’t ask about specific problems such as leakage, dryness, lack of interest or pain with sex, patients didn’t speak about their problem. Cultural taboos and embarrassment kept them quiet even when the symptoms were negatively affecting their physical or emotional health and relationships.

Typically people tolerate troubling symptoms for years and try to manage symptoms without professional assistance. The marketplace is full of highly advertised products touting solutions. Be very cautious — most are unregulated, unproven, & expensive. Some products can actually make matters worse. So, what are these unspeakable problems?

Let’s talk about bladder issues first. The National Association of Continence reports nearly 33 million people have Overactive Bladder, which can sometimes include incontinence. Incontinence happens when the muscles and nerves that help the bladder hold or release urine don’t work properly.

Questions to answer. Do you leak urine? Is there leakage when you cough, sneeze, laugh, while working out or having sex? Does the need to use the bathroom cause you to wake during the night? How often does that happen? Do you look for a bathroom everywhere you go? Do you stay home because you fear leakage? Does anything you are eating or drinking contribute to that? It helps to keep a” bladder diary” so you can accurately report specifics about these symptoms to your healthcare provider.

Medical terms used to identify specifics about the problem include:

♦ Frequency – feeling like you need to empty your bladder a lot – usually 8 or more times within a 24 hour period.

♦ Urgency without incontinence – needing to get to a bathroom “right now!”♦

♦ Urgency with the involuntary and sudden loss of urine – needing to get to a bathroom quickly but unable to make it in time, which results in leaks.

♦ Overflow incontinence occurs when the bladder is not completely emptied.

♦ Men may experience “dribbling” of urine, even after they have tried to empty their bladder — particularly if the prostate is enlarged.

♦ Overflow incontinence leaves “stale urine” in the bladder and can result in bacteria setting up housekeeping and can cause recurrent urinary tract infections.

The next category of difficult-to-discuss conditions can prevent individuals or couples from experiencing satisfying sexual activity. Some 43 percent of women and 31 percent of men report some degree of sexual dysfunction. Broad categories of sexual problems for both men and women include:

♦ Lack of interest in or desire for sex

♦ Inability to become aroused

♦ Pain with intercourse

Our attitude about discussing sex is much like our hesitancy to discuss finances. It is simply “too private” and we aren’t given lessons on the words to begin a helpful discussion with a knowledgeable health care provider.

The “little blue pill” has made it clear that at least one problem is common and can be addressed with a medical professional. Not so well-known are a host of other problems that cause much frustration, pain and misunderstandings.

For women, when estrogen declines at menopause, genital tissues become thinner. Cells lining the vagina produce less lubrication and the pH changes — which can increase bacterial infections. Some cancer medications also cause thinning of vaginal tissue. Lack of lubrication can result in vaginal dryness and pain with sex. Fear of pain leads to avoidance of intimacy and relationship issues.

Sexual problems are varied and sometimes complex. Everything from the quality of the relationship, some diseases, medications, busy schedules, and inability to communicate sexual wants and needs to the partner can cause problems. We aren’t generally given much specific information with the “birds and bees” talk. We need the vocabulary and the right setting to make these topics “speakable” so solutions can be learned and utilized.

In an effort to address these common issues, the Women’s Information Network, Inc. will host a workshop that brings together experts in gynecology, urology, sex therapy, and pelvic floor physical therapy. They are very comfortable with these topics and will provide a frank discussion of common problems, offer solutions and answer questions.

I call this workshop, “Issues Below the Belt.” So, put on those big girl panties and learn about what’s happening below your belt. Mark your calendar for February 6, 2020. See my web site,, for details and registration. If you can’t attend, at least speak with your healthcare provider about any issues you have. Simply say, “I’m concerned about …” and say what you have on your mind.

Sharon Baker, BSN, MN, CWHNP is the president and founder of Women’s Information Network Inc. She may be reached at 706-506-2000 or by email at

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