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estrogen

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

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

Estrogen in Men – Not Just a Female Hormone

Traditionally, estrogen is thought to be an exclusively female hormone. However, if you take a closer look at what estrogen does, you’ll learn that this “female” hormone plays a vital role in men’s (sexual) health as well.

There are three major endogenous estrogens in females that have estrogenic hormonal activity: estrone, estriol, and estradiol. However, the estradiaol, the predominant form of estrogen, is critical to both men and women. Estradiol plays a key role in sexual function as it is essential for modulating libido, erectile function, and spermatogenesis (the production or development of mature sperm, without which, one might not be able to fertilize the female counterpart).

Estrogen receptors, as well as aromatase (the enzyme that converts testosterone to estrogen) are abundant in the brain, penis, and testes. All three of these organs are essential to “normal” sexual function. When aroused, estradiol synthesis is increased in the brain as well as in the penis and testes.

Our hormones co-mingle in a variety of ways, for example, estradiol regulates testosterone in the mature penis. Although our hormones work together to balance our bodies, low testosterone or elevated estrogen can increase incidences of erectile dysfunction.

As with women, men can have a fluctuation in estrogen production. When a man’s body produces too little or too much estradiol, there are a range of symptoms that may occur:

  • Sexual dysfunction (low libido, decreased morning erections, decreased erectile function)
  • Enlarged breasts
  • Lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH)
  • Increased abdominal fat (mostly associated with low estrogen)
  • Feeling tired
  • Loss of muscle mass

Estradiol boosts serotonin levels naturally. When this hormone is out of balance, serotonin levels drop (this is true for women too – which is why estrogen is most commonly known as the hormone connected to mood and behaviour). Typically, when one’s serotonin drops, the body will naturally counteract it by kicking out norepinephrine and epinephrine (thanks adrenals!), to balance the body. In cases where a person suffers from chronic stress or has weak adrenals, the whole balancing act gets out of whack. That’s when symptoms kick in:

Hormone therapy is an effective solution in cases where the body isn’t producing a natural amount of any given hormone. Other ways to help your body balance and regulate hormone levels include: reducing stress, eating well, and exercising routinely. You can take your health into your own hands by understanding the basic ways your body functions.

If you are ever uncertain about what does what or how something works (or if something isn’t working the way you think it should), call us up! We encourage you to get in touch if you are ever concerned about anything related to your overall health, especially when related to your sexual wellness. You’d be surprised to learn that you aren’t alone if you call your doctor and #HaveTheBallsToTalkAboutIt

 

Dr. Steinberg

Estrogen and the Cycle – Part 2

Traitement PRP pour femmes Montréal - o shot

All month long, a woman’s body produces estrogen. If you have a “normal” menstrual cycle, then you will see fluctuations in the amount of estrogen produced, with a high during ovulation, and a low when you have your period. But, there are many other factors that play a role in a woman’s increased or decreased production of estrogen.

Estrogen is mainly produced in the ovaries (small amounts are also produced in the adrenal glands and fat tissue). Estrogen then moves through your blood and acts everywhere in your body helping with growth, maintenance, and repair of reproductive tissue, as well as influencing other body tissues and bone mass (think osteoporosis).

As a woman’s body naturally has highs and lows of estrogen levels, you might notice anything from mood or behavioural changes, oil secretions (acne), to fluctuations in sex drive. Although it is natural to see peaks and dips in estrogen throughout the cycle, let’s look at what it might feel like if your estrogen levels dip lower than your monthly usual.

Fluctuations in Estrogen: A Dip

Why would your estrogen levels fall? This question is often asked, and although there is no one certain reason, here are a few possibilities:

  • Hypogonadism
  • Hypopituitarism
  • Pregnancy failure (due to estriol)
  • Perimenopause and menopause (due to estradiol)
  • Polycystic ovarian syndrome (PCOS)
  • Anorexia nervosa (eating disorder)
  • Extreme exercise or excessive training
  • Temporal and temporary cause: immediately after childbirth and during breastfeeding

Some of the symptoms of low estrogen levels include:

  • painful sex due to a lack of vaginal lubrication
  • an increase in urinary tract infections (UTIs) due to a thinning of the urethra
  • irregular or absent periods
  • mood swings
  • hot flashes
  • breast tenderness
  • headaches or accentuation of pre-existing migraines
  • depression

Taken in stride, any one of these symptoms might be something you feel every now and again, but if these symptoms persist, then perhaps you suffer from low estrogen levels. A simple blood or urine test from your doctor could clarify the situation, and treatment can begin.

Fluctuations in Estrogen: A Rise

Puberty brings on a normal rise in estrogen levels. That’s because estrogen is a “chemical messenger” that helps your body develop from girl to woman. Playing a role in breast development, a more mature curved figure, and hair growth. In terms of adolescent surges in estrogen, the hormone is doing its job. But if you are already a woman (hormonally speaking), then excess estrogen (called estrogen dominance) might contribute to weight gain (or women who are extremely overweight), fibroids (non-cancerous tumors) in the ovaries, loss of sex drive, depression, and fatigue.

Estrogen and Sex

So let’s get down to the business of Sexual Wellness: Reduced estrogen levels can cause shrinkage of the vaginal mucosa. This shrinkage results in the narrowing of the vaginal opening, which is a condition called vaginal atrophy. Commonly, if the opening is narrowed, a woman might experience pain during sexual intercourse. Estrogen plays an integral role in maintaining a healthy sex life, and when it comes to staying lubricated, there are topical creams that can help. However, there are a number of other ways to treat vaginal dryness. The standard treatment today consists of applying vaginal creams or suppositories containing Estrogen. This can be very effective but the regular application of the medication can be messy and cumbersome. 

Here are two other treatments you might want to look into if you’re experiencing an underproduction of natural lubrication:

  1. Vaginal Laser Therapy (diVa) involves a renewal treatment with diVa Laser. It’s an effective solution to vaginal dryness or laxity. The laser painlessly stimulates the thickening of the mucosal layer, restoring a more youthful tone. diVa works both internally and externally to tighten skin, and restore function and appearance.
  2. The O-Shot PRP injection stimulates vaginal and clitoral tissue rejuvenation for a better overall sexual and urinary wellness. Although still a new therapy under evaluation, the early results of PRP therapy are encouraging with minimal side effects. And for many women, the results are almost immediate.

By restoring vaginal health we often see a return in libido, orgasm more easily achieved and vaginal lubrication increased, putting an end to painful intercourse.

Estrogen affects your physical, mental, and emotional health. Impacting everything from your stress levels to sex drive. It’s important that if you feel any symptoms related to a rise or fall in estrogen that you seek medical assistance; professional help may help alleviate any underlying causes. There is no reason you should feel out of sorts, we can help.

 

Dr. Steinberg

Estrogen: A 3-Part Series

Estrogen is a natural hormone produced by the body, and although it is most commonly associated with women, estrogen occurs in men as well. There are a few vital contributions that estrogen has to the healthy development of our bodies, especially when it comes to puberty and reproduction. But, there are times when our bodies may produce too much or too little estrogen; when that happens, shifts occur and a number of symptoms may arise. In this 3-part series, we will go through what estrogen is, the various under- and over-production effects of estrogen in women, and lastly, we’ll take a peek into how estrogen plays a role in a man’s overall health. In this article, you’ll get a simple overview of what estrogen’s role is in our bodies.

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The first thing you need to know about estrogen is that it is produced naturally in the body with fluctuating highs and lows throughout a woman’s cycle. The highest is in the middle of the menstrual cycle and the lowest during your period. As we stop ovulating, estrogen levels drop, this explains the connection between low levels of estrogen and menopause.

Known as the sex hormone, estrogen contributes to a variety of functions:

  • turns a girl into a “woman” through puberty – growth of breasts and pubic hair, and start of menstrual cycles
  • important to childbearing
  • keeps cholesterol in control
  • protects bone health (for example, osteoporosis)
  • affects your brain (mood), heart (decreased estrogen can bring on increased inflammation), skin (dry), and other tissue (vaginal walls)

Estrogen is just one of the hormones that plays a role in the normal sexual and reproductive development in women. Women with low levels of estrogen who are experiencing difficulty getting pregnant, might be put on hormone therapy which will introduce extra estrogen to the body to help simulate the hormone cycle. For women who are trying to ward off pregnancy, birth control acts as a bio-identical hormone supplement to maintain levels of estrogen (and progesterone); without a surge in estrogen, your ovaries will not release an egg.

The effects of increased or decreased estrogen levels in the body extend beyond whether our reproductive organs can successfully do their jobs or not. As our sex hormones are not solely made to reproduce, one of estrogen’s other functions is to keep the walls of the vagina lubricated with clear fluid and the lining healthy, thick, and elastic. By maintaining healthy levels of lubrication, the vagina welcomes penetration (i.e. sexual intercourse) without distress or pain. Should the levels of estrogen dip, this can impact the amount of moisture available, making sexual intercourse less enjoyable due to dryness.

Vaginal dryness is a treatable symptom of reduced estrogen levels. Also known as vaginal atrophy or GSM (Genitourinary Symptoms of Menopause), this condition can lead to distressing urinary symptoms. Vaginal estrogen cream has been the only therapy available up to recently. But now, through Vaginal laser Therapy (diVa) or the O-Shot PRP Therapy, we can restore function and appearance of the vagina both internally and externally. Your sexual desire will often return and vaginal lubrication will increase, helping you maintain healthy vaginal function and allowing sexual intercourse to be more pleasurable.

Estrogen plays a vital role in a woman’s development. As we saw, estrogen helps with the reproductive aspect of being a woman (puberty, menstrual cycles, childbearing), but it also helps with a woman’s overall health from affecting mood and behaviour to producing natural lubrication in the vagina.

There is so much to learn about estrogen, in our next blog, we’ll talk more in depth about what happens when your body produces too little or too much estrogen. We’ll take a look vaginal dryness as well as all of the treatments available.

It’s important to know your body and understand what is going on beneath the surface. It may seem like you don’t have control over the what your body naturally does on its own, but you do – and by paying close attention to your behaviour and general health, you can play an active role in tending to your happiness and overall well-being.

 

Dr. Steinberg