Common sex and pregnancy problems: Q & A

Women of all ages have questions about sex and their bodies; middle-aged women with questions about menopause and younger women with concerns about their relationships or their pregnancies. This Q&A provides answers to some of the most asked questions.

Q: Having sex is difficult for me because I'm dealing with serious vaginal dryness. Is there anything I can do to fix that?

A: Most middle-aged and older women experience vaginal dryness. To deal with it, try using water-based lubricants or longer-lasting vaginal moisturizers, available at any pharmacy. If the problem continues, check with your doctor. You may have low estrogen levels that can be boosted with topical estrogen cream or hormone replacement therapy (HRT). Weigh the HRT option carefully, however. Although it may solve the lubrication problem, it may also raise the risk of other health problems.

Q: My husband is struggling to have sex. How do we know whether his problem is physical or emotional?

A: Here's a really easy way to tell the difference: Have your husband test himself for nighttime erections. Before bedtime, wrap a small strip of tissue paper around the penis and tape the ends together to form a band (don't put tape all the way around the penis). If the paper is broken in the morning, he's probably had an erection. If a man is having erection problems during sex because of emotional issues, he will probably still have erections while he sleeps. The more scientific way to detect nocturnal erections is to be monitored during sleep, either in a sleep lab or with a monitor you use in your own bed. If a man doesn't have erections during sleep, his problems are likely physical.

Q: I'm pregnant with my first child, and my doctor just told me I have something called "gestational diabetes." Should I worry?

A: By itself, gestational diabetes shouldn't worry you, but it should prompt you to follow your doctor's advice extra carefully, especially when it comes to your diet and exercise. The condition occurs in about two to five percent of pregnant women during the second half of gestation (usually in the third trimester) as hormones guiding fetal development in the placenta interfere with normal insulin function. Basic symptoms mirror those of other forms of diabetes, but when the baby arrives, gestational diabetes — or GDM — usually goes away. But don't be lulled into thinking that gestational diabetes is strictly temporary or isn't worth taking seriously. GDM increases the risk of miscarriage and caesarean delivery. And, because it often causes the child to grow large before birth, GDM can contribute to complications at delivery. Having given birth in the past to a child weighing nine pounds or more suggests you're at risk for GDM. Just as important, most women who develop GDM do so because their pancreas is already weak (they're often overweight), making them vulnerable to getting full-blown diabetes later on — which occurs in 35 to 60% of cases.