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Dr. Steinberg

Menopause and the Hypoactive Sexual Desire Disorder

How do you want to spend those long nights in bed: watching endless Netflix or ruffling the sheets? For a lot of women, the biggest hill to climb when it comes to hitting middle age is menopause. While for some, the word menopause has negative connotations—aging, brittle bones, loss of sexual desire—the truth of matter is that menopause can actually be a good thing, especially when it comes to sex!

As you go through menopause, you’ll notice a few things—hot flashes and night sweats aside—namely, your libido will slowly wean. This is due to decreased hormone levels. The transition will leave you feeling at a loss in your partnership, mainly because your desire to engage in sexual activity is no longer what it used to be. This might cause friction in your relationship because it’ll might make you feel unfulfilled in the intimacy department.

The physical effects of falling estrogen levels undermines sexual motivation for many reasons, but one main, and painful reason, is vaginal dryness. Although the lack of lubrication is not directly related to menopause, the age-related decrease in testosterone can have an impact on a woman’s desire to get physical because the idea of potential pain is what lingers in her future. If it doesn’t feel good, then you’ll obviously opt to abstain.

That’s when a quick O-Shot therapy or diVa Laser Vaginal Renewal treatment is well worth the investment: sex in your post-menopause can be more fun than you imagined! (think: no more worries about getting pregnant, no more kids at home interrupting the fun, and you’re finally primed and know exactly what you like!)

Proper hormone management can set things straight and get you right back into the game. No more menses to make a mess of things… you’re a treatment away from remembering how great sex can be without that painful sensation of chaffing skin rubbing you to a jolting halt. Whether it’s lubricants or a non-invasive procedure, Elna Sexual Wellness can help walk you through your options and open up a whole new world of post-menopausal sex!

Call or email today for more information.

 

Lori.

Treatments for Erectile Dysfunction

Before beginning a course of treatment for erectile dysfunction, you’ll first need the condition to be diagnosed. Erectile Dysfunction is when a man is unable to achieve or sustain an erection firm enough for sex. It’s also not a one-off situation. ED is characterized by the inability to achieve or sustain an erection more than half the time. It’s important to understand that ED is more common than you think – it happens to approximately 50% of men between the ages of 40 to 70 years old. Don’t be stressed over it, if anything, that will only add anxiety to the performance and things could get worse from there.

So, you’ve seen your urologist and it’s been established, you have ED. What next?

Oral medications like Cialis or Viagra may be prescribed. They are the most common treatment insofar as PDEs inhibitors are concerned. They increase blood flow to the penis so that an erection may be achieved (and of course, sustained as desired).

There are also injectable medicines that are readily available. Injectable medications stimulate blood flow so as to achieve and sustain an erection as desired.

PRP Therapy is another avenue that may be recommended. Platelet-Rich Plasma Therapy (also known as the P-Shot) takes the patient’s blood, separates the platelet-poor from the platelet-rich plasma, and then re-injects it into the afflicted area. The experimental PRP therapies revitalize muscles and tissues as well as improve circulatory function.

Erectile Dysfunction Shock Wave Therapy is the application of low-intensity shockwaves sent to reopen the veins and re-establish proper blood flow to the penis.

If your doctor determines that the ED is stemming from something more psychological than physiological, then sexual therapy (counselling) will be recommended. Depression, stress, anxiety (even performance anxiety), and relationship issues can all play a role in ED.

If sex in your relationship is important to, why throw in the towel and succumb to your ED? You don’t have to forever miss the intimacy? Erectile Dysfunction is a treatable condition and most men are able to return to healthy sexual function once they’ve been prescribed a proper course of treatment. So, keep your head up, visit your urologist and set a plan in motion so you can get back in the game!

Dr. Steinberg

Erectile Dysfunction from a Woman’s Point of View

For most couples, sexual intimacy can be a vital part of a romantic relationship. So what happens when a man is starting to experience a breakdown on the erection front? Dealing with the plethora of issues that he might be experiencing—from physical to emotional—your man might seek medical attention to help him with the wide range of issues he might be dealing with so that he may restore proper function. But, what about the woman? How does erectile dysfunction affect her?

The distress of not being able to stay in control compounded by the embarrassment he might feel in not being able to perform will definitely take a toll your relationship no matter which way you slice it. The physical and emotional intimacy that sex provides is not to be taken for granted, so if your man is struggling with his erection, lend a hand (metaphorically speaking) and get that conversation going.

What is erectile dysfunction?

Erectile dysfunction is basically the inability to become erect or sustain an erection long enough for sex. This health concern affects the woman involved as her sex life is being shifted off course, and while the dysfunction is happening in someone else’s body, the symptoms are trickling into her life as well.

How can you help your man?

As the woman on the other end of erectile dysfunction, it is important to get your man to talk about it. Having an open discussion about your sex life will establish trust and open the lines of communication. A lot of the time, the man won’t want to broach the topic on his own, so you might have to take the initiative and get that conversation going. If you find you’ve tried, but to no avail, or you don’t feel comfortable bringing it up unmediated, then try seeking the counsel of a sex therapist. A sex therapist will try to hone in on the source of the issue and find active ways, as well as potential treatments, that are fitting for the case at hand.

It’s not just physical

Most of the time, when it comes to erectile dysfunction, there is a combination of both physical and emotional issues blocking the natural flow of things. In most instances, physical and psychological issues work in tandem, because even if the issue is solely physical, it isn’t long before the man starts to anticipate his inability to perform, and then like a self-fulfilling prophecy, the erection is impossible to achieve or maintain. The connection between the mind and body is certainly there, and when it comes to sexual malfunction, a holistic approach is the most effective way to treat the problem.

Perhaps your man would be more likely to meet with a doctor to learn about all of the available treatments out there. If he hasn’t sought medical advice on his own, then take your sex life into your own hands and book that appointment for the two of you. The support of a partner can see positive effects that will trickle into the relationship. Knowing he can lean on you for help, trust you to help him take action, and feel like you are in this together, are all simple advantages to taking your partner’s health concerns seriously and helping him get the medical attention he most likely needs.

Dr. Steinberg

The Pleasure in Sex

For centuries upon centuries, and even to make it a little less abstract, up until less than 30 years ago, sex education in North America was funnelled down to a talk about reproduction, and safety. By and large, the conversation went something like “these are your body parts, this is how to avoid unwanted pregnancy, and this is so and so STD.” Conversation over. That about brings us up to date on sex talks in schools, in the homes, and in conversation amongst friends. But, one very important aspect of sex talk has been left out and it is finally taking its place centre stage: Pleasure.

How can you and your partner have a better sexual experience?

According to Peggy Orenstein, author of many works discussing the discrepancy between a man and woman’s sexuality, being able to articulate your needs to your partner is one of the fundamental ways to have enjoyable sexual experiences. Pleasure-seeking sex is something that has long been shamed or stigmatized, especially for women whose sexual openness would be labelled as something other than normal. But attitudes are changing and with that, so is the conversation.

Speaking up and letting your partner know what you like and need is becoming more and more common in practice and here is one reason why: learning more about your body and all of its parts allows you to better articulate what feels good and where. Another reason is that people are becoming more candid in their conversations and focusing more on mutual trust, connection, and affection, rather than the prior framework of risks and dangers. Of course there is the fundamental mutual responsibility to practice safe sex, and that is still something that should be largely discussed, but once that conversation has been exhausted, there should be one chapter (if not a few) on sexual intimacy, pleasure, desire, arousal, and enjoyment.

“How do you measure your pleasure?” is one thought-provoking question to get the conversation going. What is good sex? What is bad sex? How do you know that you enjoyed (or are enjoying) a sexual experience? In her TED Talks, Orenstein touches on a slew of questions that seem so basic, but are in fact so far removed from the conversation. It’s important, as a sexually active person, to take the time to think about what you enjoy and what the parameters are that make sex fun and pleasurable for you. Communicating that with your partner is the next step to make sure that you can explore your new findings.

Being able to have an intimate talk with your partner about what you like and what you dislike can help your relationship grow and will hopefully create a space for you to enjoy your relationship even more. Sarah McLelland, psychologist, researcher and professor, explains that there is such a thing called “intimate justice” and it’s about who is entitled to engage in enjoyable sex… the short answer? You are.

Want to learn more about sexual wellness or just need someone to talk to about your sexual health? We are a phone call (or email) away and we are always ready to talk.

 

Dr. Steinberg

Adult Circumcision

You’ve lived this long, you’ve come this far, why now? Why get circumcised as an adult?

Some men come into our clinic to discuss circumcision based on the religious or cultural beliefs. Others prefer the cosmetic appeal of a circumcised penis. While both of these are great reasons to go through with the simple procedure, many men ask (in fact, it’s a widely held debate) if there are any health benefits to a circumcision. The long and the short of it is, yes. Simply put, one of the most common reasons for an adult circumcision is Phimosis, a condition in which the foreskin is so tight that if left untreated, it can cause hygiene problems, pain during urination, and can contribute to painful erections. Also, by removing the foreskin that covers the head of the penis, a man’s potential for contracting potential infections or diseases are significantly reduced.

Ultimately, the choice is deeply personal. However, if you are interested in understanding what the potential benefits are to a little snip, here are 5 health-related benefits to circumcision:

 

 

  1. Foreskin can trap bacteria and other infectious agents. By removing the foreskin, your overall genital hygiene will be improved, thus reducing the risk of balanitis (an inflammation of the glans penis) and other infections.
  2. Statistically, uncircumcised men have a higher incidence of prostate cancer.
  3. Studies have shown a significant reduction in the risk of invasive penile cancer.
  4. Adult or infant, circumcision reduces the risk of urinary tract and bladder infections.
  5. The human papillomavirus (HPV) can adhere to foreskin. Although men are usually only carriers, and therefore can transmit HPV to their female partners, it’s important to note that circumcision reduces the risk of cervical cancer in a female partner by 5.6 times. That’s kind of major.

There are a few other major benefits, such as reduced risk of phimosis, and reduced risk of HIV/AIDS (the HIV virus enters through the inner lining of the foreskin which is thin and vulnerable).

At Elna Sexual Wellness we employ both the standard technique as well as the Pollock Technique according to each unique situation. The Pollock Technique takes under 10 minutes and requires only a local anesthetic along with some skin glue (instead of sutures, which significantly improves cosmetic outcomes). We are diligent about follow-ups to ensure that all is healing properly, and are committed to making our patients feel safe and at ease about the procedure.

With only 2-3 days of downtime and about 6 weeks of healing time before engaging in sexual activity, it’ll almost look and feel like nothing ever happened!

If you are curious about circumcision, call or email for an info session. Our experts will answers any of your questions and provide you with the answers you need to make an informed decision.

Dr. Steinberg

The P-Shot

The P-Shot was created by Dr. Charles Runels to help men who suffer from erectile dysfunction get that so-desired pep back into their step. Named after the Greek God of Virility, the Priapus Shot, aka the P-Shot, delivers approximately seven different growth factors into the penis to stimulate the regeneration of new cells, collagen and blood vessels so as to rejuvenate tissue so that a firm and sustained erection can occur.

Unlike our gargantuan-endowed friend Priapus, the P-Shot will not deliver an oversized and permanent erection, but rather will increase blood flow to the penis allowing for spontaneous arousal and desired sexual response. You know what that means? A healthy sexual lifestyle might be in your future!

How does this magical P-Shot work? Good question. It’s simple.

The P-Shot is an experimental procedure that uses platelet-rich plasma (PRP), which basically means that your own blood is reinjected into your body to attract reparative stem cells that immediately work to restore penile muscle and tissue. Let’s rewind a step.

The Process:

The P-Shot process involves a quick withdrawal of blood from the patient’s arm. Your blood is then transferred to a centrifuge where it spins for about 10 minutes. This process separates the platelet-rich plasma from the platelet-poor plasma. Re-injecting the PRP into the penis, blood flow is stimulated and ready for action.

By harvesting your own plasma-enriched growth factors and injected them back into your blood supply, the P-Shot is essentially a natural treatment, and because it’s natural, the procedure does not present any side effects.

The benefits of PRP Therapy can include:

  • Erections achieved and maintained during intercourse
  • Increased sensation and pleasure
  • Improved self-confidence
  • Restored intimacy in relationships
  • Spontaneous response to sexual desire

The benefits of the P-Shot have been known to last for up to a year. While the P-Shot is a relatively new procedure and is still considered experimental, it is of note that men who suffer from erectile dysfunction have seen improvements. Whether it’s a placebo effect or a direct effect from the treatment… well, let’s just put it this way, it’s definitely worth a (P-)shot to find out!

Dr. Steinberg

Where’s your Mojo

There is no magical equation on how to derive at what is too high a sex drive and what is too low a sex drive. When it comes to understanding your sexual desire, it’s all about the subjective experience. Knowing what feels “normal” for you and feeling out your own personal fluctuations. If you’re in a relationship, you might use your partner’s libido as a barometer to measure the highs and lows you feel, or you might be in touch with your peaks synching up with certain times of the month, for example. Either way, it’s important to keep in mind that both women and men can experience fluctuations in sexual desire; some of that can be attributed to biological factors like hormone shifts, while some of those rises and falls can coincide with emotional or psychological changes in your life.

Let’s think about what a libido is and where it is located.

Historically speaking, the libido used to be exclusively associated with the sex drive. While this is partially true in today’s world, there are now many other factors that come into play when trying to locate the libido. In terms of psychoanalysis, Sigmund Freud defined the libido as the energy created by the survival and sexual instincts. Not located in one particular area (although it is most likely located in the brain, as Freud believed it was part of the unconscious), the libido is the driving force of all sexual behavior. The libido is the source of our wants and urges, as well as the epicentre of all pleasure-seeking impulses.

Departing from our psychoanalytic father, the libido has taken on new meaning as more well-rounded research has been done in the past century. We now understand the sex drive to have more than just conscious and unconscious motivations and desires. One’s interest in sex is a combination of factors from, as mentioned earlier, biological, psychological, physiological, emotional, and social. Not to mention that other factors can play a role: illness, medication, say nutrition, and other lifestyle habits. Everything affects everything and back around again.

 

Symptoms of low sex drive aren’t as straightforward as you may think. No interest in any type of sexual activity is one major symptom, however it is not the only symptom as a low libido extends to sexual fantasies and thoughts as well. Having too high a sex drive can also be an issue for some, especially if it is getting in the way of your work, ability to focus, or daily activity, or, if you are in a relationship and your partner’s sex drive does not match your own.

Think about your libido. Have questions? Want to talk it out? Call or email Elna Sexual Wellness and let’s get the conversation going.

Dr. Steinberg

Intercourse Shouldn’t be Painful

Although the typical female response to sexual arousal is for the vagina to produce a liquid that moistens the area, it should not be taken for granted that our bodies always do what we want them to do. When sufficient lubrication is not produced, often times, in an intimate situation, despite her state of arousal, a woman will suffer from painful intercourse (also known as dyspareunia) due to insufficient lubrication. Dyspareunia is defined as painful sexual intercourse persistent or recurrent genital pain before, during, or after intercourse.

There are a few reasons why a woman might suffer from dyspareunia. Physiologically speaking, the body naturally lubricates the vaginal area. However, decrease in estrogen, the reproductive hormone, often leads to the decrease in lubrication of the vagina. As estrogen dwindles, as it does with childbirth, breastfeeding, menopause or due to certain medical conditions/treatments, the vagina feels the effects. Dryness, laxity, and other symptoms can result in pain during or after penetration, as well as a burning, throbbing, and an itching sensation.Pleasurable sex is not a natural law that comes with the territory. Many women have to work hard for it. In fact, over 40% of women have reported that they suffer from (or have suffered from) painful intercourse. That’s 40% too many! Pain during sex is not, and should not be just par for the course. There are treatments out there to help women, physically and psychologically overcome the pain and distress that sexual intercourse is causing. Some of the options out there include: diVa Laser Treatment, the O-Shot, pelvic floor therapy, and counselling. Most often, the recommendation pairs two (or more) therapies together for optimal results.

Because the cause of dyspareunia is varied and the degree of pain falls on a spectrum (some women feel pain from inserting a tampon, while others can begin to have sexual intercourse only to run dry within a few minutes), the treatments we offer are best prescribed case-by-case.

Let’s look at diVa laser therapy and consider some of the benefits:

  • Increased lubrication and sensation during intercourse
  • Tightened vaginal canal
  • Enhances ability to reach orgasm
  • Improved control over urinary incontinence
  • Significant improvement in confidence and quality of life

Does sexual intercourse hurt? Do you feel like your body is failing you? Is it taking a toll on your overall emotional and sexual health? If you answered yes to any one of these questions, it’s time to pick up the phone or start typing that email. Yes, talking about sex can be difficult, but leave it to us professionals to make sure you feel comfortable so we can sort out whatever issue you may have… contact us and you’ll be one step closer to a healthier (and more pleasurable) sex life!

Lori.

What is Sex Therapy Anyway?

Sex therapy has been around for decades, helping women, men, and couples learn how to navigate the huge topic of sex and sexual wellness. I’ve come to understand that most people have limited knowledge about sex therapy and most of what they’ve gathered comes from movies or social media. Unlike the quasi-sex therapist from Meet the Fockers (think Barbara Streisand), sex therapy is not about touching, nudity, and tips and tricks to spice up your sex life. Sex therapy is a legitimate form of psychotherapy whereby the patient(s) seek the help of a health professional to overcome sexual problems or improve sexual feelings and resolve any intimacy issues they may have.

There are a number of reasons why one would seek the counselling of a sex therapist, and in my field, more often than not, I recommend counselling (specifically with a sex therapist) to my patients – here’s why:

As humans, we have multiple systems working in tandem at all times. To treat one aspect or one (dys)function in an isolated manner would be to disregard the human as a whole person. Sounds simple, but the interdisciplinary approach to medicine is a wave that hasn’t fully caught on worldwide, although, it is my belief that the wave is coming and it will be tidal.

We are holistic beings and I treat my patients as such. That means that if a man should come in suffering from erectile dysfunction, I might treat with Shockwave Therapy, Testosterone Replacement Therapy or the experimental P-Shot, but I will almost certainly recommend counselling as well. Whether the premature ejaculation stems from a physical issue or has a psychological origin, physical inevitably seeps into the psychological and the other way around. It’s the basic nature of a mind / body connection; it’s how each pone of us functions on a very fundamental level.

Sex therapy is a great treatment option for those suffering from a plethora of sex concerns, such as:

  • Concerns about sexual desire
  • Erectile dysfunction
  • Ejaculating early (premature ejaculation)
  • Difficulty with sexual arousal
  • Body image
  • Anxiety
  • Menopause
  • Trouble reaching orgasm (anorgasmia)
  • Painful intercourse (dyspareunia)
  • Intimacy issues related to a disability or chronic condition
  • Conflicts with partners about sexual needs, desires, frequency or specific sexual activities

Not limited to the list above, sex therapy is also a forum for people to talk openly and confidentially about any concerns or questions they may have about sex, their sexual lifestyle, and overall sexual wellbeing. You might not have an identifiable physical issue, but might still be interested in sex therapy, because here’s another thing – sex is a part of our lives and it is important that we understand what it means to us and why. There is a strong interaction between thoughts, feelings, social/cultural factors, behaviours, and biological components. By unpacking each one of these five points, a sex therapist will help you identify your values, your beliefs, and your ideas of what sex is as opposed to what you might have previously though sex should be. That is the first step toward a healthier sexual wellness.

There are many benefits to sex therapy. A few notable goals include:

  • Achieving a healthy sexual life
  • Reducing anxiety associated with sexual activity
  • Learning new skills and healthier ways of approaching sex
  • Feeling in control of one’s sexuality and regaining confidence
  • Learning concrete strategies for managing uncomfortable thoughts, emotions, and harmful behaviours that are impacting sex
  • Minimizing pain during intercourse

By understanding and dismantling old attitudes and habits that get in the way of enjoyable sex, sex therapy will help you establish new beliefs that reflect your values so that you can increase sexual arousal, feel less anxious and more comfortable about sex, and ultimately help lead a better, healthier, sexual life. If you aren’t sure sex therapy is for you, call or email to learn more. Put it to you this way, the first step is easy, all you have to do is start talking.

Dr. Steinberg

What is Anorgasmia?

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Reaching orgasm might seem like a logical conclusion to sexual activity. However, it shouldn’t be taken for granted that an orgasm just happens. For some, waiting for that orgasm to happen feels like an impossible dream. Whether it’s lifelong, acquired or situational, if you are experiencing difficulty reaching an orgasm, your sex life can feel compromised.

More common than one might think, anorgasmia—the medical term for difficulty reaching orgasm—affects about 10-15% of women. It could feel quite frustrating if you are experiencing this sexual dysfunction, but the truth is there are a wide array of treatments available. Despair not, once you’ve seen a doctor and the cause has been established, you can be well on your way to reaching a (hopefully, mind-blowing) orgasm.

Symptoms of anorgasmia range from long delays to complete incapacity in reaching climax. If you take the time to sit back and think about what is required in order to achieve orgasm, it is actually a more challenging task than one might believe. A combination of sexual arousal, complete relaxation, ease and comfort with yourself or your partner, as well as a few other psychological or emotional factors all work in tandem to bring you to that climactic moment of your sexual activity. It is not just some stroke of luck that your body can take you to that euphoric state… it’s actually hard work for some women (and men)! It’s important to not feel ashamed or stigmatized about your body, and for most, releasing that negativity is the first step toward letting go and feeling comfortable having your body take the lead.

Maintaining your overall sexual wellness is a vital part in overcoming anorgasmia. First and foremost, getting to the root of the issue is a fundamental step that you and your doctor will work on together so as to properly assess the situation and treat it accordingly. For some, the correlation is straightforward, as anorgasmia can be linked to physical, emotional, and psychological factors, like the ones listed below:

Physical factors can include:

  • Illness (diabetes, for example)
  • Aging (low estrogen levels, loss of natural lubrication in the vagina)
  • Medical treatments (such as hysterectomy, oophorectomy, or cancer surgeries)
  • Other sexual dysfunctions (vaginal dryness, dyspareunia)
  • Alcohol abuse

Emotional / Relationship factors can include:

  • Poor communication
  • Relationship conflicts, resentment toward partner
  • Lack of connection with partner
  • Domestic violence or abuse

Psychological factors can include:

  • Stress
  • Past sexual, physical, emotional abuse
  • Negative self-image, embarrassment
  • Cultural/ religious beliefs related to sexuality
  • Mental health conditions (such as depression and anxiety)

The medical field has made great strides in coming up with effective treatments for anorgasmia. From prescription medicine to sex therapy, the range is wide and the options varied. Two treatments that we practice at Elna Sexual Wellness, the O-Shot and diVa Laser Therapy, encourage a more optimized sexual experience by stimulating tissue regeneration around the clitoral and vaginal areas, as well as provide more lubrication to the genital area, which can in turn reduce painful intercourse. Whether it’s a conversation with a counsellor or a non-invasive shot, sometimes, restoring sexual performance just requires that you to take the first step… calling your doctor. Yes, it can be that easy.

Lori