Love &
Intimacy

"Time spent with the right person is like a vacation from the world."

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Love and Intimacy are probably one of my all time favorite topics. Love alone has the power to heal relationships, the loss of love has the power to destroy and/or transform the soul. The loss of love creates one of the deepest pains felt. It is inevitably part of every human's life experience. It can be overwhelming. It can be beautiful. It has the power to affect the subconscious, motivate, and influence dreams. Love or the loss of it can change the mood from the highest high to the lowest low, and so it would make sense that this part of the human experience is worth fighting for more than any other. No matter where you are at in your relationship journey, or journey with yourself, my hope is to help provide some helpful information & options to improve what is, in my opinion, the absolute best part of life; love & intimacy. 

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Having love and being in love has been shown to lower anxiety & depression, leads to higher self-esteem, greater empathy, and more trusting intimate relationships. Being in love releases oxytocin and dopamine, activating the reward circuit, helping to make love and love making a pleasurable experience. 

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LETS TALK HORMONES

• Estrogen-The most prevalent and arguably the most important female hormone is responsible for regulating almost every function in a females body. From menses to ovulation to pregnancy to creating beautiful feminine features such as soft skin and curves, strong bones, and higher libido...yes libido. It is the main hormone responsible for regulating the menstrual cycle and it's decline is responsible for menopause.

• Progesterone-The second most prevalent hormone in the females reproductive cycle is responsible for regulation and maintenance of pregnancy as well as growth of the uterine lining during the menstrual cycle. Exogenous progesterone as well as androgens contribute to causing unwanted acne. 

• Testosterone-a very essential, but often overlooked, hormone in women; with shamefully very few studies on how levels affect the female body is also crucial to balancing health. Levels are somewhat difficult to accurately measure due to constant fluctuations throughout the month as well as fluctuations in Sex Hormone Binding Globulin (SHBG) in females. However being able to calculate the Total Testosterone level as well as the women's SHBG level can help get a target range of healthy testosterone supplementation in a female.  It is thought that low levels of testosterone as well as estrogen can cause decreased sexual desire, muscle weakness, fatigue, and decreased intimate thoughts.

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THE MENOPAUSE SPECTRUM DEFINED

• Perimenopause: Most women hit this between age 45-50, but it can occur prematurely even as early as a  decade before. Having an oophorectomy (surgical removal of the ovaries) causes immediate menopause. Most common symptoms are hot flashes and irregular menstrual cycles.​​ FSH & LH blood levels elevate and can be checked if desired to see where you are on the menopause spectrum. 

• Menopause: Final menstrual period. 

• Post-menopause: One year after the final period. 

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HRT-Hormone Replacement Therapy-When should you start?

• Estrogen supplementation is recommended as soon as perimenopause starts. During perimenopause Estradiol in the form of a cream can greatly relieve symptoms of vaginal dryness, painful intercourse, decreased libido, and vasomotor symptoms such as hot flashes/sweats. Once menopause occurs estrogen can also be administered in the form of a daily pill if the women has had a hysterectomy. Low dose estrogen cream is simple and easy to use. 

  • Benefits of Estrogen cream: Can be individually titrated based on perimenopausal symptoms and may be used daily until vasomotor symptoms lesson and titrated down. Estrogen creams can greatly improve sexual satisfaction by maintaining increasing libido, vaginal lubrication, preventing vaginal atrophy which also helps decrease urinary incontinence symptoms.

• Estrogen/Progesterone in combination can be used in the form of a cream or pills. Progesterone has a protective effect on the lining of the uterus helping to prevent endometrial cancer in those with a uterus. It can also be used in low dosage as a form of birth control as long as one is not at risk for blood clots (DVT/PE).

• Progesterone only can be used alone if the women has a history of DVT/PE or is breastfeeding and desires to not become pregnant. 

• Testosterone is a natural hormone in the female body. The female body naturally converts a portion of testosterone to estrogen. Most recent studies have shown that testosterone in small doses can safely be given to women who are perimenopausal who are able to get regular blood testing completed and dosing titrated to their individual needs. Benefits of testosterone include improving bone and muscle mass, increasing libido, pleasure, and desire. Side effects of facial hair growth, alopecia, and voice deepening do not occur if kept within the normal physiologic female range; thus why it is very important to have a provider who has extensively researched this. The most common route for testosterone replacement ideally is in the form of cream/gel. Currently there are also pellets that may be inserted beneath the skin. The pellets cannot be removed once inserted and vary in the amount of testosterone released which make side effects difficult to control. 

• Bioidentical Hormones-is a term used to describe the combination of synthetically created hormones that are identical in structure to the female bodies natural hormones and are a variation of the above hormones combined together to control individual symptoms. 

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Other options: 

• Scream Cream is a prescription cream that is made at a compounding pharmacy that can be applied up to an hour before sex to enhance stimulation and pleasure. It works by increasing blood flow to the sex organ responsible for creating orgasm.

• Viagra/Cialis may be prescribed for the man in your life by submitting a Men's Questionnaire Form. 

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