Back to top3. Menopause“If someone is having night sweats, my first thought is to ask them about their periods to see whether they are menopausal,” Barrie Weinstein, MD, an assistant professor of endocrinology, diabetes, and bone disease at the Icahn School of Medicine in New York City, tells SELF.Menopause can happen at any point in a person’s 50s, 40s, or even as early as their 30s if they experience premature menopause, according to the Mayo Clinic. Thanks to fluctuating hormones—specifically, reduced estrogen and progesterone—menopause can cause a slew of unpleasant symptoms, including hot flashes that lead to night sweats, chills, irregular or absent periods, mood changes, vaginal dryness, a slower metabolism, and thinning hair, among others, per the Mayo Clinic.Menopause is a completely normal condition that doesn’t automatically require treatment (unless it starts too early, which can be a different story), but that doesn’t mean you don’t have options if symptoms like night sweats are interfering with your life. “If patients are having night sweats that are intolerable, they can discuss with their doctor whether hormone replacement would be a good option for them,” Dr. Weinstein says. Different kinds of hormone therapy can help relieve various menopause symptoms, according to The American College of Obstetricians and Gynecologists (ACOG). But if that’s not something you’re interested in or your doctor doesn’t recommend it as a safe choice for you, there are other medications, including some low-dose antidepressants, that can help decrease those dreaded hot flashes, according to the National Institute on Aging.Back to top4. Obstructive sleep apneaObstructive sleep apnea, or OSA2, is a common sleep disorder that causes your breathing to stop and start briefly while you’re snoozing. If you have OSA, your throat muscles relax when they shouldn’t, which interferes with your airway’s ability to get enough oxygen while you sleep.And yes, it can make you sweat. “One of my colleagues says it’s like you go to the Olympics every night because you’re working so hard to breathe,” Rafael Pelayo, MD, a clinical professor in the division of sleep medicine at Stanford University and author of How to Sleep: The New Science-Based Solutions for Sleeping Through the Night, tells SELF. Besides night sweats, other symptoms of OSA include loud snoring, excessive fatigue during the day, abruptly waking up during the night while gasping or choking, morning headaches, mood changes, a lower sex drive, and more. If that sounds concerning, well, you’re right on target. OSA can be serious and requires prompt treatment.Treatment options include lifestyle changes like using a nasal decongestant before you sleep or avoiding sleeping on your back, sleeping with a continuous positive airway pressure (CPAP) machine to keep your airways open, using a mouthguard to do the same, and more intensive options, like surgery to remove the tissue that’s blocking your airways.Back to top5. Acid refluxAcid reflux happens when stomach acid travels back up into the esophagus, which commonly triggers the feeling of heartburn3. When this happens chronically—more than twice per week—it’s known as gastroesophageal reflux disease (GERD). Anecdotally, some people who have acid reflux or GERD experience night sweats, which tend to resolve once the acid reflux is treated, Dr. Paauw says. There are very few studies exploring the link between night sweats and acid reflux, so experts aren’t 100% certain why the two are connected. However, Dr. Paauw believes acid reflux may trigger the autonomic nervous system4, which regulates bodily processes such as breathing, to increase heart rate. And an elevated heart rate may lead to excessive sweat, he says. When someone is lying down, they don’t have the benefit of gravity to help keep stomach acid from flowing into the esophagus, which may explain why people with acid reflux experience night sweats, Dr. Paauw says.
When it comes to migraine attacks, every hormone can play a role. That’s because all hormones can affect brain function, Salman Azhar, MD, a neurologist at Lenox Hill Hospital in New York City, tells SELF. But in terms of migraine in cisgender women, changes in estrogen—the primary female sex hormone—is the main culprit, says Dr. Krel. Case in point: According to the Mayo Clinic, steady levels of estrogen can help ease both regular headaches and migraine attacks. However, when estrogen levels oscillate, which happens throughout a person’s life, migraine can get worse.When are hormone fluctuations most likely to occur?During your menstrual cycle, estrogen naturally drops right after ovulation, then again just before your period starts, says Dr. Krel. “It is during these moments, when estrogen is lowest, that some women tend to experience more frequent migraine attacks,” she says. In fact, among people with menstrual periods who have migraine, at least 60% report menstrual-related migraine attacks.Estrogen also increases during pregnancy, potentially improving the frequency and severity of migraine attacks. But after giving birth, the hormone rapidly drops, often causing migraine to roar back with an almighty force, according to the Mayo Clinic.And then there’s perimenopause, or the years leading up to menopause, which might start anywhere between your mid-30s to mid-50s. This time is characterized by uneven fluctuations in hormones, including—you guessed it—estrogen. Specifically, the body starts making less of the hormone, potentially causing more intense and frequent migraine attacks in some people. But once the body stops making estrogen altogether, hormone-related headaches may improve.Bottom line: Fluctuating hormones, of any kind, can trigger migraine attacks. Experts don’t fully understand why estrogen fluctuations can catalyze the development of migraine, though.Here are some possible explanations:Estrogen may affect pain neurotransmitters.Estrogen affects the activity of certain neurotransmitters (chemical messengers released by nerve cells) involved in migraine attacks and pain. As a 2018 review article published in the Frontiers in Public Health notes, estrogen increases the production of serotonin, a neurotransmitter that regulates many biological processes.3 This includes the sensation of pain, Dr. Krel says. According to a 2022 study published in Cells, estrogen also has a protective effect against migraine—but when it fluctuates, so does serotonin, which could potentially trigger a migraine attack. Similarly, estrogen increases the release of gamma-aminobutyric acid (GABA), a neurotransmitter that reduces pain. But again, when estrogen fluctuates, so does GABA, which may also result in migraine attacks.4Estrogen may protect against inflammation in the brain.Estrogen may also help protect against inflammation in the brain. Low levels of the hormone may increase this inflammation, potentially contributing to those painful migraine attacks.4 Finally, estrogen is needed for healthy relaxation of the blood vessels, including those in the brain. When estrogen rapidly drops, the blood vessels may constrict, ultimately leading to a migraine attack.1 It’s worth noting again that the high rate of migraine in cisgender women isn’t linked to the presence of estrogen itself. Instead, it’s more about the fluctuations. As Dr. Azhar points out, people assigned male at birth also have estrogen, albeit in smaller amounts. But since they don’t experience the same estrogen fluctuations, people assigned male at birth who have migraine are less likely to have hormonal triggers.Don’t forget a migraine attack can have other triggers, too.A lot of things can trigger migraine attacks, says Dr. Azhar. “When you’re susceptible to migraine, either because of genetics or your own physiological makeup, a series of triggers can culminate into an attack.” Hormonal variations happen to be one of those triggers and an especially strong one, he says.
Kidney stones develop when salts and minerals commonly found in your pee pile up, crystalize, and stick together in your kidneys. Generally, this happens when your urine becomes concentrated for various reasons, including dehydration. For many people, drinking plenty of water throughout the day can help lower their chances of developing kidney stones4. But there are some medical conditions like gout (which causes joint swelling), that can increase your chances of developing these painful, pebble-like deposits, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Taking certain medications can also cause kidney stones.Interstitial cystitisInformally called “painful bladder syndrome,” this condition lives up to its name, as it can cause abdominal, bladder, and pelvic pain. (And yes, pain when peeing.) Generally, your pain starts when your bladder gets full and escalates until you let it all out. Then, you will have some relief until your bladder fills up again, according to the NIDDK. Aside from this, you may have the urge to use the bathroom very suddenly and more often than you normally do. Experts don’t know the exact cause of interstitial cystitis, but people who have the chronic condition may notice that dehydration, sex, and holding their pee makes their symptoms worse.Obstructive uropathyWith obstructive uropathy, your urine doesn’t drain through the urinary tract properly and backs up into your kidneys, causing a blockage. This typically happens as a complication of another health issue, such as kidney stones or a more serious condition like ovarian cancer, according to the National Library of Medicine (NLM). Other signs of a blockage include pain in your sides (near your kidneys), getting the urge to pee often, decreased urine flow, and feeling like your bladder is never truly empty. If you think you have obstructive uropathy, it’s important to see a doctor as soon as you can because the blockage can cause bladder and kidney damage without treatment.Back to topHow do I stop my pee from burning?Treatments and remedies for dysuria largely depend on what’s causing that painful urination in the first place. In general, though, Dr. White says that “if the symptoms are persistent after two to three days, getting worse, associated with other bothersome symptoms like fever or ulcers on the vagina, these are all reasons to be seen by your doctor.”If it’s a UTI:If you suspect you have a UTI, it’s crucial to see a doctor who can order a urine culture to confirm your diagnosis. If you do have a UTI, then a round of antibiotics can kick the infection (and burning pee) to the curb. Otherwise, your doctor can work with you to determine the real cause of your discomfort when urinating. As we mentioned, if left untreated, a UTI can spread and turn into a kidney infection, which can be potentially life-threatening. In addition to being more likely to get a UTI if you have a vagina, you’re also more likely to get a UTI if you’re sexually active, have a suppressed immune system, are in menopause, or have kidney stones or other complications blocking your urinary tract (among other risk factors), according to the Mayo Clinic. Over-the-counter urinary pain relief meds, like Azo, can ease your symptoms, but do not treat the infection, Dr. White says. If UTIs regularly besiege your poor body, make sure to take preventive measures, like staying hydrated, wiping from front to back, and trying to pee after you have sex if that seems to set off symptoms for you. And if you specifically get two or more UTIs in six months or four or more within a year, your doctor may be able to offer you preventive treatment like a single-dose antibiotic you take after sex, the Mayo Clinic says. People who have gone through menopause may take topical vaginal estrogen to help with recurrent UTIs. If it’s a yeast infection:Antifungal medications can clear up the infection (and symptoms like painful urination). Some of these are available over the counter, and some are prescribed. With that said, it can be smart to talk to a doctor before grabbing an OTC medication, especially since some other vaginal issues, including STIs or UTIs, can seem a lot like yeast infections. (Here’s a more in-depth explanation of treating a yeast infection at home.) Beyond that, if you have four or more yeast infections a year, you can talk to your doctor about preventative strategies, who will likely prescribe a longer course of antifungals. To avoid recurrent yeast infections, Dr. Yamaguchi recommends wearing cotton underwear for breathability (or at least underwear that has a cotton crotch) and changing ASAP after you work out instead of staying in sweaty gear because yeast can thrive in moist and warm environments5.If it’s bacterial vaginosis:Your doctor can do a few simple tests to determine what type of infection you have, and if they find bacterial vaginosis is behind your dysuria symptoms, they’ll prescribe antibiotics for you to take either orally or vaginally, the Mayo Clinic says.If it’s an STI:If you’ve been sexually active and are now feeling pain after peeing, it’s worth heading to the doctor to be safe, if you can. If you do have an STI, treatment depends on what type you’re diagnosed with. If it’s herpes, your doctor will probably prescribe antiviral medication like acyclovir (Zovirax) or valacyclovir (Valtrex) to use when you have symptoms, the Mayo Clinic says. For chlamydia, you’ll likely be treated with antibiotics, the CDC says. If gonorrhea is the cause of your painful urination, the CDC recommends having a single dose shot of intramuscular ceftriaxone and an oral dose of the antibiotic azithromycin. For trichomoniasis, your doctor will recommend that you take a large dose of either metronidazole (Flagyl) or tinidazole (Tindamax), the Mayo Clinic says. It’s really important to get tested for an STI if you think you have one. Left untreated, some infections (like chlamydia and gonorrhea) can have long-term consequences including infertility.If it’s a sex-related vaginal tear:To cut back on that yikes-inducing feeling, Dr. Yamaguchi recommends pouring warm water over your vaginal area while you’re peeing. “The temperature will help interfere with the nerve pathways,” she says. And to avoid the issue altogether, she suggests making sure you’re plenty lubed up whenever your vagina’s getting some attention. If your vaginal tissue is more fragile due to atrophy and lubrication doesn’t help prevent abrasions, you can ask your doctor about other options like estrogen replacement therapy, Dr. White advises.If it’s a childbirth-related vaginal tear:Pain related to vaginal and/or perineal tears is an unfortunately common circumstance after vaginal childbirth. There are a few strategies you can try for relief, like using perineal irrigation bottles. These are devices many new moms rely on that make it even easier to squirt warm water on themselves to dull the pain. According to the Mayo Clinic, you may also want to try using ice packs (wrapped in something like a towel to protect your skin), taking sitz baths, or putting chilled witch hazel pads on the affected area (a sanitary pad in your underwear will help keep the witch hazel pads in place). Pain relievers, numbing sprays, and stool softeners may also help—talk to your doctor to figure out what might be right for you.If it’s due to products like soap or douches:This is more about prevention. Stop using any products you think are giving you trouble—these commonly include scented soaps, vaginal hygiene products, and douches. Try replacing them with gentle, fragrance-free soap and some water to wash your vulva (your external genitalia). Again, you don’t even need to wash your actual vagina. Let it clean itself in peace, please!If it’s post-menopause atrophic vaginitis:Sadly, many people who experience this dysuria cause don’t seek treatment, either because they’ve given up hope on feeling better or they’re too shy to discuss it with their doctor, according to the Mayo Clinic. If you’re dealing with this, chat with your doctor to determine whether hormonal supplementation with estrogen may help your symptoms, and if not, how to find relief. Other options include vaginal moisturizers, lubricants, dilators, and numbing agents, the Mayo Clinic says.If it’s kidney stones:Treatment depends on the type of kidney stones you have (yes, there are numerous types based on the substance they’re made of), their size, why you developed them in the first place, and your specific symptoms, according to the NIDDK. A doctor can run multiple tests, such as a urine test to look for high amounts of minerals, or an X-ray to look at the size and location of your kidney stones. Your treatment can be as simple as drinking lots of water to help the stone pass (even though this will likely be painful), or it might involve having a procedure that uses sound waves to break up larger stones.If it’s interstitial cystitis:Since there’s no cure for this condition, treatment will aim to help relieve your individual symptoms. For example, you may drink lots of fluids to avoid dehydration or try pelvic floor therapy if you have muscle spasms, according to the NIDDK. Bladder training6, which involves holding in your urine for longer than you typically do, may also help. Before you start a bladder training program on your own, though, it’s best to talk to your doctor about how to do this without making your symptoms worse.If it’s obstructive uropathy:If your symptoms suggest obstructive uropathy, chat with your doctor about testing, which may include an ultrasound of your abdomen or pelvis, according to NLM. If there is an obstruction, your doctor will talk through options about relieving symptoms and removing the blockage, depending on the root cause of the condition. For example, you may have a stent placed in your ureter to drain urine, in addition to surgery to repair the obstruction, according to NLM.
The concept of a low sex drive in women—and frankly, in anyone—is often paired with many misconceptions. The truth is, sexual desire can be a pretty fickle thing for everyone, regardless of gender identity, sexual orientation, or relationship status. While it can be tempting to boil libido down to a biological need or innate human drive, that thinking is just not reflective of our current understanding of sexuality. “Ultimately, libido is our desire for sex, rather than a drive for sex,” Robin Buckley, Ph.D., a clinical psychologist and couples therapist in New Hampshire, tells SELF.That’s not to say there’s no biological basis for how often you want to have sex. Research shows libido is greatly influenced by hormones1, and there are so many things that can have an impact on your hormonal makeup and on the hormonal changes that occur within your body throughout your life. Sex drive is also affected by physiological factors (like your neurologic, vascular, and endocrine system),2 as well as a number of psychosocial factors (like your self-esteem and the way you feel about your body).3Some of these factors are in our control and some simply aren’t, yet they all have a thread in the complex web of sexual desire. So it’s no wonder that humans would have a wide range of, well, horniness. In fact, what seems like a “low sex drive” to one person might seem high to another—there’s really no simple answer to a question like “why is my sex drive low?”But if your own desire to have sex seems off from your baseline, or you are wondering if you’re experiencing some symptoms of low libido in women, including those assigned females at birth and those who are transgender, there can be some specific underlying causes to consider. SELF spoke to sex and sexuality experts about what those can be—and what you can do if it’s truly bothering you.First, is it normal to not want to have sex?Our desire for sex exists on a spectrum and can be fluid from person to person—and within ourselves—over time. So, simply put, it can be normal to not want to have sex.There are so many periods in your life when sex is (understandably) the last thing on your mind, according to the Mayo Clinic. This includes things like a major life change like a move to a new city, becoming ill or experiencing an injury, feeling depressed, starting a new medication with unexpected side effects, or living through a global pandemic, to name a few.But you also don’t need to be going through a Big Life Moment to “justify” a low libido. Fluctuations in the desire for sex are extremely common. “Just because someone has a low libido at one point in their life doesn’t mean that they’ll have low libido all of their life,” Lauren Streicher, M.D., professor of clinical obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine and author of Sex Rx, tells SELF.These changes can happen over months or years, even day to day. It’s also normal to never or rarely experience the desire for sex. (People who relate to those feelings may identify as asexual.)However, there is a clinical condition characterized by a sex drive that’s persistently lower than baseline: hypoactive sexual desire disorder (HSDD). “Hypoactive sexual desire disorder can have a negative impact on a person’s relationships and personal health,” Brett Worly, M.D., an ob-gyn at The Ohio State University Wexner Medical Center, tells SELF.When a person is diagnosed with hypoactive sexual desire disorder, it means they have lost some or all motivation to engage in sexual activities for at least six months or longer. On top of that, this lack of sex drive must be causing a lot of personal distress. Experts estimate that the condition may affect up to 10% of women.4Generally speaking, though, there is no “normal” amount of sex you should be having, whether you are in a relationship or not. The “right” amount of sex to be having is the amount that you and your partner or partners mutually feel comfortable with and consent to—and that doesn’t have to look the same for everyone.