Sexual Wellness
Your sexual health is part of your health. Full stop.
Low libido, painful sex, vaginal dryness, difficulty with arousal or orgasm. These are medical concerns. They are common across every stage of life and they are treatable. You aren't broken, and you don't have to accept these symptoms as inevitable. You also don't have to bring them up to us apologetically.
Many people live with this for years before bringing it up.
Sometimes because they've tried before and been dismissed. Sometimes because they're not sure it's "bad enough" to mention. Sometimes because the appointment was over before they got to it.
Sexual health concerns are among the most common things we see, and among the most undertreated. Not because effective care doesn't exist, but because the conversation rarely happens.
At Good Energy, you don't have to work up to it. Whatever you've been living with quietly, we have time to talk about it.
A biopsychosocial approach.
Four dimensions, considered together — never in isolation.
Physical
Tissue health, pain, pelvic floor, medical history.
Hormonal
Estrogen, testosterone, contraception, menopause.
Emotional
Stress, body image, mood, past experiences.
Relational
Partnership, communication, life circumstances.
What we address
Sexual wellness looks different for everyone. We treat the following concerns:
Your providers
Maria Escamilla, DNP, CNM, APRN-FPA
Maria brings a whole-person, biopsychosocial lens to sexual health care — treating these concerns with the same clinical seriousness and compassion she brings to every area of women's health.
Sarah Stetina, MSN, CNM, APRN-FPA, MSCP
Sarah approaches sexual wellness with clinical depth and genuine warmth — creating space for the conversations clients have often wanted to have for years but haven't known how to start.
Your questions, answered
Is it normal to have a lower sex drive?
Changes in libido are extremely common: across hormonal shifts, life stages, relationship changes, stress, and more. What matters is whether the change is bothering you. If it is, it's worth talking about. There's no threshold of "bad enough" to bring it up.
What is HSDD?
Hypoactive sexual desire disorder is a recognized medical condition characterized by persistently low sexual desire that causes personal distress. It is the most common female sexual concern and one of the most undertreated. It has real, evidence-based treatment options, including FDA-approved medications and hormone therapy, and a biopsychosocial approach that looks at the full picture of what's affecting desire.
Can hormones affect sexual health?
Significantly. Estrogen, testosterone, and progesterone all play roles in libido, arousal, lubrication, and tissue health. Hormonal shifts during perimenopause, menopause, postpartum, or while using hormonal contraception can all affect sexual function. We look at the hormonal picture as part of every sexual wellness evaluation.
What is a biopsychosocial approach to sexual health?
It means we don't look at sexual health concerns as purely physical or purely psychological. Sexual wellbeing is shaped by your body, your emotional state, your relationship, your history, your stress levels, and more. Effective care addresses all of those dimensions. We may recommend a combination of medical treatment, referral to pelvic floor physical therapy, and referral to a sex therapist or mental health provider — whatever combination is most likely to help.
Do you refer to pelvic floor physical therapy?
Yes. Pelvic floor physical therapy is one of the most effective interventions for painful sex, vaginismus, and related concerns, and we refer regularly. We can help you understand what to expect and connect you with trusted providers.
I've never talked to a provider about this before. What should I expect?
An unhurried conversation with a provider who has heard it before and isn't going to make it awkward. You can share as much or as little as you're comfortable with. We'll ask questions, listen carefully, and together figure out the best place to start. There's no wrong way to begin this conversation.