The Midlife Vajayjay with Dr. Anna Cabeca

Today on Midlife Conversations, I've got one of my absolute favorite people. She's a personal girlfriend of mine, but she's also known as the girlfriend Dr. Dr. Anna Kabeca. Now not only is she an OB GYN and a triple board certified doctor, but she's a best selling author of three. She's a mom, she's a friend. She gets us. She is fully in midlife with us. She gets us. I've had her on the show before. I had her on my summit as well. I had to have her back today though, because I want to talk specifically, specifically, specifically about the midlife vajayjay. Now why am I calling it a vajayjay? Because we don't want to get banned, we don't want to get blocked and I want you to have this information. So for the sake of this show and right now we are using toddler language, we're going to today for this but we are talking about that for the title, the midlife vajayjay. We're talking about issues with that. We're talking about dryness, sexual health, why it hurts down there sometimes. What's, why is it changing appearance wise. And then most importantly, most embarrassing for many of us is incontinence. Like what's going on when we sneeze, what's happening there? Thank you so much, Dr. Anna, for being here.

It's a pleasure to be here with you to talk about this very important topic.

So it is very important and it's not talked about enough. And I think there's a lot of women walking around embarrassed about this and I want to bring it to light. So let's start with what's actually normal. And I'm talking to the midlife woman right now. So guys, if you're on, this is not for you. This is for your wife. You can listen and learn. If you are not experiencing the same that you can listen and learn. But we're talking specifically to the midlife woman right now.

Yeah, yeah, specifically too, as our hormones change. And this is the changes can start in our early 30s, right? So we always say an ounce of prevention is worth a pound of cure. And if we know what to expect, we are better defenders of that. Right? So I think that's important to understand and it is natural, right? The changes that we experience, if we have slap lines, smile lines, all that is part of natural aging. But when they're happening down there, that can lead to crack. Quality of life issues, discomfort and incontinence are two big Ones So discomfort with sex, so less pleasurable sex or even painful sex. And then urgency running to the bathroom, not making it in time after voiding. We call it post void dribbling or leaking when you cough, sneeze, run, jump, do the activities you love to do, have sex. Yeah, all the things. All the things. And so there's a common thread here and it is tied into the loss of hormones that we experience when we age. I hate to start off on a negative and it really is, is avoidable. It really is avoidable. But so many people don't realize that or we're just told by the doctor, you need this pill and for sure.

And well, let's start with that because what, what's, what is normal and we should, we accept and what is like, no, we can prevent this and then if we haven't prevented it, what can we actually remedy and fix? I want to, I want to kind of break it into those categories because we really have all three people. Let's start with, let's start with preventative. Like how do we prevent this from happening?

Yeah. So first preventing it by eating healthy. So for me that's the keto green lifestyle. Staying away from carbs, intermittent, you know, intermittently having feast opportunities, working with, optimizing your insulin so that you're insulin sensitive and optimizing the stress hormone cortisol so that oxytocin, the hormone of love connection and anti aging and you know is, is in abundance. So that powerful hormone oxytocin. So that key.

And before you keep going on that, because I know that I want to, I want to deal with what's going to come up for people, somebody that's going to go, what? I don't believe in that. I don't do keto, I don't. What, what can you share about that? Like we don't have to go full in detail, but I want them to hear from your perspective why that's so important to you.

Yeah, it's so important because in midlife we become more insulin resistant and so that time, 40s to 50s, our risk of diabe increases. And right now we're estimating 70% of Americans over age 50 are pre diabetic and increase in that number is increasing every day. So why is that happening? Because, you know, there's a few reasons, but as our hormones start to decline, they're protective and they help support our body's metabolism. As we know like all of a sudden we experience the 5, 10, 20 pounds of weight gain without doing anything different. Right. And so that's a hormonal shift. We're becoming more insulin resistant, and our hormones that build muscle and bone are becoming less efficient. But it's important to understand that our, you know, estrogen is essential for gluconeogenesis to produce the fuel to keep muscles and our brain on point. Got it. And that's important. So when that's declining, we've got to shift to periodically using ketones, really optimize insulin. The more insulin sensitive we are, the more we can have flexibility in our diet and lifestyle. And we get that through changes to our diet and lifestyle. So that's where we can optimize the way our body uses fuel midlife.

So if you are listening to that and you feel at all resistant or defensive, what I'm going to suggest is if what you're doing is working, keep doing it. Like, if you don't have some of these issues, you feel great, then you don't have to listen to that. But if you are struggling with some of these things, I would take that on. I would say I'm not keto, but I'm keto ish. I'm keto ish. Um, so I do adopt, like, the lower starchy carb. I'm more of. My carbs are vegetables, low glycemic fruits, things like that. And it has made a big difference for me. But we're all individual and personal with this. But Dr. Anna has a lot of studies and research and experience behind this. So if what is working is not working for you anymore, this is something to take on. Okay, so in addition to that, eating healthy, what else do we do to prevent.

Yeah, so back to the eating healthy part. That's really important because it is. A vagina is an extension of the gut, essentially, like the health of vaginal tissues. The mucous membranes within the gut, within the vagina are reflection of what's happening in the gut. If we have an unhealthy gut, if we have yeast infections, a dysbiosis, imbalanced bacteria, you know, irritable bowel syndrome, that's going to affect the vaginal health and the perineum, the rectal health, the. The entire pelvic floor. And I always like to say, you know, this is important that we talk about this and take care of what I call the most important anatomy of our body. Clitoris to anus, you know, clitoris designed for pleasure. A lot of nerve endings there. When we have issues, yeast infections, pelvic pain, cyst, hemorrhoids, all incontinence. Really changes the quality of our life. And if we can prevent that, as well as naturally reverse that, those symptoms, then we have better quality of life, that we're unlimited in what we want to do. And that's important to understand. So the diet does tie into vaginal and perineal health.

Okay, so preventative. Also, let's talk about where hormones play a role here. Like when is the right time, wrong time? And let's talk about things you apply. Should that be done as a preventative?

Yeah, yeah, so definitely. And so again, working with women through their life time and always from during pregnancy, that's my opportunity to tell women to start doing your pelvic floor exercises. So with pelvic floor exercises, nutrition, pelvic floor exercises, and then adding back the nutrients your body needs. Now we want to keep our body healthy from the inside out, but also from the outside in. And this is where, as a gynecologist, I use creams such as topical anti aging cream. The one I created is called Jalva and has dhea, which is a pro hormone at the cellular level. It helps, it converts to estrogen and testosterone. So then your body is building back its own natural healthy tissue and blood supply and nerve supply and natural secretions to the pelvic floor. So this is so important. So we want to add back these ingredients. And what I found is topically applying DHEA with plant rose, you know, stem cells from the alpine rose, plant clitoris to anus, we get this amazing regeneration of tissue.

So can you start using this right away? Like if someone's listening and they're 35, they're 30, they just had babies, or can they start using this? Is there any harm in using something like that early?

You can use it periodically. Like we've had some gynecologists recommending it to their postpartum patients to help with postpartum incontinence and to help after an episiotomy to restore that tissue faster and getting great results. We've had gynecologists having, you know, prescribing in a, women with, you know, fgm, female genital mutilation, women with Lichten sclerosis, women with, you know, early signs of incontinence. And we know we just need that, a little support in this, in this time. And depending on your exercise and what activities you've been doing, those of us who have been very sedentary over the past few years or with life working at a desk, that can also affect the weakness, you know, can add to weakness in the pelvic floor. So adding back nutrients that help you gain strength to the pelvic floor and improve your body's natural secretions is powerful. In your 30s, in your 40s, indefinitely. 50, 60, 70, 80. I have women in their 80s.

Okay, so before I get into like reversing or what we do now on the preventative side, can you speak a little bit into hormone replacement? Just a little, Because I know people questions about that, like, are you a fan of bioidentical? Are you a fan of traditional synthetic hormones? What do you think about people that prescribe the pill for this?

Oh, yeah. So first of all, I coined a term called hormone replenishment. I'm about hormone replenishment, not replacement. First of all, what we do with birth control pills, we replace your body's natural hormones and we suppress your own ovarian production. That's not good. If we need to use birth control pills to keep from getting pregnant, that's the use or short term for some medical condition. I mean, okay, absolutely, I've done that. But if we're working on addressing the underlying issues to the problem, it is never the reason to suppress our body's own natural function. And when we are using replenishment, we do want to use bioidentical hormones, hormones that are similar to or exactly like the hormones that our body is producing anyway and in levels that are healthy levels, but not suppressive levels, so that we're not shutting down our body's own natural production. For example, we know that if we give high dose testosterone to men, over time their testicles will shrink. Whoa, okay. And they're like, I'm okay with it. I like this testosterone. But what happens when we stop? They significantly can experience depression, rapid aging, suicidal ideation and crashing fatigue. And their body's not producing their own testosterone anymore. It's been shut down. Now, over time, it may come back. And it depends on what hormonal regimens they were on and it may not. So it's important to understand that with women too, we see that with, you know, post birth control syndrome, we see an imbalance in hormones. And the hormone disruptors that we were taking from the synthetic pills can cause long term complications. So in menopause using, I will start with, I will start top down first. I start with detoxification, supporting your adrenal glands, getting your body to produce more of its own natural da dhea. And then I'll add adaptive, such as, you know, maca, my mighty maca supplement with 30 superfoods, you know, to support the adrenals to make more of its own DHEA and to detox the liver so your body's able to use your hormones more efficiently. And then I'll add in progesterone and or dhea and then maybe estrogen or testosterone in menopause and beyond. That can make a huge difference. And a little bit goes a long way. But we always want to, you know, keep supporting the body's natural production.

Got it. Okay, so let's say we missed the boat. We did not do any of the preventative stuff. We did all of the wrong things. That was me. I mean, I was on birth control pills for my gosh, 20 plus years. You know, I stopped before having my daughter, but I, but I forever, I have, I was on those, I didn't do any of the preventative stuff. And then I walk into all the problems. So talk to us about reversing. Like, what realistically can we do to fix reverse, stop that from progressing?

Yeah. When it comes to vaginal and vulvar health. So it is those pelvic floor exercises. It's healthy, essential fatty acids in your diet. So those good fats. Right. It's low carb, low protein. Low carb, high protein. Because we want to have a low inflammatory diet, whatever that looks like for you. But you know, you want that low inflammatory diet, adding back probiotics, using a product like Jalva to keep those natural nutrients readily available to the pelvic floor so you don't experience those changes and, you know, self pleasuring good sex. And this is an issue that I've heard over and over again. Working with clients, you know, for many years, over 10,000 women individually and then so many more online. But the comment is that, you know, I didn't realize how bad it got until I started feeling good again.

That's powerful. Is it true when, when doctors say use it or lose it, like if someone is not married right now or they're not, whatever, they're in the sexless marriage, which unfortunately is very common in midlife. I hear it too much. Is that true? Like, is this, there's something to the whole use it or lose it.

Yeah, there absolutely is. Just like any, any muscle we exercise, if we don't use it, if we're not doing sit ups, our muscle or abdominal muscles will get weaker. If we're not doing pelvic floor exercises, our pelvic floor muscles will get weaker. The, you know, the advant sex, intercourse, you are doing pelvic floor contractions, you are increasing blood flow and friction so that's important. Now, can you substitute with, for example, jade eggs and something like a perifit, a bio feedback device to strengthen your pelvic floor. Absolutely. And then soft, gentle touch to the clitoris. Also, there's whole. The whole concept of clitoral trauma and losing sensation because of high vibration from vibrators. So the clitoris has 8,000 nerve endings when you, you know, can traumatize it to get that more sensation. If you're doing that, you need java. You need java on board. And you need to take a break from that vibrator so we can resuscitate.

Oh, my God. Flow and nerve problem for women that they did not know about. That's so interesting. Okay. Why is that a controversial topic about the use it or lose it. Like, I know when I had. I've had guests on that mention that and I get, like, there's a doctors that attack that. Like, what's that about? Where does that come from?

I don't know. I don't know. But I think, you know, I. That's a really good question. I mean, it does sound. I don't. I'm not going to say it's not. It's not. I don't take it as a misogynistic.

Yeah, but that's how they take it. But I don't.

Because, like, as a woman, our body is designed for pleasure. And if we're not experiencing pleasure, we're, you know, we're losing that aspect. So whether it's self pleasure. Yeah.

Because you have control. You can do your own thing.

Absolutely. Do your own thing. And even, you know, that concept is not to forget. I mean, because what I want women to do is have more oxytocin, more pleasure, more love and connection in their life. That comes from self love. Right. That comes from.

I don't think it's a mis. But you're right. I think it becomes as. It becomes like a misogynist thing. But we're not. That's not what you're saying. You're saying.

Yeah, I don't look at it that way, and I apologize if anyone takes it that way. But I think it's that like any muscle, any activity that makes sense, but you can take.

You can do your own thing. Chicken wing, do your thing. You don't do your own thing. There's plenty of things. Okay, I want to know all about Jova because. Okay, fairness to Anna, she's my friend. She has been giving me, supplying me with java for, like a few several years now. And like, I would get it. And I'm like, that's cute. And I don't think I did anything with it. And then I finally started learning more. I'm like, wait, I have a supply. Why am I not using this? And there is an absolute difference when you start using it.

So.

So I feel really dumb that I, you know, like, I literally had it in front of me and I was not understanding or using it, and now I am. So can you explain, like, first of all, why did you make it? Like, why. Why did you decide to make this versus, like, other things on the market and then talk just to explain all that to us?

Yeah. So early on, as a gynecologist and doing surgeries on women, pelvic surgeries for prolapse, for incontinence, I learned very quickly that if I used testosterone and DHEA vaginally or topically, or even progesterone, I got better surgical results. And so I started getting really good at this. Natalie. Like, prior to bladder sling procedures, to mean. To give an example, one day I did six bladder sling procedures. So I started.

What is that? To stop urinary discontinue.

To stop urinary incontinence? Yeah, to kind of tax up the urethra so you don't leak when you cough and sneeze. And I got great results. But then, you know, I started hearing about mesh erosion, So I certainly didn't want any of my patients to experience that. So I started using hormonal creams after surgery. And then I thought, what if I do it before surgery and I'll have better tissue and they'll have better results? And so I started. I mean, I got so good at using it. I do my evaluation, put them on vaginal or topical hormones, because I always say, if it doesn't bring you pleasure, don't put it in the vagina. But, you know, after surgery, we got to do it. So. So we. And my patients would come back in a month or two later for their pre op and say, Dr. Ann, I don't have incontinence anymore. Whoa. And so I didn't have to operate on them.

That's wild.

It's wild. And so when I closed my practice, you know, well, during my practice, I also started creating vaginal DHEA tablets. In early 2010, I had these vaginal DHEA tablets, but then I had to stop it, because if it's inserted vaginally, it's considered a drug and the FDA can come after me. And so I was like, why don't I Create a vulvar cosmetic. So I created the first. First vulvar cosmetic. And my commitment to my patients was to create something topically that was, you know, that was better than anything I can write on a prescription pad.

Okay.

So I got into the research, and I found, you know, the plant stem cells from the alpine rose. And they're anti. I mean, they're used in very expensive cosmetic creams, and they are, you know, restore collagen, decrease fine lines and wrinkles, and are antiviral.

We use this on our face, too. Well, that's what we don't know about.

I know, right? That's why I created the upper lip formula and the low lip formula. So I say, friend doctor, we take care of your lips above and below the hips.

Oh, my gosh.

I know.

She's got the lip duo. Oh, my gosh. That's so cool. You had a graphic that you wanted to show. I want to. Can I do. And if you're watching this, you're listening to this on podcast, you might have to go over to my YouTube to see this picture. But you wanted to explain. Explain what a healthy versus atrophy look like.

Yeah, yeah. When we hear the word atrophy, we can get very scared. Women will say, oh, my gosh, I've been giving this diagnosis of vaginal atrophy, but my doctor says, that's just normal. It sounds terrible. I'm like, it is terrible. Let's see what. You know, there are natural changes to aging, right? We can age healthily. The smile lines, laugh lines, or unhealthfully. Right. But naturally, as we age, because of hormonal changes, and we'll see a decrease in blood flow and a decrease in the natural secretions of the vaginal walls. And that's normal. Our ovaries shrink. The uterus shrinks a little bit, but the vaginal wall shrinks. So all of a sudden, you go from this amazing ruby red vagina with lots of elasticity and good folds that can stretch to let a baby through to a thin, narrow tube that can be painful to put a finger in. Okay. And that has. That happens. And so we. You know what? We don't. And the reason, again, the reason that happens is declining hormones, a decrease in glycogen levels, a decrease in the natural bacteria, and an increase in the ph, so it's more alkaline. Hence the vaginal odor, the fishy odor, the increasing fishy odors after you have sex, discharge after sex. These things are more likely during this time. Microabrasions from Using a tampon when you're in your 40s and the vaginal walls are drying. What we found with research and using DHEA vaginally and I found as well, using it topically, you can restore the rogation. I have a 65 year old woman who says her gynecologist told her she has the vagina of a 25 year old. Another woman at 67 who's told she has the vagina of a woman 20 years younger. And this is, this is what we want, right? This is what we want because they're having healthy sex lives. They're enjoying themselves, they're not wearing panty liners each day. I've had four big babies in my 30s. I struggled with incontinence issues. I was afraid to jump on the trampoline. I'm 57 now and thanks to Java and pelvic floor exercises, let me tell you that it is, you know, I mean those, those problems are gone unless I stop doing those things. And then there's an.

When they, I hear a lot of doctors talking about like vaginal rejuvenation. Is that not necessary if you do something like Jalba?

Well, if you do go for vaginal rejuvenation, you want good hormones on board. So we know that in the research, like the laser studies. And I think there's benefits to that too. I mean, to compound like I will do IPL on my face and some red light and all that good stuff. So pelvic floor, it helps with the tissue. But what we know is that pre menopause, the vaginal rejuvenation laser procedures work good post menopause is considered ineffective. However, if we add back our hormone, increase our natural blood, you know, mucous membranes and blood flow, we improve and do our pelvic floor exercise, we increase the healthy muscle and connective tissue in the pelvic floor, then we'll get better results with vaginal rejuvenation that will last longer. And those of us that have done vaginal rejuvenation using jalva afterwards will maintain those results a lot longer. So the women I quoted have never had any vaginal or vulvar laser procedures.

How long would somebody need to use Java to start creating a difference?

So I usually say start slow, like every other day, because especially if you have very dry vaginal issues or lichen sclerosis or some other BOVAR issues, because it is designed to work fast, right? Like if you're starting a new skin care treatment, you want that healthy turnover of. And so, and also when we go from the Sahara dry area to the Amazon, nice and moist. You can get some yeast infection that's dormant. It didn't cause every other day. So every other day for the first one, one week or two weeks, then go to daily. And usually some people see results right away in the first time. Yeah. But I usually say especially if you've been having discomfort with sex, use it for at least two weeks first and then have, then have sex.

Do you put it outside and inside?

You can put it just outside clitoris to anus. It's so well absorbed. And you can use it during sex. You can use it on the penis. It's fine with oral sex. Again, the ingredients are so clean. There's no hormone disruptors so it's perfectly safe too if it gets in the vagina.

So okay, so everyone gets mad at me. They're like every time I hear an expert, we need the thing. But this is something, this is important you all because like, like she's saying, I mean this is, we talk about our eyelids, we talk about our elbow skin, we talk about our face skin, but we're not talking about this. And this is what makes us like this is a part, this is us. This is where women. This is part of us. This is important. We've got to take care of it. So I'm, I'm using it daily now. I, it took a little while for me to get convinced and now I definitely can see and feel a difference. So this is something that I use every single day. I keep it, it's in my, my morning routine. So I'm going to highly suggest that you get it. Where should people go? I'll link it up in the show notes. But if they're just listening and they're going to remember a site, where do you want them to go?

Yeah, first of all, go straight to dranna.com will also give in the show notes the free trial link to be able to get a seven day samp jalva for free. That's great. Yeah. And and also with jalva full tube, we have a small tube and a full tube. I mean you're going to want the full tube. We have 100% money back guarantee. I promise you if it doesn't work for you, you're not liking it. My support team is here to help you. We're here to help you and educate you on the most important anatomy of your body. And if this isn't working for you for whatever reason, I will 100% guarantee your money back.

That's amazing. That's a rare offer. I mean you all seven days free. Don't hesitate. Go run and do like for sure it's free. Dr. Anna, thank you so much. I'm sure I'm going to have to have you back on because I always have so many questions for you and you explain things so well. Thank you so much for being here today.

Thank you for having me. Thanks everyone.