Thanks for tuning in to the Armor Men’s Health Hour Podcast today, where we bring you the latest and greatest in urology care and the best urology humor out there.
In this segment, Dr. Mistry and Donna Lee are joined by special guests from River Place OB-GYN, Dr. John Thoppil and Women's Health Nurse Practitioner Dana Wicker to discuss the intricacies in arousal for both men and women. While we often discuss low libido in men on the Armor Men's Health Hour, Dr. Thoppil and Dana are able to provide us with a more in-depth look at the experience of low libido for women. The factors that contribute to sexual arousal and desire for women are multi-factorial (as they can be for men, too). This means that other stressors in a woman's life as well as her overall physical health can contribute to a low desire for sex. Understanding the factors at play in lack of arousal can help providers to select the most appropriate way to treat it. Luckily, there are several easy and very successful treatment options for women with low libido. Two discussed today include Viveve, a radio-frequency treatment used to help rejuvenate vaginal tissue to improve laxity (which often occurs after childbirth, weight loss, or typical aging) as well as urinary incontinence and sexual response. After one annual treatment and zero pain, women see amazing results that also give them increased vaginal lubrication--that will definitely help with arousal! The other treatment is Cliovana, a sound-wave technology much like "shock wave" treatment for erectile dysfunction which increases blood flow to the clitoris by as much as double! This has the benefit of not only increasing arousal but also lowering the orgasm threshold by bringing extra blood flow to this hyper-sensitive area. If you or someone you love is struggling with sexual arousal, please know you have options! Give River Place OB-GYN or NAU Urology Specialists a call today to schedule a consultation.
Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.
We enjoy hearing from you! Email us at armormenshealth@gmail.com and we’ll answer your question in an upcoming episode!
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Speaker 1:
Welcome to the Armor Men's Health Hour with Dr. Mistry and Donna Lee.
Dr. Mistry:
Hello and welcome to the Armor Men's Health Hour. I'm Dr. Mistry, your host, here with my incredible, very funny and professional practice manager, Donna Lee.
Donna Lee:
Always an insult, but not today. Thank you. Happy day, everybody. Dr. Mistry is going to be nice in this segment.
Dr. Mistry:
I try to mix it up a little bit.
Donna Lee:
They don't know what to do with that.
Dr. Mistry:
You know, we've been doing the show for two years.
Donna Lee:
Has it been? It feels like two minutes...underwater.
Dr. Mistry:
Underwater. I'm pretty sure you stole that joke from somebody.
Donna Lee:
I stole it from my husband, because tells me it's it feels like we've been married 10 minutes and then he says,"underwater."
Dr. Mistry:
Underwater. Very nice. Very nice.
Donna Lee:
There you go. You're welcome, Michael.
Dr. Mistry:
This is a men's health show. I'm a board certified urologist.
Donna Lee:
Are you?
Dr. Mistry:
She is...certifiable.
Donna Lee:
I'm a board certified cohost.
Dr. Mistry:
She is not Dr. Donna, despite what she puts on her...
Donna Lee:
I got, I got two pieces of mail home that say Donna McBride MD.
Dr. Mistry:
Oh my lord.
Donna Lee:
From some company, some loan company...yeah, that's right.
Dr. Mistry:
This show is brought to you by the practice, I started in 2007 NAU Urology Specialists.
Donna Lee:
Old man walking.
Dr. Mistry:
Old man walk...I do feel like an old man, sometimes.
Donna Lee:
You should. You got a broken thumb from a gun.
Dr. Mistry:
That's right. It's just the skin. It'll be okay. It'll be okay.
Donna Lee:
Can you do surgery with that?
Dr. Mistry:
Yes, I can do surgery with it.
Donna Lee:
Okay.
Dr. Mistry:
Our practice really focuses on more of a holistic approach to men's health. We really take a lot of cues from the fact that we've been doing hormone therapy for such a long time. And so many of the patients that were getting hormone therapy were not feeling better because they still remained overweight and had bad sleep apnea and had terrible cholesterol and hypertension. It wasn't the testosterone that was going to fix them.
Donna Lee:
Right. They liked their testosterone number, but still felt like crap.
Dr. Mistry:
That's right.
Donna Lee:
And we're like,"Well, maybe you need to lose a hundred pounds...and stop snoring."
Dr. Mistry:
And so when we are here, when we're here to help you, if, if you want to make an appointment with a comprehensive men's health program, and for any of your urologic needs, you can. Donna, how do they do that?
Donna Lee:
They call us at(512) 238-0762. Or you can visit our website armormenshealth.com. And you can check out our podcasts wherever you listen to podcasts. We're in Round Rock, North Austin, South Austin, and Dripping Springs, Texas, where they love dripping.
Dr. Mistry:
They love dripping and dripping. We're trying to fix that. We talk about sexual health and men all the time.
Donna Lee:
Every day, all day.
Dr. Mistry:
And when I do a slide, I have the slide where the man, when it talks about sexual functioning only has one switch, and the woman has like a hundred switches. Have you seen that slide than I do?
Donna Lee:
No, but you've told me about it. I bet it's funny.
Dr. Mistry:
Yeah, it's a pretty funny slide. So I thought what we would talk about today is on the women's side, some of the barriers and kind of tools that we have to help improve a woman's sexual functioning. We talk about it, you know, every so often through the paint standpoint. I wanted to talk about technology. So we have some friends and partners with us from River Place OB-GYN, founder of River Place OB-GYN, Dr. John Thoppil. Thank you for joining us today, John.
Dr. Thoppil:
Happy to be here.
Dr. Mistry:
And your partner in crime, your nurse practitioner, and that's Dana Wicker.
Dana Wicker:
Hi, thanks for having us.
Dr. Mistry:
Oh, thank you guys for joining us today. When it comes to women's sexual health, I think so many men just get confused, right? Because they're not sure if they're not having sex because they did something wrong or something is wrong. When, when a man has erectile dysfunction, a lot of times the woman will blame herself and say,"Oh man, it must be something I did. I don't turn them on enough or something." And I always kind of giggle. I'm like,"Do you know this guy probably, if he could get an erection gets turned on by like..."
Donna Lee:
The wind.
Dr. Mistry:
Yeah. You know, and anything. So from that standpoint, it's oftentimes something organic as opposed something psychological. When you find women complaining about sexual issues, what are some of the main complaints that they present with?
Dana Wicker:
Well, most often people, I like to say, this is a doorknob conversation. It's at their well-woman visit, and we'll do all of the check-boxes for their general health and wellness, and then they'll say...
Dr. Mistry:
And they say their husband is shaped like a door knob?
Donna Lee:
The one that curves? Like Peyronie's? I'm looking at one right now.
Dr. Mistry:
Three inches long and six inches around.
Dana Wicker:
As we're leaving the room, they'll say,"And I have no desire for sex. My libido stinks." So that's most often what people will complain about. But what we like to say is exactly what you said, is women are really multifactorial. My favorite description of women versus men is waffles versus spaghetti. So men can keep everything in like little wells, and like the syrup is just in the little, well, and if it's sex time and my penis works, we're going to have sex. But women are very multi- factorial, so they they're like spaghetti where all of the noodles are all mixed together. And they've got swim lessons for kiddos, they've got the vet appointments, they're, you know, also struggling with low libido. So it's very, we have to kind of tease apart what is biological thing versus what's going on in their life versus what their relationship is looking like. So it's all of those pieces pulled together, but that's usually the complaint for us is,"My libido stinks," but we sort of have to stop right there and figure out,"Okay, how many pieces are playing into this?"
Dr. Mistry:
So, John, one of the hard parts with that door knob conversation is you just spent your, the 12 minutes you had with, to spend with that lady.
Dr. Thoppil:
That's right.
Dr. Mistry:
And now she wants to have what she may think is a very quick conversation. And that conversation is long. So I tell them to come back and talk about it because I want to give them their due times. What is your evaluation? Both from a history physical and laboratory standpoint usually entail?
Dr. Thoppil:
Sure. So I think when it comes down to it, to exactly that it's usually the end and sometimes they're almost embarrassed to say it and they think it's going to be quick. For the reason that you just elucidated, we don't want it to be quick, right? Because it is such a comp-, you know, a complicated issue.
Dr. Mistry:
She doesn't want it to be quick, either.
Dr. Thoppil:
So we I'm so happy to have Dana involved. You know, Dana has had a passion to this area. So we've actually operated a sort of a side clinic--it's called Sex ATX. So you can come and we're focused on libido, we're focused on anatomical defects, we're focused on those type of things. And so this, this is an important issue. It's important for health. I mean, female orgasm has to have a biologic reason, right? God didn't give us things that serve no purpose. You know, there's, stress-relief, there's some evidence that orgasm improves fertility function. There are other things that go along with it.
Dr. Mistry:
In a man it helps reduce prostate cancer risks. For sure, there are reasons.
Dr. Thoppil:
There are reasons are reasons, right? And so I think I'll be honest. You know, for the last 10 years before I had this up, we dreaded that conversation. We didn't want it, cause we didn't have the time and we didn't have a fix. We saw, and Dana helped bring up the fact that this is such a big need that we want to focus on that. In terms of evaluation, it's, it's that figuring out, you know, is there other things going on in life? Is there pain with intercourse? Is, does she have low estrogen? Is it pure libido by itself without physiologic discomfort? Are they, you know, abnormal in hormones, hot flashes, something else going on? So testosterone, that's a whole separate, complicated issue. But specifically in women that have had surgical menopause, that's where testosterone has been most shown to be beneficial, but for the average younger woman, not so much.
Dr. Mistry:
So Dana, when it comes to technology, we have, we have the tools.
Dana Wicker:
We do.
Dr. Mistry:
Why don't you give us a little overview of some different and maybe more kind of cutting edge technologies that you guys use to help with sexual functioning, as well as, you know, some other things that women may complain of--stress incontinence, low vaginal lubrication, things like that.
Dana Wicker:
Yeah. So we have two really great technologies that we use. One is called Viveve. Viveve is, it's radio-frequency delivery of energy into the vaginal tissue with the intent to improve vaginal laxity, like after aging, weight loss, childbirth. It improves lubrication during intercourse and it improves urinary incontinence. So there's not a man out there who if they peed their pants during the day, wouldn't do something about it. But for some reason, women think that this is okay, and they laugh about it and talk about it with their friends, but they don't think to tell us so that we can help them fix it. It's an easy, painless, one-hour procedure. It's amazing. You just come in, and you can scroll on Instagram while we do it. And after 30 days, you start to notice results from that cellular change.
Dr. Mistry:
Is it just one treatment for stress incontinence or multiple?
Dana Wicker:
It's one treatment per year, which is amazing. It's phenomenal. People have really, really great results from this. And with the bonus of increased sexual lubrication.
Dr. Mistry:
And radio frequency ablation, we use in many different types of procedures. It's really designed to induce a little bit of tissue damage to help increase tissue healing.
Dana Wicker:
Right. And so there's no, there's no pain, there's no pain with this one. And so it increases, it will intentionally damage the collagen fibers so that your body will kind of come behind and with an inflammatory response fix it.
Dr. Mistry:
Well, that's awesome. And John, what about sexual functioning? Tell me about technologies designed for that.
Dr. Thoppil:
Viveve also does help with that. They actually have randomized trials--and I know you're a data guy--that showed improvement in both stress incontinence, but sexual response, also. Published in peer review journeys--journals. But I think you're alluding to the other technology that we do, and that's called Cliovana. Many of your patients have heard about shockwave therapy. You know, they have ED, something I know that you guys definitely offer as one of your many, many options. The clitoris itself has an, has a similar physical structure. Right? What we typically see is just what you think of the clitoris is it's just literally the tip of the iceberg. If you actually saw a picture of the clutter and you saw the arms extend how large the organ is, there's significant blood flow that goes to the area. Sound wave therapy, just like for treatment of ED can, in trials, double clitoral sensitivity. So if you have increased clitoral sensitivity and blood flow, you know, if somebody has a erection as a male, you know, does that increase the desire to have intercourse? Absolutely it does. Right? The corollary would be if you increase blood flow and response from the clitoris, would that improve potentially libido? Absolutely it would. So lubrication would improve sexual, response would improve. But man, I know a lot of you out there that would love to improve, you know, libido for both of you. This might be an option worth exploring.
Dr. Mistry:
And this issue of arousal in a woman, I try to always explain to couples that arousal in a man and woman physiologically are the same. So if you have diabetes, high blood pressure, use a beta blocker, if you have previous pelvic surgery, you're going to have difficulty getting that clitoral erection and feeling aroused. It didn't occur to me that this would be a natural extension, and now I'm ashamed that I didn't come up with it.
Dana Wicker:
Well, the other thing that's really helpful is that this will reduce the reserve for a woman to tip over into an orgasm. So if you, if you and your partner have an orgasm gap, which is a nice way to say that perhaps the man finishes faster than the woman, this can kind of help narrow...
Dr. Mistry:
That's not normal?
Donna Lee:
What does that mean?
Dana Wicker:
...that can help to narrow that gap, which will also increase satisfaction, and I think would probably increase the chances that this would happen more than once.
Dr. Mistry:
This is an exceptional conversation. I want to thank you guys so much to discuss kind of this very sensitive topic and to know that you guys are doing it with your patients in such an exemplary manner. How do people make an appointment with you?
Dr. Thoppil:
So you can go to our website, sexatx.com, or call our office and ask for our consultation with Dana(512) 473-8300.
Dr. Mistry:
Well, thank you guys so much for joining us today.
Donna Lee:
Thank you. Our pleasure.
Speaker 1:
The Armor Men's health hour. We'll be right back. If you have questions for Dr. Mystery, email him at a farmer men's health, the ed gmail.com.