What sexual health counselling covers
Sexual health is a normal part of overall health. It includes physical comfort, emotional wellbeing, safety from infection and the freedom to make your own choices about sex and relationships. Many women in India grow up with little reliable information on these topics and feel shy about asking.
In sexual health counselling, a gynecologist or trained counsellor listens to your concerns, gives accurate information, looks for medical causes and suggests treatment or referral where needed. Unmarried women, married women, new mothers and older women can all use it. You do not need to have a serious problem to ask a question.
Counselling is not the same as a lecture on morals. The aim is to help you understand your body, feel at ease and enjoy a healthy, safe intimate life on your own terms. Small worries that are addressed early are much less likely to grow into lasting difficulties.
Concerns you can bring up
Physical concerns
- Pain, burning or bleeding during or after sex
- Vaginal dryness or tightness that makes penetration difficult
- Itching, sores, unusual discharge or worry about a sexually transmitted infection
- Changes after childbirth, surgery or menopause
Emotional and relationship concerns
- Low or absent interest in sex
- Difficulty becoming aroused or reaching orgasm
- Fear or anxiety about first intercourse
- Differences in desire between you and your partner
- The effect of stress, body image or past unwanted experiences
Questions about safe sex, vaccination against HPV and preparing for marriage also belong here.
Common concerns and what may lie behind them
Sexual difficulties usually have more than one cause. The table gives examples only. A doctor needs to assess your own situation.
| Concern | Possible causes | What may help |
|---|---|---|
| Pain during sex | Dryness, infection, endometriosis, muscle tightening | Treating the cause, lubricants, pelvic floor therapy |
| Low desire | Stress, tiredness, hormonal changes, some medicines, low mood | Counselling, medicine review, treating health issues |
| Penetration not possible | Involuntary tightening of vaginal muscles (vaginismus), fear | Education, gradual exercises, counselling |
| Dryness | Breastfeeding, menopause, some medicines | Lubricants, moisturisers, local treatment |
| Unusual discharge | Yeast, bacterial or sexually transmitted infection | Tests and prescribed treatment, partner treatment if advised |
Dryness and discomfort are especially common after childbirth and around menopause. They can be discussed as part of postnatal care or menopause management too.
Privacy and consent
Doctors are bound by professional rules to keep what you tell them confidential. You can ask to speak to the doctor alone, without your partner or relatives in the room. You can also ask for a female doctor or a female attendant during any examination.
Nothing is done without your agreement. You may refuse an internal examination, and an examination is not always necessary. If you have experienced sexual violence or pressure, a counsellor can listen without judgement and guide you towards medical care and support services.
It is natural to feel embarrassed at first. Doctors who work in this field hear such questions every day and will not be shocked. Using the words you are comfortable with, in the language you prefer, is perfectly fine.
What happens in a session
- You describe your main concern in your own words. Writing it down beforehand can make this easier.
- The doctor asks about your periods, pregnancies, medical conditions, medicines, mood and relationship, to understand the full picture.
- If it would help, and only with your consent, a gentle examination is carried out.
- Tests such as swabs, urine tests or blood tests may be advised if an infection or hormonal problem is suspected.
- The doctor explains the likely causes in simple language and corrects common myths.
- Together you agree on a plan. This may include self-care steps, medicines, exercises, counselling sessions or referral to a psychologist or physiotherapist.
- A follow-up visit reviews progress. Your partner may be invited to join if you wish.
Improvement often takes several sessions, especially where anxiety or long-standing pain is involved. Costs vary by city, hospital and the number of sessions needed.
Looking after your sexual health
A few habits lower the risk of infection and help you stay comfortable:
- Use condoms correctly to reduce the risk of sexually transmitted infections
- Choose a reliable method from the family planning and contraception options if you want to avoid pregnancy
- Ask your doctor about HPV vaccination and cervical screening
- Get tested if you or your partner have symptoms or a new partner
- Avoid douching and scented washes, which can upset the natural balance of the vagina
- Talk openly with your partner about comfort, consent and pace
When to see a gynecologist
Some symptoms point to a medical condition and should not be left to settle by themselves. Arrange a visit if you have:
- Bleeding after sex
- Pain during sex that is new, severe or getting worse
- Sores, blisters, warts or lumps in the genital area
- Discharge with a bad smell, unusual colour or itching
- Burning when passing urine along with fever or lower abdominal pain
- Unprotected sex with a partner who may have an infection
- Distress about your sexual life that affects your mood or relationship
If you have been forced into any sexual act, seek medical help as early as possible. This article shares general information and is not a substitute for personal advice from a qualified professional.
This page is general information for readers in India. It is not medical advice. Speak to a qualified gynecologist about your own health.