Female Sexual Health
What is 'female sexual disorder' and is it the same as 'female sexual dysfunction'?
"Female sexual dysfunction'' and "female sexual disorder" are actually two separately classified terms. If it's female sexual disorder then it means that it's causing the woman personal distress. Female sexual dysfunction means that she may be experiencing problems in this area, however it's not really bothering her. She has low libido but she could care less cause she's cuddling her husband, or she can't stand her husband or whatever it is. So that's the difference between disorder and dysfunction, as it's defined right now. But the types of dysfunction or disorders that woman can experience are problems with libido or desire: problems with arousal, which is lubrication sensation, genital tingling sensations, orgasmic disorder, difficulty achieving orgasm, inability to achieve orgasm, change in the nature or intensity of orgasm and pain -- those are the types of dysfunction woman can experience. It's a disorder if it's causing her personal distress.
What kinds of doctors treat female sexual disorders?
I thank healthcare professionals. Healthcare in general is becoming more consumer driven. So doctors, in general, are making themselves aware of these issues, and for the most part are open. They might not have all the answers, but they're open to listen to these concerns. The types of doctors that women should seek out would be first their OBGYN, secondly, their family care doctor, or internist, their Urologist, if they have a Urologist, and start there. And, it may not be that they have all the answers, but it's a place to start and if the patient brings in information: a book, a manuscript, a paper or magazine or something that they've read, that often times helps as well.
How does a doctor evaluate my sexual health?
I think the first thing that is part of the sexual health evaluation is a full hormonal and metabolic panel, which is a blood test where we assess lipid profiles, your cholesterol levels, your thyroid function, your adrenal gland function, your ovarian function, to determine what hormones are being produced and if they're within the normal range. We then correlate that with whatever symptoms you're having, taking into account your lifestyle and your diet, the level of exercise you have, the amount of stress that you have in your life, what the status is of your relationship. We weigh all those factors, in addition to a physical exam.
What are some common causes of female sexual dysfunction?
The most common cause for female sexual dysfunction is aging and menopause. The same is the case in men. As men age, and as women age, sexual function complaints dramatically increase. The other medial reasons why women experience sexual complaints are not that much unlike why males experience erectile dysfunction: high blood pressure, diabetes, coronary vascular disease, medications (not only the antidepressant medications but a lot of the blood pressure lowering medications and cholesterol lowering medications), birth control pills, prior pelvic surgery, and childbirth. Those are some of the medical and physiologic reasons why women experience problems.
What roles do estrogen and testosterone play in female sexual health?
Generally testosterone is associated with libido problems, desire problems. In terms of arousal, that's more estrogen based. So if a woman is having problems with arousal or vaginal dryness the first thing to do would be to check estrogen levels and check vaginal health. And vaginal health is an indication of estrogen levels. And often times when a woman receives estrogen replacement therapy she also requires estrogen therapy vaginally. So vaginal estrogen or topical estrogen replacement therapy is probably the first line of treatment in a menopausal woman.
What is a woman's sexual response cycle?
The sexual response cycle changes throughout a woman's lifetime. So, what is healthy is governed by what she feels satisfied by. What is dysfunctional is when she feels distressed or bothered. So, healthy is individually defined by each particular woman. However, that being said, there are what is considered dysfunction which depends on what the complaint is. Low arousal, meaning low lubrication, loss of libido, meaning low sexual desire, difficulty achieving orgasm or pain. Those are all categories of sexual dysfunction that aren't necessarily in the normal continuum.
Can growth hormone help a woman's sexual health?
Growth hormone is a hormone secreted in the brain that declines as we age in both men and women. So a woman in her 60's versus a woman in her 20's, the 60 year old has about half as much growth hormone as the 20 year old. And what growth hormone does is basically regulates a whole neuro endocrine access. So it affects bone mineral density, it affects immune function, it affects lean muscle mass to fat mass, it affects metabolism, it helps to break down sugar, it helps to break down fat, helps with wrinkles because it causes the cells to retain more water, it causes hair growth and nail growth, and it's fabulous for increasing sexual energy and sexual drive. Now it is not indicated for that purpose, it's not FDA approved for that purpose, it can be used off label for women or men with growth hormone deficiency, but you do have to be very cautious of it, you have to be, you know, know who the doctor is that's prescribing it and you need to have your levels monitored if it's something that you're interested in exploring.
What is 'vaginal rejuvenation' and can it help improve a woman's sex life?
The term "vaginal rejuvenation" originally developed from a laser where individuals or physicians were lasering the inside of the vagina which caused scar, which then caused tightening. So yes you were tighter but you also couldn't dilate and it resulted in pain and tears and infections and a lot of problems associated with that. I think the relationship between plastic surgery and sexual health-at least in my mind-is from the concept of beauty from the inside out. Women want to feel good, look good and be sexy. Or feel sexy and feel sexual. In terms of my treatments with hormones with estrogen, progesterone, testosterone and some cases growth hormone, that works in conjunction with some of the cosmetics' skin therapies, because estrogen not only works in the vagina, it helps to improve skin health and skin elasticity and the collagen of the skin. So everything that I do to help my patients with their sexual health, my colleague who deals with the outside is delighted because it makes his results better, it makes his wound-healing faster and the healing time is a lot better.
