“Viagra has brought women out of the closet on this,” Dr. Whitmore said. “It’s given them a way to talk about it. Suddenly he’s got a sex life again and she’s crying in pain. No one’s talked about the impact Viagra would have on her, which is why it’s important to work with the couple. She needs to understand what she’s going through is normal.” Their practice includes six sex therapists and a psychologist who often wind up seeing both partners.

Originally, Dr. Kellogg and Dr. Whitmore had separate practices and referred patients to each other. They estimate that in 50 percent of cases, there’s an overlap between pelvic-area health problems and sexual dysfunction, which led them to merge their practices 15 years ago.

Dr. Owen Montgomery, chairman of obstetrics and gynecology at Drexel University medical school, said that the treatment model Dr. Kellogg and Dr. Whitmore have created for women  a combination of sophisticated pelvic and urinary care along with sexual medicine and therapy all under one roof  is one of just a few in the country. “They’re on the cutting edge of a new field,” he said. “I used to have a gynecologist partner and if a middle-aged woman asked him about sex, he’d say, ‘I don’t talk about sex.’ Thankfully, that’s changing.”

Patty Maisano, 50, a nurse who’s been married to her second husband for 13 years, first visited the office with pain problems that required a hysterectomy and urinary surgery. But once these issues were addressed, she said, she continued to have pain during sex. Dr. Kellogg and her team offered a variety of medications, injections, lubricants, sprays and exercises over the next few years, which Ms. Maisano said made only “moderate improvements” in her sex life. What finally worked, she said, was a nonhormonal topical product called Zestra, made from botanical oils and meant to heighten sensitivity to touch. “This last month, I feel like I’m back in my 20s,” Ms. Maisano said. “My husband is just thrilled that we can be intimate and both get pleasure out of it. I can see a sigh of relief that I’m not in pain.”

“So many women give up,” she added. “That’s a shame. It’s so important. You marry your best friend, but intimacy is what makes a marriage work.”

Zestra is a favorite of the center’s patients, said Dr. Kellogg, who has worked as a paid consultant for Semprae Laboratories, which makes the product. But she cautions that even if a product helps arousal, that is not the same as desire, and rekindling desire is the most complex challenge in her work.