How to Optimize Your Sexual Health & Longevity with Dr Amy Killen - Women for Longevity

Welcome to today's Women for Longevity talk, and today it's all about how to optimize your sexual health and longevity. And we have Dr. Amy Killen here, uh, who will give the presentation and is also available for all of us for Q&A afterwards. And as Liz Parrish says, uh, Amy is awesome.

Thanks, Liz.

So I just wanted to share that, makes it or not, but I wanted to share that. Okay, so before we, uh, dive into the presentation, let me try to as quickly as possible introduce you a little bit more to the Women for Longevity Club and what's all about, and a little bit about the founders, etc. So, uh, the Women for Longevity Club is basically an invitation-only club for women who are involved in longevity, uh, in health, uh, and aging, basically research, in entrepreneurship, etc., and who are really passionate about the topic. So, and like, in a way, we have We thought that the motto of "Together We Can Achieve More" is really valuable for women in this industry because if together we can share the latest information, the latest science, the latest technologies that are only coming out, the latest devices, gadgets, approaches, anything you can think of, then we really are, all of us are at the cutting edge. And that's what we need, especially in this industry. And we do want to support each other. And I talk a little bit about the whole idea of networking in a moment. But first, I think, kind of let's introduce the founders, which is first like is Nicolina Lauck. Then we have Claudia von Boeselager, who is not here today because she's recording a podcast right now. But I will introduce her. And it is myself, Ines O'Donovan. So, Nina, do you want to introduce yourself first?

Yeah, shame we don't have Claudia. So, I run GlycanAge, which is measuring how fast you're aging by looking at the immune system and low-grade chronic inflammation. And we're also looking at the glycobiology or the biology of sugars and how it's involved in personalized medicine and also predicting certain diseases before they happen. A lot of it also going into women's health. And you— are you gonna do Claudia? Yeah, Ines, you're muted.

Yeah, I'll do Claudia, but do share your best tip, and also if you could already share kind of about the next talk.

Yes, so I don't have a very specific special tip today, but maybe change coffee to matcha latte. That kind of coffee gives me a little bit of jitters, and this works perfectly. And for the next talk, we're going to have Jenna MacInnis, who wrote a book called Immunity: The Science of Staying Well for Longer. And she's an immunologist but also very involved in microbiology. So it'll be Connectome System, Microbiome, and how that affects our healthy aging and longevity.

Good tip against the jitters from coffee is L-theanine. Okay, so Claudia von Boeselager is a biohacker. She is the founder of the Longevity and Lifestyle podcast that I've already mentioned that she's recording for right now. Right now. And she's a serial entrepreneur. She's an investor. She's a mentor. And she's absolutely passionate about the topic. And her claim to fame is that she's 11 years younger biologically than her chronological age, even though I do beat her by 18 years. But she cannot reach that because she's 10 years younger than me. So, OK, who am I? I'm the CEO of Genesima and editor-in-chief of Genesima magazine. I have quite a rich experience and long experience, I'd say, and also quite a good network in health, aging, and longevity. And I have been one of the first biohackers in the world, and I call it biofitness because it makes much more sense if you can actually translate it into practical tips that we can integrate into our daily life. And I share that in, like, on so many things— in the Genesma magazine, in my weekly newsletter, in coaching in— what else do I do? Public talks, workshops. And I've just basically just in the process, I just have just launched a Genesima Academy. So my tips, there are two that relate to today's topic, and I hope that they are not part of Amy's. So one of them is that Basically, a way to postpone menopause, which is interesting for a lot of women, is to have some weekly sexual activity. And that could go from sexual intercourse all the way to stimulating yourself, caressing yourself, etc. It's basically— it's a sign to the brain to say, hey, you're actually still needed. So that seems to work according to research. Another tip, and I just use that because, like I said, because Claudia is not there, is, and that's, uh, is mostly anecdotal, but, uh, so like my coachee last week, she told me that, um, her pubic hair has gone back from white to black, mainly due to taking NMN. And we have heard that, like, I've heard that from others already, and we've seen that in a way in mice as well, that their fur was better. So Very quickly about networking. So after the last talk— and you see I'm rushing through because I want to give Amy more time. So networking. After the last talk, we heard from several that you do want to basically connect with each other, which is absolutely the idea of this club. And there are several ways that we have in mind. And please share your thoughts in the chat. One is we do want to give shoutouts to companies, researchers, people in general who have a certain achievement, who have some news, or anything that you think is valuable to share. So we do want to give a few shoutouts in the future. Let us know beforehand so that we can basically get that ready. And also the other idea is then for actual networking that within the overall group that we meet— we'll see how often, but maybe quarterly or so— as a group to actually share. Okay, everybody introduces themselves and talks more about what they're up to so that we can create maybe some corporations among you or stimulate some ideas. And the first one is probably going to be in February, but it depends on how interested you are. Then the other thing that we had been talking about is what about creating like a WhatsApp group or LinkedIn chat group or so? Let us know if and what you want. Like if you do want friends in the WhatsApp group, then we can start creating that right here and then. Is that what you said, Nina? So Nina would set that up right away. While Amy is talking, and we can basically start getting some communication going that way. So that's it from my side. Over to Amy. I let Amy introduce herself. But for you, kind of when you have questions, you can ask them already in the chat and we come back to them later on or raise your hand. But now over to you, Amy.

All right, thank you. Can you guys hear me? Yes. Okay, wonderful. So, I'm Amy Kellett. I'm a physician here in the United States in Utah. And I was— my history was I was an ER doctor for a long time, but for the last 8 years, I've been focused specifically on regenerative medicine and integrative medicine with a strong focus on sexual health and also skin health. But today's talk is going to be about sexual health and kind of what we can do using integrative medicine and regenerative medicine to maintain sexual health and kind of promote sexual longevity. So, and I had 20 minutes or so is how much I'm going to be aiming for, apparently. So let me— I do have some slides and we'll kind of go through them. Some of them we'll just kind of skip through, but let's see what I can get here. Okay. Can you see the pink lady? Everybody can see the pink lady. Okay, perfect. So the talk is called Sexpotential Medicine and Basically, the idea is that, you know, we are, as all of us know, we're living in this sort of exponential age of medicine where we're, you know, really just now starting to see exponential growth in all of medicine as we see the convergence of various fields, you know, whether it's nanotech or robotics or AI or, you know, all of these different things kind of coming in converging with traditional medicine. And we're seeing this everywhere. And we're also seeing this in sexual medicine, which is what is, I think, very exciting. We'll skip this story. There's a whole yoga story, but there's not time for that sort of thing. So as a lot of you guys already know, there are so many benefits to staying sexually active, and whether that's, you know, with someone else or with yourself, there seem to be some benefits to both. But basically, there's things that happen cognitively. We can see— we see less cognitive decline in people who are sexually active later in life. Hippocampus doesn't seem to shrink as much. We see, you know, less stress. We see less depression. We see less body image problems and self-confidence problems and anxiety. And all of this probably goes back, you know, partially to the fact that we have less— lower levels of cortisol, we're sleeping better. There's boosted immunity that have been seen as well. Some studies in college kids, for instance, and the ones who were having sex 1 to 2 times a week had higher salivary IgA levels and were thus prone to fewer viral infections than their colleagues. Interestingly, in that group, and it was a small study, but in that group, the ones who were having sex more often than twice a week actually were a little bit worse off than the ones that were just 1 to 2 times a week. So I'm not saying don't have a lot of sex. I'm just saying that was kind of an interesting observation. And of course, there's also the social benefits of being sexually active if you have a partner, the intimacy of that, the, the closeness of that. And because loneliness and isolation have become such a huge problem, including a huge medical problem— in some studies, they say that loneliness kills as many people as obesity and alcohol— and not that sex is going to solve all those problems, but maybe it keeps you a little closer to a partner or partners and makes you feel a little bit less lonely. There's a study in women that shows at least an association. A lot of these are associations and not, you know, not a causation, but association between longer telomeres and sexual activity in women, which is interesting and probably makes sense for a lot of different reasons. So lots of benefits to sex. I think a lot of us want to be able to stay sexually active as we get older. And the question is, you know, how do we do that? And why is that a problem? So for women, about 40% of women at any given time are unsatisfied. And that could be, you know, a range of things. That could be lack of libido, that could be arousal problems, it could be orgasmic problems, or it can be problems with pain. And oftentimes it's a combination of those things, right? And along the same lines with men, we see over the age of 40, up to 40% of men have some degree of ED. So you get your— you have your guys with ED, you have your women who are kind of unsatisfied for various reasons. And you have a lot of problems. And the problem, the biggest thing is that most of these women and men who have sexual problems are not treated currently. So 75% of men with ED and at least that many women who have sexual problems are not getting treatment. And I think part of the issue is that previously in the, you know, in sort of previous years and previous decades, women especially didn't think that there was much that could be done. And they thought it was normal and this is just how it is. And even if it's not normal, like what can anyone do about it, right? This is just how it is. This was an interesting study that I saw this at a presentation by a lady named Alexandra Drane. And she was talking at an Exponential Medicine conference back in 2016. And they had done this, her group had done this study looking at things in our lives that so stress us out and so preoccupy us, they prevent us from taking care of our other kind of chronic health problems. So things that, you know, they were so stressed out by it that we don't take our blood pressure medication and we don't call our primary care doctor to get an appointment and we don't do this sort of self-care kinds of things that we should to stay healthy. And an unhealthy sex life was the second most important thing that causes people to not take care of their other chronic problems, which was really, really— this is really a surprise to me. Money concerns was number one. And sex life problems was number 2. So, you know, there's the idea at least that an unhealthy sex life or sort of a, you know, one that stresses you out can negatively affect your health and a positive sex life can sort of do the opposite. So, this is my 4-pronged approach to sexual longevity. And this works for men and women. And I think it works probably beyond just sexual longevity. If we were to look at actual longevity, there's a lot of things in this that I think apply to that as well. But it starts with the mind. So, mind the mind. Boost blood flow, optimize hormones, and support the structures. And we'll go through all of these things individually. So as far as the mind goes, and I'm not keeping track of time because my watch is not working, so just like wave me down when we're getting close. As far as the mind goes, you know, obviously there's a very strong correlation between sexual health and mental health. And especially for women, we see that we really do have to be kind of in the right frame of mind. We have to have our stress levels relatively controlled, that for us, being in this sort of fight or flight, you know, over-sympathetic drive state is not conducive to having a satisfying sexual experience. And there's a lot of reasons for that. But getting our mind right and kind of stress controlled is really important. And I know my field of study is not— I'm not a sex therapist or a psychologist or psychiatrist. So I'm not gonna talk about, you know, as much the emotional side or sexual trauma or things like that. Obviously those things are really important. And if that's something that is at play, then seeing the right person is necessary. But just for people who don't really have a lot of trauma but are just wanting to get in the right space. So there's sort of old fangled things and new fangled things that we can do, right? There's obviously breathwork and journaling and getting outside and meditating and walking in the woods and all of these things to reduce cortisol levels. But then there are also a lot of new femtech apps and devices and things out there that are kind of interesting that are, that in the last couple of years, we're starting to see an increase in that femtech market. And we're, you know, it's still a pretty small market comparatively. But, you know, mostly these are women-run companies that are looking at promoting women's sexual health and women's mental health. And so these are some of the ones that are out there. Rosie is an app that basically uses— it's a sexual education combined with like some erotic stories, combined with, you know, surveys, combined with tips and things like that that you can do. Furly Juice Box Dipsy— some of these are sort of more women-focused erotic stories. But there's a ton of these that are coming out. And whether or not you think that an app can help you with your sex life, I love the idea that there are women out there who are looking at this and working on this problem because I think it's something that has been an underserved population and problem for a long time. As far as looking at sort of what are the components that go into the brain part of sex, like getting our brain ready for sex, a couple of different things that are in effect here. Oxytocin, of course, we all know is the bonding hormone. That's a big one. That's going to be pro-erectogenic. This is for men and women. Nitric oxide, which I'll talk about later, is a huge one. This is going to work on multiple levels, but it works on the brain to get your brain ready for sex. And then the brain, of course, sends signals down and releases more nitric oxide to get your sexual organs ready. Then there are some of these— oops, go back, sorry— these growth hormone secretagogues or growth hormone agonists that are going to increase growth hormone production. And we see some peptides, things like ipamorelin or CJC-1295. Or even human growth hormone, which can positively affect the sexual centers of the brain. Dopamine, which, you know, dopamine we can get from exercise, we can get from just planning exciting things, can positively affect your sexual responsiveness. And there are drugs like apomorphine, for instance, which we use a lot in men for sexual dysfunction as a dopamine agonist that can be really effective. And then the melanocortinins are really interesting as well. Melanocortinins like PT-141, which is a peptide that has been actually approved in the US as an FDA-approved drug called Velyse, works on the melanocortinin pathway and is very pro-stimulatory and, and erectogenic. And what's interesting about this one is it actually increases libido and increases blood flow to the sexual organs. So it's not just— it doesn't just work on the brain or just on the sexual organs, but there are some side effects with that, so it's not perfect. So as far as that second step, after we kind of get the brain in order, how do we make sure that we're getting blood flow where we need it? So just like with the guys. Women obviously need blood flow to the clitoris, to the vaginal wall, in order to have vaginal lubrication, in order to have arousal sensation increases, all of that. And lack of blood flow is definitely one of the problems that we see in older women that results in less sensation down there, less pleasure, less orgasm. So, some things that you can do to increase blood flow, healthy lifestyle, which I think this whole group probably knows about, maintaining nitric oxide, and then some other therapies that maybe further boost blood like hyperbaric oxygen. I won't go through all of these. You guys know this stuff, but basically be healthy is the first thing. You know, it's funny on, on like social media and such, I always, you know, I'll talk about all these different sort of newfangled therapies and ideas and try this and try this. And someone in the comments is always like, what about just being healthy? And I'm always like, yes, of course. Like that to me is, is it's like a, it's understood that that's the first thing and we'll talk about what else, but yes, that's the first thing for sure. Nitric oxide is one of my favorite things to talk about because it's so important for just general health. I think that it's a, it's an under-talked-about little chemical, but nitric oxide is the main chemical messenger that tells our blood vessels to vasodilate or to kind of open up. It does a thousand other things as well. That's just one of them, but it's necessary for vasodilation. As we get older, we make less and less nitric oxide because we see atherosclerosis in the blood vessels, and half of our nitric oxide is made within the blood vessels by those endothelial cells. So as we develop atherosclerosis, we can't make as much nitric oxide. So now you have this sort of double-edged sword where you have more narrow blood vessels because they're filled with plaque and you can't vasodilate because you don't have nitric oxide. So you just can't get blood flow where you need it. And that's everywhere. That's the brain, that's the heart, that's the lungs, that's your— that's the vagina. Like, it's happening everywhere. So this is really important. I love this graph because it shows us why it's so important to be adopting these healthy lifestyles, right? Where if we are in the blue, which I think all of us are striving to be, we're still going to see decreased levels of nitric oxide as we get older, but it's a lot better than if we are sort of the average person or people who have a poor diet and aren't exercising. But there's still a drop-off starting at about age 35 to 40 that we have to be aware of. So some of the things that we can do to increase nitric oxide: exercise, you know, get some sunlight, get outside, or red light therapy can do it as well. Things like PEMF can increase nitric nitric oxide. Hyperbaric oxygen can also do it. And then the other part of it is getting foods that are high in nitrates. And these are not like your bacon. This is more like your green leafy vegetables, your fruits and vegetables. So green leafy vegetables, beets, citrus, pomegranate, things like that. Because we can get nitric oxide from food, but we have to have a couple of things in our bodies to do that. So the first one is we have to have healthy nitric oxide-reducing bacteria in our mouth. Because we can't actually do it on our own. And so one tip here is to avoid antiseptic mouthwash because that will kill those bacteria and prevent you from being able to make nitric oxide from food. And then the second step actually happens in the stomach. We need to have a good amount of acid in the stomach to make nitric oxide from the nitrates in food. And for those millions of people around the world who are taking acid blockers like the proton pump inhibitors or even the H2 blockers, those are going to prevent you from being able to make nitric oxide, which is probably why medications like the PPIs have, are, you know, are known to significantly increase cardiovascular disease, heart attacks, strokes, all of those things. That's all nitric oxide mediated. And then supplements like L-arginine, L-citrulline can also be helpful in this regard. Hyperbaric oxygen, I won't talk about too much, but there are some sexual studies in men that show that hyperbaric oxygen can reduce ED. And that makes total sense because as we're using hyperbaric oxygen, you're essentially increasing blood vessel formation, you're increasing angiogenesis and increasing increasing oxygen-carrying capacity, you're increasing nitric oxide. So it makes sense that these things could be helpful for men. And I think also for women, if that was the problem. Part 2 is hormones. This is a huge topic. And I think something that's really interesting for women, especially because we start seeing hormonal changes, you know, at 30, 35, 40, you know, in that 10 years or so before menopause, we start seeing changes, you know, lowering of progesterone levels, lowering of testosterone levels. And then after menopause, we'll start seeing, you know, a huge drop, of course, in estrogen as well. DHEA is also important for those things. And so, you know, what do we do about that? And I think there's a lot of schools of thought. I personally am pro-replacing those hormones for most women and doing that with, you know, bioidentical hormones that are similar to what you're already making. Obviously, there are some contraindications to that, but for the most part, there are safe ways to replace almost all of these hormones. And for those of us who are trying to really maintain this healthy sort of anabolic state as we get older, that's continuing to be strong and it's continuing to be you know, sort of longevity-provoking, I think that these hormones are important. Cortisol is obviously important, and then thyroid and growth hormone. All of these are going to change as we get older. Thyroid tends to go down with age. Growth hormone definitely goes down with age. Cortisol goes up with age. And so these could all be replaced. Part of this can be done with lifestyle, and some of it can be done with actual medications. There's some interesting functional genomics tests out there these days that could be really helpful in telling us how we should replace replace these hormones. And I'm giving you this example. You don't have to understand it all, but this is, this is actually my, my test that it was done. And what this shows here is that I'm someone who makes, that tends to make testosterone. I don't tend to make a lot of estrogen from that testosterone. So I make a little bit, but not a lot, but I do make testosterone. But so I'd have a little bit of estrogen and, but the estrogen I have tends to want to go down a metabolic pathway that's going to be more likely to create these sort of bad estrogens, the 4-hydroxy estrogen and the 16-alpha hydroxy. And this is important because as I approach menopause, I'm not there yet, but when I get there, I have to know that if you were to give me supplemental estrogen, too much of it, then it's possible I'm the kind of person who will make sort of these bad estrogens that are going to increase my risk for things like breast cancer or uterine cancer or just side effects. Effects, you know, swollen breasts and irritability and weight gain and things like that. So these kinds of tests are really helpful and can help us as we start thinking about replacing hormones to tell the doctors and the patient, how do we replace them? What's the best way? Because we're not all the same. This is from the DNA Company, by the way. And then the last little bit is here is support the structure. So we can use things like regenerative biologics. We can use in-office energy devices. We can use at-home devices. And I'll give you some examples of those. How's my time? How are we doing? One minute.

You still have 3 minutes.

Okay, okay, perfect. 3 minutes. Okay, so regenerative biology. I do a lot of work with stem cells and PRP and exosomes and all of these things, and basically the idea behind all of these therapies is to inject something into our bodies, into our vagina, our clitoris, our labia, whatever it is. Inject something that then tells our cells that are already living there to become more active. So it tells our cells to Hey, hey, we actually need to keep, you know, to keep making collagen, or we need to keep making blood vessels, or we need to keep making elastin, or whatever it is. Because as we get older, our own stem cells become less active. And so with regenerative biologics, we're trying to increase the activity of our own stem cells that are already living in a given area. So PRP has been around for a long time. That's just made from your own blood. That does that to some degree. And then as we kind of gotten more and more advanced. We have things out there that we can use that are a little bit stronger. Stem cells in the US, we can only use autologous stem cells at this time. So I could, you know, I could use stem cells from the patient, primarily bone marrow stem cells. We used to use fat-derived as well, but use stem cells from the patient where we take their stem cells, we process them, and we put them back in and we do injections into the genital organs in women and men, or things like exosomes, which are a part of a big group of compounds called secretory secretomes, which are basically anything that's released by the cell. Exosomes are kind of these little messenger bubbles that carry within them a lot of the regenerative proteins and microRNA and things that can tell your cells to become more active. And those are off-the-shelf products usually made from placental tissue. There's me getting ready to inject. My injection needle is actually a little bit bigger than that. So, but we numb it up first. Don't worry. And then last little bits here, some in-office devices for women. I, you know, vaginal lasers and vaginal radiofrequency devices can be really helpful for treating things like stress urinary incontinence if it's mild or moderate, as well as treating lack of lubrication or sensation. There's some different, different devices out there and different combinations, but these are things you can do in the doctor's office in 1 to 3 treatments and you may see a significant benefit, and there's no downtime for most of these or pretty minimal. I'll skip over the penis pumps. And the last things are some things you can do at home. I'm a big fan of some of these pelvic floor strengthening devices. These are kind of like Kegels on steroids. So those of us who aren't so good at doing our Kegels every day, which includes me, these are kind of, you know, fancy ways to do that. So there are TENS devices like these that I have here, which are transcutaneous electrical devices, which are, you know, intravaginal. You turn them on and then you just get these crazy contractions of your pelvic floor muscles. And it's, luckily you can change the level because it's pretty intense. It's like, oh my gosh, what's, it's like when I was pregnant and I was having like pregnancy contractions. And then there's Eletone is a new company that has an extra extra vaginal, so it just attaches kind of on the outside of you and it can do the same kind of contractions. I like these at-home devices. These are sort of gamified Kegels devices. So you actually are, you know, kind of playing Frogger with your vagina at home. You're able to see what you're doing, you know, on the screen. So you put this little device inside and then on your phone screen, you're going to see how strong your contraction is, how long it's lasting, you know, like you get points, like, you know, gold star, good job. And there are several different companies out here doing this. This is This is especially obviously great for after you give birth and you have weaker muscles. But I think as we get older as well, because especially postmenopausal, if you've lost estrogen and not replacing it, then you start to see atrophy and weakening of all of your pelvic floor muscles, as well as your vaginal wall and mucosa and all of that. Red light therapy is something I like a lot as well. This is actually a wellness device. It's not a medical device, but this one is red light therapy, which we know it can be effective for increasing mitochondrial energy production and increasing nitric oxide production. And this one also includes a little bit of heat and a little bit of sound vibration. So it's a little bit fun and also a little bit good for you, but it increases blood flow, increases sensation, and it can help strengthen those muscles in there as well. And this is just an over-the-counter device. You can just buy it on Amazon or wherever. And finally, we actually have now some sort of bio tracker meets vibrator devices. This is the Lioness, and it just came out last year. There was a waitlist for like 6 months to get this thing. And you know, there's some, there's some problems with it. I don't love it, but I do like the idea of it, which is essentially it's going to track how strong your orgasms are. And so if you have this inside, when you have an orgasm, it's, it's like essentially tracking how long it is, how long, you know, how long it lasted, how strong it was, et cetera. And so if you're one of the kind of people who want to keep track of that, you could be thinking like, well, how is stress affecting this? How is my diet? How is my, you know, how is this and that and alcohol and all these things? And you could kind of keep track of all that, which I think is interesting. And maybe it's the beginning of us being able to track more of our sexual health because there's a lot of literature for men and sort of the studies in men and sexual health. And because we can see when they're having, you know, when they're having an erection, when they're having an orgasm, you can see it. But women, you can't really. And so it's a lot harder to do animal studies on, you know, little female rats and harder to do human studies on female sexual health because it's all internal and you can't see it. So maybe this is kind of leading the way to being able to track some of that. All right. So here's kind of putting it together. And we just talked about all of these things, so I won't recap it, but basically this is a 4-pronged approach. It's pretty, it's pretty easy to do, you know, a few of these things from each category and kind of work your way up. And obviously you can't do everything and you shouldn't have to, but these are just some ideas on ways that you can kind of start to put those pieces together. And that's me. So we'll, of course, we will connect later on LinkedIn or wherever. I know a lot of you already, but there's different ways to find me. I'm pretty active on Instagram. So that's probably probably if you want to follow me, I talk a lot about sexual health as well as just other random things. Okay, I'm going to make my screen, my screen small. All right, that's it.