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sex

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.

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

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

What’s the O-Shot All About?

It’s been around for a while, but more and more women are finally catching on to the major benefits of, drumroll please… the O-Shot. Ground-breaking in its field, the O-Shot provides everything from easier arousal and increased lubrication to much needed relief from urinary incontinence.

It was only a matter of time until science and technology caught up to the sexual revolution. It took a few decades, but the O-Shot is here to stay. Taking a look at a woman’s relationship with sex, the O-Shot responds to many of the common problems women face and seeks to restore sexual function so women can enjoy sexual activity (pain-free!).

 

How does it work?

The O-Shot, also called the “orgasm shot,” delivers regeneration cells that immediately revitalize muscle, tissue and nerves. To alleviate female sexual dysfunction (and increase bladder control), the O-Shot begins with a simple blood extraction consisting of PRP (platelet-rich plasma), which is then injected back into the vaginal area, to increase blood flow, reawaken or stimulate sexual function. A natural solution and highly effective treatment, the O-Shot has multiple benefits, including:

  • Increased sexual desire
  • Improved or resolved urinary incontinence
  • Increased vaginal sensitivity and pleasure
  • Increased natural lubrication
  • Decreased pain during intercourse
  • Increased ability to have a vaginal orgasm

There are a number of ways to treat weakened muscles (like the ones that support the bladder), for example, Kegel exercises (pelvic floor physical therapy), bladder training, and surgery. But another simple, and non-invasive technique used widely is the O-Shot.

If you suffer from urinary incontinence or are experiencing any form of sexual discomfort or dysfunction, consider discussing your options with Elna Sexual Wellness. At the very least, you’ll learn something new!

 

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

Elna Sexual Wellness Was Created for You

The Elna Sexual Wellness clinic was created with one vision in mind: to provide a safe space for people to restore and enhance their sexual health. What does that mean?

Sexual wellness includes a wide spectrum of topics ranging from physiological health to psychological wellness. At times an issue might take on a physiological manifestation when in fact the cause lies in an unhealthy thought process. Or, sometimes the opposite is true: the mind is stressed or anxious and so your body responds by malfunctioning. Most often, when it comes to matters of sexual health, the root of any issue is a healthy dose of both body and mind. By taking a holistic approach to our patient’s overall well-being, we are able to best assess what the core of the issue is and from there provide a better and more precise targeted treatment program.

Sexual wellness is open communication. Sexual wellness is maintaining healthy function over your body parts. Sexual wellness is understanding yourself, your limits, what feels good and right, and what feels comfortable. Sexual wellness is a vital aspect of your life.

First and foremost, establishing open and honest communication with your partner is fundamental in establishing a sexual relationship that works on a highly functional level. Before you can explore a frank dialogue with your partner about intimate matters, it is important that you take the first step in taking the conversation inward through self-exploration and self-reflection. By building a strong sense of what a healthy sex life looks like to you, you will better be able to articulate that to your partner.

Sexual wellness is open communication

Counselling is instrumental in getting the ball rolling. Whether you have an issue on your mind or if you’re curious about what is “right,” “normal,” or “common” when it comes to sex, a sex therapist can help unpack any ideas or misconceptions you might currently be holding that are hindering you from a healthy sex life. The notion that there is an established set of rules as to what is considered “normal,” for example is something that a counsellor can help you think about; sexuality is a highly cultured and socialized topic, and so by having an impartial expert with whom to discuss matters, is a healthy place to start. By exploring notions that keep you bound in thoughts and feelings that might not belong to you, you can free yourself of conventions and rules that aren’t yours. All of this is done with the utmost discretion and confidentiality.

Sexual wellness is maintaining healthy function over your body parts

Our mission is to restore and/or enhance your sexual wellness. We have a multidisciplinary approach to treating men and women on their sexual health; with every issue that is brought forth, there is opportunity to build a multi-layered treatment plan that integrates all parts of the being both body and mind. Urology plays a strong role in sexual wellness in treating anything from erectile dysfunction and painful intercourse to low sex desire (or low libido) and incontinence. With cutting-edge treatments and technologies, we treat with oral or topical medications, non-invasive procedures, counselling, and more. It’s all about finding the right fit for you and making sure you feel the most at ease with whichever program we decide to proceed with.

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Sexual wellness is understanding yourself

Elna Sexual Wellness holds no judgment. Our patient-doctor confidentiality is set in place so that you feel comfortable diving deep into your thoughts so we can best understand where you are coming from. Our discretion and confidentiality is our promise. The safer you feel, the more chance we have of restoring your sexual wellness.

A healthy intimate relationship is something we strive to achieve when working with individuals seeking to improve or restore full function of their physical body and mind when it comes to sexual matters. There are far too many people living with anything from discomfort to embarrassment, but it shouldn’t have to be that way. That’s why we created the Elna Sexual Wellness clinic—to offer a holistic approach to treating your sexual wellness, because #sexmatters.

-The Elna Sexual Wellness team

Premature Ejaculation: You Can Have Control

You’re in bed with your partner and you’re getting intimate. Sexual intercourse begins and before you can control it, you’ve finished. You lay there, beside your partner and begin spiralling down the rabbit hole with negative thoughts about what is wrong with you. You’re embarrassed and your anxiety about your performance takes over. Sound familiar?

Many men suffer from what is known as Premature Ejaculation. But, just to be clear, premature ejaculation is not defined by the speed in which you finish, but rather whether you finished when you desired to. Being in control of your ejaculation is a more precise definition of what we, in the medical field, call Premature Ejaculation (PE).

Although many men have been known to finish too quickly, there are a large set of factors that distinguish a one-time occurrence from frequent PE. If you ejaculate sooner than you’d like to during sexual intercourse, and this is happening more often than that one time you got too drunk or went a long time without ejaculating, then it’s probably time to see a doctor to figure out what’s going on.

When it comes to premature ejaculation, there is always the possibility that psychological factors (poor body image, depression, relationship issues, and so on), are working in tandem with the physiological causes (abnormal hormone levels, abnormal levels of neurotransmitters, inflammation and infection of the prostate or urethra, and so on). By understanding the full spectrum of the disease, you will be able to begin treating the issue so that sexual intimacy can be improved.

By sitting down with men or couples (depending on the situation), we try to learn where the problem is stemming from. There can be a host of variables that are playing a role in your sexual experiences, by knowing all of the symptoms and how the disease is affecting you (and your relationship), we can better prescribe a course of action that will help you gain control of your ejaculatory function.

We will often recommend sex therapy for patients suffering from premature ejaculation. Counselling is vital for so many reasons, but the main one is whether your premature ejaculation is caused from psychological issues or not, once a man starts to experience PE, anxiety settles in fairly quickly thereafter. Anticipating frustration or shame, or feeling embarrassed about ejaculating prematurely is common and can exacerbate the issue. Talking through the stress of performance can dissipate the anxiety that goes along with it.

In the realm of medication, we typically prescribe anti-depressants (like Paxil, for example) which can help delay ejaculation. We could also explore numbing ointments (such as EMLA cream) in the realm of topical medication. EMLA is rubbed onto the head of the penis approximately 30 minutes prior to sexual activity. There are also a variety of behavioural changes or techniques you could try to help delay ejaculation. These can all be discussed with a counsellor or doctor.

Sexual experiences should not bring on stress, and anticipating ejaculating before desired is no fun for anyone. You can improve your overall sexual wellness by seeking help. It’s that easy. You just need to #HaveTheBallsToTalkAboutIt.

Dr. Steinberg

The Orgasm Gap

Elna Sexual Wellness - Erectile Dysfunction

You may have heard of things like the pay gap or age gap, but what you might not have heard of is a little thing called the Orgasm Gap.

Let’s rewind a few decades, way back to the 1960s when the sexual revolution was at its core. The idea of sex being a taboo topic was being challenged in hopes of celebrating the act as a part of normal life. Talking about sex and liberating it from it from the repressive state it was in for so long was quite the feat for the 60s. So much changed for women because of the fight they put up. Take contraception for example, that’s a notion that is so common in this day and age, it’s crazy to think that at one point it was against the law. But, despite the road that was paved by our foremothers, one major inequality remains to this day: equal pleasure.

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Today, sexual education is part of school curriculums as early as Kindergarten. Children are taught about their reproductive organs and the mechanics of sex. But, what about the pleasure aspect of it all? By not describing potential sensations, encouraging self-exploration, and being given the tools to speak to your partner about intimate issues, then sex is not an act people engage in for fun, rather it becomes something more results-oriented. See where we’re going with this? Here’s the thing, as long as pleasure is left out of the conversation, then sex is being misrepresented as being an act exclusive to reproduction. You know what that means?

Think about it. Go through the motions in your head. If sex is for reproduction, then who is the one who orgasms? That’s right. The man. Well, there you have it. The Orgasm Gap.

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The Orgasm Gap refers to men having more orgasms than women in heterosexual encounters (yes, heterosexual, because funny enough, in lesbian sexual encounters, the gap is not quite so big). Culturally, the importance of women “finishing” or feeling pleasure is considered less important than a man reaching the finish line. But why?

A lot of factors play key roles in why a woman’s pleasure is less sought after than a man’s:

  • Sex for reproduction
  • Feeling self-conscious
  • Lack of communication between partners
  • Insufficient clitoral stimulation
  • Not feeling entitled to feeling pleasure

When referring to sexual intercourse, we immediately connect the idea to penetrative sex. However, most women do not reach climax through penetration. Mislabeling clitoral stimulation as “foreplay” is part of the problem, because as long as we think of a woman’s orgasm as the pre-act, the less likely the woman will ever reach an orgasm. Very few women are able to reach orgasm through penetration, unlike what is represented in the media. Most women can achieve orgasm through masturbation, but again, this can make a woman feel uncomfortable during the act… to reach down and take care of herself evokes a take-charge kind of woman. But it shouldn’t.

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In the wake of #MeToo, women of 2019 are picking up where our 60s sisters left off. The Orgasm Gap is just one more challenge to take on. A reflection of today’s woman, roaring, empowered, justice-seeking, the Orgasm Gap is going to be squeezed tight.

Equal pay? Working on it.

#BelieveWomen? We do.

Eternal search for the missing orgasm… On our way!

Lori