By admin 
For 17 years as an OB-GYN, I asked women the standard questions: When was your last period? Are you planning a pregnancy? When was your last mammogram and Pap smear? Important questions, every one of them.
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It took me longer than it should have to notice the question I was never trained to ask appropriately aged women: Is sex comfortable? Do you still feel like yourself in your own body?
That silence isn’t an oversight by individual doctors; it’s built into the system.
Modern women’s healthcare is organized around three goals: reproduction, disease prevention and longevity. We are good at all three. But once a woman is finished having children and her screenings come back normal, medicine often considers the job complete.
For many women, it isn’t.
A woman can have a normal mammogram or a normal Pap smear and still be struggling with painful intimacy, daily discomfort, loss of sensation or changes that undermine her confidence. These concerns rarely threaten life, but they can profoundly affect how life is experienced.
Consider menopause, which every woman who lives long enough will reach. As estrogen falls, sex can become painful, sleep can suffer and everyday comfort can slip away, reshaping a marriage and a sense of self. These problems are common, well understood and often treatable. Yet survey after survey shows that most women are never asked about them, and many never raise them on their own. They assume this is simply what aging requires and endure it in silence.
I want to be precise about what I am and am not saying: I am not suggesting every woman needs treatment, a procedure or an intervention. Most women need information, options and a physician willing to take the conversation seriously. What I am saying is that an entire dimension of health for women remains a blind spot in modern care. It includes comfort, function, intimacy and quality of life.
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It is easy to treat these concerns as less serious than real medicine — a quality-of-life issue rather than a health issue. That distinction is exactly the problem. They affect how a woman sleeps, how she feels in her own body and how she manages her closest relationship. In any other area of medicine, we would not ask a man to simply live with that. We should not be making an exception for women.
The encouraging part is that this gap is fixable, and the solution does not require a breakthrough. It requires treating women’s intimate and sexual health as a recognized part of medicine. That means training physicians to ask about it, screen for it and address it, rather than leaving it a topic both sides hope the other won’t mention.
This begins with a simple question asked without embarrassment in an ordinary appointment.
If you are a woman who has been quietly putting up with something, tell your doctor. You are not complaining, and you are not being a bother. It is a real health problem, and it can often be helped. And if you are a physician, ask the questions I went too long without asking.
We have become very good at helping women live longer. We should be equally committed to helping them live well.
Michael Reed, MD, is a board-certified OB-GYN and certified menopause practitioner who practices in Davis and specializes in women’s sexual and vulvar health.
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