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Introducing Mental Health At HerMD

Our biology and psychology are interconnected. In medical care, no matter the physical illness or medical condition, these processes can impact an individual’s body, brain, and emotional well-being. There is always an emotional reaction to a physical condition. Run a marathon, and your legs may be exhausted and cramping, but your brain is ecstatic because you have achieved your goal of completing the race. 

Now, consider the effect of painful muscle cramps in a uterus, on a monthly basis due to fibroids or endometriosis.  The mental toll of chronic pain can be severe. A detailed treatment plan that truly provides whole-person care not only includes a medical or biological approach but also requires one to look deeper, at all the puzzle pieces, including your emotional well-being.  

Mental health should similarly be considered in your medical treatment when looking at gynecological conditions. Many gynecological conditions, such as excessive bleeding from fibroids or endometriosis pain, can cause both short-term and long-term pain and lead to a decrease in quality of life if not treated appropriately.    This pain or discomfort on a daily basis can affect your ability to function effectively and efficiently both at the workplace and at home.  You may withdraw from social activities or ignore your once-loved hobbies. It is not uncommon for people who report chronic pain also to have sleep disturbances, anxiety, daytime fatigue, or difficulty concentrating. Decreased appetite and mood changes are also not uncommon. 

How does integrating mental health into your medical treatment fit into your sexual healthcare?  At HerMD, we often say the brain is the biggest sex organ. This may seem like a shocking statement. However, when you consider the relationship between the mind-body connection and your whole body health, it starts to make a bit more sense. Sexual health concerns such as lowered libido, changes in arousal, or inability to have an orgasm can also have implications on your overall mental health. The actual diagnosis of  “sexual dysfunction” includes the concepts of personal distress. These problems are, by definition, distressing. Sexual problems can lead to stress, anxiety, and relationship frustration.  Changes in sexual function coupled with emotional adjustments may create the perfect storm for developing depression, anxiety,  or lowered mood. Depression and loss of libido or sexual interest often go hand in hand, and it’s not uncommon to have both diagnoses.  Both need to be addressed simultaneously and systematically to move forward in your journey of sexual wellness.

Menopause is a key time frame to integrate mental health counseling into your care plan because of the hormonal shift, and related symptoms patients will experience.  Symptoms like hot flashes are disruptive to sleep, chronic sweating in public, and painful vaginal dryness during sexual intimacy, can all create a situation which can predispose you to developing a lowered mood. Menopausal hormonal changes can certainly influence your overall frame of mind. It is not uncommon for patients to become short-tempered during menopause which can also impact your relationship with your partner, co- workers,  or children. Some patients in menopause report that after their periods have stopped, they become angry or frustrated. They ask themselves questions like “Why me?” and “How can I cope with this time of my life?” 

Who can benefit from integrating mental health counseling into their medical  treatment plan? No matter your age,  body type, or size, there are times in our lives we may look in the mirror and do not recognize the reflection. Sometimes looking good may help us feel good. The way we self-identify, or our self-esteem, impacts our emotions.  If we are not feeling our best, we may become frustrated, sad, or disappointed. Addressing and confronting your personal concerns, directly, head-on, can elevate your mood and improve emotional and sexual confidence. 

Michael Krychman, MDCM

Dr. Michael Krychman is a Board Certified OBGYN and an AASECT Certified Sexual Counselor and Supervisor. He specializes in menopausal health, hormone therapy, sexual pain disorders, vulvar disorders and loss of libido, chronic medical illness, and medical devices and their impact on female sexual function.

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