Welcome to my first blog post. My specialties include sexual medicine, vulvar/pelvic pain, vulvar dermatology, and hormone replacement therapy. It may be difficult to understand this field of medicine, but I promise these issues are real and they leave many women suffering in silence. I am dedicated to breaking the silence and changing lives through evidence based medicine and research.

One might ask how I became interested in this field of medicine. The answer is quite simple – I listened to my patients.

My journey to becoming an expert in sexual medicine started in 2006. At that time I was frustrated because I did not have the knowledge or skills to treat women presenting with sensitive issues such as pain with intercourse or a lack of sexual desire. I felt compelled to help these women because many of them had asked their healthcare practitioner for help, but quickly became hopeless after hearing replies such as:

“No one ever died from not having sex.”

“Just have a glass of wine and relax.”

“Your exam is normal and there is no cause for the pain. The pain must be psychological.”

“You have breast cancer – be thankful you are alive. Having sex should be the least of your worries.”

To address this gap in medicine, I looked to the national experts for guidance. In the fall of 2006 I completed an internship with Dr. Susan Kellogg Spadt at the Pelvic & Sexual Health Institute in Philadelphia. Shortly thereafter I returned to the Midwest to start the first clinic devoted to sexual medicine and vulvar pain. I hope you will find my blog helpful and realize you are not alone.

Men vs. Women

Sexuality is an important part of a woman’s biological lifecycle that emerges from the first sexual experience and continues to evolve through the years past menopause.  My female patients often ask me why men have so many treatment options for issues with sexual functioning.

“Men have a little blue pill [Viagra]. Is there a little pink pill for women?”

The answer is no because the process of sexual functioning is very different between men and women. In the 1950’s, Masters and Johnson studied both genders through direct observation in the laboratory. They discovered similarities between both sexes and published their groundbreaking findings as a four-stage model of sexual response. Masters and Johnson’s model is described as “linear” in which each phase occurs in an orderly fashion: excitement, plateau, orgasm, and resolution.

Over the next several years, sexual health experts acquired a deeper understanding of female sexual functioning due to advances in research. The experts realized the importance of sexual desire and felt previous models did not recognize the fact that women have other motivations for engaging in sexual activity.  As we moved into a new millennium, Rosemary Basson proposed a new model of female sexual functioning. This model was “circular” and included psychological, biological, and physiological factors.  Many female patients of all ages related to this model because their motivation for engaging in sexual activity was complex and influence by outside factors such as fatigue, stress, raising a family, financial issues, depression, pain with intercourse, cancer, weight gain, unrealistic expectations, vaginal dryness, relationship conflict . . . the list goes on and on.

My first blog is a general introduction. My goal is to address the many issues a woman may experience throughout her life and bring the “pink elephant” out of the closet.  If you have thoughts about future blogs, please send me a message at melissadahir@creighton.edu. Your message will be confidential and I look forward to your feedback.

Melissa Dahir, DNP, IF