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One woman's
personal story

“My marriage has been transformed”

There’s no issue more personal than sexual health, which is why many woman are afraid to seek assistance. In fact, many don’t even realize there are experts who focus solely on helping women find solutions to a variety of sexual challenges.

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Providers Who
Understand You

Sarit Aschkenazi, MD, MS, FACOG
Medical Director
Sarit Aschkenazi, MD, MS, FACOG, Medical Director

Deb Ketterhagen, APNP
Deb Ketterhagen, APNP

 

 Introducing Women's Sexual Health Program
Intimacy, sexuality — sensitive topics for sure. However, many of us desire satisfying sexual health as a vital part of our lives, so we need to discuss these topics. Women’s sexual health is important to your overall emotional and physical well-being. And if it’s missing, we may feel a void, an unspoken need.

If you’re feeling this way, please know that you’re not alone and that medical professionals at ProHealth Care are here to help address your concerns and answer your needs whether they’re physical or emotional. Health care providers now agree that healthy sexuality is a key aspect of your overall quality of life and well-being — physical, mental, spiritual and sexual health.

We’ll take a personalized approach to your care by listening and responding to your questions, which we realize may be difficult to ask. Ultimately, we’ll create an appropriate treatment plan to put you on a path to healthy sexuality and help improve your quality of life.

Take the next step.

Improve the quality of lifeand rediscover the joy of intimacy. Appointments are available at Waukesha Memorial Hospital and Oconomowoc Memorial Hospital. To schedule an appointment, call 262-928-2595. We encourage physician referrals or you may call and make an appointment with us on your own.

Turn to our caregivers

If you’re an adult woman, you may benefit from our women’s sexual health team — all trained in the field of sexual health and members of leading national professional organizations, including the American Urogynecologic Society, American Association for Sexual Educators, Counselors and Therapists (AASECT), American College of Obstetrics and Gynecology (ACOG), International Society for the Study of Women’s Sexual Health (ISSWSH), North American Menopause Society (NAMS) and the National Vulvodynia Association.

Based on your diagnosis, treatment plan and goals, we’ll customize a care team for you, which may include advanced practice nurses, physicians, physical therapists, registered nurses, behavioral therapists and other specialists.

Our clinical providers include:

Sarit Aschkenazi, MD, MS, FACOG, Medical Director

Sarit Aschkenazi, MD, MS, FACOG, Medical Director

“I believe in educating women about their health — during each stage of life — and empowering them in their health care decisions. There is no greater satisfaction for me than in helping my patients achieve their health and wellness goals by developing individualized treatment plans targeted to improve quality of life and functionality based on the most current research available.”

 

Deb Ketterhagen, APNP

Deb Ketterhagen, APNP

“I believe in developing strong and trusting relationships with the women I serve. My promise is to provide compassionate, research-based care with special attention to your individual psychological, spiritual, personal values and preferences. Your visit will be comprehensive and friendly, and you’ll leave feeling comforted and valued.” 

woman with scarfBenefits of sexual health

Sexual health offers many health benefits, including:

  • Improved relationships and intimacy
  • Enhanced self-esteem
  • Enhanced mood
  • More restful sleep
  • Reduced depression

 

 

Issues affecting sexual well-being

young loving coupleDid you know that approximately 43 percent of American women experience sexual concerns at some point in their lifetimes? If this is you, you’re not alone.

Sexual issues may occur at any age. They can result from physical and/or psychological factors, past or current relationships, stress, trauma, medications and certain medical conditions. Also, you may experience changes in your sexual function at various times of your life due to life events. Thankfully, sexual concerns are often very treatable.

Psychological factors

  • Relationship issues
  • Depression/anxiety
  • Sexual abuse or trauma

 

Life changes

  • Childbirth 
  • Menstrual issues/PMS
  • Menopause

 

Medical conditions

  • Cardiovascular disease
  • Cancer diagnosis and treatment
  • Back injuries
  • Diabetes
  • Thyroid disorders
  • Pelvic floor disorders
  • Chronic pelvic pain
  • Multiple sclerosis

Medications

  • Blood pressure
  • Anti-depression and anxiety
  • Antihistamines
  • Antipsychotics
  • Hormones

 

Drug use

  • Alcohol
  • Nicotine
  • Narcotics
  • Stimulants

 

Sexual issues we treat

Our sexual health program provides treatment options that address these areas of concern:

  • Sexual dysfunction
    • Decreased sexual interest
    • Decreased sexual arousal
    • Decreased lubrication
    • Pain during intercourse
    • Delayed or absent orgasm
    • Genital pain 
  • Chronic pelvic pain — assessment, diagnosis and treatment
  • Behavioral/relationship problems
    • Communication
    • Body perception and image
    • Abuse or negative sexual experiences

Solutions for improving sexual health

women drinking coffeeOur sexual health experts provide a professional and private environment where you’ll feel comfortable. We believe that open and honest communication is essential for your treatment success.

Your first visit will include a comprehensive history and evaluation. You’ll complete clinical questionnaires to help guide us in creating the best treatment plan for you. After an initial evaluation, we may recommend additional diagnostic tests.

Treatment plans

Your treatments will depend on your goals, medical conditions and findings. Addressing "the whole picture" is crucial to finding solutions for you. Treating any medical illnesses or chronic pain condition is important.

Physical therapy also may be appropriate for you. In addition, psychotherapy may be a part of your evaluation and treatment plan, which may include recommendations for individual or couple therapy.

Changing or decreasing your medications to determine which might play a role in sexuality should be undertaken slowly — one step at a time. In addition, we may recommend hormonal medications for specific conditions, medications and or devices.

Understanding sexual health conditions

 

Biofeedback:  physical therapists conduct this treatment mainly to help you learn how to strengthen and relax your pelvic floor muscles in order to improve your bladder function and decrease pelvic pain. Biofeedback uses electronic and mechanical instruments to accurately measure the action of your pelvic floor muscles and provide “feedback” information.

Chronic pelvic pain:  pain in your pelvis, anterior abdominal wall, lower back and/or buttocks that lasts longer than six months. Clinically significant chronic pelvic pain affects your quality of life, your ability to function well physically and your ability to sleep.

Clitoris:  a small, sensitive, erectile organ at the upper end of the female genitals. A clitoris is a female sexual organ that is often compared to the male penis because of its sensitivity.

Dysmenorrhea:  a medical term for painful periods. It’s the leading cause of lost time from work or school for women in their 20s. You’ll experience painful periods, especially within the first few days. Your symptoms may include nausea, diarrhea, lower back pain, lower abdominal pain, and pain within or near your hips or inner thighs.

Endometriosis:  a medical condition in which tissue similar to the lining of your uterus grows outside your uterine cavity on other organs inside your body. It’s found most commonly on tissues overlying your ovaries, Fallopian tubes and other pelvic organs. Endometrial tissue responds to hormones just as it does in the lining of the uterus: it grows, thickens and then breaks down — shedding and bleeding at the end of each month-long cycle. This condition may be associated with pelvic pain or infertility.

Interstitial cystitis:  also known as painful bladder, this is a chronic bladder condition, in which the cause not fully understood. During flares, symptoms can include bladder pain, urgency, frequency and pelvic pain. Frequency can be quite severe and persistent, as often as every 10 minutes. The condition is often misdiagnosed as recurrent urinary infections, or other conditions associated with urgency or frequency.

Kegels:  an exercise developed by Arnold Kegel, MD, designed to strengthen your pelvic floor muscles — especially the pubococcygeal (PC) muscles — to increase vaginal muscle tone, improve sexual response and limit involuntary urine release due to stress urinary incontinence. These exercises are often prescribed following childbirth or during and after menopause.

Myofascial pelvic pain syndrome:  refers to pain in your pelvic floor muscles attributed to increased pelvic floor muscle tension. It may be caused by a variety of muscular or neurologic disorders as well as pelvic floor.

Myofascial trigger points:  abnormally tight bands of muscle fibers that cause pain. It usually involves localized areas of muscle spasms that cause active or passive pain and tenderness.

Neuropathic pain:  refers to pain resulting from damage or disease affecting the somatosensory system (sensations in your skin and deep tissues). It may be associated with abnormal sensations (dysesthesia) or pain produced by normally non-painful stimuli, often described as burning pain, coldness, “pins and needles,” numbness or itching.

Pelvic floor dysfunction (PFD):  this refers to any disorder involving your pelvic floor muscles and the pelvic organs supported by your pelvic floor. It’s often associated with other conditions that combine to cause chronic pelvic pain.

Pelvic inflammatory disease (PID):  an infection of your pelvic organs, usually involving your uterus, tubes and ovaries. It occurs when bacteria travel up though your cervix into your uterus and infect your internal female reproductive organs. It can lead to serious infections, abscesses or infertility, if left untreated.

Perineum:  surface area between your thighs extending from your tailbone to your pubic bone that includes the anus and the external genitals.

Prolapse:  a condition where pelvic floor organs, such as your uterus or vaginal walls lose their support and herniate (fall) through the vaginal opening. This is truly a hernia that results from weakening the pelvic floor support; weakening of the muscles and ligaments, which suspend the pelvic floor organs in position. This is a very common condition and can present in different stages. Mild prolapse can be treated with exercises and physical therapy.

Provoked vestibulodynia/vulvar vestibulitis syndrome:  a localized, provoked pain specific to an area of the vulva between your clitoris and your vaginal opening. You may have noticed the pain the first time you tried to use a tampon or attempt intercourse, or it may have developed over time. It’s associated with severe vaginal pain with penetration. You may notice tenderness and pressure in your vulva area. Symptoms include severe pain with pressure or vaginal entry, burning, stinging, irritation or raw sensations. You also may feel the urge to urinate frequently or suddenly.

Uterine prolapse:  this occurs when the ligaments and muscles near your uterus are no longer strong enough to hold your uterus in place and it can’t remain in its normal position. Your uterus can fall/slide into the vaginal area. This condition can be a result of childbirth or other chronic condition that cause a lot of pressure to the pelvic floor such as obesity, chronic cough, constipation or heavy lifting. It can result in a sensation of constant pressure, incomplete bladder or bowel emptying, painful intercourse, frequent urination or even vaginal bleeding.

Vaginismus:  painful involuntary contraction of your vagina in response to physical contact or pressure (esp. in sexual intercourse).

Vulva:  the external female genitalia, composed of the hairy areas surrounding the vagina, labia majora (large lips) and minora (small lips), the clitoris, the opening of the vagina and the urethra.

Vulvodynia:  a disorder associated with vulvar pain, burning and discomfort, which interferes with your quality of life. It can be caused by trauma, infection, inflammation, skin conditions or medical conditions that cause nerve injury. Often times the cause is unknown.