Female Sexual Wellness Explained: Menopause, HRT & Libido

You know, when your hormones are low, sex at some point could be a chore. But our goal is to not make it a chore to give you that arousal back and actually change it from being a chore to being magic and getting that intimacy back. Not, like I said before, a luxury, but to give you that vital sign back to bring you back where you used to be.

So I'm Dr. Charles Mokin. This is Danielle Stabley. She's the medical director at Allure Medical. And I want to talk to her about. We see a lot of women who are menopause or perimenopausal, and we're mostly focusing like reducing breast cancer risk, cardiovascular risk, improving energy, less fatigue. But part of it is sex and having good sex and enjoyable sex. And when a woman goes on hormone replacement therapy, estrogen, testosterone, and progesterone, her interest for sex gets aroused. More intimacy interest and more. Better ability to have an orgasm. But talk about other things we can do for women that that's working, but it's just not getting where they want to go or even recreationally they might want to have, you know, more better.

Yeah, more better. So sexual health is something that is so important. And I think women deserve to know that there are other things out there that can help them improve their intimacy. And it's not so much that sexual sex drive and, you know, better ability to have orgasms and sensitivity is a luxury. It's more a vital sign. Right. This is something that women want to have to have youthfulness, to feel alive again and to kind of bring back where they used to be in their sex life. So some of the things that we address for women in the office is, of course, when they're already on hormone replacement, they're going to get a little bit improve lubrication, vaginal lubrication. They're going to have a little bit more arousal and sex drive. But to help improve sensitivity and orgasms, we offer something called the O shot. And what that is is just using your own blood platelets. So we'd actually draw your blood, spin down the blood platelets, centrifuge them, and we can inject them into the clitoral area, which increases sensitivity and the ability to orgasm in a deeper way. And this is something women come back probably every six months or so and say that they want to repeat it because they're having just improved sex life at home. Another thing we do is something called the G spot shot. And that's actually there's a bundle of nerves intravaginally. Everyone's probably heard of the G spot, but intravaginally, this bundle of nerves, what we do is inject it with filler, hyaluronic acid, and it increases that target so it's easier to find, easier to hit. And women, again, get a deeper arousal, a deeper orgasm, deeper sensitivity, and just overall better sex life. Those are two things that I would say are most common that we do in the office to improve sexuality.

And for the G spot shot, is that about every six to nine months, too?

About the same, yes. So probably six to nine months. Some of our women, they just come once a year, but the ones that are a little bit more active, I would say every twice a year, six to nine months.

Let's talk about some other things, like screen cream. Apply locally. Yeah.

This is something that we probably should talk about more often, is these other options that we have. But yes, women want to increase sensitivity. The screen cream, we can prescribe to a pharmacy and you put it on about a half hour prior to. And we like to call it kind of does the foreplay for you. So it gives you more interest in having sex at that time.

Yeah, we can kind of think of it as a topical Viagra for women, even though it doesn't really have Viagra in it. That brings up the idea of, can you use Viagra Cialis for women? And the answer is you can. And a common way to use it for women is in a little tablet that goes under your tongue with oxytocin. So oxytocin and Viagra together increases not just the blood flow to your genitalia, makes you more sensitive, but it makes women have deeper orgasms when they have the oxytocin. Again, all these things are not 100%. You try them and see which one works best for you. We have two additional procedures we do for women's. Basically, their urogenital healthlets. And one of them is we have a restora chair, which is. There's another one called. There's a few different devices that are similar. There's one called msella. We have a restora one. This is a chair women sit on twice a week for three weeks. It was really designed to improve urinary stress incontinence, which it does very well, but it also causes more tightness, less feeling of things falling out during sex. And tell me about your experience with that.

Yeah, so Lady Lazy has been great. Most women came to us, of course, talking about incontinence, like you said, and it was more of a surprise to them that they had better Orgasms and better sex and more tightening and improved functionality. And even their partners, you know, would notice the difference. A little bit of vaginal tightening, just a little bit better friction, like you had said. Procedure is very simple. Typically, I'll recommend two procedures, two treatments. They'll come, they'll notice improvement after the one. But most women will say after two is when the partner really noticed the difference and the incontinence improved the most after about two treatments. They're good for about a year. And then maybe do some maintenance. You know, we have some natural laxity that occurs every year. So I feel like every woman who's had babies or potentially over the age of 40 should get a Lady Lays at least once a year after they've gone through that first two treatments.

Well, here we are, we're doing all this stuff to help women maintain their facial appearance.

Right.

And your other stuff ages too.

Right.

And this is the mucosa. It's a type of skin and it does get, not really wrinkles, but it gets lax and the tissues get thinner. And the lady lace thickens that up and tightens it up, restores collagen and elastin, which makes the thickness of the skin and the tissue and the elasticity.

Right. I mean, women say all the time, I can't jog as much or run as much as I used to because of incontinence. I can't jump on a trampoline, I can't play volleyball. I can't do things like I used to to do when you're jumping up and down and you have incontinence. So a lot of women don't know that there's non surgical options out there. And Lady Lays is non surgical. And it's two treatments. You do them about three to six weeks apart and marked improvement with incontinence. But then to our surprise, improve sexuality, improve function, lubrication, collagen stimulation, tightening.

So we went from like having better ability, have a vaginal or clitoral orgasm, more sensation, better lubrication, more friction, more, maybe more libido and energy, which some of these things do as well. And then we have more just vaginal dryness that's not responsive to hormone placement therapy. And I like using estriol, which is a very weak skin estrogen. It's a dominant one in pregnancy. It gives women the glow. Estradiol is your classic estrogen that helps your bones and your organs and protects your heart. Estridol really doesn't, but it's a skin estrogen and improved mucosa so if somebody has vaginal and dryness, they can apply intravaginally or in their vulva. Estriol. And I know there was a fear about estrogen in the past because there was mislabeled black box warning saying estrogen potentially causes breast cancer and hardly even know. That's all bullshit. Now, FDA admitted they made a mistake and withdrew it. But this is an estrogen that is not a systemic estrogen. It's a skin estrogen. And I don't think we use that enough either.

I agree. Another thing you can do is the platelets intravaginally as well for dryness. The testosterone and estrogen pellet does a great job with lubrication. And most women say that they have better sex just with doing the pellets. But the ones that have refractory dryness, we can offer the ladylase for collagen stimulation, lubrication. But then also I'll talk to them about doing the prp, the platelet rich plasma or platelet rich fibrin where we draw the blood. Same thing, spin it down. I'll inject it all along the intermucosa of the vaginal wall. And that works pretty immediately.

So let's talk about where that came from. So this is about 10 years ago. It was the people that made the Lady Lace technology. Some doctors in Europe, they were looking at women that had gynecologic cancer and had surgery or radiation. And they have. They were left with what we call dyspareunia, painful sex, severe to where it affected their life, their marriage, their happiness. And nothing seemed to work with that. And they did a series of patients where they did the Lady Lace procedure specifically with PRP at the same time. And everyone had resolution. And in my experience when I treated with this, it is life altering because, you know, we have some women that just want to have better sex, but then there's women that can't have sex and there's an option for. Right. And they didn't know there was an option for them. And I want people to know there's definitely an option for you. This is very safe procedure, pretty easy procedure, relatively inexpensive, and it's something you can give a try. So if you have interest, I want to tell you that our providers are women. So you won't be talking to me about it, so you don't feel embarrassed. But you can come in and talk to one of our providers about you have sexual concerns. And I think that you know, just like looking at what your options are, looking at the cost. What are your concerns? You know, we can come up with something you can try in our practice. You know, it's mostly women, and I've encouraged our staff to, you know, try this stuff out. So you can give a firsthand account of what worked for you and the trial and error that. That in better sex leads to a better life, better relationships.

Yes, I agree. So come and see us. Like you said, we are women. We're real people. We have the same concerns that you do. We'll be able to really recognize what's going on and how we can help you.