The Fosnight Center focuses on promoting and maintaining the sexual well-being of individuals through education, prevention, diagnosis, and treatment of conditions related to sexual health. We provide services and medical care to address a variety of conditions. We support sexual education, contraceptive management, and healthy relationships to empower individuals to make informed decisions about their sexual health.
Recognizing sexual health conditions helps individuals regain confidence, improve overall well-being, and enjoy healthier, more fulfilling relationships.
Confirming sexual health conditions empowers individuals to take control of their health, enhancing their quality of life and fostering emotional and physical intimacy.
Effective treatment of sexual health conditions promotes personal wellness, strengthens self-esteem, and supports a vibrant and satisfying lifestyle.
A cancer diagnosis and its treatments can have a profound impact on sexual health, intimacy, and body image. Surgery, chemotherapy, radiation, and hormonal therapies may lead to changes such as vaginal dryness, erectile dysfunction, loss of desire, pain, fatigue, or shifts in how you relate to your body and your partner.
These changes are common, but they don’t have to be permanent or ignored. Our center provides compassionate, specialized care to support individuals and couples navigating sexual health after cancer. Whether you’re in treatment, recovery, or survivorship, we’re here to help you reconnect with your body, your desires, and your relationships, on your own terms.
For men with delayed ejaculation, there is a prolonged delay in reaching ejaculation/orgasm during sexual activity and stimulation. Many more men are dealing with delayed ejaculation than thought in the past.
Causes include disease processes, medications, genital neuropathy, excessive alcohol use, hormone imbalances, depression, and pelvic floor concerns.
Treatment approach to delayed ejaculation includes isolating the cause and using a multidisciplinary technique to improve erectile ability, increase blood flow and nerve sensitivity through pelvic floor physical therapy, and cognitive/behavioral therapy.
Pain with intercourse is a common complaint for women of all ages.
Research now shows that the majority of dyspareunia is caused by physical conditions that plays a large psychological influence on sexual health.
Dyspareunia, itself is not merely a disease but rather a symptom with many different causes.
Together, you and your sexual health care team will work collaboratively to develop an individual treatment plan to optimize your sexual health.
Epididymitis is inflammation of the epididymis—the coiled tube at the back of the testicle that stores and carries sperm. It often causes pain, swelling, and tenderness in the scrotum, sometimes accompanied by fever or urinary symptoms. It’s most commonly caused by bacterial infections or by urinary tract infections (UTIs).
Diagnosis includes collecting a detailed history, performing a physical exam, urine tests, STI screening, and possibly a scrotal ultrasound.
Millions of American men experience erectile difficulties and the most common sexual health compliant reported by men.
Studies have shown that roughly 40% of men in their 40’s and 70% of men in their 70’s have erectile concerns. Ed is defined as the inability to achieve and/or maintain an erection sufficient for sexual activity.
Causes can include physical, psychological, or both. The most common physical cause of ED includes blood flow insufficiency – coronary artery disease, hypertension, and hyperlipidemia.
Other physical causes include diabetes, low testosterone, hormonal imbalances, Peyronie’s disease, tobacco use, sleep apnea, excessive alcohol use, obesity, medical treatments, Parkinson’s, and neurological disorders. Psychological causes include depression, anxiety, stress, performance pressures, and relationship discord.
Treatment includes identification of the cause as well as optimizing blood flow and nerve sensitivity with medications and pelvic floor physical therapy.
Cognitive/behavioral therapies work will as an adjunct therapy to improving medical comorbidities. Working together with a sexual team is essential to maximizing erectile potential.
See Sexual Pelvic Rehabilitation Program for more information. There are experimental therapies that include low intensity shockwave therapy and plasma rich protein.
Interstitial cystitis (IC), also known as painful bladder syndrome, is a chronic condition that causes bladder pressure, pelvic pain, and urinary symptoms like urgency and frequency—often without an infection. The discomfort can range from mild to severe and may worsen during certain activities, including sexual activity.
At our center, we offer a comprehensive, personalized approach to managing IC. Treatment may include lifestyle modifications, bladder retraining, physical therapy, medications, and advanced therapies like bladder instillations or neuromodulation.
If you’re experiencing ongoing bladder discomfort or painful intimacy, our specialized team is here to help you find relief and improve your quality of life.
One of the most prevalent sexual health concern is hypoactive sexual desire disorder (HSDD), defined as chronic low sexual desire causing personal distress.
Research estimates that 1 in 10 women has HSDD. Causes can include hormone changes, medication side effects, trauma, pain, and even stress.
A thorough medical assessment including questionnaires, history taking, and physical exam are key in diagnosing HSDD.
Treatment options include medications, behavior homework assignments, and working collaboratively with a sexual health team.
The menopause transition can be a time in a woman’s life where she may feel liberated or frustrated secondary to hormonal changes.
This new phase in life can encompass several stages including perimenopause, menopause, and postmenopause. The average age for a woman to start menopause is 51, however hormonal changes can happen up to 10 years prior to her final menstrual period.
Symptoms include irritability, fatigue, memory concerns, “brain fog,” hot flashes, night sweats, sleep disturbances, vulvovaginal concerns, and other physical changes.
Although menopause is not a specific medical condition, this natural transition process can lead to personal distress and need for therapy options.
Treatments include OTC medication, prescribed medications, as well as lifestyle and behavioral modifications.
Anorgasmia is defined as long term inability to achieve orgasm after adequate sexual stimulation causing personal distress in women.
Studies have revealed that approximately 15% of all women struggle with achieve orgasm and 10% report never achieving orgasm in their life.
Diagnosis focuses on ruling out medical conditions and blood tests to determine how your body’s endocrine system is functioning.
Treatment involves a multidisciplinary approach through medical interventions with vibration therapy, optimal sexual positioning/props, and medications; pelvic floor PT to increase blood flow, muscle relaxation, and rebuild nerve function; and sex therapy to initiate individual and partner behavioral assignments.
Overactive bladder is a common condition that causes a frequent, urgent need to urinate—sometimes leading to leaks before you can get to the bathroom. It can disrupt daily life, sleep, and even intimacy, but you’re not alone—and it’s treatable.
We specialize in helping individuals manage OAB with personalized treatment plans that may include behavioral strategies, pelvic floor therapy, medications, and advanced options like bladder Botox/Dysport or nerve stimulation.
If bladder urgency is interfering with your confidence or comfort, we’re here to help you take control.
Pelvic floor disorders occur when the muscles, ligaments, and connective tissues that support the pelvic organs are not functioning properly. These conditions can affect people of all genders and may lead to symptoms like pelvic pain, urinary or fecal incontinence, constipation, painful sex, and a feeling of pressure or bulging in the pelvic area.
Some people experience hyperactive pelvic floor muscles, where the muscles are too tight and unable to relax properly. This can contribute to pain, urinary urgency, difficulty with bowel movements, and sexual discomfort.
Common pelvic floor disorders include pelvic organ prolapse, overactive bladder, pelvic floor muscle dysfunction, and hypertonic (overactive) pelvic floor muscles.
We offer inclusive, evidence-based care to help you restore comfort, function, and confidence in your pelvic and sexual health.
The pelvic floor is an intricate weave of muscles, ligaments, tendons, and fascia structures supporting the pelvic organs.
When there is abnormal tone, pain, shortening, weakness, spasm, discoordination, and impaired contractile properties, the pelvic floor can become hypertonic (high-tone) or hypotonic (low-tone) leading to a wide array of pelvic floor concerns.
Symptoms include urinary incontinence, fecal incontinence, dyspareunia (painful intercourse), decreased lubrication, and referred pain. Causes include but are not limited to pelvic/lower back trauma, medications, anxiety/depression, pregnancy, childbirth, pelvic and abdominal surgeries.
Research shows that female athletes are at increased risk for high-tone pelvic floors.
Diagnosis can be made on physical exam paying close attention to the core, pelvic floor, hips, and lower back.
Often, a pelvic floor PT will use a surface electrode to assess the resting tone of the pelvic floor muscles and evaluate muscle coordination and contractility.
Treatment options include pelvic floor physical therapy along with trigger point release, medications, mindfulness, and breathing techniques.
Perimenopause is the transitional phase leading up to menopause, when the body’s hormone levels, especially estrogen, testosterone, and progesterone, begin to shift. This stage can start in the 40s (sometimes earlier) and may last several years. Common symptoms include irregular periods, hot flashes, sleep disturbances, mood changes, vaginal dryness, changes in libido, and pelvic discomfort.
Perimenopause can impact both pelvic and sexual health in significant ways. Our team provides supportive, personalized, innovative care to help you navigate this transition with confidence, comfort, and clarity.
A newer sexual health concern, genito-pelvic dysesthesia (GPD) or persistent genital arousal disorder (PGAD) is associated with spontaneous, unwanted, persistent genital sensations.
Symptoms can include pelvic pressure and/or discomfort, engorgement, pulsating, and throbbing that is not relieved with orgasm.
Causes are multi-factorial and individually based on each person’s history.
Treatment options include avoiding stress, relaxation techniques, medication adjustments, nerve blocks, neuromodulation, and pelvic floor physical therapy.
Peyronie’s disease is caused by fibrous scar tissue involving the fascia structure surrounding the penile shaft.
This palpable scar causes a penile deformity in the erect state, including bending, curvature, narrowing, hinging, and shortening of the penis.
Painful erections and loss of sensation often occur which can lead to other sexual health concerns along with inability to penetrate during intercourse.
The exact cause of Peyronie’s is still being investigated however we do have strong evidence that shows trauma or injury to the penis may cause a proliferate fibrous reaction in the fascia sheath leading to the formation of a plaque.
Many other causes are being explored including genetics, inflammatory diseases, and autoimmune disorders.
Diagnosis can be made through a medical history and thorough physical including a pelvic exam. An artificial erection and penile ultrasound may be performed in the office to isolate the plaque location and measure degree of curvature.
Treatment options are based on several factors associated with the timing of the plaque, goal for penile function, and current comorbidities. Therapies include medications, intralesional injections, topical formulations, and surgical interventions.
A very common sexual health concern, premature ejaculation occurs when a man ejaculates sooner than he or his partner would like., typically within one to two minutes upon penetration. It is estimated that at least 1 in 3 men have experienced rapid ejaculation.
Diagnosis of early ejaculation is made mostly through a medical history.
Causes are thought to be mostly psychological, however hormone levels, concomitant erectile dysfunction, and aging are also contributions.
Treatment options include medications (both oral and topical), disease management, behavior homework assignments, setting realistic expectations, pelvic floor physical therapy, and working collaboratively with a sexual health team.
Scrotal pain can be acute or chronic and may stem from a variety of causes, including nerve irritation, muscle tension, past injury, infection, or pelvic floor dysfunction. Sometimes, pain persists even after other conditions have been ruled out, leading to ongoing discomfort that affects daily life, sexual function, and emotional well-being.
Our team takes a comprehensive, whole-person approach to scrotal pain, working to understand the root cause and provide individualized treatment focused on relief, function, and quality of life.
Testicular pain can be sharp, dull, or aching, and may come on suddenly or develop over time. It can result from infections, injury, nerve sensitivity, pelvic floor dysfunction, or referred pain from nearby muscles or organs. In some cases, pain persists even when no clear cause is found, leading to frustration and decreased quality of life.
Our clinic offers compassionate, evidence-based care to evaluate and treat testicular pain with a focus on restoring comfort, function, and sexual well-being.
Testosterone plays a key role in sexual health, mood, energy, and overall well-being. Testosterone deficiency can occur due to aging, hormonal imbalances, medical conditions, or certain medications. Early signs of low testosterone may lead to fatigue, low libido, erectile difficulties, decreased muscle mass, mood changes, reduced sexual desire, low energy, and diminished sense of well-being.
Low testosterone can result from a range of factors. Some of the more common secondary causes include certain medications, chronic inflammatory conditions, higher body fat, HIV/AIDS, and the natural aging process.
Our team provides thorough assessment and individualized treatment options to help restore hormonal balance, enhance sexual health, and improve quality of life for people of all genders.
Treatment includes correcting the underlying condition and/or testosterone supplementation through medications including topical gels, oral, injections, or pellets.
Urinary incontinence, the involuntary leakage of urine, is a common but often under-discussed condition that can affect people of all ages and genders. It may occur with coughing, sneezing, exercise, urgency, or without warning. Common types include stress incontinence, urge incontinence, and mixed incontinence.
Whether symptoms are mild or more disruptive, urinary incontinence can impact daily life, confidence, and intimacy. Our clinic offers compassionate, evidence-based care to help you regain control and improve your pelvic and bladder health.
Vaginal dryness is a common concern that can affect individuals at any age, though it’s especially prevalent during and after menopause, breastfeeding or lactation, after pelvic surgeries or certain medical treatments. It may cause discomfort, irritation, urinary symptoms, or pelvic pain with intimacy, and can impact sexual well-being and quality of life.
Our team provides personalized, affirming care to identify the underlying causes and offer effective evidence-based treatment options, helping you feel more comfortable, confident, and connected in your body.
Vaginismus is vaginal tightness causing discomfort, burning, pain, penetration or insertion difficulties, or complete inability to have vaginal intercourse.
The vaginal tightness results from a limbic system protective mechanism response that signals the body to brace and protect against potential harm.
Vaginismus typically results secondary to a phenomenon called the cycle of pain.
Treatments include a multidisciplinary approach through pelvic floor PT, vaginal dilator training, medications, vaginal inserts, biofeedback, and cognitive/behavioral therapy.
Vestibulodynia is a chronic pain condition affecting the vestibule, the area around the opening of the vagina. It is often described as burning, stinging, or rawness, especially with touch, tampon use, or sexual activity. The pain can be persistent or triggered and may occur without any visible signs.
Though common, vestibulodynia is frequently misunderstood and misdiagnosed. Our team specializes in identifying and treating this condition with a holistic, trauma-informed approach to help relieve pain, restore comfort, and support sexual well-being.
Vulvar disorders can cause chronic discomfort, irritation, or pain in the external genital area and are often misunderstood or misdiagnosed. These conditions can significantly affect quality of life, sexual function, and emotional well-being.
Common vulvar conditions include:
Vulvodynia – Ongoing vulvar pain, often described as burning, stinging, or irritation, without an identifiable cause. It may be provoked (with touch or activity) or unprovoked (spontaneous), and can affect daily comfort and sexual health.
Lichen Sclerosus – A chronic skin condition that leads to thin, white patches on the vulva. It can cause itching, pain, and scarring, and may lead to changes in vulvar appearance if left untreated.
Lichen Planus – An inflammatory condition that can affect the vulva, vagina, and other mucosal areas. It may cause redness, soreness, discharge, or erosive lesions, sometimes making intercourse or even daily hygiene painful.
Lichen Simplex Chronicus – Caused by a cycle of itching and scratching, this condition results in thickened, irritated skin that can be intensely uncomfortable and difficult to manage without proper care.
At our clinic, we specialize in the diagnosis and treatment of complex vulvar conditions. We provide thorough, trauma-informed, and affirming care to help relieve symptoms, promote healing, and support your pelvic and sexual health.
Vulvodynia is an all-encompassing term associated with pain in the vulva and vestibule.
Pain can occur anywhere on the vulva, either localized or generalized.
The most common symptom is a burning sensation although other sensations such as a sharp, knife-like pain, dull ache, or pressure can happen as well.
Causes can include inflammatory or infectious processes, neurogenic, genetic, stress, or hormonally mediated.
A simple cotton swab test can be performed during a pelvic exam to assess the nerve sensitive of the vulvar skin.
Treatment involves simplifying hygiene practices, avoiding irritants, topical corticosteroids, medications, pelvic floor physical therapy, procedures/surgical interventions, and cognitive/behavioral therapy.
