Content approved by: Dr Farzana Khan, MD, MRCGP, DFFP — Specialist in vaginal health with 20+ years’ medical experience across dermatology and gynaecology. Care is balanced, evidence-aware, and patient-centred.
Dr Farzana Khan qualified as an MD from the University of Copenhagen in 2003. She has worked in dermatology and obstetrics & gynaecology across the North of England and completed her MRCGP (CCT, 2013) and the Diploma of the Faculty of Sexual & Reproductive Health (2013).
Her clinical focus is vaginal health—including dryness/GSM, sexual function concerns, lichen sclerosus, and comfort or volume changes. She explains conservative and medical options first, then discusses regenerative or aesthetic procedures where appropriate.
Dr Farzana is a key opinion leader on women’s intimate health and been featured in the press including the daily mail and on BBC radio. Dr Farzana also trains clinicians as a Trainer with Neauvia, NuV Laser, Asclepion Juliet Laser, and RegenLab. Ongoing CPD includes IMCAS, CCR, ACE and expert training in intimate fillers, PRP and polynucleotides.
Authored and medically reviewed by Dr Farzana Khan. Last updated: 1 November 2025.
6 Surprising Truths About Sexual Health We Learned From a Top Women's Clinic
It’s a frustratingly common story: you turn to the internet with an intimate health worry, only to be met with the same tired advice to "just relax," "use more lubricant," or "do your Kegels." But true sexual wellness is frequently more complex and counter-intuitive than we're led to believe. The signals our bodies send can be easily misinterpreted, leading to treatments that don't work or even make things worse.
Key Takeaways
- Misdiagnosis is Common: "Recurrent Thrush" is often Cytolytic Vaginosis (CV), which requires the opposite treatment.
- Medication Impact: The Pill and SSRIs have biological mechanisms that can physically block desire and sensation.
- Stop the Kegels: For pain, the pelvic floor is often too tight (hypertonic), not too weak.
- Safety First: FDA approval is meaningless in the UK. Look for UKCA/CE marks.
Table of Contents
1. Your "Recurrent Thrush" Might Be Something Else Entirely
If anti-fungals make your burning worse, you may have Cytolytic Vaginosis (CV). This is an overgrowth of "good" Lactobacilli, making the vagina overly acidic. A clinical secret is the timing: symptoms worsen the week before your period (Luteal Phase) and improve during bleeding, as menstrual blood is alkaline.
Home pH Test Guide:
- pH < 3.5 (Very Acidic): Likely Cytolytic Vaginosis.
- pH 3.5 – 4.5 (Normal): Likely Thrush.
- pH > 4.5 (Alkaline): Likely Bacterial Vaginosis (BV).
Book Specialist Review 2. Your Daily Medication Could Be Sabotaging Your Sex Life
Sexual problems are often a biological side effect of medication, not "in your head."
The "SHBG Trap"
Culprit: Hormonal Contraception (The Pill).
Increases Sex Hormone Binding Globulin (SHBG) which acts like a sponge, soaking up free testosterone. This kills desire and can thin the vestibule.
The "Sensation Blocker"
Culprit: SSRI Antidepressants.
Increased serotonin inhibits dopamine pathways, causing "Genital Anesthesia"—making orgasm difficult even when aroused.
3. More Kegels Aren't Always the Answer
The Hypertonicity Myth
A tight muscle is often a weak muscle because it is exhausted. Performing Kegels on a tight pelvic floor is like doing bicep curls with a cramped arm.
The Fix: You must learn to "Down-Train" (Release) before strengthening. Look out for "Referred Pain"—like a hip ache caused by a trigger point in the Obturator Internus.
Is your pain caused by tension?
Get Support4. Many "It" Procedures Lack Solid Proof
Regulatory Warning
FDA Approval is meaningless in the UK. Medical devices here must have a UKCA or CE mark.
Beware of the "Intended Use" trap: A laser might be CE-marked for skin (dermatology), but using it "off-label" internally carries higher risks.
5. Your Brain Can Learn Pain—and Be Retrained
Chronic pain involves "Central Sensitization," where the nervous system's volume dial is turned up. This creates a Fear-Avoidance Cycle:
6. Healing Follows a Strict Biological Clock
Managing expectations is key. Biology cannot be rushed.
| Process | Timeline | Clinical Insight |
|---|---|---|
| Collagen Remodeling | 12 Weeks | Immediate "tightness" is often just swelling. True strength peaks at 3 months. |
| Nerve Regeneration | 1mm / Day | Sensation returns incredibly gradually over months. |
| Muscle Hypertrophy | 8-12 Weeks | Weeks 1-4 are just neural adaptation. Don't quit early. |
From Confusion to Clarity
Armed with this knowledge, you are no longer a passive recipient of generic advice. You can become a powerful advocate for your own health.
