Podcasts about hsdd

Dr. Deb Muth 0:00 Welcome back to Let’s Talk Wellness Now. I’m your host, Dr. Zab, and we are continuing our discussion this week on 0:08 peptides. And so, if you haven’t heard our first conversation about peptides, 0:13 please go back and look at that episode. We talk all about the manufacturing, the safety, the quality of peptides, and we 0:20 dove into GLP1s. And today we’re going to dive into peptides for sexual 0:26 wellness, immune function, growth hormone, and all the amazing fun things 0:32 we can do with peptides. So, as usual, grab your cup of coffee or tea, settle 0:37 in, and let’s talk wellness now. And we’re going to take a short pause from our sponsor. I know we’ve got to do 0:44 that, you guys. They’re who keep us on the air. So, I’m going to pause for just a minute and be right back after this 0:50 message from our sponsor. Ladies, it’s time to reignite your vitality. Primal 0:56 Queen supplements are clean, powerful formulas made for women like you who want balance, strength, and energy that 1:03 lasts. Get 25% off at primal queen.com. Serenity Health. That’s primalqueen.com. 1:10 Serenity Health. Because every queen deserves to feel in her prime. All 1:15 right, everybody. We are back. And are you ready? We are talking all things peptide and I am opening the show today 1:23 with sexual wellness. Yes, I’m going there, you guys. I am going there. You 1:29 know, this has really become a big issue for people um of all ages. It’s not just 1:3 4us older people. It’s younger people, too. And there’s a whole variety of reasons why we have sexual dysfunction. 1:42 And when we’re talking about sexual dysfunction, we’re not just talking about it doesn’t work, right? Or I can’t 1:48 reach orgasm. A lot of it is around desire and um the thought of it and 1:54 wanting to connect, wanting to be kinder to one another, wanting to be touching 2:00 one another. A lot of it resolves or revolves around that. And so there are some peptides that can help us and I’m 2:08 really excited to be able to talk about those today. So the first one is called PT-141. 2:14 This targets the brain not the periphery. Right? So for many women I 2:20 will always tell you sex starts between here. It is a brain thing for us. It is 2:26 not necessarily a physical thing. For guys that’s a little different. It’s very physical. For women it’s all in our 2:32 brain. So tip for you men that are listening. You have to prime your woman’s brain first if you want her to 2:38 have sex with you that night. You have to be nice to her. You have to bring her flowers. Do the dishes for her. Do 2:45 something kind. Bring her a cup of coffee or tea or a glass of wine. Take her to dinner. You have to woo her. And 2:51 I don’t care how long you’ve been married. That has to happen. And tip number two, don’t say anything stupid 2:57 that day. I’m just being honest. When you guys say things that make us upset, 3:03 that lingers with us for the rest of the day. And it’s it’s a turnoff for us. And 3:08 for a lot of women, we can’t get past that when it comes time to snuggle at night. And sex doesn’t always have to be 3:14 at night either. So, you can tell I really love talking about this conversation, but we’re going to get into the peptide part of it because this 3:21 is going to help people. So, um, PT-141 is marketed as I’m going to slaughter 3:28 this name, Vali, and it represents a fundamentally different approach to 3:34 sexual dysfunction than the PDE5s inhibitors like Slenden, Viagra, 3:40 Tedataphil, which is Seialis. And while the PDE5 inhibitors work specifically by 3:47 enhancing blood flow to the genital tissues, PT-141 works centrally in the brain by 3:54 modulating neural s neural circuits involved in the sexual desire and 4:00 arousal. Now PT-41 is a cyclic hpatipeptide. It’s seven amino acid 4:07 peptide arranged in a cyclic structure that acts as a melanoortin receptor 4:13 agonist and with particularly the infinity for MC3R and MC4R subtypes. 4:20 It’s actually a metabolite of the melanotan 2, a peptide originally 4:26 developed for tanning that was also found to enhance sexual desire in early 4:31 studies. Now the melanoortin system in the brain is involved in multiple functions including energy homeostasis 4:39 but it also is involved in sexual motivation and arousal behaviors. The FDA approved PT-141 in 2019 specifically 4:48 for the treatment of acquired generalized hypoactive sexual desire 4:54 HSDD in permenopausal women. So for the first time we have a medication that was 5:01 approved by the FDA to use for women for sexual dysfunction. We have had all of 5:07 these seialis tedataphil viagros for men but we had nothing for women. And so 5:12 this is amazing that this is available for women and approved by the FDA. It’s a big deal. This represents the first 5:19 and only FDA approved medication specifically targeting these circuits of sexual desire rather than the peripheral 5:27 arousal mechanisms. And this indication is quite specific, meaning it was developed at some point, not lifelong. 5:35 So I if you’ve had sexual dysfunction your entire life, this medication was 5:40 not approved for you. But if it’s something that you developed over time, like when you went through pmenopause or 5:46 menopause or some women have this experience happen after childirth, that’s what we’re talking about here. 5:53 Now, it’s also not just um supposed to be used if you dislike your partner, 5:59 right? If your relationship is bad and you dislike your partner, this probably isn’t going to fix a ton. It might help 6:05 a little bit, but that’s not what it’s meant for. So, you really have to know what you’re using it for and why. And 6:11 the other thing that I would say is this is something that we don’t go to if your hormones are not balanced properly. You 6:17 have to balance your hormones properly before using something like this because it still may not work. Now, the only 6:24 caveat to that is if you’re a woman that has a risk of breast cancer and can’t use hormones, then that’s a different 6:31 story and we would have that conversation about whether or not this medication would be appropriate for you. Now, the FDA label specifies PTA1 uh 6:39 PT-141 as it not being indicated for HSDD in causes where low sexual desire 6:46 is due to coexisting medical or psychiatric conditions, problems with relationships, like we had talked about, 6:53 side effects to medications or other substance use. This specifically reflects the importance of differential 6:59 diagnosis. Low sexual desire can have many root causes and PT-41 is only 7:05 appropriate when those causes have been ruled out. Now, I have I used PT41 in 7:10 people who have sexual dysfunction issues as a result of using 7:16 anti-depressants. Yes, I have. I’ve used Flynn in that effect as well. And it 7:21 does work sometimes, but it doesn’t work completely. But you need to know that that is not what the approval is for the 7:27 FDA. So that is done in something that we call off label use. So very important 7:33 to know. Now in these clinical trials leading to FDA approval, this was published by Kinsburg and colleagues in 7:40 obstetrics and gyne gynecology in 2019. PT-141 demonstrated statistically 7:46 significant improvements in sexual desire and decreases in distress related 7:51 to low desire compared to placebo. The effects manifest over 45 minutes to 7:56 several hours after the injection and the mechanisms involved modulation of dopamine and melanoorton pathways in the 8:04 hypothalamus and the brain regions that involved sexual motivation. Now cardiovascular effects of PT 141 require 8:12 careful attention. This drug causes transient increases in blood pressure about 3 to four points and transient 8:20 decreases in heart rate. And because of this, it is contraindicated in patients 8:25 with uncontrolled hypertension or known cardiovascular disease. And it has been studied in patients who’ve had recent 8:32 cardiovascular events or sorry hasn’t been studied hasn’t been studied in patients who’ve had recent 8:39 cardiovascular events. So patients need to have their blood pressures checked before starting therapy. Nausea is 8:45 extremely common. It is one of the biggest things I often will tell people to take an anti-nausea medicine if 8:52 they’re going to do this because the last thing you want to do is inject this medication and think it’s going to give 8:57 you this great time with your partner and you’re so nauseated that you can’t even perform, don’t want to kiss, don’t 9:05 want to do anything. It it can be pretty profound for some people. um it does affect about 40% of the patients in 9:12 clinical trials which is why many clinicians require or recommend an 9:17 anti-nausea medication like I had just said other common adverse effects include flushing injection site 9:24 reactions headache in about 13% of the population which I have seen worse if 9:30 people are prone to headaches and the headaches are pretty intense so I will also have them premedicate if they have 9:36 that um sensitivity ity with a Tylenol or Advil, Alie, whatever it is they 9:42 typically use for their headaches to help prevent that from occurring. Now, some patients also experience a 9:50 generalized hyperpigmentation of their skin, particularly in areas with chronic friction, and this may not be reversible 9:57 after discontinuation. So from an integrative perspective, PT-41 10:03 represents one tool in addressing female sexual dysfunction, but it should never be the first or only intervention. And 10:11 low sexual desire in women is complex. Multiffactorial involving hormonal imbalances, low testosterone, estrogen 10:18 deficiency, progesterone imbalances, thyroid dysfunction, adrenal dysfunction, and with elevated or 10:24 disregulated cortisol levels, sleep deprivation, relationship issues, unresolved trauma, including sexual 10:31 trauma, chronic pain, body image concerns, and medication side effects such as SSRIs are notorious for this. So 10:39 a comprehensive hormone panel including total and free testosterones, estradile, 10:45 progesterone, DHEA, thyroid function in cortisol assessment, ideally four-point 10:51 cortisol, salivary should precede any pharmacological intervention. And additionally, addressing the 10:57 psychological component and relationship dimensions through appropriate therapy is necessary. I have a lot of patients 11:03 that say, “This is just too much work for sex. I don’t want the side effects. I don’t want to deal with this.” and that’s totally fine. But for some 11:09 people, their sexual dysfunction is actually causing more problems on their 11:14 relationship and they want to do something to fix that. And just know that if you’re using a peptide like this 11:20 that comes with some of these side effects and you have to premedicate for it, it is not the end of the world. Um, 11:27 but it may be a possibility that you may need that. So, let’s dive into body composition and growth hormone access. 11:34 So Tesmarellin is the only FDA approved GH 11:40 analog. Tesarelin is marketed as Agrifta and Agria SV. It is a synthetic analog 11:48 of human growth hormone releasing hormone. So GH RH human growth hormone 11:53 releasing hormone. These things are such long names it’s confusing and it’s difficult to spit out, right? It 11:59 consists of 44 amino acids. The structure is identical to our own 12:05 body’s growth hormone GHR um with the addition of trans3 hexonol group which 12:14 stabilizes the molecule that extends its half-life compared to the native GHR. 12:19 The mechanism of tesmarellin is elegant in its preservation of physiological 12:24 growth hormone GH secretion patterns and rather than administering an exogenous 12:30 growth hormone directly, tesmarillin binds to the GH receptor in the anterior 12:36 pituitary gland stimulating the indogenous pulsatile release of GH. So 12:42 you know it it’s slower in that stimulation and it pulsates instead of a direct rise and fall. This pusile 12:49 pattern more closely mimics natural GH secretion which occurs in bursts 12:54 primarily during sleep. The GH then stimulates the liver to produce insulin-like growth factor IGF-1 which 13:01 exerts many of the downstream metabolic effects including lipolytic effects on 13:07 the atapost tissue. So fat atapose and how we break that down. The FDA approved 13:13 tesmarellin in 2010 for a very specific narrow indication, the reduction of 13:19 excess abdominal fat in HIV infected patients with lipodistrophe. This 13:25 condition characterized by abnormal fat redistribution with accumulation of visceral body fat and the loss of 13:32 subcutaneous fat in face and limbs developed as a complication of an 13:37 antiviral therapy particularly with older protease inhibitor reg uh 13:42 regimens. The visceral fat accumulation in patients is not just cosmetic. It’s associated with increased cardiovascular 13:49 risk, insulin resistance, and inflammatory markers. The pivotal trial that led to the FDA approval included 13:56 work by Stanley and colleagues published in the annuals of internal medicine in 2014. It demonstrated that tesmarillan 14:03 significantly reduced the visceral atapose measured by CT scan by approximately 15 to 20% which is a 14:10 significant difference to placebo over a short period of time only 26 weeks. Now, 14:16 interestingly, the total body uh weight typically remained stable or even 14:21 increased slightly as the reduction of visceral fat was sometimes offset by increases in lean body mass or 14:28 subcutaneous fat. This highlights an important point. Tesmearellin is not a weight loss drug in its conventional 14:34 sense. Its effects are specifically on body composition and fat redistribution. 14:40 Now the glucose metabolism effects of tesmarellin do require careful monitoring because GH and IGF1 can 14:47 induce insulin resistance. Tesmearellin can increase glucose levels and hemoglobin A1C and in these clinical 14:54 trials glucose tolerance and new onset diabetes occurred in some patients. So 14:59 this creates a therapeutic paradox while res reducing visceral fat we should theoretically improve metabolic health. 15:07 The GH mediated insulin resistance can worsen the glycemic control and patients 15:12 with diabetes require particularly close monitoring. The potential need for adjustment in diabetic medications can 15:19 occur. So I already know what you guys are thinking. Can I use Tesmarellin and 15:24 GLP1 at the same time? And the answer is yes. Especially in those people that we 15:30 know have an insulin resistance already or are prone to that, we can use lowd 15:36 dose micro doing GLP-1 along with tesmarellin to help prevent this from 15:42 occurring um or reduce the risk of it occurring. Now there are some other adverse related problems to growth 15:49 hormone access which include fluid retention which can uh manifest as uh 15:55 ankle swelling, joint pain, muscle pain, paristhesas, carpal tunnel syndrome is 16:01 common to see. Of course you can always see injection site reactions reported about 26 to 30% of the time in the trial 16:08 participants. And this also theoretically has a concern about IGF-1 elevation potentially promoting 16:14 malignancy through long-term data is limited. So we have to be cautious about 16:20 this but it is a growth hormone and anything that is a growth hormone can cause cells to grow and it cannot 16:26 necessarily differentiate between healthy cells and bad cells. So the drug is contraindicated is contraindicated in 16:33 patients with active cancer and in patients with the disruption of the HPA access from conditions like pituitary 16:40 tumors, pituitary surgery, head of radiation um and traumatic brain injury. 16:46 Now off label use of tesmarellin for general anti-aging or body composition 16:51 optimization in non-HIV population, it doesn’t have FDA approval. There is no 16:58 FDA studies. um that promote this, but practitioners do prescribe it for these 17:04 purposes under an experimental and not supported by FDA approved indications. 17:10 And um from an integrative medical standpoint, optimizing natural growth 17:15 hormone secretion through lifestyle interventions, high quality sleep is important. GH primarily is excreted 17:22 during sleep and deep sleep waves. So improving your deep sleep is important. Intermittent fasting can also increase 17:28 growth hormone by five-fold as demonstrated in a Hartman and colleagues uh study from the journal of clinical 17:35 endocrinology and metabolism in 1992. And highintensity interval training, adequate dietary protein, blood sugar 17:42 control, these all can help naturally increase your growth hormone. So, let’s 17:47 dive in now and talk about bone health. peptide hormones um such as oh I’m gonna 17:54 I’m gonna really slaughter this name. Terraparatide is a true bonebuilding 18:01 peptide. It’s marketed as forio. It’s a recumbent form of the first 34 amino 18:08 acids out of 85 of the human parathyroid hormone PTH. It represents a unique 18:13 approach to osteoporosis treatment because it’s one of the few truly anabolic anabolic bone therapies meaning 18:21 it actively binds new bone rather than simply preventing bone loss. The biology 18:26 of parathyroid is fascinating and seemly contraindicated or uh contradictory. 18:32 Continuously sustained elevations of PTH as occurs in hyperarathyroidism 18:37 is catabolic to bone. So people who have hyperarothyroidism typically have significant bone loss 18:44 especially before it’s diagnosed and it causes causes increased bone 18:49 reabsorption loss of bone density increased fracture risk and however 18:55 intermittent exposure to PTH as achieved with once daily uh injections of forio 19:01 has the opposite effect. This intermittent exposure preferentially stimulates osteoblasts bone building 19:08 cells over osteoclasts bone reabsorbing cells and it leads to 19:13 the net bone formation. So terraparatide binds to the PTH receptors on 19:20 osteoblasts and renal tubular cells in bone. It increases the number of 19:25 activity of osteoblasts stimulating the differentiation of osteoblast precursor cells and may 19:32 reduce osteoblast apoptosis basically programmed cell death allowing this bone 19:37 building cell to work longer. The result is increased bone formation, improved bone architecture and tbacular 19:45 connectivity and ultimately increased bone mineral density um particularly in the hip and the spine which is so 19:51 difficult to regain. The FDA approved this medication in 2002 based on pivotal 19:57 studies by Near and colleagues published in the New England Journal of Medicine in 2001 which demonstrated significant 20:05 reductions in vertebral and non-vebral fractures in post-menopausal women with 20:11 osteoporosis. specifically uh reduced new vertebral fractures by 20:17 65% and nonvettebral fragility fractures by 53% 20:23 compared to placebo over a median followup of 21 months. This is really 20:29 incredible because we have not seen this kind of um change uh in other 20:35 medications that we’ve used for osteoporosis. So current FDA approval 20:40 indicates uh this for post-menopausal women with osteoporosis at high risk for 20:46 fracture, men with primary or hypoconatal osteoporosis at high risk for fracture 20:53 and men and women with glucocord cord glucocordide 21:00 induced osteoporosis at high risk for fracture. The high risk qualifier is 21:05 important. uh terrapeptide is reserved for patients with severe osteoporosis, 21:11 multiple fractures, very low low bone density and those who have failed or are 21:16 intolerant of other therapies. The most significant concern for this medication 21:21 is highlighted in a boxed warning with rat toxicology studies where it caused 21:27 osteioaroma which is a bone cancer in a dose dependent and treatment duration dependent manner. The revolence of this 21:34 finding to humans is debated. Rats have fundamentally different bone biology than humans with continuous bone growth 21:41 throughout life and different PTH receptors. Now post marketing 21:46 surveillance in humans hasn’t shown a clear increase in osteocaroma risk but 21:51 theoretically concerns persist and because of this terapeptide is 21:57 contraindicated in patients at risk baseline risk for osteioaroma 22:02 including those with pageantss disease of the bone unexplained elevations of alkaline phosphate prior skeletal 22:10 radiations bone metastases or skeletal malignancies and pediatric patients or young adults 22:16 with open hyes. There’s also a lifetime treatment duration of only 2 years and 22:22 terrapeptide can cause transient hypercalcemia. So an elevated blood calcium and as PTH normally increases 22:31 calcium levels by enhancing bone reabsorption, increasing renal calcium 22:36 reabsorption and promoting activation of vitamin D which increases intestinal calcium absorption. Some patients 22:43 experience orthostatic hypotension within 4 hours of injecting requiring 22:48 caution in at risk populations for blood pressure. Common side effects include 22:53 muscle pain, joint pain, pain in the limbs, nausea, headache, and dizziness. So from an integrative bone health 23:00 perspective, terrapeptides should be part of a comprehensive strategy. Adequate calcium intake, 500 to a,000 23:08 milligrams of calcium a day from food and supplements combined. and vitamin D. 23:13 Getting vitamin D levels of at least 50 to 80 are essential for the drug to work 23:20 optimally. But beyond this, bone health requires vitamin K2, which directs calcium into the bones rather than soft 23:27 tissues, magnesium as a co-actor in bone metabolism, trace minerals like boron, 23:33 copper, silica, and of course, adequate protein intake, which many of us, especially as women, don’t do 0.8 8 to 1 23:42 gram of protein per kilogram of body weight, weightbearing exercise. Of 23:47 course, these all provide mechanical signals that complement the biochemical 23:52 symbol uh signals of terrapeptide. Sequential therapy is also critical. The 23:58 bone mass gains from terraparatide can be lost if patients don’t transition to 24:05 an anti-resorbbitive agent a bisphosphinate after completing this therapy and the anabolic effects to 24:12 build bone but maintaining the new bone requires preventing excess reabsorption. 24:18 So positive things about this but there are definitely some concerns as well. So 24:23 the next one we’re going to talk about is Lu Prolrooide. It is marketed under 24:29 the multiple brand names of Lupron, Depo, Eligard, and it’s a synthetic 24:34 nonapeptide analog of naturally occurring ginonadotropen releasing 24:39 hormone G&R, also called luteinizing hormone releasing hormone, LHR. 24:46 It’s a fascinating example of how manipulating natural hormonal feedback systems can create therapeutic effects. 24:53 So, G&RH is normally secreted in a pulsatile fashion by the hypothalamus 24:59 and travels to the anterior pituitary where it binds to G&R receptors and 25:05 stimulates the release of luteinizing hormone LH and follical stimulating hormone FSH. These ginatotropins signal 25:13 the ovaries or the testes to produce sex hormones, estrogen, progesterone in 25:18 women, testosterone in men. Uh, luoprololi lupron as a GNR agonist 25:26 initially mimics the action of natural G&R causing an acute flare response with 25:33 uh increased LHFSH secretion which temporarily increases sex hormone 25:38 production. However, the continuous administration which is in the depo 25:44 formulations, the GNR receptors in the pituitary become desensitized and 25:50 downregulated. And after about 2 to four weeks of continuous exposure, LH and FSH 25:56 secretion is profoundly suppressed, leading to what’s termed as chemical 26:01 castration. Testosterone levels in men drop to castrated levels less than 50 26:08 and estrogen production is marketkedly suppressed in women. This bifphasic 26:13 response creates both therapeutic applications and management challenges in prostate cancer where tumor growth is 26:20 typically androgen dependent and the ultimate goal is testosterone suppression. However, the initial 26:27 testosterone surge during the flare phase can temporarily worsen symptoms potentially causing increased bone pain, 26:34 urinary obstruction, or even spinal cord compression in patients with metastatic 26:40 disease. This is why uh luoprolide is often started with an anti-ad androgen 26:47 like bicladamide for the first two to four weeks to block the effects of the 26:52 testosterone surge. The FDA has approved lupalide for multiple indications across 26:59 formulations. In oncology, it’s used for palletive treatment of advanced prostate cancers. In gynecology, various 27:06 formulations are approved for endometriosis, for pain management and lesion reduction and for fibroids. 27:13 Typically for pre-operative uh hematological improvement in anemic patients. In pediatrics, it’s used for 27:20 central precocious p puberty basically to halt the premature sexual development of these young people. Now, there are 27:28 adex uh adverse effect profile that reflects profound hormonal suppression. 27:34 In men treated for prostate cancer, hot flashes affect about 59% of the patients. Other common effects include 27:41 general pain, swelling, bone pain. Um long-term use of these medications leads 27:47 to metabolic changes. It increases fat mass. It decreases lean mass. It worsens 27:53 insulin sensitivity, disrupts the cholesterol uh lipid panels, increases 27:59 diabetic risk, has some concerns over cardiovascular disease. And the metaanalysis have shown increased risks 28:06 of heart infarction, myocardial inffection, sudden cardiac death, and stroke in populations receiving 28:13 long-term androgen deprivation therapy. The bone effects are particularly dramatic. Without sex hormones, bone 28:20 density decreases significantly, typically 3 to 4% per year during the 28:26 first two to three years of therapy. And this bone loss may not fully be reversible after the the therapy 28:32 discontinues. The American Society of Clinical Oncology recommends bone density monitoring and consideration of 28:39 bisphosphinates uh in men receiving long-term androgen deprivation. In women treated for 28:46 endometriosis or fibroids, the estrogen suppression creates a hypoestrogenetic state similar 28:54 to menopause. Hot flashes affect 90% of patients with other common effects 29:00 including headaches, emotional irritability, decreased sex drive, vaginal dryness, bone density loss. And 29:08 because of these bone concerns and treatment duration with endometriosis, typically limited to six months, though 29:14 some formulations allow for longer use with adback hormonal therapy to 29:20 partially mitigate these side effects. The mood and cognitive effects can be s 29:25 significant. I’ve seen it over the years. the depression, the memory impairment, difficulty focusing and 29:31 concentrating. It can be very very traumatic and the quality of life that 29:37 happens for these uh women and men can be unbearing for many of them. Um, from 29:44 an integrative perspective, patients receiving this medication need comprehensive support care. Bone health 29:51 interventions using calcium, vitamin D, vitamin K2, weightbearing exercise, 29:58 cardiovascular risk management becomes critical, including blood pressure monitoring, lipid management, diabetes 30:05 screening. For hot flashes management, some patients respond to black coohos, 30:10 sage, or vitamin E. Though evidence is mixed and individual response varies, 30:16 omega-3s may help with the mood and the inflammation, resistance training becomes specifically important to 30:22 preserve lean muscle mass in the face of hormonal suppression. 30:27 Now there’s something called calcetonin salamon which is marketed as miaelin. 30:34 It is a nasal spray. It is now discontinued. And foral is the new 30:39 synthetic polyeptide hormone of 32 amino acids identical to calcetonin of salamon 30:47 origin. It represents an interesting case study in how initial promise gives 30:52 way to safety concerns that regulate a therapy to historical footnote status. 30:58 Calcetonin is naturally occurring hormone in humans. It’s secreted by the paraphalicular sea cells in the thyroid 31:04 gland. Its primary physiological role is to lower blood calcium levels by 31:10 directly inhibiting osteoclast activity, reducing bone reabsorption, increasing 31:16 renal calcium secretion or excretion, and possibly reducing the intestinal 31:21 calcium absorption. So, salamon calcetonin is used therapeutically because it’s more potent and longer 31:27 acting than human calcetonin. The FDA initially approved calceton and salmon 31:34 for several indications post-menopausal osteoporosis in women more than five 31:39 years post-menopausal when alternative treatments are not sustainable. Padet’s 31:44 disease for bone and hypercalcemium as emergency treatments. The nasal spray formulation is particularly popular for 31:53 osteoporosis because it offered a non-injectable alternative to bisphosphinates. 31:58 However, in 2012, the European Medicine’s Agency, EMA, conducted a 32:05 comprehensive safety safety review after a poolled analysis of 21 clinical trials 32:10 involving over 10,000 patients showed a statistically significant increase in 32:15 malignancy risk in patients treated with calceton salamon compared to compared to 32:21 placebo. The overall malignancy rate was 4.1% in calcetonin treated patients 32:28 versus 2.9% in placebo patients. The types of cancer 32:34 varied with no single cancer type predominating, making it difficult to establish a clear mechanistic link. 32:41 However, the signal was concerning enough that the EMA restricted the use of calcetonin containing medicines. In 32:48 the United States, the FDA issued communications about malignancy signal and conducted its own review. While they 32:56 didn’t fully withdraw the drug, the cons consensus shifted dramatically. The nasal spray formulations miaelson was 33:03 voluntarily discontinued by the manufacturer and current clinical practice guidelines now consider 33:10 calcetonin salamon as a second line or lower option for osteoporosis. While 33:15 behind bisphosphinates, dennism mob, uh, terrapeptide, the analesic effect of 33:21 calcetonin in bone pain, particularly in acute vitibbral, uh, compression 33:26 fractions from osteoporosis or pageantss disease may still provide a role for short-term use in these selected 33:32 patients. The mechanism of this pain relief is unclear, but may involve 33:38 effects of endorphin systems and/or direct actions on pathways. The history serves as an important reminder in 33:45 peptide medicine. Initial approval and early clinical use does not guarantee 33:50 long-term safety effects. Post marketing surveillance and poolled analysis of the clinical trial data can reveal adverse 33:58 effects that weren’t apparent in initial studies. It also underscores why newer 34:04 agents with better safety profiles um have largely replaced calcetonin in 34:10 clinical practice. So this is really an important thing. Not one thing stays the same forever. We have to change as we 34:18 identify new and better products as we identify problems and concerns. I will 34:24 always tell my patients if you are uncertain of taking a new drug which we 34:30 all should be wait five years. Within five years we are going to find the 34:36 problems that they didn’t find in the clinical studies. Remember, a lot of these clinical studies are small, small 34:43 groups, short periods of time. It’s expensive to do these trials. So, if you 34:49 wait for five years, in the first two to three years, you will see the problem start to emerge. And what are you going 34:55 to look for? You’re going to look for the the news um commercials from lawyers 35:02 suing a drug. And they will tell you what the problem is. and then you can decide, is this something that I want to 35:09 use or not. Don’t jump on bandwagon and be the first one to do this, especially 35:14 if you’re sensitive. You know, give it time so you can see exactly what’s going on. So, I’m going to end our show on 35:22 this and we are going to pick up on part three of peptide therapy in our next 35:28 segment where we’re going to talk about the investigational peptides and some 35:34 exciting things that are happening with that. So, I want to thank you for joining me today on Let’s Talk Wellness 35:39 Now. It’s always a pleasure having a conversation with you guys and I hope this brings value to you with what we’re 35:45 talking about. If you have ideas for topics that you want me to discuss, 35:51 please message us, you can share your comments on Facebook, you can email us, 35:58 um you can get a hold of us however you would like to share that. I do look at the comments below in the episodes as 36:04 well. So you can place your comments there. And once again, one of the best things you can do for me is like, 36:11 subscribe, and share so that we can spread the messages of what we’re doing. 36:16 I do this at no cost. I don’t make any money out of this. I do this as an 36:21 educational purpose for everybody else. I love doing it, but it really helps us 36:28 on the algorithms if you would be just willing to like, subscribe, and share. 36:33 So, thank you for spending your time with me. I know time is important.The post Episode 257 – Peptides for Sexual Wellness & Hormonal Health: PT-141, Growth Hormones, Bone Health & More! first appeared on Let's Talk Wellness Now.

In this final episode of my Menopause Awareness Month mini-series, we're tackling a question I hear almost daily: Does testosterone replacement really help women? The answer is yes — absolutely, when it's prescribed and monitored by a clinician experienced in midlife hormone therapy. Here's what's important to understand: both men and women have testosterone — the difference is in the amount, not the presence. On average, women have about one-tenth the testosterone of men at a similar age. Beyond its well-known role in sexual desire (particularly for women with Hypoactive Sexual Desire Disorder, or HSDD), optimized testosterone supports a wide range of systems that often decline during midlife. Adequate levels can: ✨ Enhance muscle mass and protect bone density ✨ Improve mood, motivation, and cognitive clarity ✨ Support deeper, more restorative sleep If you're wondering whether testosterone might help you, consider these three simple screening questions: ✅ Did your sex drive use to be better? ✅ Do you wish it were better? ✅ Is that change causing you distress or relationship strain? If you answered “yes” to these, it's worth checking your levels. For most women, healthy ranges fall around 50–100 ng/dL — but what truly matters is how you feel, not just the number. This episode explains how we safely restore testosterone to optimal levels and why individualized, physician-guided therapy makes all the difference.

In this episode, Katlyn Moss talks to guest speakers Aimee Feste, CNM and Kiran Sigmon, MD, who will dive into the challenges and treatment options surrounding perimenopause and menopause, offering practical advice for healthcare providers and women navigating these life stages. They also share some information on hormone testing limitations, the role of hormone therapy, non-hormonal treatments, and key resources available for healthcare providers and patients.Resources  The Menopause Society https://menopause.org/ Books/Podcasts:“The Menopause Manifesto” Dr. Jen Gunter “You are not broken” Podcast and book. Dr. Casperson board certified urologist“Hit play not pause” Athlete perspective podcast“Come as you are” Podcast and book as well as new book “Come Together” Emily Nagoski PhD sexual health researcherTestosterone info: Article: ISWISH (International Society for the student of Women's Sexual health) has a great website. https://www.isswsh.org/ They have article: “Clinical Practice Guideline for the Use of Systemic Testosterone for HSDD published” https://www.auanet.org/about-us/media-center/press-center/american-urological-association-releases-new-guideline-on-genitourinary-syndrome-of-menopause#:~:text=This%20Guideline%20includes%3A,%2C%20low%2Ddose%20vaginal%20estrogen.We would love your feedback on our podcast!  Please take our listener survey to provide your comments.Follow us on FacebookFollow us on InstagramMusic credit: "Carefree" Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 4.0 Licensehttp://creativecommons.org/licenses/by/4.0/Please provide feedback here:https://redcap.mahec.net/redcap/surveys/?s=XTM8T3RPNK

A chronic and pervasive absence of sexual fantasies and interest in sexual activity characterises HSDD.Homesite: https://michaelformanwriting.com/

BONUS ORIGINAL CONTENT: The introduction and limitations of the drug Addyi, known as the 'female Viagra,' including its side effects and mixed effectiveness; A listener's concerns about liver fibrosis, providing dietary and supplement recommendations for liver health; The impact of plastic exposure on cardiovascular health, emphasizing the widespread and harmful effects of phthalates found in plastics.

In this episode, Dr. Carolyn Moyers dives into one of the most overlooked yet impactful topics in women's health: low sexual desire. Despite growing recognition of sexual wellbeing as a key part of overall quality of life, sexual concerns are still rarely addressed in clinical settings. Drawing from the ISSWSH Process of Care for Hypoactive Sexual Desire Disorder (HSDD) and a new 2025 study published in Menopause, Dr. Moyers explores the barriers women face in getting support—and what healthcare providers can do to change that.Nearly 50% of postmenopausal women experience GSM symptoms — yet many suffer in silence. From vaginal dryness to recurrent UTIs and painful sex, these symptoms are chronic, progressive, and treatable.In this episode you will learn:Why sexual health conversations are often missing from routine careHow to use the Decreased Sexual Desire Screener (DSDS) to identify HSDDWhat a targeted physical exam can reveal—think clitoral adhesions, vulvodynia, high-tone pelvic floor dysfunction, and moreMedical and psychological conditions that contribute to low desireHow medications may be sabotaging sexual functionEvidence-based treatment strategies that go beyond “just relax and try wine”Why giving women permission to talk about sex is a clinical skill we all need to practiceISSWSH Process of Care for the Management of Hypoactive Sexual Desire Disorder in Women, published in Mayo Clinic Proceedings, April 2016New study in Menopause (May 2025) exploring physician barriers to addressing sexual concerns in clinical care

Today, we're speaking to Dr Stephen Gibbons, Consultant Clinical Biochemist at Leeds Teaching Hospitals NHS Trust, and Dr Clare Spencer, GP Partner and Menopause Specialist at the Meanwood Group Practice in Leeds.Title of paper: Optimising testosterone therapy in patients with hypoactive sexual desire disorderAvailable at: https://doi.org/10.3399/bjgp25X741321TranscriptThis transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions.Speaker A00:00:00.400 - 00:01:08.824Hello and welcome to BJJP interviews and welcome to our new season of the podcast. Hope you all had a great break over Easter and thanks again for listening to this podcast today.My name is Nada Khan and I'm one of the associate editors of the BJTP. In today's episode, we're speaking to Dr. Stephen Gibbons, consultant clinical biochemist at Leeds Teaching Hospital NHS Trust, and Dr.Claire Spencer, a GP partner and menopause specialist at the Meanwood Group Practice in Leeds. We're here to talk about the recent clinical practice paper published here in the bjgp.The paper is titled Optimizing Testosterone Therapy in Patients with Hypoactive Sexual Desire Disorder. So thanks, Stephen and Claire, for joining me here today.It's great to talk to you about this paper, especially because it's in an area of a lot of interest to patients and clinicians in general practice wondering what to do about testosterone prescribing.I guess I wanted to kick things off, Stephen, really, by asking, what made you start investigating testosterone replacement in patients with hypoactive sexual desire disorder?Speaker B00:01:08.952 - 00:03:09.662So it was actually a conversation with a colleague at work over coffee and she mentioned to me that she'd noted quite a lot of high testosterone in females of a particular age and she was asking why that might be. So I explained it's probably because of TRT in this condition called hsdd, but that was kind of quite anecdotal at that point.So we thought we'd do a clinical audit. So myself and two colleagues, Kia and eloise, we audited 100 patients from Leeds.So we looked at a sample of 100 patients on TRT for HSDD and we audited them against the British Menopause Society guidance, which state that you should do a pre testosterone measurement and then you should check at at six to eight weeks, I believe. And what we found is that actually there was quite poor compliance with the BMS guidance. And at this point we felt a little bit out of our depth.But we thought, well, this is quite alarming. Probably the most alarming thing was the number of patients with a really high testosterone that weren't adequately followed up.So we thought, right, let's bring some clinical experts in at this point. So that's when we got in touch with Dr. Spencer and Dr. Jasim and Dr. Wal Ford, who's also on the paper.She's a consultant endocrinologist at Leeds, and we kind of had a look at the data and we all agreed that, you know, there were significant findings. And the question was why?Because there are quite comprehensive guidance out there from the bms, but I think we all felt that potentially they lacked some of the finer detail. Potentially in some areas they were a little vague. So that's when we came up with these additional recommendations.And they're certainly not supposed to replace the BMS guidance, but it's a supplementary kind of recommendations to support the BMS guidance. So that's where we started, really.Speaker...

We need to talk about the glaring inequity in Australian healthcare that's affecting millions of women. After 18 months on menopause hormone therapy, testosterone has transformed my life, restoring my vitality, sharpening my focus, lifting my mood, and reawakening my sexuality. Yet accessing this life-changing treatment reveals a troubling gender bias in our healthcare system.While nine testosterone products for men are subsidised through the PBS, Androfeme - the only female-specific testosterone cream in Australia - remains unsubsidised, costing women over $100 per script. This forces many of us to use male-formulated alternatives that require daily careful self-measurement, an imprecise and frustrating workaround that no woman should have to endure.The numbers are staggering: an estimated 1.34 million Australian midlife women experience Hypoactive Sexual Desire Dysfunction (HSDD), yet face significant barriers to diagnosis and treatment. Despite testosterone therapy being used safely and effectively for women since the 1940s, with Australian-made Androfemme recognised globally as a gold standard treatment, women continue to bear financial burdens that men don't face for essentially identical symptoms.The solution is straightforward: include Androfemme on the PBS, just as other menopause treatments have recently been added.Share this episode with friends, family, healthcare providers, and decision-makers. Together, we can amplify women's voices and demand the equal treatment we deserve. Women's health is not a luxury - it's time our healthcare system reflects that truth.Links:National Women's Health Advisory Council's ReviewWhat is HSDD?Australian Paper on HSDDTestosterone has been treating women since 1940'sTestosterone for women: what you need to knowThank you for listening to my show! Join the conversation on Instagram

Low libido, or hypoactive sexual desire disorder (HSDD), can be a tough challenge for many women, particularly during midlife.In this episode, I take a closer look at the various medical treatments available for low libido, covering everything from prescription medications to hormone therapy and beyond. Whether you're dealing with hormonal shifts, relationship challenges, or simply feeling drained, this episode offers practical advice and solutions to help you regain your sexual vitality and feel more like yourself again.If this episode resonates with you, don't forget to subscribe, share with someone who might benefit, and leave a review! Let's continue the conversation and break the stigma around libido and midlife—together.Timestamps:(00:00:00) - Introduction (00:01:12) - What causes low libido?(00:02:08) - Factors contributing to low libido(00:03:19) - Overview of prescription drugs(00:04:22) - How Addyi works(00:05:33) - Vyleesi overview(00:06:34) - Viagra and Cialis for women(00:07:35) - Testosterone and hormone therapy(00:08:35) - Wellbutrin and libido(00:08:35) - Cannabis and libidoKaren Bigman, a Sexual Health Alliance Certified Sex Educator, Life, and Menopause Coach, tackles the often-taboo subject of sexuality with a straightforward and candid approach. We explore the intricacies of sex during perimenopause, post-menopause, and andropause, offering insights and support for all those experiencing these transformative phases.This podcast is not intended to give medical advice. Karen Bigman is not a medical professional. For any medical questions or issues, please visit your licensed medical provider.Looking for some fresh perspective on sex in midlife? You can find me here:Email: karen@taboototruth.comWebsite: https://www.taboototruth.com/Instagram: https://www.instagram.com/taboototruthYouTube: https://www.youtube.com/@taboototruthpodcastKaren Bigman, a Sexual Health Alliance Certified Sex Educator, Life, and Menopause Coach, tackles the often-taboo subject of sexuality with a straightforward and candid approach. We explore the intricacies of sex during perimenopause, post-menopause, and andropause, offering insights and support for all those experiencing these transformative phases.This podcast is not intended to give medical advice. Karen Bigman is not a medical professional. For any medical questions or issues, please visit your licensed medical provider.Looking for some fresh perspective on sex in midlife? You can find me here:Email: karen@taboototruth.comWebsite: https://www.taboototruth.com/Instagram: https://www.instagram.com/taboototruthYouTube: https://www.youtube.com/@taboototruthpodcastTake control of your pleasure with my Pleasure Playbook, filled with tips to help you connect with your body and enhance intimacy. Download it now at

In today's episode, we continue our series on female hormones, focusing specifically on testosterone. While testosterone is often associated with male traits, it plays a crucial role in women's health as well. Key Points Discussed: Production and Regulation: Testosterone in women is produced by the ovaries and adrenal glands. The ovaries secrete testosterone as part of the overall balance of sex hormones. Functions of Testosterone in Women: Muscle Mass: Helps build muscle mass and strength. Bone Health: Important for preventing osteoporosis. Libido: Significant for sexual desire and arousal. Mood and Energy: Can impact mood and energy levels. Cognitive Health: Emerging research suggests it may play a role in brain health. Testosterone Levels Over Time: Peak in mid to late 20s and gradually decline with age. By menopause, levels are about half of their peak. Symptoms of Low Testosterone: Decreased libido, fatigue, mood changes, muscle weakness, and cognitive difficulties. Testosterone Therapy: Can improve sexual desire and satisfaction in women with hypoactive sexual desire disorder (HSDD). Mixed results on mood and energy improvements. Potential side effects include acne, hair growth, and voice changes. Long-term risks are still being studied, including cardiovascular health and breast cancer risk. Guidelines and Recommendations: North American Menopause Society: Recommends testosterone for women with HSDD. Endocrine Society: Advises against testosterone therapy unless other treatments have failed. I also shared my personal experience with hormone replacement therapy, which has significantly improved my well-being. This conversation is crucial as women's health has often been overlooked in research. It's time we address these issues openly. Thank you for tuning in. Please subscribe, share, and leave comments to help the channel grow. Sending you joy, love, peace, and healing. Have a great day! To work with me: https://www.drmarbas.com/ A Big Thank You To Our Sponsors: If you want to work with the best Whole Foods plant-based body recomposition coach, I highly recommend checking out what www.fitvegancoaching.com offers. I did their program and was able to lose 7% of body fat, build lean muscle, and improve my running time. As a loyal subscriber, you get $250 savings on their coaching services. To learn plant-based cooking and get your medical questions answered, join The Healing Kitchen, taught by Brittany Jaroudi and me! Click here to learn more: https://www.drmarbas.com/the-healing-kitchen

Ever find yourself saying “Honey, I have a headache”' more often than you'd like? You're not alone. In this episode, Dr. Rahman reveals the hidden reasons behind persistent low libido and offers practical solutions to help break the cycle and reignite intimacy.Dr. Rahman dives deep into hypoactive sexual desire disorder (HSDD), the most common form of female sexual dysfunction, affecting up to 40% or more of women. This episode is packed with valuable insights, from the biological intricacies of libido to the innovative treatments available today.Dr. Rahman's thorough exploration of HSDD helps listeners understand the vast influence of factors like brain neurotransmitters, hormonal imbalances, and socioeconomic conditions on women's sexual health. She emphasizes that understanding these elements is key to effective treatment and overall quality of life.Dr. Rahman's episode is a must-listen for anyone dealing with low libido or in search of a better understanding of women's sexual health. This episode is packed with actionable information, making it clear that acknowledging and addressing sexual dysfunction is essential for living a fulfilled life.Highlights:Understanding HSDD: Discover how HSDD impacts women and why addressing it is crucial. From fluctuating libido to distressing low sexual desire, Dr. Rahman explains it all.Biopsychosocial Approach: Learn how Dr. Rahman assesses HSDD through a comprehensive lens, looking at biological, psychological, and social factors.Groundbreaking Treatments: Get familiar with innovative treatments like Flibanserin (Addyi), Bremelanotide (Vyleesi), and the off-label use of testosterone. Dr. Rahman shares her clinical experiences and patient outcomes with these medications.Impact of Mental Health: Understand the significant role of mental health in sexual function. Whether it's anxiety, depression, or the side effects of medications like SSRIs, Dr. Rahman elaborates on how these factors interplay with HSDD.The Role of Self-Care: Dr. Rahman underscores the importance of self-care beyond the physical, emphasizing the need for mental and emotional well-being.Remember, no one can advocate for your health better than you can. Dr. Rahman's mission is to empower you with information so you can make informed decisions about your health.Who else should we feature on Gyno Girl Presents: Sex, Drugs, and Hormones? Tune in, like, share, and leave a 5-star review on Apple Podcasts to help more listeners discover this invaluable resourceGet in Touch with Dr. Rahman:WebsiteInstagramYoutube

About my Guests:  Dr. Peet is a board-certified OB/GYN who specializes in bio identical hormone therapy and sexual health for men and women. He went to UT Austin for undergrad and then Texas A&M for Medical School. He completed his OB/GYN Residency at Scott & White Hospital. His private practices, Woodlands Gynecology & Aesthetics and Woodlands Medical Aesthetics Institute, have been open since 2000. He speaks for several Aesthetic and Laser companies in addition to being on the medical faculty for Evexias Health Solutions, a bioidentical hormone pellet company. His mission is to help his patients look better, feel better, and live better. Dr. Peet: website Summary Dr. Cassie Smith discusses hormones and sexual health with Dr. Johnny Pete, a board-certified OBGYN. They address common questions and misconceptions about hormones, including the link between hormones and cancer. Dr. Pete explains when a woman presents with fatigue, mood issues, and sexual dysfunction the cause is androgen deficiency. He explains the importance of hormones for overall health and well-being, and how optimizing hormone levels can improve quality of life. They discuss the benefits of bioidentical hormones and the use of pellet therapy. The conversation emphasizes the need for individualized treatment and the importance of finding a knowledgeable provider. Dr. Pete and Dr. Smith discuss low libido in women and erectile dysfunction in men. They emphasize the importance of addressing the root causes of these issues, such as hormonal imbalances, inflammation, and poor blood flow. They also highlight the role of testosterone in improving sexual health and the benefits of bioidentical hormone replacement therapy. They explain 90% of women have low libido after their ovaries are removed, and at least 50% have this by age 30-40 years old. Other treatment options mentioned include vaginal lasers, pelvic floor exercises, peptides, and ozone therapy. The conversation concludes with practical tips for improving overall health, such as fasting and spending time in the sun. Time Stamps 00:00 Introduction and Overview 02:23 Dr. Johnny Pete's Background and Journey 05:13 The Importance of Sexual Health and Wellness 07:34 The Basics of Hormone Therapy 09:26 Debunking Myths: Hormones and Cancer 18:07 The Benefits of Bioidentical Hormones 24:21 The Advantages of Pellet Therapy 29:01 Long-Term Use of Hormones 31:53 Finding a Knowledgeable Provider for Hormone Therapy 33:24 Understanding Low Libido in Women 36:46 The Role of Testosterone in Sexual Health 43:53 Causes and Treatment of Erectile Dysfunction 59:26 The Benefits of Ozone Therapy 01:00:23 Practical Tips for Improving Sexual Health Connect with Modern Endocrine: Check out the website Follow Cassie on Instagram Follow Cassie on Facebook Follow Cassie on YouTube Follow Cassie on TikTok Sign up for Modern Endocrine'sSign up for Modern Endocrine's newsletter Disclaimer 

"HSDD" as a diagnosis has been gone for some time. According to the ACOG, the DSM-V defines the combined entity of female sexual interest/arousal disorder as a complete lack of or a substantial decrease in at least three of the following symptoms for at least six months: interest in sexual activity and sexual or erotic thoughts or fantasies. This is the most common sexual dysfunction in women, affecting an estimated 5.4–13.6% of women, based on who you read. It is most prevalent in women between the ages of 40–60 and in women who have undergone surgical menopause. Now, a new publication from the Green Journal (June 18, 2024) provides a potential “new”therapeutic option for women, although the data for this actually first came out June of 2023. Can topical sildenafil help with Female Sexual Arousal Disorder? There is already an over the counter cream like this!Let's take a look at this June 2024 RCT. PLUS, we will also briefly discuss the EROS device for female sexual arousal.

In this Healthed lecture, GP, Dr Ginni Mansberg explains transdermal testosterone treatment which is now available in Australia, the usage recommendations and treatment, and effective management of HSDD in post-menopausal women.See omnystudio.com/listener for privacy information.

Have you ever found yourself not in the mood for sex? What causes this feeling? What do you do when that mood becomes the norm? This week's episode of the Dildo Whisperer takes a look at ways to turn that mood around to help you get back to having a healthy sexual relationship.  Send the us your sex and relationship questions and maybe you will inspire the next episode of The Dildo Whisperer. We have two ways to reach the show. You can call into our show at 844-695-2766 or you can email us at Askthedw@gmail.com. Follow us on social media @dildowhisperer The Dildo Whisperer is produced by DNR Studios. To subscribe to this show and the rest of the DNR Network of shows including the Cookie Jar Podcast visit: www.dnrstudios.com

Download The Peptide Cheat Sheet: https://peptidecheatsheet.carrd.co/

Sometimes you're in the mood to hit the sheets with your partner and other times it's the last thing you want to do. But if you suffer from a condition called hypoactive sexual desire disorder (HSDD), you may experience not wanting to get frisky often. Also known as “Female Viagra”, this little pink pill is the first prescription medication for low sexual desire in women. That's right, ladies, hypoactive sexual disorder (aka not wanting to have sex) is one of the most common sex problems in the world! And if you're a woman who's tired of her low libido, then this non-hormonal therapy may be just the answer you're looking for. In this episode, Dr. Oakley & Holly break down the good, the side effects, and everything in between on the libido-boosting “Pink Pill”, Addyi. A big Shout-Out to our fabulous Sponsor UTIVA!!! Utiva Bladder Health is clinically proven to help reduce overactive bladder and lower urinary tract symptoms. You can help lower your risk of preventing UTIs. Dr. Oakley loves and recommends Utiva to her patients after radiation to the pelvis, from uterine cancer, ovarian cancer, cervical cancer to breast cancer and she takes it daily herself. Check it out: https://www.utivahealth.com/ - Her favorite is the Utiva Cranberry PACs: it's a simple, small, once-a-day pill taken for daily support of the urinary tract to prevent ongoing UTIs. PACs are also the antioxidant of the cranberry and provide other gut health benefits. Just toss it in your purse so you'll always be prepared!! Thank you, ladies, for listening. Always feel free to ask Dr. Oakley any women's health questions at any time. Please send in your comments, questions, and suggestions for future topics at TheLadyBodPod@gmail.com for the chance to have your questions answered on the show! #pinkpill #lowlibido #femaleviagra #femalesexualhealth #urology #takethatcrotchupanotch

Sometimes you're in the mood to hit the sheets with your partner and other times it's the last thing you want to do. But if you suffer from a condition called hypoactive sexual desire disorder (HSDD), you may experience not wanting to get frisky often. Also known as “Female Viagra”, this little pink pill is the first prescription medication for low sexual desire in women. That's right, ladies, hypoactive sexual disorder (aka not wanting to have sex) is one of the most common sex problems in the world! And if you're a woman who's tired of her low libido, then this non-hormonal therapy may be just the answer you're looking for. In this episode, Dr. Oakley & Holly break down the good, the side effects, and everything in between on the libido-boosting “Pink Pill”, Addyi. A big Shout-Out to our fabulous Sponsor UTIVA!!! Utiva Bladder Health is clinically proven to help reduce overactive bladder and lower urinary tract symptoms. You can help lower your risk of preventing UTIs. Dr. Oakley loves and recommends Utiva to her patients after radiation to the pelvis, from uterine cancer, ovarian cancer, cervical cancer to breast cancer and she takes it daily herself. Check it out: https://www.utivahealth.com/ - Her favorite is the Utiva Cranberry PACs: it's a simple, small, once-a-day pill taken for daily support of the urinary tract to prevent ongoing UTIs. PACs are also the antioxidant of the cranberry and provide other gut health benefits. Just toss it in your purse so you'll always be prepared!! Thank you, ladies, for listening. Always feel free to ask Dr. Oakley any women's health questions at any time. Please send in your comments, questions, and suggestions for future topics at TheLadyBodPod@gmail.com for the chance to have your questions answered on the show! #pinkpill #lowlibido #femaleviagra #femalesexualhealth #urology #takethatcrotchupanotch

Jeremie and Bryde chat with Dr. Harper about the number one concern about sex expressed to her by her patients and a surprising behavioural health tool that can be used as a science-backed intervention, and they cover the Rosy app and what is unique about its approach to sexual health. Tune in to hear about HSDD and its significance to our mental and sexual well-being.For more information check out: https://meetrosy.com/ Hosted on Acast. See acast.com/privacy for more information.

Amidst the beauty of parenthood, it's common for women to encounter challenges in their intimate lives. The emotional and physical changes that occur after childbirth can affect a woman's perception of herself and her sexuality.We received the question: “Can women become basically asexual after having one or more children?”In the episode, Dr. Rachel Pope is joined by expert Dr. Sheryl Kingsberg to answer it. Dr. Kingsberg is the chief of behavioral medicine at MacDonald Women's Hospital/University Hospitals Cleveland Medical Center and a Professor in Reproductive Biology, Psychiatry, and Urology at Case Western Reserve University. They discuss desire, sex drive, and the definition of Hypoactive Sexual Desire Disorder (HSDD).Featured in this episode: Shifts in desire throughout a person's life The distinction between Asexuality and HSDD Postpartum depression and Psychotherapy Other causes of low desire (This Is Your Brain On Birth Control by Sarah E. Hill)Take the Decreased Sexual Desire Screener (DSDS) Screener here.If you find that the challenges in your sex life persist or are causing significant distress, consider seeking professional help. Sex therapists and counselors specialized in sex can provide valuable guidance and support tailored to your unique situation.Submit your questions on anything and everything women's health-related and we will answer them in one of our episodes.Want more from Our Womanity?Take the Vulva Quiz to see how well you know women's bodies.Looking for practical advice for women in their 60's who want to become sexually active or want to improve their current sex life? Check out Sex in Your Sixties: Who says the fun has to stop? Written by a multidisciplinary group of health professionals who address issues such as pain with sex, low desire for sex, orgasm difficulties, your bladder and sex, same sex partners, vulvar skin conditions, trauma and more.Subscribe to our newsletter here to stay updated and not miss out on new episodes.

You can also check out this episode on Spotify!Dr. Mary Claire Haver is a board certified OBGYN and women's health advocate who has helped thousands of women going through menopause actualize their health and wellness goals. Dr. Haver's goal is to empower and educate women in their mid-lives, and help women advocate for themselves in the doctor's office. On this episode of Beyond the Prescription, Dr. McBride and Dr. Haver break down the myths and facts about menopause and hormone therapy. They discuss the harms of fear-based narratives in medicine and the importance of balancing risk to help women live longer and healthier lives.So, should you or shouldn't you take hormone replacement therapy? Dr. McBride wrote a longer piece about this decision-making process here. The upshot?* Menopause is defined as having gone a full calendar year without a menstrual period. A woman's midlife decline in estrogen and progesterone levels can cause short-term symptoms (like hot flashes, vaginal dryness, and insomnia) and can increase the risk for long-term health problems (like cardiovascular disease and osteoporosis).* In general, menopausal hormone therapy (MHT) is considered safe for most healthy women when it is initiated within 10 years of menopause.* Estrogen itself does not seem to increase the risk of breast cancer for the vast majority of women.* Unless she has had a hysterectomy, a woman should take estrogen and progesterone together.* Micronized (aka “bioidentical”) progesterone does not increase the risk of breast cancer; synthetic progesterone does seem to increase the risk, but only slightly.* Dr. McBride recommends not panicking about the new Danish study suggesting an increased risk of dementia in women who take MHT. Why? It was an observational study (not a randomized controlled trial or RCT) therefore it cannot prove causation; the study population used oral estrogen and synthetic progesterone which are not the standard of care in the U.S.; myriad RCTs show the opposite finding: that MHT is likely protective against premature cognitive decline, especially when started early. * Too many women needlessly suffer through menopause because of false narratives about the safety of MHT and because discussions about quality of life often aren't prioritized.* Don't take it from her! Dr. McBride encourages you to share the latest expert statement from the North American Menopause Society with your own doctor to help guide your decision-making process.* Women are entitled to make their own decision about hormones, armed with the data, and with an understanding of their unique risks and benefits.Dr. McBride will answer your questions about menopause and HRT on Friday. Submit your question right here!Join Dr. McBride every Monday for a new episode of Beyond the Prescription.You can subscribe on Apple Podcasts, Spotify, or on her Substack at https://lucymcbride.substack.com/podcast. You can sign up for her free weekly newsletter at lucymcbride.substack.com/welcome.Please be sure to like, rate, and review the show!The transcript of the show is here![00:00:00] Dr. McBride: Hello, and welcome to my office. I'm Dr. Lucy McBride, and this is Beyond the Prescription, the show where I talk with my guests like I do my patients, pulling the curtain back on what it means to be healthy, redefining health as more than the absence of disease. As a primary care doctor, I've realized that patients are more than their cholesterol and their weight.[00:00:31] We are the integrated sum of complex parts. Our stories live in our bodies. I'm here to help people tell their story, and for you to imagine and potentially get healthier from the inside out. You can subscribe to my free weekly newsletter at lucymcbride.substack.com and to the show on Apple Podcasts, Spotify, or wherever you get your podcasts.[00:00:57] So let's get into it and go Beyond The Prescription. Today on the podcast, I'm talking with the incredible Dr. Mary Claire Haver. She's a board certified OBGYN who has helped thousands of women who are going through perimenopause, menopause, and beyond actualize their health and wellness goals. She realized after decades of practice that she hadn't learned as much as she should have about the science of menopause, aging and inflammation.[00:01:27] She really took a deep dive into the science and has created an online course called The Galveston Diet with the goal of empowering and educating women in their mid lives. Mary Claire, thank you so much for joining me today on the podcast.[00:01:41] Dr. Haver: Thanks for having me.[00:01:42] Dr. McBride: Let's talk about the fact that women have been notoriously excluded from medical studies. Women have also been deprived in many ways of access to nuanced information about their own bodies and health. And so it's interesting right now that menopause is having this moment, right?[00:02:01] It's like Susan Dominus wrote this beautiful article about how women have been misled, and I think women around the country, around the world were like, “yes. Oh my gosh. Thank you for seeing me and hearing me.” And I think it's a historic moment where women are finally recognizing that they need to be seen and heard, and that their menopausal symptoms are not just in their head and that it's time to get the facts to put ourselves in the driver's seat. So let's just start with that article. So tell me what happened when that article in the New York Times came out, did that change increase the volume of phone calls coming to you? What? What did it mean to you?[00:02:39] Dr. Haver: I think it just validated and reinforced what I was already doing on social media and that really people were sending me the article by the thousands—I was getting tagged. I was getting, “why aren't you in this article?” I didn't even know it was being written, and I just felt like it was really well done and it really was the tip of the iceberg, but it was the first meaningful publication—in such a respected area—that really was drawing attention to the problem. But women have been screaming about this for years, and I'll tell you, so I finished my OBGYN training in 2002, which was also the year the WHI stopped the study on hormone replacement therapy and basically ended any meaningful research into menopause care for at least 20 years. [00:03:36] And when I graduated from that training program, I would've sworn on a stack of Bibles based on my board scores and my level of training that I was a world-class menopause doctor. And it wasn't until 20 years of clinical practice that I realized in going through my own menopause journey that I was not a good menopause doctor, that there were serious gaps in my own education and training.[00:04:03] So when you look at an OBGYN residency, and I know this because I was a former residency program director, and over half of what we do, probably 55 to 60% of what we do is obstetrics. All important stuff. Then everything else gets shoved in the box called gynecology. And in that gynecology box we have pediatric gynecology, we have GYN oncology, we have reproductive endocrinology, which is fertility.[00:04:29] We have everything, and menopause gets a tiny sliver of that time and education. There are only 20% of residents coming out today who feel that they had any clinical menopause training, meaning went to a clinic where they were specifically addressing a woman in menopause. When multiple surveys have been done, the doctors are realizing this is important, but they didn't get the training.[00:04:56] Nothing was really focused on that. Not to say that what we learned wasn't important. It's just menopause has never been prioritized.[00:05:03] Dr. McBride: Why do you think that is?[00:05:05] Dr. Haver: So I think it's a perfect storm of societal norms of medical education, how women have been treated through the years in medicine. I don't know about you, but we had a saying, if it walks like a duck, it talks like a duck… we love a differential diagnosis.[00:05:22] We love a standard set of symptoms, and I think one of the problems is that menopause has a very diverse presentation in each woman. Even identical twins can have completely different symptomatology. We're all going through something very similarly endocrinologically as far as our ovaries beginning to lose their eggs, and the decrease of estrogen and leading to the full menopause with no estradiol. But how that presents in our bodies is very different. So unless you've been trained in the nuances of how to pick this up, then you're going to miss it unless she's just waving a flag with hot flashes and no periods. But the symptoms of menopause begin in perimenopause seven to 10 years before.[00:06:03] So we have this entire generation of women who are suffering and going to their healthcare providers with this kind of laundry list of symptoms. And if the doctor isn't trained to realize that this constellation could all have a common denominator of decreasing estrogen levels, they may get told it's all in their head, or this is a normal part of aging, or there's nothing we can do, white knuckle it, suffer through it, you'll be fine.[00:06:30] And we're just leaving them without… they're walking out feeling dismissed, feeling like maybe they're crazy and that they are going home to cry over, I can't get any help for this. [00:06:42] Dr. McBride: I couldn't agree with you more that medical school and residency, while of course I learned a ton, did not do a fantastic job at countenancing suffering that you can't see, that you can't measure in a blood test or a CAT scan, night sweats, hot flashes, vaginal dryness. Pain with intercourse, relationships, struggles because of sexual dysfunction, decreased arousal—what we call low libido.[00:07:10] Those are things you can't see. Plus, women are used to suffering. We are very comfortable in the space of suffering, right? We deliver babies. We have our nipples cracking and bleeding with these infants hanging off of our chest. And I think it's not hyperbole to say that women are pretty good at suffering.[00:07:34] And so I think it makes sense that gynecologists who only have so much time in the office to talk to patients. And who only had a certain education and that didn't encompass menopause per se. And when we aren't comfortable talking about things we cannot see and we can't measure, we can't quantify despair, that it gets brushed under the rug.[00:07:57] It reminds me a lot of, my interest is in the relationship between mental and physical health. The relevance of mental and physical health, how we all have anxieties, we all have fears, we all have moods, we all have relationships, and we didn't talk about that at all in medical school. My psychiatry rotation was about addressing patients who are in institutions and paranoid schizophrenics, which of course is relevant, but it's not speaking to the universality of mental health as a common sort of ground zero for our whole health. So I think what you and I are doing is trying to shine a light on these universal phenomena—grief, loss, anxiety, moods, relationships. And in the case of women, the fact that every single woman, if you live long enough, will go through menopause as defined by…[00:08:47] Dr. Haver: A hundred percent.[00:08:48] Dr. McBride: The gradual decrease in the production of estrogen and progesterone, and a little testosterone, and we need to talk about it. We need to be open about it. We need to empower women with the questions to ask their doctors.[00:09:03] Dr. Haver: I think the other thing to mention here, and it's really getting brought to the forefront with the political discourse going on right now, is that society in general stops valuing a woman somehow after she's done with the ability to reproduce. And we're seeing it, and I think this is manifesting in how we are not focusing on menopause care, why the research dollars are not going to menopause care.[00:09:30] When you look at women's health spending at the NIH, it's, I think it was several billion, but only 45 million was spent on anything to do with menopause, and that was like 0.3% of the funding in women's health was going to anything to do with menopause when a third of us living, breathing, functioning women are suffering right now due to their menopause journey. We're just not valuing them.[00:09:58] Dr. McBride: And then we have, of course, the headlines that came out in 2002 when the Women's Health Initiative was stopped early, and the headlines screamed things like, I mean… you put the word breast cancer out there in a headline and the fear of breast cancer. What happened in 2002 is that this enormous study, that was the first study on hormone replacement therapy powered by NIH and Bernadette Healy was the first female head of the NIH was stopped early because there was a signal suggesting that hormone replacement therapy causes breast cancer. Now, when you hear that as a woman and women are—we're smart, we're paying attention, we also are not immune to fear-based messaging. And so talk about what happened and how it has taken us so long to correct the narrative on hormone replacement therapy as a treatment for menopausal symptoms.[00:10:52] Dr. Haver: So the fanfare with which that announcement was made was pretty much unprecedented in medicine. There was a press conference called in DC and there were reporters everywhere, and one of the—it was only one person in the study who decided to release this information. This was before the study had actually even been published.[00:11:17] Healthcare providers couldn't even read the article and decide for themselves. So everyone's in their offices, I'm in residency, and we're just doing our normal day-to-day lives. And it was like a shot went off across the world in our world that estrogen causes breast cancer, hormone therapy is going to kill you.[00:11:36] And that was the take home message. And all of us were reeling. We're reading the headlines. No one can get their hands on the study for another week or two. 80% of prescriptions for hormone replacement therapy stopped immediately based on one announcement. And in the 20 years, that 22 years now that have ensued since that publication, so much of that has been walked back on multiple levels.[00:12:04] It's been reanalyzed, looked at, retracted. People have apologized who were in the study, and none of that has gotten any of the fanfare. It's been really hard. The best book that came out was Estrogen Matters, the Avrum Blooming book. He really broke that study apart so a layman could read it and understand, and the fallacies of the study and the things that it really represented.[00:12:28] So the average age in the study was 65 years old. We weren't talking about newly menopausal women in the beginning of their menopause journey and the potential benefits, the estrogen only arm had a 30% decrease risk of developing breast cancer. No one talks about that. And that women who were diagnosed with breast cancer, it was itI believe the risk went from 3.2 to 3.8% if I have the numbers correct, and that represented a 25% increase, but it was still very small. And that the women who were on hormone replacement therapy at the time of their diagnosis had a 20 to 30% higher survival rate, five-year survival rate than the women that weren't.[00:13:09] So women were not allowed to digest that information and decide for themselves what their tolerance to this risk was, and if they still, for the health benefits, for their quality of life, they were absolutely denied. So in desperation, I think practitioners began giving people antidepressants, which can be helpful, but it's never the gold standard and the gold standard for menopausal symptoms is always going to be estrogen. But doctors just were so terrified. The patients were terrified. They didn't want to get sued.I remember being fearful of being sued for giving hormone replacement therapy.[00:13:49] And the mantra, like I was taught, kind of was only give it if she's threatening suicide, like if there's no other option, you know, otherwise do anything other than giving her back the hormones she so desperately needs.[00:14:02] Dr. McBride: Yeah, it's such an example of the paternalism of medicine or maternalism because I think women doctors too were depriving women of these hormones, but it's more this sort of like sense that doctors should be the gatekeepers and we should be the arbiters of the patient's risk tolerance. It reminds me a heck of a whole lot of COVID when instead of giving the public sort of nuanced information about, you know, calibrating your risk mitigation measures to your actual level of risk, given your age and underlying health conditions and number of vaccines.[00:14:39] Instead just telling people, here's what you do. Regardless, we are going to tell you how much risk to tolerate in medicine, as you well know, first of all, patients don't trust doctors who think they know everything. I mean, I don't, and I certainly don't know everything. And I think we owe patients…We owe women the ability to make their own decisions based on the facts and the information they have, and we need to countenance the invisible suffering, just like we countenance the risk of breast cancer. Certainly there are risks of hormone replacement therapy and there are risks of not being on hormone replacement therapy. And let's talk about both and let's try to thread that needle with the understanding that life is risky.[00:15:21] There's risk everywhere you go. You could live your life not on hormone replacement therapy cuz of the fear of breast cancer that may be completely founded because of a family history, a genetic predisposition, but then you're going to have to tolerate perhaps an increased risk for cardiovascular disease, an increased risk for premature cognitive decline, an increased risk for osteoporosis, sexual side effects, etc.[00:15:42] We owe women the discussion, the conversation. But as you know, the conversation takes time. And then it takes more time when you have to undo a fixed narrative that a woman is bringing to the doctor's office saying, “oh wow. I don't want to be on hormones because that causes breast cancer. And that's not because these people are not intelligent, it's because they've been told…”[00:16:05] Dr. Haver: It's going to ake everybody being on board. It's going to take years, but I am so proud to be on… I can't believe this. I'm just a regular OBGYN. There's nothing special about me and, but I…[00:16:19] Dr. McBride: Oh, there's so much special about you. [00:16:20] Dr. Haver: I'm kicking the door down on this I feel like… And it's probably the thing I'm most proud about in medicine, and I've delivered about tens of thousand, over 10,000 babies. I've done thousands of surgeries, all good stuff. But I feel like this is the biggest impact I can make for women's health ever.[00:16:40] Dr. McBride: I think you're making a big difference. I mean, it's amazing to me how menopause is having this moment right now. My friend Sharon Malone, who's a dear friend and colleague, was just on Oprah talking about menopause. I mean, thank you Oprah, for shining a light. My friend Rachel Rubin, our mutual friend, Kelly Caspersen, I mean, we're talking about sex, we're talking about vaginal lubrication, libido.[00:17:01] We're talking about taking control of our health kind of for the first time in a long time. I don't know if you think it's related to COVID and to me COVID laid bare our vulnerability to narratives that aren't always rooted in truth. COVID laid bare the vast marketplace of sort of pseudoscience and weird stuff.[00:17:24] It also laid bare how vulnerable we are as consumers of the healthcare industry. And how we really need to know what questions to ask. And so then I think, that's where I came in. I started writing and podcasting and you started doing your messaging and it's, I think people are really glad to have people they trust without any sort of agenda.[00:17:42] Dr. Haver: Social media for me opened my eyes to how much misinformation as far as menopause care, how much disinformation and misinformation was out there. And then one of the caveats of this menopause explosion and what the New York Times touched on is the gold rush. And so my… I live in the menopause metaverse, I call it, and my social media feed is just filled with everything menopause.[00:18:13] The wackadoodle companies that are coming up with miracle cures and vitamins and promising you're getting your unrealistic expectations of what this one little herb or something can do and get your life back and lose weight and get your sex life back and all this stuff. And none of it is founded in any evidence.[00:18:32] They're marketing to a very vulnerable population. They're desperate and willing to try anything at this point because they can't get it from, most of them can't get it from their healthcare provider, and so a lot of these new companies are popping up and really exploiting this very vulnerable population, and it makes me insane.[00:18:50] Dr. McBride: I know. I feel like wellness is a word that I think MDs and medical professionals should embrace, right? Like, what else am I doing other than helping people be well? But the wellness industry is taking advantage of women's vulnerabilities, insecurities and lack of access to the truth. And then it's fleeing them and giving them false promises. Not always. I mean, there's some good actors.[00:19:16] And I believe in vitamin supplementation if you're deficient in something in addition to getting your nutrients through food. But I think we agree that there's no sort of supplement that's going to kind of fix your broken marriage and your low libido that stems from sexual trauma or… we have to do the work, we have to do the hard job of looking at these parts of our lives that doctors unfortunately haven't really countenanced and we have to understand that the treatment for menopausal symptoms and the way to prevent the downstream cardiovascular, cognitive, and bone related health problems that stem from the absence of hormones is hormone replacement therapy.[00:19:56] Women are entitled to a conversation with their provider about hormone replacement therapy. Whether or not they take it is a different story, but in general, the benefits of hormone replacement therapy outweigh the risks in women who are within that 10 year window from their last menstrual cycle[00:20:11] Dr. Haver:  Right. And when a patient leaves my clinic, now again, I have a background in nutrition. I'm certified in culinary medicine. I can do this with confidence in myself that I know what I'm doing. I give them what I call the menopause toolkit, and so the first thing we address is nutrition. I'm lucky enough that I have a body scanner where I can measure muscle mass.[00:20:34] All of this is all so intertwined, visceral fat, body fat. So I give them very direct nutritional recommendations based on their body composition. We talk about hormones—pharmacology, hormonal pharmacology, and non-hormonal pharmacology based on their symptoms. We talk about supplementation based on what their nutrition profile looks at.[00:20:56] We talk about stress reduction, we talk about sleep quality, and every single one of those things is important to turn that wheel so that you can have the best healthspan and lifespan when a patient comes to my clinic. Yes, she's suffering, but her goal is not to have a bikini. Most of them… they don't care about bikinis anymore.[00:21:14] Sure, that'd be great. But they're more looking at their parents and what themselves and their siblings are going through taking care of parents with chronic disease. When I have a patient who is caring six or 10 years for a debilitated parent or grandparent, it shapes their lives and they are so motivated. What can I do now to keep me from doing this to my children, to my loved ones, to my nieces and nephews. I want to live the most independent, healthiest life that I can. So I'm not gonna burden the people I brought into this world with my disease and illness. Now, there's no guarantees on that. They're like, “how can I stack those cards in my favor?”[00:21:55] And I said, okay, let's get started. Nutrition, exercise, pharmacology, sleep, stress. It all works together to get you where you wanna be.[00:22:04] Dr. McBride: You're absolutely right and it so dovetails with the way I talk to my own patients and the way I write that sleep is arguably the best chemical boost you can give yourself—getting good sleep. Now, it's easier said than done. I mean, just telling someone to sleep more is not the end of the story for most people. But managing stress, having brain space to be mindful about our eating, our relationships, being in touch with how we feel, sort of being in the driver's seat, if you can, of your everyday habits. I think all of that relates to symptoms of menopause. It also relates to just our everyday health.[00:22:44] I think you're right. You look at our parents, our patients in their middle age often look at their parents and they see if their mom has osteoporosis and maybe some cognitive decline. Their dad may have cardiovascular disease or vice versa. And those are not a hundred percent preventable of course, but it's pretty incredible what hormone replacement therapy will and can do if you pair it with appropriate lifestyle modifications and you pair it with someone who's a good coach and a good guide because it's not enough for me to say, eat less red meat, Exercise more, sleep eight hours, manage your stress, take hormones, Good luck. I mean, first of all, I don't do all that stuff well all the time myself. Most humans need a trusted guide. They need structure, they need support, they need follow up, and they need cheerleading, and they need data and evidence and facts to guide their behavioral changes.[00:23:36] How does your program work? Like tell me, if you have a new patient who comes in, you do an assessment, let's say you recommend hormone replacement therapy. How does that look? I mean, do you typically recommend the patch? Do you recommend the ring? Do you recommend oral hormones? Tell me about the menu of options for hormones.[00:23:54] Dr. Haver: So I do stick to the FDA approved options. Estradiol is the number one hormone that I prescribe. So there are synthetic estrogens on the market. There's the conjugated, equine estrogens on the market. There are also different compounded options because compounding is not subject to regulation. It's not subject to testing. It can be very variable. I really want to stick to—I know when I pull it off the shelf, it's what I use for myself. There's a 98% chance of what they say is in that box, is in it, and that my patient's going to get a steady state. I usually go with a transdermal option over oral for estradiol because the first pass effect of the liver, which you and I know, when that estrogen bump hits the liver, it upregulates our clotting factors. So there's about a seven out of 10,000 women increase. So not very much, but still seven women who will have a blood clot. I can negate that and put you back to your baseline.[00:24:55]  Not saying you will never have a clot, but I won't increase that risk with a transdermal option. And because of cost, affordability, and options, I usually do an estradiol patch. If we decide on progesterone as well, There's some wonderful new data that's come out looking at different progesterones, synthetic versus progesterone, which is what our ovaries make… I hate the term bioidentical because it's become a marketing term, not a medical term…[00:25:19] Dr. McBride: Thank you. Oh my gosh. Thank you.[00:25:21] Dr. Haver: Women are getting sold a bill of goods and they're being told lies and they're being told the most ridiculous marketing that, oh, buy BHRT… I'm like, I don't use that term. I talk about estradiol and I talk about progesterone. I do not pick up a phone and call another physician and talk about bioidentical. That is, I would be laughed out of… I think people meant well with it, but it's turned into this crazy marketing term to get you to buy their product. So for progesterone I do the oral micronized progesterone. It has the best safety profile for breast cancer.[00:25:57] Actually, in the latest studies, no increased risk of breast cancer. It was the synthetics. So I tend to avoid those as much as possible. So for myself, I use an estradiol patch and I take my oral progesterone at night. I still have my uterus. For me, I find progesterone sedating, which is a benefit because it helps me with sleep.[00:26:17] Now, if someone is also having severe vaginal atrophy, I look at vaginal preparations. I love a vaginal ring. Nobody can afford it. It is top tier for most insurance plans. It's a wonderful method of delivery. I think it's amazing, but again, cost is a problem. So for vaginal estrogen, I tend to stick with the vaginal estrogen cream, which is generic and is very affordable for most patients if we decide she needs testosterone.[00:26:47] And I pretty much only prescribe that in a case of hypoactive sexual desire disorder. There's not enough evidence yet for me to prescribe it for other reasons I don't. Everyone's testosterone is low, guys, everyone, you don't even need it checked if you're menopausal, half of your testosterone unless you have a tumor.[00:27:06] And so if she's suffering from HSDD, then we discuss different options, the vii, the adi, the testosterone, if she chooses testosterone, because I don't have a great FDA-approved option. And it's very difficult for my patients to get the man's version because they only need 1/10  of the dose and they have to break the packets open and it's just Complicated. I will do the local compounding pharmacy to get some testosterone for them.[00:27:30] Dr. McBride: So helpful. So I wanna ask you a couple questions and just to clarify for listeners, vaginal estrogen, in my humble opinion, I wonder if you agree topical estrogen or just vaginal estrogen in a tablet form that is not systemically absorbed, is just topical to help with vaginal dryness. It also can help with urinary continence. It can help with muscle tone in the pelvic floor if paired with PT or just Kegels. That should be in my opinion, over the counter. That should be non-prescription. It should be something women are…[00:28:01] Dr. Haver: Yes, and I believe it is in the UK now.[00:28:04] Dr. McBride: And even for women who have had breast cancer, it's, and look, talk to your primary care provider, your OBGYN. Don't take my advice on the internet, because I'm not your doctor necessarily, but I think it should be over the counter when you talk about vaginal estrogen, like a femme ring. The femme ring is the vaginal estrogen formulation. That is systemic hormone replacement therapy. The hormone replacement therapy we're talking about is to help with not only the symptoms locally, but also the sort of whole person, the bone density, the cardiovascular risk protection.[00:28:38] So yeah, you're right. The femme ring is extremely expensive, but if someone's insurance happens to cover it, the femme ring, there's a nice way to go with the estrogen, and then you have to do the progesterone. In addition, if you have a uterus, you have to take progesterone with estrogen. Those are the two train tracks, because without progesterone, estrogen alone can stimulate the uterus and cause uterine cancer.[00:29:01] So that's sort of the mantra. Testosterone, as you said, is sort of out of the box a little bit, but it is becoming clear that it's good for hypoactive sexual desire disorder. I do have patients asking me about it because they're like, “What about belly fat, muscle mass? Can I use testosterone for that?” I know you have this wonderful program you're doing on Instagram with the belly fat challenge, and you're doing this on the heels of your Galveston diet. So tell me about testosterone for women a little bit more if you could vis-a-vis metabolism muscle mass.[00:29:31] Dr. Haver: So one of the phenomena that we know about in body composition changes through the menopause transition, we see an acceleration of body fat deposition. So it's kind of steady state and then whoop goes up in perimenopause and we see an increasing of the rate of muscle loss with age. It's called sarcopenia, which is the natural loss of muscle mass with age, and you have to combat that with consistent resistance training and adequate protein intake.[00:29:57] There's no way around it. You are going to lose muscle if you don't do the thing. And that's just your body breaking down. And that muscle is so much more important than I ever learned in school. It is controlling our insulin resistance. It is controlling our strength and functionality. And so I am one of those girls who was genetically low muscle.[00:30:16] I was always lean. But lean to me means muscle. I didn't have very much growing up. I could never do a pull up. I still can't do one. And so there's some thinking, so I'm using testosterone for myself off label, and I'm very clear about that because I'm genetically predisposed to low muscle mass. I measure it every day. I'm about the 90th percentile and I wanna hang on to that. So I'm doing a very low dose of transdermal testosterone in order to help my efforts of protein intake and resistance training to hang on and possibly build some muscle. So my levels are physiologic. I check my levels every three to six months.[00:30:56] I think the last one I was 47. And so in our natural lifespan, When we're our reproductive height, when our libidos were on point, your testosterone level is never above 70, and some of these pellet companies are recommending that you be super physiologically dosed with no evidence to support it.[00:31:18] I have had patients come and say, just check my level. My pellet should have worn off six months ago. They're still out of 300. That is men start at 246. Okay, so I asked the patient, okay, let me just make this clear. Are you transitioning? I fully support that. If this is what you're doing, I'm not the right doctor to help you through this, but, and they're like, no, I'm like, your levels are at a transitioning level. [00:31:41] I don't have clinical evidence to support a super physiologic dose of testosterone for patients. And that's what's being sold to them by a lot of these camp bonding companies.[00:31:53] Dr. McBride: So you're saying the data are not there yet, but there's enough evidence in your mind to use it at a physiologic dose to combat sarcopenia, which is low muscle mass. In addition to using it off label for people with low sexual desire, low libido.[00:32:11] Dr. Haver: Yes. So we have great studies for menopausal women, and testosterone clearly showed a benefit. FDA has not picked up those studies and that work hasn't been done yet. It takes a pharmaceutical company saying, it's worth it for me to do this, and they're not doing it because it's, it's all about economics and there is ot a lot of money in it for them, which is why we don't have an option.[00:32:34] Dr. McBride: Right. Let's talk diet and nutrition and what happens to our bodies around menopause. I've just gone through menopause myself. I'm on hormone replacement therapy. Woohoo. It's fantastic. I mean, my symptoms weren't that dramatic, but I think what happened was when I went on hormone replacement therapy, I just felt like myself.[00:32:54] It wasn't like I could name what it was. I mean, I had some hot flashes, night sweats weren't bad, but I don't know, I just slept better. I felt like myself again. But nutrition, so patients commonly come into me around perimenopause in their late forties, early fifties saying, my belly fat has increased. I've never had belly fat there. And they're just, their body composition has changed and they find it harder to…[00:33:20] It's true that estrogen in the absence of estrogen makes it easier to accumulate weight in our middles typically, and then it increases our risk for insulin resistance or pre-diabetes or diabetes.[00:33:33] So what are you counseling patients? I know it's not a one size fits all prescription, but what are you counseling patients in general about how to combat that metabolic shift and the weight distribution?[00:33:44] Dr. Haver: So there are certain behaviors and patterns of eating that we know through studies that for women in their menopausal journey, are going to lead to less accumulation of visceral or belly fat. When we say visceral fat, I want to be clear. So we have the fat, we've known our whole lives, subcutaneous fat.[00:34:03] It gives us our breasts, our butts, our curves, our cellulite. We don't like it. It's cosmetically distressing, but in, in usual physiologic amounts, it's not dangerous. Okay, visceral fat is different. That's the fat inside of our abdomens and our wrapping around our organs. That at a level, at a certain level starts leading to inflammation.[00:34:21] It produces cytokines, it's linked to cardiovascular disease, stroke, diabetes, et cetera. And we see a rapid accumulation of this fat in the menopause transition due to multiple factors, but leading off with decreasing estrogen levels. So, what can we do about it? So number one, women who have 25 grams or more of fiber in their diet per day have a much lower risk of visceral fat, and there's probably several reasons for this. It slows down the absorption of glucose into our bloodstreams, which lowers our insulin levels. It keeps us full longer. You're less likely to overeat or make different choices. [00:34:55] Number two, having a diet that has less than 25 grams of added sugar in your diet per day—less visceral fat and added sugars are the sugars in cooking and processing. And I'm not talking about keto, so I'm talking about the sugars that are found naturally in fruits, vegetables, dairy, they come in a package with fiber, with other micronutrients, with other things that keep you healthy and slow down their absorption.[00:35:21] It's Very different from drinking a soda, and that's the number one source of added sugar in the United States in women's diets is beverages that sugar is instantly absorbed. It instantly goes into the bloodstream, causes a spike in glucose, and the concomitant rise in insulin levels, which then drives fat to the abdomen.[00:35:37] The whole thing happens so fast before you even realize it drives your blood sugar down. Boom, you're hungry again. And so keeping those added sugars less than 25 grams per day. Not to say you can never sip on a soda or have a cookie, but you have a budget. And if you can keep it less than 25 a day, you're going to have less visceral fat and less ensuing health risks because of it. Third, there are some supplements done, checked on, menopausal women that seem like they were helpful. Number one is eating something rich in probiotics every day. So that could be yogurt, kimchi, miso, tempe, whatever… chinese pickles, there's lots of options, but the study that was done in menopausal women was actually done on supplementation, because that's easier to control and study is give someone a pill versus have them eat a tub of yogurt.[00:36:25] So, when the study was done on obese, menopausal women with hypertension, so the weight loss was the same. They put them both on calorie restricted diets, but added in a probiotic supplement for Group B, and the supplement group had less visceral fat, so they did their visceral fat measurements, and they also had lower blood pressure.[00:36:44] So keeping the gut microbiome healthy, both through fiber, which we talked about earlier and with probiotics, restocking the pond, as I call it, can be really helpful. Turmeric supplementation or eating diets rich in turmeric, not so typical in the US. People are now drinking turmeric teas or adding it to certain things, but turmeric supplementation, especially if you add a black pepper extract, can be really helpful.[00:37:06] Zone two training. It's getting real with Peter's book, Peter Attia's book. It's getting really popular right now. Zone two training is training below the level that you can talk through, so like when you're a little bit breathless and so there's multiple, you can google different ways to calculate what that is.[00:37:22] 220 minus your age, 60 to 70% of that is one thing that patients use. I wear a heart rate monitor usually, and so I know what my maximum heart rates are and I can do the calculation from there, but 150 minutes a week of zone two training is really helpful in that, and resistance training is important as well. [00:37:40] Dr. McBride: Okay, so to summarize these pearls of wisdom we're talking about ideally getting at least 25 grams of fiber a day. Ideally less than 25 grams of added sugar a day. We're talking about supplements based on your unique profile and health issues, and we're talking about resistance training and 150 minutes of exercise a week, building that muscle mass, keeping that motor running. In addition, we talked about sleep stress management. I mean, that's a good kit. I mean, it's a lot to do. You know, when I talk to patients about these kind of lifestyle modifications, they often aspire to these things. They aspire to sleep more or drink less alcohol.[00:38:19] Eat less sugar. One of the challenges is minding the gap between our best intentions and the execution, as I say to patients all the time,even walking around your block for five minutes after work is better than nothing. While you're on the phone, maybe do a couple squats or wall sits.[00:38:38] Notice how you feel if you take a week off of alcohol. I decided to take May off of alcohol, not because I have an alcohol problem per se, but just because I feel better without it. And it really does take at least a week in my mind to kind of notice the effect. One night's not gonna do it. So my advice to patients is just small, incremental bite-sized changes. Don't try to make wholesale changes in every aspect of your everyday health because you just won't do it.[00:39:08] Dr. Haver: Exactly. I say, we have the rest of your life to figure this out. Let's take this one step at a time. Here's the ultimate plan. We're building a house here, so first we have to lay the foundation, then we're gonna put up the studs. Then we're gonna, you know, like we have to take this step-by-step. We don't want you to be overwhelmed. We don't want you to feel like these are new habits. We're building one habit at a time.[00:39:29] Dr. McBride: That's right. That's right. Mary Claire, thank you so much for joining me today. How can people find you on the internet? In your clinic, like how can people find your wisdom and expertise?[00:39:41] Dr. Haver: So we have tons of blogs packed with information on how to advocate for yourself at your doctor's visit and you know what tests to ask for. There's lots of nutrition information at our website at galvestondiet.com. You can also find me on my biggest social media channels on Instagram and TikTok. [00:40:06] Dr. McBride: Thank you all for listening to Beyond the Prescription. Please don't forget to subscribe, like, download and share the show on Apple Podcasts, Spotify, or wherever you catch your podcasts. I'd be thrilled if you liked this episode to rate and review it. And if you have a comment or question, please drop us a line at info@lucymcbride.com.[00:40:28] The views expressed on this show are entirely my own and do not constitute medical advice for individuals that should be obtained from your personal physician. Get full access to Are You Okay? at lucymcbride.substack.com/subscribe

In this episode of Causes or Cures, Dr. Eeks chats with Dr. Comninos about Hypoactive Sexual Desire Disorder (HSDD) and his and his team's research on a potential new treatment called Kisspeptin. He will discuss prevalence, diagnosis, symptoms, how the diagnosis may be misdiagnosed as Erectile Dysfunction Disorder, and current treatment approaches to HSDD. In detail, he'll describe what Kisspeptin is and how it might help. He'll also talk about the clinical trials he has conducted involving both men and women diagnosed with HSDD and how well Kisspetin worked in those clinical trials. Dr. Comninos is a Consultant Endocrinologist at Imperial College London where he also leads the Imperial Endocrine Bone Unit. He has authored over 75 clinical and translational publications in reproductive endocrinology, with a focus on reproductive hormones and their influence on both behavior and bones. You can learn more about him here.You can contact Dr. Eeks at bloomingwellness.com.Follow Dr. Eeks on Instagram here.Or Facebook here.Or Twitter.Subcribe to her newsletter here!Support the show

Dr Edouard Mills, a Researcher and Clinical Lecturer in Endocrinology at Imperial College London, joins the Men's Health Podcast to discuss all things hypoactive sexual desire disorder (HSDD), and delves into the latest research on the promising potential of Kisspeptin as a treatment for HSDD.

Last week we focused on medications that may decrease interest in sex. We also covered PT-141 (bremelanotide), a peptide therapy used to help women and men with low sex drive, and Kisspeptin-10, which helps with increased arousal and sexual attraction.  Since then, we have had a lot of questions from our women podcast listeners about other common causes and symptoms of low sex drive and how it's diagnosed and treated. So today, we thought we could help answer some of those questions. It's important to know that there's a difference between sex drive and arousal. A person's sex drive is the desire or interest in having sex. Sexual arousal is feeling "turned on" or sexually excited. A person can feel sexually aroused but not want sex. Likewise, a person can want sex and not be able to become physically aroused.  What are some symptoms related to low sex drive? People can experience little to no interest in all types of sexual activity (including masturbation and sexual fantasies). Others can have little to no sexual thoughts or difficulty initiating sex or find little to no pleasure in having sex. What are some common causes of low sex drive in women besides medications? We touched on this a bit last week, but low sex drive in women has many potential causes. Medical conditions like depression, hypothyroidism, diabetes, and high blood pressure, may all cause a low sex drive. Even hormonal changes (e.g., during pregnancy, after childbirth, or while breastfeeding) can decrease interest in sex. In fact, this can happen for months after having a baby. During this postpartum period, your body undergoes significant hormonal and physical changes that may lead to a lower sex drive. The good news is that once you've completely recovered from your pregnancy and delivery, your sex drive should recover. And some people with relationship or mental health issues have a low sex drive. This shouldn't be a surprise that your emotional health can affect your sex drive. Clinical studies have shown that low sexual desire is strongly linked to depression and anxiety. Also, many women suffer pelvic floor disorders (e.g., recently having a baby, being in menopause, being overweight, or heavy lifting regularly) that can cause pelvic pain during sex. And pain with sex can cause a bunch of negative emotions related to sex itself, like frustration, fear, and stress.  Speaking of stress, chronic, everyday stress can also cause a low sex drive. We've talked about chronic stress before in the context of weight gain. I think it's important to remember that cortisol is a hormone released into your bloodstream when your body undergoes stress. This hormone causes an increase in your heart rate and blood pressure. However, over time, if your body experiences repeated stress, you may begin to feel tired and depressed. As a result, your body will start using other hormones like estrogen and testosterone to overcome high-stress levels. This leads to a low sex drive. How is low sex drive diagnosed? It's common to experience a low sex drive as we age and in menopause. This is due to decreasing testosterone levels and other physical changes (e.g., vaginal dryness, burning, and irritation) that occur as we age. A decline in sexual desire over time is normal for many people. Still, when a low sex drive continues longer than 6 months and affects a person's quality of life (e.g., causes emotional distress or relationship issues), this can be considered hypoactive sexual desire disorder (HSDD). There's no test to diagnose HSDD; however, having an open, honest discussion with your healthcare provider about your sex drive is a good start. They can determine if your low sex drive is due to psychological issues, medication, or if there's another cause, like an infection or hormonal changes.  If your medication is causing a low sex drive, your healthcare provider may have you stop the medication if it's not needed. Or they may switch you to an alternate medication that doesn't cause a low sex drive. But don't stop your medication without speaking to your healthcare provider first. Your healthcare provider may suggest other medications or peptides like PT-141 or Kisspeptin-10.  Thanks again for listening to The Peptide Podcast. You can find more information at pepties.com. We love having you as part of our community. If you love this podcast, please share it with your friends and family on social media. Have a happy, healthy week! Pro Tips We're huge advocates of using daily collagen peptide supplements in your routine to help with skin, nail, bone, and joint health. But what do you know about peptides for health and wellness? Giving yourself a peptide injection can be scary or confusing. But we've got you covered. Check out 6 tips to make peptide injections easier. And, make sure you have the supplies you'll need.  This may include syringes, needles, alcohol pads, and a sharps container.

Our guest this week is Kate Organ of The Menopause Specialists who is chatting to us about how our sex lives can change as the result of Menopause, whether this is through sex being painful, suffering from GMS (genitourinary menopause syndrome) or you find yourself single and menopausal, Kate discusses why orgasms are good for you but what if we have Hypoactive sexual desire disorder HSDD; ie low libido? Kate gives us the latest information on treatments for GMS, and we ask should you be using localised oestrogen or lubrication, or both? Menopause can have a huge impact on relationships and intimacy yet there is still much taboo and secrecy that surround it. Even the closest of friends may not discuss what is happening, or not happening in the bedroom. Kate tells us how our mental health can have a huge impact on an intimate relationship. It's not all bad either - we discuss how we can have the best sex and relationships at this time of life, finding our confidence and knowing what we want. Kate is the founder and consultant pharmacist at The Menopause Specialists South East Clinic, working alongside GP Katie Burlington. Kate completed her menopause training through the British Menopause Society and the Newson Health Menopause Society and holds numerous post graduate qualifications specialising in mental health care, leading her to be a menopause, PMS and PMDD specialist. She strongly believes in a holistic approach to health and says ‘We want every woman to have a positive experience of the menopause and perimenopause'. You can watch the full interview on our YouTube channel: https://www.youtube.com/channel/UCFgmHLcdx28eco-XlkWYwUA   We find out that Boris Johnson is wanting to bestow a knighthood on his father, Stanley Johnson. And ask should this be allowed after Stanley has been accused of domestic violence? Jinty investigates how Spain are leading the way into research on measuring acceptability of intimate violence against women and it's significance in normalising domestic abuse. Do you feel overwhelmed when you have a full diary of meetings and events planned? Lou asks if this is an after effect of the pandemic or if we want to slow the pace in menopause.   In our Book Collective we read chapter 9 of Rebel Bodies by Sarah Graham, ‘Death means we believe you now. Neurotic mothers in healthcare. We read the emotive stories of Claire Norton and her daughter Merryn, Steph and her daughter Daisy and the force of nature Caron Ryalls the mother of Emily. The real evidence of the gaping gender health gap.   There's a fantastic quote for you this week too and find out how we got on with our WI. It's another episode brimming with chat, your comments, and all the usual shenanigans. So, settle in for this hour(ish) podcast full of meaningful chat.   Our campaign for a Menopause Clinic in Devon is moving closer but we still need signatures on our petition: https://www.change.org/p/wheresmyclinic Or to send your testimonials please email us: menopauseclinicdc@gmail.com And finally, if you would like the templates to send to your MP or CCG please visit our website: https://menopauseclinicfordevon.co.uk   Kate Organ: Website: www.menopausespecialists.com                      Instagram: @the_menopause_specialists --- Send in a voice message: https://podcasters.spotify.com/pod/show/womenkindcollectivepodcast/message

A libido-enhancing therapy did different things to the women and men who watched erotic videos in an fMRI machine, while a promising birth control drug for men ticks all the right boxes (and none of the scary ones).

The perfect male contraceptive would be fast acting, 100% effective, temporary and painless — without affecting performance or libido. A new trial appears to have done that.

Urologist and sexual medicine specialist Dr Rachel Rubin is helping women everywhere understand how their body works, so that they can be the CEO of it. Find how how she's creating orgasm equality and raising awareness for HSDD. Revive the sex drive you once knew and visit HSDDtreatment.com

Shared with love by Jan James, Hope After Breast Cancer Find out more about our private Facebook support groups (Booby Buddies, Hope After Breast Cancer, Sex After Breast Cancer, Booby Buddies en Español) here. Joining our Newsletter List will give you a monthly recap of our best content, as well as information about available training and support. Subscribe to our Hope After Breast Cancer Podcast on your favorite podcast platform! Check out http://sexafterbreastcancer.com/ for quick access to our Sex After Breast Cancer community, experts, and resources. If you value the information I provide, the time I put into serving our community, and would like to support my work, please consider subscribing with a paid membership to TEAM HOPE for just $5 a month at Buy Me A Coffee. And please pray for my efforts to have significance in the lives of the women we serve! Thank you!   SPECIAL OFFER from Dr. Lyndsey Harper Dr. Harper is the founder of Rosy Wellness (“The Sexual Wellness Solutions We All Deserve”), and she provided our community an amazing offer. Download her Rosy App in your app store. Download the Rosy app in your app store to check it out and get a free month of Silver Membership! Code: AFTERBC Good for a FREE 1-Month Silver Membership to the Rosy App  Link: https://bit.ly/3KV61dt   Dr. Lyndsey Harper, OB/GYN, joins us to discuss SOLUTIONS to lack of libido—and gives us HOPE! Libido is a pretty complex topic, and Dr. Lyndsey recognizes that the majority of us were not warned that breast cancer treatment would impact our libido and our intimate lives. Common causes of lack of libido— Change in hormone status could be caused by the addition of a hormone blocker, surgically induced menopause, and more. You might have a change in the way you view yourself sexually. Low sexual desire affects us as women and how we see ourselves. The relationship component could be impacted. Your partner may view you differently from a sexual perspective. Libido can be impacted by a variety of emotional components including stress Quick numbers 39% of ALL women report a lack of libido 20% of ALL women report difficulty with orgasm 85% of women have orgasm through clitoral stimulation, not penetrative intercourse The breast cancer community seems to be impacted at a higher level. Spontaneous desire (being horny) vs. responsive desire (whatever turns you on)—Some women have neither.   Dr. Harper indicates “the best side effect-free solution is erotica.” There is evidence-based research showing erotic can increase desire.   10% of women have no desire, even if they have the best partner, no stress, etc. They may be suffering from HSDD (hypoactive sexual desire disorder).   There are two prescription medications to consider for low libido. Addyi – Take nightly prior to bed. Number one side effect is sleepiness. About have the women who use it have increases in desire. An 8-week trial is usually suggested. Vyleesi – Given by auto injection not more than 2x per week. Decreases inhibition. Works in 60% of women. An 8-week trial is usually suggested. A medication review can be important. Different medications can have negative sexual effects.   “Scream cream” by your provider's prescription is recommended for help with arousal and orgasm. There aren't a lot of randomized control trials for its use.   Use vaginal moisturizing (hyaluronic acid, vaginal estrogen therapy) for discomfort, painful intercourse.   Genitourinary Syndrome of Menopause (GSM) is a progressive condition, so it's prudent to be proactive with vaginal health. It won't get better without your action.   Pelvic floor therapy is HIGHLY recommended for women with breast cancer! This type of therapy helps with issues concerning your bladder, bowel, balance, or painful intercourse. Pelvic floor muscles could be too tight or not strong enough, and only an exam by a pelvic floor therapist can let you know what needs to happen for you to have a happy and healthy pelvic floor.   If you have mismatched libido with your partner— Consider erotica as a prescription. Make a date for intimacy. The lower desire partner should take the lead on initiating intimacy. Use of sex toys will help provide more blood flow to your vulvar region. Remember to download the Rosy app in your app store to check it out and get a free month of Silver Membership! Code: AFTERBC Good for a FREE 1-Month Silver Membership to the Rosy App  Link: https://bit.ly/3KV61dt Disclaimer: While professional experts and the Company address health issues and the information provided on this Website and its components relates to medical and/or health issues, the information provided is not a substitute for medical or health advice from a professional who is aware of the facts and circumstances of your individual situation.

Today, we will discuss low libido or hypoactive sexual desire disorder in premenopausal women. This is the number one cause for sexual dysfunction in women. We will discuss this with Dr. Kim Fuller, sex therapist, and Dr. Sally McPhedran, obstetrician-gynecologist. We will discuss the biopsychosocial evaluation and the evidence-based therapies for this condition.Articles discussed can be found here https://drive.google.com/drive/folders/1OjnaoIBVGxgthaPbL9Ccn9bDeEOR6O_3Contact Information: Dr. Kim Fuller 216-250-1607 Dr. Sally McPhedran 219-778-1257To comment or inquire about today's discussion go to:ohiosexualhealthcollaborative@gmail.com

She started with Slate Pharmaceuticals, which redefined long acting testosterone treatment for men then moved to Sprout Pharmaceuticals which broke through with the first ever FDA-approved drug for low sexual desire in women — dubbed “female Viagra” by the media. After selling the company for $1B in 2015, she successfully fought to get the drug back and launch it on her own terms. Meet Cindy Eckhart! Addyi - Filbanserin - The first FDA approved medication to treat the condition Hypoactive (low) Sexual Desire Disorder (HSDD), characterized as frustrating low libido, is the most common form of sexual dysfunction in premenopausal women. Though not fully understood, HSDD is believed to be caused by an imbalance of chemicals in the brain. Are we limiting women by “protecting them”? How did Addyi come into her life? Data on Addyi and breast cancer is coming out! Prescription versus supplements and what is “natural”? You make it look glam – but is it a slog? She wants to make 1 Billion of wealth for women! “Success comes from courage” – Cindy Eckhart https://addyi.com https://thepinkceiling.com https://www.instagram.com/cindypinkceo/ https://www.youtube.com/watch?v=DyuSZ80-kZI Love these interviews? Want to join them live with me? https://www.kellycaspersonmd.com/membership Our podcast sponsor is Bonafide Bonafide products help women embrace the natural changes that occur throughout all phases of life. Discount code for 20% off:NOTBROKEN Sales link: https://hellobonafide.com/notbroken

“Low Libido”, Candice LangfordAs a pelvic physio working with individuals with painful penetration, the topic of ‘low libido' comes up a lot. So here are a few foundations that I have found to be helpful in exploring ‘what to do' about ‘low libido'. “Low libido” or as you will learn “FSIAD” is a common and juicy topic! We cover a lot; Human S. Response Cycles, Arousal NON-CONCORDANCE, DUEL CONTROL MODEL, Responsive Desire…As well as TOOLS for you to explore!But this is still just the tip of the iceberg, it's an interconnected topic with many factors weighing into your experience of altered desire and arousal!Note; research populations are changing to become more inclusive.  If you hear me saying ‘female' in relation to a study - it is relating to the parameters set in that study. We can assume that the individuals included, identified as ‘female'. In addition to this, most research is based on heterosexual relationships. This too is changing to include different relationship structures & preferences.Contact Candice Langford Website:  https://nurturepelvichealth.com/ Instagram: https://www.instagram.com/nurtureyourvagina/Facebook: https://www.facebook.com/CandiceLangfordPhysioTo recommend interviewee guests and suggest topics, please leave a review for the show along with your suggested topics. You are also welcome to head over to the YouTube channel and leave a comment with your desired topics and guests.  More from Candice IG: @nurtureyourvagina NurturePelvicHealth.com Use the code NURTUREPOD for a 20% discount on any courses.Todays Sponsor: Guided By Glow  Guided by Glow is giving our listeners $20 off the annual membership. Use the promo code NURTURE on guidedbyglow.com  This promo is available only through the website but if you prefer an app you can also access a few free glow sessions through their app!Disclaimer: Material and content discussed on the Nurture Pod are intended for general information only and should not be substituted for medical advice Thank you and as always, stay curious!Candice

On this episode, Dr. Lodhi is joined by her sister, Rafia, as they explore and answer everything you need to know regarding Hypoactive Sexual Desire Disorder. From why and how women get diagnoses with this mental and physical disorder, to how it can be treated, and everything in between, this episode will give you a clear outline of exactly what HSDD is and is not. Disclaimer: Anything discussed on the show should not be taken as official medical advice. If you have any concerns about your health, please speak to your medical provider. If you have any questions about your religion, please ask your friendly neighborhood religious leader. It's the Muslim Sex Podcast because we just happen to be two Muslim women who talk about sex. To learn more about Dr. Sadaf's practice and to become a patient visit DrSadaf.com Follow us on Social Media... Instagram: https://www.instagram.com/drsadafobgyn/ (DrSadafobgyn) TikTok: https://www.tiktok.com/@drsadafobgyn (DrSadafobgyn)

Join host, Dr. Carolyn Moyers, as she has an awesome conversation with Dr. Sameena Rahman, MD who is a board certified OBGYN who practices in downtown Chicago and is known as GynoGirl on all social media platforms. Listen as they discuss what sexual medicine really is. Hypoactive sexual desire disorder (HSDD) is a type of sexual dysfunction in which women lack motivation or lose desire to have sex for an extended period of time (at least 6 months), causing significant levels of personal distress. Symptoms of HSDD include decreased spontaneous sexual thoughts or fantasies, decreased responsiveness to stimulation, inability to maintain interest through sex, and loss of desire to initiate sex. Women with HSDD may also avoid situations that could lead to sexual activity. Did you know there are treatments available? Men have the little blue pill - now women have options. Listen to Sky Women podcast this week to learn about Addyi, Vylessi, and Testosterone use for low desire. Website: http://www.cgcchicago.com/ Instagram: https://www.instagram.com/gynogirl/ . . . Dr. Moyers is a fellow of the International Society for the Study of Women's Sexual Health (ISSWSH). Schedule a consultation at Sky Women's Health today to see what options are right for you. **This is not medical advice, just medical education. Please ask your doctor medical questions as they pertain to your specific situation. Educational purposes only. #menopause #vaginaowners #changethecycle #anatomy #painfulsex #sexmedicine #sexmed #obgyn #reproductivehealth #sexualhealth #gynogirl #libido #lowdesire #skywomenshealth . . . Dr. Carolyn Moyers, DO is a board certified OBGYN and Neuromusculoskeletal Medicine physician, and founder of Sky Women's Health, a boutique practice in Fort Worth, Texas. Welcome to the Sky Women community where we are all stronger together. COME SAY HI!!! Instagram: https://www.instagram.com/skywomenshealth Facebook: https://www.facebook.com/skywomenshealth Email: hello@skywomenshealth.com Sky Women's Health: Https://www.skywomenshealth.com 617 Travis Ave, Fort Worth, TX 76104 To become a patient: email hello@skywomenshealth.com or call 817-915-9803. Listen to the SKY WOMEN PODCAST here: ITUNES: https://podcasts.apple.com/us/podcast/sky-women/id1541657642 SPOTIFY: https://open.spotify.com/show/79VnnWYtGJwlB7NrjBck7o?si=qWXpiBtPSS6OVOt0ki8EiQ --- Send in a voice message: https://anchor.fm/skywomen/message

HSDD (Hypoactive Sexual Desire Disorder) is a sexual dysfunction that can lead to a lowered sex drive. Many people may unknowingly dismiss symptoms of this disorder as a side effect of everyday stressors or aging. So, how do you know if it's time to seek professional help? Dr. Michael Krychman and Dr. Sheryl Kingsberg are here to answer all of your questions about HSDD.

Dr. Sheryl Kingsberg is a Clinical Psychologist and Chief of the Division of Behavioral Medicine, Department of Obstetrics & Gynecology, University Hospitals Cleveland Medical Center. She cites four FSDs, female sexual disorders women could experience during their lifetimes. Dr. Kingsberg says there are gender inequities around the treatment of HSDD, Hypoactive Sexual Desire Disorder. She says that 10 percent of women have a loss of sexual interest and women can be distressed by this. The medical community does not take this treatment as seriously as men's sexual function issues especially if women are post-menopausal. Great podcast as we openly discuss these taboo subjects as they relate to women's health and happiness. LeadingShe.com Instagram.com/LeadingShe Facebook.com/LeadingShe https://www.linkedin.com/company/leadingshe/

For all of the women who have ever wanted to feel sexy again; Dr. Brandye Manigat joins me in talking about cultivating pleasure and desire and reconnecting with one's libido. She shares her insights and discoveries throughout her journey of becoming a Women's Pleasure Coach. Her personal experience around low libido, as well as a lack of public information surrounding the topic, motivated Dr. Manigat to go from being an OB/GYN to a Women's Pleasure Coach, helping women to achieve lasting change in the perception of their bodies and desire. Teaching People About Arousal and Desire Dr. Manigat's teaching around arousal and desire involves having a conversation with the client about what their thoughts and ideas about sex and pleasure are, and where they stem from. These ideas are often learned through family and culture and are influenced by movies. Having a conversation about what an orgasm means to them and the steps they can take to consistently have an orgasm can help women to erase insecurities and achieve pleasure. When to Get Help? Dr. Manigat urges people to seek help when the lack of desire disrupts daily life. Sex drive is inconsistent through various stages of life; having kids, divorce, pre-menopause, menopause, etcetera. Though women can be technically diagnosed with Hypoactive sexual desire disorder (HSDD), not all women meet the criteria. This does not mean that they should not get help. How to get in touch with desire? Dr. Manigat recommends journaling as a way to untangle one's thoughts and emotions. She gives prompts to clients, such as what makes them feel sexy outside the bedroom. These prompts reveal things that could be practiced in everyday life, which helps transition pleasure both in and out of the bedroom. Low Libido at Different Ages Menopause doesn't necessarily cause low libido; however, you could experience low libido for the same reasons as before, such as fatigue and interrupted sleep, which causes depression, which in turn affects the libido. Medication taken during menopause could also lower libido. Young women could overcome low libido by reconnecting with their partner through meaningful conversations about dreams, sexual experiences, new fantasies and attempting to rekindle their intimacy. Approaches to Help Women Struggling With Orgasms Dr. Manigat advises women to educate themselves about their anatomy and multiple pleasure points and how to stimulate them to orgasm. Furthermore, she also emphasizes people being present and mindful during sex, to focus on any of the five senses to keep you in the present. Women who have never had an orgasm can educate themselves about the different ways orgasms manifest and the sensations one would feel. Take Away She leaves us with a valuable affirmation, saying, “You are worthy and deserving of pleasure. You don't have to work to earn it, it's not something you've to strive for.” Biography Dr. Brandye Wilson-Manigat, MD, also known as “Dr. Brandye”, is among the country's well-known physicians. As a board-certified OB/GYN and Women's Pleasure Coach, she brings a unique approach to women's sexual health, achieving a holistic integration of the physical, mental, emotional, and spiritual elements of you. This creates lasting positive change in how you view yourself, your body, and your pleasure. She is called upon by various local and national media outlets to give a fresh perspective and new information on women's health trends. Dr. Brandye is the founder and chief medical advisor for DrBrandyeMD.com, where she has created a safe space to discuss real-world strategies to help women learn the truth about sex and orgasms and embrace their feminine essence, and feel good both inside and outside of the bedroom. Her book, “My O My! A Committed Woman's Guide to Getting the Great Sex She Deserves”, is an Amazon #1 Bestseller and has helped numerous women to live their Best. Sex. Life. Ever! Resources and Links: Website: https://drbrandyemd.com/ Bio hacks pdf- https://biohacksforbettersex.com Sessions: https://drbrandyemd.com/services/ Book: In My O My: A Committed Woman's Guide to Getting the Great Sex She Deserves More info: Sex Health Quiz – https://www.sexhealthquiz.com The Course – https://www.intimacywithease.com The Book – https://www.sexwithoutstress.com Podcast Website – https://www.intimacywithease.com Access the Free webinar: How to want more sex without it feeling like a chore: https://intimacywithease.com/masterclass Better Sex with Jessa Zimmerman https://businessinnovatorsradio.com/better-sex/ Source: https://businessinnovatorsradio.com/185-cultivating-female-desire-dr-brandye-manigatMore info and resources: How Big a Problem is Your Sex Life? Quiz – https://www.sexlifequiz.com The Course – https://www.intimacywithease.com The Book – https://www.sexwithoutstress.com Podcast Website – https://www.intimacywithease.com Access the Free webinar: How to make sex easy and fun for both of you: https://intimacywithease.com/masterclass Secret Podcast for the Higher Desire Partner: https://www.intimacywithease.com/hdppodcast Secret Podcast for the Lower Desire Partner: https://www.intimacywithease.com/ldppodcast

For all of the women who have ever wanted to feel sexy again; Dr. Brandye Manigat joins me in talking about cultivating pleasure and desire and reconnecting with one's libido. She shares her insights and discoveries throughout her journey of becoming a Women's Pleasure Coach.Her personal experience around low libido, as well as a lack of public information surrounding the topic, motivated Dr. Manigat to go from being an OB/GYN to a Women's Pleasure Coach, helping women to achieve lasting change in the perception of their bodies and desire.Teaching People About Arousal and DesireDr. Manigat's teaching around arousal and desire involves having a conversation with the client about what their thoughts and ideas about sex and pleasure are, and where they stem from. These ideas are often learned through family and culture and are influenced by movies. Having a conversation about what an orgasm means to them and the steps they can take to consistently have an orgasm can help women to erase insecurities and achieve pleasure.When to Get Help?Dr. Manigat urges people to seek help when the lack of desire disrupts daily life. Sex drive is inconsistent through various stages of life; having kids, divorce, pre-menopause, menopause, etcetera. Though women can be technically diagnosed with Hypoactive sexual desire disorder (HSDD), not all women meet the criteria. This does not mean that they should not get help.How to get in touch with desire?Dr. Manigat recommends journaling as a way to untangle one's thoughts and emotions. She gives prompts to clients, such as what makes them feel sexy outside the bedroom. These prompts reveal things that could be practiced in everyday life, which helps transition pleasure both in and out of the bedroom.Low Libido at Different AgesMenopause doesn't necessarily cause low libido; however, you could experience low libido for the same reasons as before, such as fatigue and interrupted sleep, which causes depression, which in turn affects the libido. Medication taken during menopause could also lower libido. Young women could overcome low libido by reconnecting with their partner through meaningful conversations about dreams, sexual experiences, new fantasies and attempting to rekindle their intimacy.Approaches to Help Women Struggling With OrgasmsDr. Manigat advises women to educate themselves about their anatomy and multiple pleasure points and how to stimulate them to orgasm. Furthermore, she also emphasizes people being present and mindful during sex, to focus on any of the five senses to keep you in the present. Women who have never had an orgasm can educate themselves about the different ways orgasms manifest and the sensations one would feel.Take AwayShe leaves us with a valuable affirmation, saying, “You are worthy and deserving of pleasure. You don't have to work to earn it, it's not something you've to strive for.”BiographyDr. Brandye Wilson-Manigat, MD, also known as “Dr. Brandye”, is among the country's well-known physicians. As a board-certified OB/GYN and Women's Pleasure Coach, she brings a unique approach to women's sexual health, achieving a holistic integration of the physical, mental, emotional, and spiritual elements of you. This creates lasting positive change in how you view yourself, your body, and your pleasure. She is called upon by various local and national media outlets to give a fresh perspective and new information on women's health trends.Dr. Brandye is the founder and chief medical advisor for DrBrandyeMD.com, where she has created a safe space to discuss real-world strategies to help women learn the truth about sex and orgasms and embrace their feminine essence, and feel good both inside and outside of the bedroom. Her book, “My O My! A Committed Woman's Guide to Getting the Great Sex She Deserves”, is an Amazon #1 Bestseller and has helped numerous women to live their Best. Sex. Life. Ever!Resources and Links:Website: https://drbrandyemd.com/Bio hacks pdf- https://biohacksforbettersex.comSessions: https://drbrandyemd.com/services/Book: In My O My: A Committed Woman's Guide to Getting the Great Sex She DeservesMore info:Sex Health Quiz – https://www.sexhealthquiz.comThe Course – https://www.intimacywithease.comThe Book – https://www.sexwithoutstress.comPodcast Website – https://www.intimacywithease.comAccess the Free webinar: How to want more sex without it feeling like a chore: https://intimacywithease.com/masterclassBetter Sex with Jessa Zimmermanhttps://businessinnovatorsradio.com/better-sex/Source: https://businessinnovatorsradio.com/185-cultivating-female-desire-dr-brandye-manigat

For all of the women who have ever wanted to feel sexy again; Dr. Brandye Manigat joins me in talking about cultivating pleasure and desire and reconnecting with one's libido. She shares her insights and discoveries throughout her journey of becoming a Women's Pleasure Coach.Her personal experience around low libido, as well as a lack of public information surrounding the topic, motivated Dr. Manigat to go from being an OB/GYN to a Women's Pleasure Coach, helping women to achieve lasting change in the perception of their bodies and desire.Teaching People About Arousal and DesireDr. Manigat's teaching around arousal and desire involves having a conversation with the client about what their thoughts and ideas about sex and pleasure are, and where they stem from. These ideas are often learned through family and culture and are influenced by movies. Having a conversation about what an orgasm means to them and the steps they can take to consistently have an orgasm can help women to erase insecurities and achieve pleasure.When to Get Help?Dr. Manigat urges people to seek help when the lack of desire disrupts daily life. Sex drive is inconsistent through various stages of life; having kids, divorce, pre-menopause, menopause, etcetera. Though women can be technically diagnosed with Hypoactive sexual desire disorder (HSDD), not all women meet the criteria. This does not mean that they should not get help.How to get in touch with desire?Dr. Manigat recommends journaling as a way to untangle one's thoughts and emotions. She gives prompts to clients, such as what makes them feel sexy outside the bedroom. These prompts reveal things that could be practiced in everyday life, which helps transition pleasure both in and out of the bedroom.Low Libido at Different AgesMenopause doesn't necessarily cause low libido; however, you could experience low libido for the same reasons as before, such as fatigue and interrupted sleep, which causes depression, which in turn affects the libido. Medication taken during menopause could also lower libido. Young women could overcome low libido by reconnecting with their partner through meaningful conversations about dreams, sexual experiences, new fantasies and attempting to rekindle their intimacy.Approaches to Help Women Struggling With OrgasmsDr. Manigat advises women to educate themselves about their anatomy and multiple pleasure points and how to stimulate them to orgasm. Furthermore, she also emphasizes people being present and mindful during sex, to focus on any of the five senses to keep you in the present. Women who have never had an orgasm can educate themselves about the different ways orgasms manifest and the sensations one would feel.Take AwayShe leaves us with a valuable affirmation, saying, “You are worthy and deserving of pleasure. You don't have to work to earn it, it's not something you've to strive for.”BiographyDr. Brandye Wilson-Manigat, MD, also known as “Dr. Brandye”, is among the country's well-known physicians. As a board-certified OB/GYN and Women's Pleasure Coach, she brings a unique approach to women's sexual health, achieving a holistic integration of the physical, mental, emotional, and spiritual elements of you. This creates lasting positive change in how you view yourself, your body, and your pleasure. She is called upon by various local and national media outlets to give a fresh perspective and new information on women's health trends.Dr. Brandye is the founder and chief medical advisor for DrBrandyeMD.com, where she has created a safe space to discuss real-world strategies to help women learn the truth about sex and orgasms and embrace their feminine essence, and feel good both inside and outside of the bedroom. Her book, “My O My! A Committed Woman's Guide to Getting the Great Sex She Deserves”, is an Amazon #1 Bestseller and has helped numerous women to live their Best. Sex. Life. Ever!Resources and Links:Website: https://drbrandyemd.com/Bio hacks pdf- https://biohacksforbettersex.comSessions: https://drbrandyemd.com/services/Book: In My O My: A Committed Woman's Guide to Getting the Great Sex She DeservesMore info:Sex Health Quiz – https://www.sexhealthquiz.comThe Course – https://www.intimacywithease.comThe Book – https://www.sexwithoutstress.comPodcast Website – https://www.intimacywithease.comAccess the Free webinar: How to want more sex without it feeling like a chore: https://intimacywithease.com/masterclassBetter Sex with Jessa Zimmermanhttps://businessinnovatorsradio.com/better-sex/Source: https://businessinnovatorsradio.com/185-cultivating-female-desire-dr-brandye-manigat

Have you ever wanted to want "ice cream" more? Our friend and entrepreneur, Cindy Eckert, is back to talk more about Hypoactive Sexual Desire Disorder — also known as HSDD. Low sexual desire in women is a medical condition and there is something you can do about it. You can learn more about Cindy and her work at @cindypinkceo on Instagram or by visiting her websites at https://thepinkceiling.com/ and https://addyi.com/.  Get your copy of Everybody Fights here and if you've read it please leave us a review! We hope you get a lot out of this book: http://everybodyfightsbook.com/ Thank you again for your support. It means the world to us.    Join our Facebook family: www.facebook.com/theholdernessfamily Follow the journey on Instagram: @theholdernessfamily Find us on YouTube: www.youtube.com/theholdernessfamily Thank you for being here! Would you consider leaving a review? We also love feedback: holdermesspodcast@gmail.com About the Holderness Family
: Penn, Kim, Lola, and Penn Charles Holderness create original music, parodies, and Vlogs for YouTube and Facebook to poke fun of themselves and celebrate the absurdity in circumstances most families face in their day to day life. They published "Christmas Jammies" in December 2013 and life hasn't been the same. Since then, their popular parodies, "All About That Baste", "Baby Got Class," and original music "Snow Day" have received national news coverage. Penn, the Dad, took a chance and left his job as a news anchor to join his wife Kim, the Mom, at their video production and digital marketing company, Greenroom Communications, LLC. Lola and Penn Charles are always happy, respectful and eat all of their vegetables (that last sentence is a lie).  The Holderness Family Podcast is Edited and Engineered by Max Trujillo of Trujillo Media.

Welcome back to another episode where, this time, we tackle the issue of sexual dysfunction in women. I feel like we're not talking about this enough, whereas male sexual dysfunction is multibillion dollar industry. I'm joined by expert Doctor Anita Clayton as we talk about problems that women might face in their sex life: FOD, GSM, HSDD, FSAD - a lot of acronyms, but they'll all make sense once you listen. Dr. Anita Clayton's clinical practice and research interests focus on women's mental health and sexual dysfunctions. She is the David C. Wilson Professor and Chair of the Department of Psychiatry and Neurobehavioral Sciences, with a secondary appointment as professor of clinical obstetrics and gynecology. She is board certified in psychiatry and neurology. You can find Dr Clayton's book, Satisfaction - Women's Sex and the Quest for Intimacy on Amazon. Check out the DSDS (Decreased Sexual Desire Screener) here Check out our website itsnotacrisis.com and join our Patreon if you want to support this show. Don't forget to follow us on @ItsNotACrisisPodcast on both Instagram and Facebook for more content and even drop us a DM to say hi. And remember: It's NOT a crisis!

Welcome back to another episode where, this time, we tackle the issue of sexual dysfunction in women. I feel like we're not talking about this enough, whereas male sexual dysfunction is multibillion dollar industry. I'm joined by expert Doctor Anita Clayton as we talk about problems that women might face in their sex life: FOD, GSM, HSDD, FSAD - a lot of acronyms, but they'll all make sense once you listen. Dr. Anita Clayton's clinical practice and research interests focus on women's mental health and sexual dysfunctions. She is the David C. Wilson Professor and Chair of the Department of Psychiatry and Neurobehavioral Sciences, with a secondary appointment as professor of clinical obstetrics and gynecology. She is board certified in psychiatry and neurology. You can find Dr Clayton's book, Satisfaction - Women's Sex and the Quest for Intimacy on Amazon. Check out the DSDS (Decreased Sexual Desire Screener) here Check out our website itsnotacrisis.com and join our Patreon if you want to support this show. Don't forget to follow us on @ItsNotACrisisPodcast on both Instagram and Facebook for more content and even drop us a DM to say hi. And remember: It's NOT a crisis!

ヘルスケア商品のオンライン販売を手掛ける「Hims & Hers」がニューヨーク証券取引所に上場した。 「D2C」で最初に展開したのは、男性向けブランド『Hims』、薄毛やED（勃起不全）の薬販売をする。 2018年には、女性向けブランド「Hers」を開始。女性向けの商品ラインナップでは、経口避妊薬や「性的欲求低下障害（HSDD）」といった領域が加わる。 ★Hims & Hers https://www.forhims.com/blog/hims-hers-a-model-for-better-care-through-patient-engagement-and-telemedicine ★Youtube紹介動画 https://www.youtube.com/watch?v=TRodOz9wQCs ★Strainerの記事 https://strainer.jp/notes/2269 ★DIGIDAYの記事 https://digiday.jp/brands/hims-ceo-andrew-dudum-says-the-company-is-going-to-be-worth-20-billion/ #海外　#スタートアップ　#ED #ヘルスケア #ピル #薄毛 #治療薬 #D2C --- Send in a voice message: https://anchor.fm/daijirostartup/message

In this episode, we sit with Dr Javaid who is a female sexual health expert and the founder of HERmd, and we discuss a very common issue that affects over 50% of women in America. Sexual dysfunction is a pervasive condition that many women deal with but do not speak about because of the stigma that surrounds it. Today we discuss all things female sexual interests and arousal dysphoria. 

Hey what's up hello! This week we talk about how asexuality is viewed in both the medical and mental health world. We take a look at the DSM-5 and discuss hypoactive sexual desire disorder.Episode transcript: www.soundsfakepod.com/transcripts/medicalization-of-asexuality Articles/posts mentioned in this episode:- http://www.asexualityarchive.com/asexuality-in-the-dsm-5/ - https://www.asexuality.org/en/topic/206722-re-my-mom-pushed-me-to-bring-up-my-asexuality-at-a-doctor-appointment-late-and-looong-update/?tab=comments#comment-1064090994 - https://www.asexuality.org/en/topic/157750-should-i-tell-my-therapist-that-im-asexual/ Donate to the podcast: patreon.com/soundsfakepod Twitter/Instagram: @soundsfakepod Newsletter: http://eepurl.com/hddwsn Discord: https://discord.gg/W7VBHMt www.soundsfakepod.comSupport the show (https://www.patreon.com/soundsfakepod)

Both men and women have different type of sexual disorders. Men usually suffer to achieve or maintain an erection due to inadequate blood flow to penis. But, on the other hand, women struggle to maintain their sexual libido for sex. Over 10% females of all age groups has hypoactive sexual desire disorder (HSDD). So, usually it is not possible that Viagra 200mg (sildenafil)could help women.

Steve Bergstrom's Campaign WebsiteSteve Bergstrom's Campaign Facebook PageCommunication between HSDD and Mr. BergstromSupport the show (https://www.patreon.com/hollyspringsdeepdive)

It was 2015 when Addyi first came on the market. It took 6 years, nearly fourteen thousand test subjects, and a black box label before it cleared the FDA. It was the first, and until 2019 the ONLY FDA approved drug to treat HSDD in women. Viagra on the other hand was fast tracked in 6 months with just four thousand test subjects. Why? In Episode 9, we talk with Cindy Eckert, founder and CEO of the Pink Ceiling, about her story, from the creation of Addyi, to taking on the FDA, and becoming a voice for the millions of women who suffer from HSDD.

HighlightsListening to women in medicineReformation of the medical professionals view of womenWomen and internalizing self-deservingHow the daughter of immigrants became a OBGYN"Hysteria" and biasThe Orgasm Gap & Women's Sexual Health What is HSDD- and why most women never even heard of itWhy is sexual health so important to women's overall wellness?On combining elective beauty treatments and intimate careEmpowermentA new model for women's healthHelpful LinksThe Patient as CEOFreud on Hysteria HerMDNAMSHERMD Sexual Health Summit About Dr. Javaid@hermdhealth@somijavaidmdDr. Somi Javaid is a board- certified OB/GYN and the founder of HERmd. HERmd centers provide ALL women with comprehensive healthcare and access to experts in the field of sexual medicine, including gynecology, oncology, urogynecology, pelvic floor therapy and counseling. This integrated approach is the first practice of its kind. HERmd was recognized by Candela as a Center of Excellence: awarded for clinical excellence, protocol development, and innovation in patient care. As an expert in women's sexual healthcare, Dr. Javaid has been featured on television and #righttodesire campaign where she describes a woman's right to desire as “an absolute right... an essential right.” She is a key opinion leader for multiple pharmaceutical and device companies and has lent her expertise in discussions for promoting women's health care with the FDA. She is actively involved in research trials to narrow the gender gap in sexual health care. Her goal is to educate, advocate and empower women to reclaim their sexual health. See acast.com/privacy for privacy and opt-out information.

Urologist interview king Dr. John Lin interviews Dr. Casperson! Today's episode is sponsored by KGOAL. Use the code NOTBROKEN for a 20% discount on your purchase! www.kgoal.com Topics discussed today: Orgasmic Inequality Why PIV sex doesn't always work It takes a female longer to reach climax than a man Clitoral anatomy – knowing anatomy helps people realize they are normal. www.OMGyes.com – a great resource for sex education What do sex therapists do? – they are therapists comfortable talking about sex. Solo-sexual – having sex with yourself. Orgasmic inequality – everyone has more orgasms than the heterosexual female Why? Our society doesn't value female orgasms as much. Women want to please their partners – but don't neglect your own pleasure. HSDD – hypoactive sexual desire disorder – now there are FDA approved medications. BUT WARNING! If you think that the solution for desire is in a pill, you are likely to get disappointed. Responsive desire is the majority! You Are Not Broken! Common female sexual problems I see in clinic - Not enough lubrication – desire, arousal mismatch. - A woman takes longer to orgasm than a man does - Perimenopause and low estrogen status of vulvar tissues She Comes First – Ian Kerner https://www.amazon.com/She-Comes-First-Thinking-Pleasuring/dp/0060538260 Sex Toys – FEM TECH! they aren't scary, they are just toys. They will not save your marriage. https://techcrunch.com/2019/01/08/ces-revokes-award-from-female-founded-sex-tech-company/ https://loradicarlo.com/ The Vagina Bible – Dr. Jen Gunter. https://amzn.to/31AU6ve Becoming Clitorate – Dr. Laurie Mintz. https://amzn.to/3fMwUz9 Reclaiming Desire – Dr. Andrew Goldstein https://amzn.to/30M6Ks6 --- Send in a voice message: https://anchor.fm/kj-casperson/message

In this fourteenth episode of Sex Ed with DB, Season 4, DB interviews her gorgeous mom, Dr. Rebecca Levy-Gantt, about Hypoactive Sexual Desire Disorder, or HSDD. Dr. Levy-Gantt is a Board Certified ObGyn and a certified menopause practitioner who has been practicing for the last 10 years in Napa, California. Her special interests are menopause management, including hormones and alternative management strategies, as well as vaginal and vulvar pain syndromes. She owns a solo private practice which has been growing for the past 5 years. Read her incredible book "Womb With a View: Tales from the Delivery, Emergency and Operating Rooms" now! --- Sex Ed with DB, Season 4 Team: Creator, Co-Producer, Sound Engineer, and Host: Danielle Bezalel (DB) Co-Producer and Communications Lead: Cathren Cohen Graphic Illustrator: Andrea Forgacs Social Media Intern: Leslie Lopez Website: Alex Morton  --- Sex Ed with DB, Season 4 is Sponsored by: Clone-A-Willy, Aisle, FemmeFunn, Sweet Vibrations, ioba.toys, and Smile Makers Collection --- Love Sex Ed with DB? Email us at Sexedwithdb@gmail.com for comments and questions about what's coming up this season. --- About the podcast: Sex Ed with DB is a feminist podcast bringing you all the sex ed you never got through unique and entertaining storytelling, centering LGBTQ+ folks and people of color. We discuss topics such as intersex rights, abortion, dominatrixes, sex toys, queer sex ed, sex and disabilities, HIV, sex in entertainment, and more. --- Follow Sex Ed with DB on: Website: www.sexedwithdb.com Twitter: @sexedwithdb Instagram: @sexedwithdbpodcast Facebook: @edwithdb TikTok: @sexedwithdb ---

Today we are learning about the role of testosterone in female desire disorders. A brand new consensus guideline just came out dictating the role of testosterone in post menopausal women with low sexual desire. What a great time to learn more! You will learn: The myth that testosterone is a male hormone. How aromatase affects one's active testosterone, in both men and women. How testosterone plays a role in sexual desire and overall health. How well does testosterone work for HSDD (hypoactive sexual desire disorder). The role of placebo in sexual health studies including the Viagra studies. Side effects of too much testosterone. Who shouldn't take testosterone. Myths of testosterone. Why is there no FDA approved testosterone product for women? --- Send in a voice message: https://anchor.fm/kj-casperson/message

See all the Healthcast at https://www.biobalancehealth.com/healthcast-blog/ This week we are examining the process the FDA calls Fast Tracking of drugs. Fast track is a process designed to facilitate the development and expedite the review of drugs to treat serious conditions and fill an unmet medical need. The purpose of fast tracking is to get important new drugs to the patient earlier.  The FDA acts to check the impact on such factors as survival, day to day functioning, or the likelihood that the condition if left untreated, will progress from less severe to more severe Filling an unmet medical need is defined as providing a therapy where none exists or providing a therapy which may be potentially better than ones that are available. If there are available therapies a fast track drug must show some advantage over existing ones: Superior effectiveness Avoiding serious side effects of existing ones Improving the diagnosis of serious conditions where early diagnosis results in improved outcomes Decreasing clinically significant toxicity of available therapies which often leads to discontinuation of treatment The thought is that by fast tracking, the FDA will have the ability to address emerging public health needs. A record high 43 drugs came through in 2018. This represents 73% of new drugs approved by the FDA in 018. The Wall Street Journal says the FDA generally fast tracks drugs intended to treat conditions that are debilitating or deadly and have few or no other treatments. FDA granted fast tracking to at least 60% of the new drugs approved in each of the last five years. 10 years ago, the FDA only approved 10 new drugs by this method. There are concerns about public safety because there are trade- offs. If they approve a drug and eventually they discover some negative side effects or issues the drugs will already be on the market……..   But the data tends to be positive in favor of fast tracking: 19% of the 42 cancer drugs significantly extended patient lives as well as 26% of the 34 expedited cancer drugs approved from 2011-2014. Still, fast tracking is somewhat controversial because of political issues and questions surrounding how these decisions are made. Viagra was fast tracked because there was a social concern about men needing to have a satisfying sex life.  It was approved within six months. A similar drug for women took six years, seemingly because society does not see the value of being concerned about sexual satisfaction among women.   Generally, society sees that if you are a man struggling to have a satisfying sex life it deserves not only a solution but one you don't have to pay for. Almost all insurance companies cover this cost for men. Women's rights to sexual desire, satisfaction, and birth control are more complicated in our history and are only recently getting serious attention. Now there is a disorder called HSDD. Hypoactive sexual desire disorder. A medical condition causing low libido that affects one in ten women. HSDD has two key hallmarks: decreased sex drive and libido, coupled with feelings of distress because of the decreased sex drive. (not everyone is worried about this when they lose it) Psychological factors are considered when treating HSDD and there are also biological imbalances that cause it and nonsexual diseases like arthritis, there are certain medications that can lower sex drive, fatigue or hormonal shifts during menopause and pregnancy can as well. There has been a societal narrative that reduced everything that went wrong in the bedroom with women to psychology and everything that went wrong in the bedroom with men to biology. We believe that this is changing, but ever so slowly. There are two new drugs for women to treat HSDD:             Ayddi and Vyleesi Vyleesi is an injectable medication meant to be taken within six hours before a person intends to have sex, and works in about 45 minutes lasting about 16 hours. Ayddi is a pill taken once a day but it can take at least two weeks to start working. It was originally developed as an antidepressant, and you cannot drink alcohol while taking it. With vylessi nausea is a common side effect. Low testosterone is an issue with sex drive for women as well. If you don't want to take a prescription drug or can't afford it or your insurance does not cover it, you may want to take a supplement. Herbs like Maca and Shatavari can help boost libido in both pre and postmenopausal women but results vary and there are consistency and standardization issues with herbals. On balance, we feel that it is a good thing that the FDA is working to increase the approval process for new drugs. They are finally starting to use the European model more regularly. Hopefully this will result in better health care for the American people.

Dr. Alyssa Dweck discusses this condition that many women are uncomfortable talking to their healthcare providers about. Hypoactive sexual desire disorder or HSDD is biological and not a result of issues or unhappiness. It can be handled with the proper care and treatment. Learn more at www.Vyleesi.com. PRODUCT IS ONLY APPROVED FOR USE IN THE U.S. Sponsor: Interview courtesy of AMAG Pharmaceuticals.

Dr. Betty Rozendaal of Thornhill Naturopathic explains how to combat depression naturally Dr. Vivien Brown author of

Dr. Betty Rozendaal of Thornhill Naturopathic explains how to combat depression naturally Dr. Vivien Brown author of “A Woman's Guide to Healthy Aging” discusses HSDD Darren Farwell of the Farwell Group explains the role of an executor others of the team share tips and happy stories and more….. Linda Miller, Misty River Introductions Laurie Bell, Moving Seniors with a Smile Daniel Wiskin, Accessibility expert of the Total Access Centre Edmond Ayvazyan , Hearing Instrument Specialist, of Hearing Aid Source Centres

Video; presented by Michael L. Krychman MDCM, MPH, IF

Audio; presented by Michael L. Krychman MDCM, MPH, IF

Female sexual difficulties are more common than you think and impact couples inside and outside the bedroom. When sex isn’t easy how do you even begin this conversation with your partner or, for that matter, your healthcare provider? Sociologist, sexologist and relationship expert Dr. Pepper Schwartz joins our Sex+Health podcast for a three-part discussion on the range of female sexual difficulties and offers practical advice and resources for women (and their partners). You’re not alone! Episode One: How do female sexual difficulties (FSD) affect relationships in and out of the bedroom? Episode Two: Concerned your partner is no longer in the mood? It may be more than you think. Episode Three: Diving deeper into the most common female sexual difficulty (FSD), Hypoactive Sexual Desire Disorder (HSDD), and the other types of FSD that may be affecting your relationship.

Host: Michael Krychman, MD Women who experience low libido often feel embarrassed, lonely, and unsure where to turn or with whom to confide. Left unaddressed, this issue can have devastating effects on relationships. Dr. Michael Krychman sits down with Amanda Parrish, nationally recognized patient advocate for women's sexual health, to talk about hypoactive sexual desire disorder (HSDD) and the need for clinicians to foster open conversations with patients about low libido.

Host: Michael Krychman, MD Women who experience low libido often feel embarrassed, lonely, and unsure where to turn or with whom to confide. Left unaddressed, this issue can have devastating effects on relationships. Dr. Michael Krychman sits down with Amanda Parrish, nationally recognized patient advocate for women's sexual health, to talk about hypoactive sexual desire disorder (HSDD) and the need for clinicians to foster open conversations with patients about low libido.

The first FDA approved female , Flibanserin(aka Adyii), will be available for consumers this October, 2015!  BUT, before you jump on the band wagon there's a few things about the creation of this drug you might want to hear about...  T&A talk with Liz Canner, director of the documentary film 'Orgasm inc.' about the race for the pharmaceutical's holy grail, how the 'need' for this drug even came into being, and big pharma's influence on our sexuality.  Fascinating, informative and uncomfortably eye-opening. Watch Orgasm inc. on Netflix, iTunes and everywhere else: www.orgasminc.org And, check out A's blog, 'Female : A Cautionary Tale'  for a deeper look at Flibanserin's story Show Notes In clinical trials, the subjects kept a daily diary and across the board, they recorded no significant daily increase in sexual desire (03:47) Who started the rumors of sexism and injustice at the FDA?  (05:09) Flibanserin was originally developed as an SSRI to treat depression, but it didn’t work as an anti-depressant  (05:40) What is ‘Conditioned Branding’?  (08:05) What is HSDD and is it real? (08:50) Drug companies have to have a clearly defined disease to start testing.  (09:45) The doctors that came together to define Female Sexual Dysfunction had ties to 22 drug companies. (10:28) Relevant Links & FULL Show Notes HERE: http://www.tatalksex.com/need-female--think-twice-before-you-pop-that-magic-pill/

Host: Michael Krychman, MD Guest: Sheryl A. Kingsberg, PhD Flibanserin's approval by the FDA for women with hypoactive sexual desire disorder (HSDD), touted by the press as the "Pink Viagra," created an enormous amount of media hype across the nation. But the facts on this drug's mechanism of action, intended benefits, adverse effects, and efficacy borne in clinical trials have gone largely under the radar. Joining Dr. Michael Krychman to discuss the rise of flibanserin and its key takeaways for clinicians is Dr. Sheryl Kingsberg, Chief of the Division of Behavioral Medicine in the Department of OB/GYN and Professor in the Departments of Reproductive Biology and Psychiatry at Case Medical Center University Hospitals in Cleveland, Ohio.

Host: Michael Krychman, MD Guest: Sheryl A. Kingsberg, PhD Flibanserin's approval by the FDA for women with hypoactive sexual desire disorder (HSDD), touted by the press as the "Pink Viagra," created an enormous amount of media hype across the nation. But the facts on this drug's mechanism of action, intended benefits, adverse effects, and efficacy borne in clinical trials have gone largely under the radar. Joining Dr. Michael Krychman to discuss the rise of flibanserin and its key takeaways for clinicians is Dr. Sheryl Kingsberg, Chief of the Division of Behavioral Medicine in the Department of OB/GYN and Professor in the Departments of Reproductive Biology and Psychiatry at Case Medical Center University Hospitals in Cleveland, Ohio.

Host: Prathima Setty, MD Guest: Sheryl A. Kingsberg, PhD Hypoactive sexual desire disorder (HSDD) is the most prevalent sexual disorder for women of all ages, but it is also one of the most difficult to address. Clinicians need to understand the implications and address the concerns of their patients. Host Dr. Prathima Setty discusses this topic with Sheryl A. Kingsberg, PhD, Chief, Division of Behavioral Medicine, Department of Obstetrics/Gynecology, University Hospitals Case Medical Center, and Professor, Departments of Reproductive Biology and Psychiatry, Case Western Reserve University, Cleveland, OH. About NAMS The interview was conducted live at The North American Menopause Society (NAMS) 2014 meeting. Founded in 1989, NAMS is North America's leading nonprofit organization dedicated to promoting the health and quality of life of all women during midlife and beyond through an understanding of menopause and healthy aging. Its multidisciplinary membership of 2,000 leaders in the field-including clinical and basic science experts from medicine, nursing, sociology, psychology, nutrition, anthropology, epidemiology, pharmacy, and education-makes NAMS uniquely qualified to serve as the definitive resource for health professionals and the public for accurate, unbiased information about menopause and healthy aging. To learn more about NAMS, visit www.menopause.org.