Bioidentical Hormones, Circulation, and Rebuilding Intimacy Post-Cancer

In this solo presentation, Dr. Dino Prato, NMD, outlines an integrative, three‑step approach to help cancer survivors and their partners rebuild sexual intimacy and overall vitality. He first emphasizes restoring basic vitality through a high‑quality protein diet, eliminating refined carbs, ensuring adequate sleep (magnesium, bedtime protein, breathwork, and, if needed, research‑grade sleep peptides), regular exercise, sunlight exposure, and adaptogenic herbs such as ashwagandha and black ginger. The second step addresses hormone signaling: using bioidentical hormones in micro‑doses tailored to the patient’s cancer type (e.g., low‑dose testosterone lozenges for women post‑breast cancer, estriol vaginal gel for vaginal pain, DHEA/cortisol balance, thyroid T3‑T4 optimization, and cautious monitoring of IGF‑1). The third step focuses on circulation, recommending low‑dose PDE5 inhibitors (tadalafil), nitric‑oxide‑boosting foods (beets, cayenne), enzymatic anticoagulants (lumbrokinase), and natural agents like black ginger to improve microcirculation. Throughout, Dr. Prato stresses individualized care under physician supervision, regular monitoring of circulating tumor cells (CTCs), methylation scores, and growth‑factor markers, and the essential role of open emotional communication between partners. He concludes with a call to action for patients to seek integrative oncology support and to subscribe to the channel.
Chapters
What if I told you one of the biggest side effects after cancer is not nausea, fatigue, or hair loss? I'm talking about intimacy issues with marriage and connecting with your spouse after cancer treatment, particularly in the bedroom, because cancer can steal desire, confidence, arousal, comfort, all the above. And here's the part that breaks my heart. Many couples think it's over forever, but that's just not the case. We're gonna go through that today, debunk it, and I'm gonna give you some powerful integrative tools that can help you. I'm Dr. Dino Prato, founder of Invita Medical Centers for the last 20 For over 25 years, my team and I have worked with the most complex and difficult cancers, patients who failed some of the top cancer hospitals across the country, and we've helped them with precision targeting, helping them respond with proper in-depth testing and helping them get the care they need. And today I'm going to give you 3 areas we're going to focus on that are going to be smart and safe to helping protect your relationship and make sure you get back to the vitality and energy of your life. Now, before I get started, make sure you make no changes without talking and working with a doctor. So here we go. Cancer treatment can directly cause vaginal dryness, pain during intercourse for women, erectile dysfunction in men, sexual changes in men, especially after pelvic radiation or prostate treatments. And sexual health is part of a vitality marker. That's part of your youthful energy. If your energy's low, sleep is low, you're in stress, you have a lot of difficulty with your health, your desire drops. That's normal and natural. And if blood flow is impaired, well then function drops as well. And if your hormones are off, this creates worse messaging in your body. So cancer disrupts this vitality, our hormone signaling. Think of it like the younger you are, the more energy you have, and of course, the more energy and healthy you are, the more you have interest in the area of sexuality. So now let's talk about how we can fix this using an integrative approach. I love integrative medicine because we have so many tools in our toolbox. But after cancer treatment, or even during cancer treatment, how is intimacy being affected? This has a lot to do with the way we feel confident in ourselves. So number one, we're going to improve our vitality with nutrients, recovery, and energy. This is huge. Energy is huge because it plays a big role to health. Number 2, we're going to talk about our hormone signaling. We're going to fix those. We're going to talk about bioidenticals, microdosing, understanding hormone health. And 3, circulation, microcirculation, and helping with performance. Now really, anybody could use these tools, but we're going to focus on cancer patients. Step 1 is vitality, because people that are more vital have more intimacy because they feel healthier and alive again. We're going to start here with food, high protein rebuilding. So we want our diet to be good in protein so we develop muscle, stamina, hormones. All depends on a good high-quality protein diet. We're looking at organic grass-fed foods, getting rid of the refined carbohydrates and sugar products that affect our insulin. So high-quality proteins with each meal. We're going to fix the insulin resistance. And if you're living in a refined carbohydrate world where you're eating lots of sugars and refined products, fried foods, we're going to get rid of that. Your hormones and blood flow pay the price. We want to fix the diet because diet, sleep, and exercise are critical to health. Before we start amplifying signals with what I'm going to tell you here, we want to fix those things and we want to stabilize ourselves with good nutrient-dense foods. Sleep is so important because sleep is recovery. And here's where the body repairs itself. Here's where libido returns, is when people are, are rested and relaxed. Magnesium at bedtime is very good here, like magnesium glycinate, helps with relaxation. In fact, men can quickly tell how they're operating in that area just by looking at morning erections. If they have normal morning erections, that means things are good. They start losing that, that means they need to get these areas under control. So sleep is very, very important. The other one I want to talk about is adaptogens and nutrients. So these are the nutrients you need to take and adaptogens you can use to help your body. Give your body things like ashwagandha. It's considered the Indian ginseng because it's an adaptogen and it helps you deal with stress. So if you find the right doses and you have good quality, this can help restore your vitality. Black ginger— I'm going into all these herbs so I can give you natural methods. We're going to get into off-label drugs here in a minute. Black ginger kind of acts as a natural version of like a tadalafil. Not the same, but it provides microcirculation, has some anti-cancer properties, immunity. So see, these are safer things we can use, and we'll bring these up as we go through these specific areas. So in step 1, it's important to return our energy, stamina, and libido. This is diet, sleep, and exercise. This is important to restore your youth biology. I don't want to skip that because people always like to prescribe medications, or doctors jump right into that without fixing these fundamentals. So here's how we're going to do this. Step 1, we're going to improve our exercise as well. Walk daily. We're going to do some weight-bearing exercise if we can, a couple times a week. Resistance training. I like rebounding because you get the g-force of the rebounding, but you get cardiovascular support and move the circulation and the lymphatic system. Get out in the morning and get our sunlight, reset our circadian rhythms, help our body detoxify from these processed foods, and start eating nutrient-dense foods. Now we're starting to fix what I call food, diet, and sleep cycles. And if you have really bad sleep, let's say your sleep is very difficult to repair, you could possibly use peptides. Now, whenever I mention these peptides that I'm talking about here, they're not FDA approved, they're for research uses only, and you should be working with a doctor. But there are some peptides like DSIP which give better delta sleep, and these could potentially be used as a research peptide to help with deeper sleep, get in that rhythm of sleep for people who have serious sleep dysfunctions after we've tried magnesium and other tools that help us sleep. Because when we get that deep REM, we get parasympathetic, we get a lot of healing. In this step 1, we want to improve our vitality and energy and metabolic function, and that's where we get those things done. So we get the diet, the microbiome fix, we get exercise, we get oxygen moving, we get our sleep moving. Now we can start doing things to our body, because if we don't fix those things, we aren't going to get the best signaling no matter what we're taking and doing. And when I mention sleep, you want to start with things like magnesium, like making sure you have enough protein before you go to bed so you don't wake up with hypoglycemia. Set that circadian rhythm. Maybe wear a mask over your eyes. Don't jump into peptides and medication. Start with those things. Breathwork. See if that can help you get into your parasympathetic sleep. If you wake up in the middle of the night, that's okay. Maybe you need to say a prayer, relax, breathe, and go back to sleep. You don't have to beat yourself up that you're not getting perfect sleep. It takes a while to get your body into those rhythms. Some people have sleep apnea, so they might need devices in their mouth to help them get oxygen at night. Weight. Sometimes you can get airway devices that help you breathe better, or you can work with a doctor and really get tested for this and improve on that sleep apnea. But as you lose weight, improve vitality, increase your energy, that too will improve. Let's move to step 2: hormones. Now, the hormones I like to talk about in the world of integrative medicine is bioidentical. I know you'll hear things elsewhere. I like hormones that most match our natural body's hormones, and I like them in the micro or correct doses, not too high, that provide benefit without being overdosing. And so when hormones make sense, let's say patients do not have a hormone-sensitive cancer. If you have a hormone-sensitive cancer like a breast, estrogen, progesterone, we're not going to use that. We'll use something else. Okay, we'll get into that here in a minute. Or you have prostate cancer, and I'm going to use testosterone. We'll use something else to help with circulation. So I like the microdosing, and I like it in a way, once the diet and lifestyle are in place, to add these in to help us. So this is important. The cancer history changes everything, because if you have cancer, we don't want to just be giving hormones recklessly. Hormone-sensitive cancers need workarounds, like breast and prostate, like I just mentioned, ovarian, uterine. These lanes require more consideration. For example, we might consider in these women that have any one of these cancers and they're healing, we might use a low-dose testosterone lozenge that's bioidentical. We might use that because in the literature we've seen something very interesting. It potentially shows when in combination with aromatizing inhibitors, it can reduce the risk of invasive breast cancer in women. This is testosterone as a lozenge, and studies suggest that 39% to 47% lower incidence of breast cancer in women. So testosterone in the right doses, low dose for women under the care of a physician can make a big difference in returning libido, energy, healing. So this is good because we can't give estrogen and progesterone, and we can use other tools also to help with circulation, acting as a protective agent and also rebuilding stamina, health, libido, and the desire again to be intimate. And for women, hormone-sensitive breast cancers, if let's say they have pain, vaginal pain like sharp razor blades— I've heard it all, things that are really discomforting— you can use a very microdose, like a 0.005% estriol. It's a certain type type of estrogen that we're not worried about. It's estriol vaginal gel, and it can be custom compounded, and you can add a few other things there that help to reduce the pain during intercourse. And so that's going to help you reduce pain without having to take anything that would be a cancer risk. It's a localized therapy when you use this estriol cream that has evidence base suggesting minimal systemic absorption. It doesn't get to the rest of the body. And so that has to still be done under the care of physician, and that could potentially be a workaround when you have a lot of pain in that area, and now you've incorporated a little bit of that testosterone, and Now you're helping the body with all the nutrients, and maybe you can improve circulation in the body using tools like beets that increase nitric oxide. Reducing stress, that's a really big part for women, especially to be aroused. They need to be relaxed. That's a big part of it as well. And so you can look at things even like black ginger. If you're not able to do testosterone, black ginger in a microdose has some cancer protective properties, but also can help circulation and give some energy. You can also look at peptides that are approved if you're working with a doctor, maybe bremelona tide, like a nasal spray that could potentially help for hyposexual desire. So you may not need all of these things. That's why you start very slow, month after month, monitoring these things under the control of a doctor. And unlike using hormone therapies, these act to help the nervous system improve desire. You have to make sure you have good cardiovascular health because some of these things can affect your blood pressure and circulation. So it's why I always like to combine these with great natural blood thinners. If you're on a medication, do not add blood thinners without working with a doctor. But here we can use nanokinase, lumbrokinase, to help circulatory function, cardiovascular health, and help our receptor sites work better. Let's look at a different category of patients. They are non-hormone sensitive situations, meaning we're not really worried about hormones. And with these patients, we want to start with bioidentical testing and combination. So in this case, a man may not have prostate cancer, might be a different cancer type, and we, we're not really worried about growth factors in their case. So we can now look at giving microdose hormonal care that could support their vitality and health. Same thing for women that have non, like, hormone concerns and the cancers that were linked to that. We can use bioidentical identicals in the right way at a very low risk to really help that patient. Let's move on to what everybody else needs to look at. Something in the relationship with sleep, but this is from a hormone perspective, is looking at DHEA to cortisol ratios. And we want that DHEA to be there because it'll blunt the cortisol, but it helps with repair and immunity and health if it's in the right doses under the care of a physician. Now, the other factor we want to look at is thyroid balance. So we want to make sure your T3 to T4 ratios are correct. We want to make sure that the T3 is in the right place so we have have good immunity. Sometimes even in men, we might use microdose progesterone, very microdoses, to help them sleep and deal with stress and without affecting their libido. So there's a lot of different clinical pathways, but we're always careful of growth hormone pathways because we don't want growth signaling to grow cancer. So we're monitoring things like IGF-1 and other markers. That's why it's important to work with a doctor so we can monitor these things, make sure that the microdoses are there without causing or worsening a cancer, but getting your vitality and life back, because there is life after cancer. So we want to balance the hormone Now, let me move on to another category: circulation. Sexual function involves great vascular health, and microcirculation matters, especially after treatment that stresses your body. So, in this foundation, we want resilience of the endothelial lining and blood vessels. We want to have good blood pressure, and we don't want high sugar in the body. And so, things like low-dose tadalafil— yes, like a Cialis microdose— to be fantastic for men who have prostate cancer, because in some of the literature, it's shown to prevent prostate cancer. It's a PDE5 inhibitor, so it improves erectile erectile dysfunction and circulation, and it has benefits also with benign prostatic hyperplasia. So it's commonly used to treat erectile dysfunction, and it can be used in a nice proper dose to help a patient with circulation and helping them with erection. And so this is good because this will allow the circulatory function to occur the way you want it to, so you have good health. That's why combining these things— the diet, lifestyle, sleep, and the right maybe medication or the right natural agents— can really help you restore your health. I like to look at things like cayenne pepper and beets, which are natural nitric oxide. Cayenne pepper can improve circulation. I also like looking at circulatory enzymes again here, like lumbrokinase. So we have good microcirculation, which helps with erection in men and also pelvic circulation in women. These are enzymes that have been well researched to prevent clotting. They help reduce metastases and the spread of cancer in our clinical experience. And these little tools all add up, and you can use these to improve your lifestyle. So microcirculation is an important concept, and we can easily improve on that with the right natural anticoagulant. Now, if you're on medications, make sure you're being tested by a doctor because you don't want to overdose, get bruising and bleeding. Circulation is very important, and things I mentioned earlier like black ginger can also help with circulation and again help with erectile dysfunction in men. So it's a combination of these microcirculatory patterns improving. So here's what we did in our framework. Number one, we fixed vitality. We got sleep, nutrients, we basically detoxified the body, we got exercise involved, and we used adaptogens like ashwagandha, maybe black ginger. We use magnesium for sleep, and we really got our body moving. That Step 1, because we want to get our body healthy. We did that for several weeks, got the patient feeling good, energy is good. Then we came in and looked at hormones. We said, okay, if you have no hormone-sensitive cancers, we're going to do bioidenticals, and we're going to do the right microdoses to help you. We don't need to give high doses. We're not talking about bodybuilders here. We're talking about microdoses to keep vitality and health along with exercise and diet. And if we're a female that had breast cancer, we're looking at maybe considering a low-dose testosterone, and we're considering that because that could potentially help. We're also looking at any estriol creams if we need to, if we have vaginal pains and we want to improve on that. These are simple things. You work with your doctor, they can help you with this. If we're men and we're thinking about, okay, we have erectile function issues, we're going to work on circulation. So some of the tools here is we can't use testosterone because maybe there's a testosterone-sensitive cancer, meaning testosterone doesn't cause prostate cancer, but once you've developed prostate cancer, you don't want to feed it. So here we're going to look at circulation, like tadalafil. Maybe we're going to increase cayenne pepper and beets and look at our microcirculation with lumbrokinase. Women should do that as well, improve their microcirculation. With enzymes like lumbrokinase. Now, I want to bring in one other area that's so important, and I think I don't want to just talk about the integrative side, but the emotional connection between spouses. It's so important that you talk and communicate, pray together, talk about what's going on, because real intimacy starts way before there's physical intimacy. And this is so important because when people have this open dialogue and communication, you don't feel rejected, you don't feel unloved, you don't feel abandoned. And that does play into our sexuality. We have to feel loved, supported, cared for by our significant so that we can then have a loving, respectful relationship. And so that's the key here, is to have open dialogue, work together, and support each other. You know, it's a difficult thing to go through cancer. It's very difficult on the whole family. But as you make your way through, don't feel like you're stuck. Don't give up. Use the tools that I've mentioned. Talk and work with good doctors. If your doctor doesn't want to work with you, find a good integrative doctor. We work with patients all the time to support them through these processes so they can heal and be healthy. Now, when you're doing this, you also want to make sure you're screening, screening with circulating tumor cells, methylation scores. We look to see what we call leading indicators way before a tumor would reappear or we'd see anything in imaging. We would see it in these microcirculating tumor cells. So if by chance you were on an herbal therapy or a natural therapy and your CTCs are climbing, well, we're going to stop that, get back on care, readjust it, help the patient knock those circulating tumor cells down to zero, and then begin a different therapy that isn't going to be stimulatory. Watch our IGF-1, make sure we're not pushing growth factors, look at our immunity because that's critically important, and see what we're doing to to balance out somebody's quality and length of life, which is so important, and your sexuality plays a role in that. I know that 90% of you who are watching this have not subscribed, so please subscribe to our channel. Support precision oncology so we can get it around the world and not be stuck in the one-size-fits-all model. Mm-hmm.










