Low Libido? Get your mojo back | Dr. Shel Wellness & Aesthetic Center

Effects of Low Libido on Patients

• Creates low self-esteem
• Promotes low self-worth
• Decreases open communication with partner (can cause embarrassment and lack of being able to discuss with partner or medical professional)
• Leads to depression, feeling withdrawn, feelings of inadequacy, etc.
• Creates anxiety

Causes of Low Libido in Women

• Imbalanced Hormones
• Nutritional Deficiencies
• Psychological / Emotional State
• Vaginal Atrophy & Relaxation Syndrome

A. Imbalanced Hormones

Hormonal Imbalance and Low Libido

• It is estimated that 50%–75% of women experience symptoms related to hormonal imbalance
• Decrease in progesterone and testosterone production starts in 30’s and 40’s in most women
• Decline in production of sex hormones and hormonal imbalance leads to low libido and lack of sexual interest (among many other symptoms)
• 30’s and 40’s — Estrogen dominance caused by low levels of Progesterone
• 50’s and beyond 
  • Low levels of Estrogen : Vaginal Dryness, Painful Intercourse Low Libido
  • Low levels of Progesterone : Mood swings, depression Low Libido 
  • Low levels of Testosterone : Lack of drive and lack of sexual interest Low Libido

Determine Hormonal Balance

Prior to introducing hormone replacement, extensive history, examination, and testing are needed

• Medical / Surgical / Social / Family history / Gynecologic
• Comprehensive symptom checklist
• Pap, MMG, BMD, Colonoscopy (age dependent)
• Baseline testing needed: CBC, CMP, Vit D3, Hemoglobin A1C, Fasting Insulin, Thyroid, Hormones, & Cortisol testing

To Achieve Better Sexual Health

• Balance Hormones & Adrenals
• Improve Psychological / Emotional State
• Provide Treatment for Vaginal Laxity
• Provide Treatment for Vaginal Atrophy & Incontinence

Hormonal Imbalance and Sexual Function

• More commonly noted in women than in men
• Decrease in progesterone and testosterone production starting in 30’s and 40’s
• Decline in production of sex hormones and adrenal imbalance leads to low libido and lack of sexual interest (among many other symptoms)
• It estimated that 50% – 75% of women experience symptoms related to hormonal imbalance

Advanced Hormonal Testing & Treatment

Test female hormones with saliva and/or blood to determine accurate baseline and doses required:

• Estrogen / Progesterone / E/P Ratio
• Testosterone / DHEA-S
• Salivary Cortisol (4x per day)
• Full Thyroid workup

Balance w/ BHRT to Improve Libido

• Evaluate symptoms and use laboratory tests to determine each patient’s customized dose
• Follow up with each patient closely: every 3-6 months, or more often if needed
• Replace only what is low or missing with Bio-Identical Hormones
• Prescribe the Bio-Identical Hormones in a fashion that matches each person’s symptoms and hormonal needs
  • Transdermal / Troches / Injectables / Pellets / Vaginal creams

Benefits of Bio-Identical Hormones

• Increases Sexual Interest
• Reduces Vaginal Dryness
• Increases metabolic rate
• Improves insulin sensitivity
• Regulates body temperature
• Helps maintain muscle
• Improves sleep
• Maintains the amount of  collagen in the skin
• Helps maintain memory
• Decreases risk of colon cancer
• Increases HDL by 10 to 15%
• Enhances energy
• Improves mood
• Increases concentration
• Maintains bone density
• Reduces homocysteine
• Decreases wrinkles
• Natural calming effect
• Lowers high blood pressure
• Assists with eliminating fats from the body

Benefits of Balanced Hormones with BHRT

• Libido improves with Balanced Hormones!!

B. Nutritional Deficiencies

Statistics

Post-menopausal women make up an average of 13% of the US population, but consume Over 30% of prescription drugs. Prescription medications can lead to nutritional deficiencies, thus low libido. Even if a patient is on BHRT, they will not properly absorb hormones when they are nutritionally deficient.

Symptoms of Nutritional Deficiency

• Low libido
• Fatigue
• Lethargy
• Foggy thinking
• Dry skin
• Brittle nails
• Weight gain
• Depression
• Low immunity
• Hair loss

Treatments to Improve Nutritional Deficiencies & Thus Libido

• Recommend treatments based on micronutrient test findings
• B12 injections 2x per week
• Myer’s IV cocktail
• Glutathione IV
• Heal the gut first for maximum absorption of nutrients
• Use only professional grade supplements

I. Improving Libido with Natural Supplements: Di-Indole Methane (DIM)

• Supports healthy hormone detoxification.
• Promotes the healthy pathway of estrogen (2-hydroxy).
• Reduces the unhealthy pathway of estrogen (4 & 16-hydroxy).
• Bio Response is a highly absorbable form of DIM.
• Helps alleviate the symptoms of estrogen dominance and thus improves low libido.

II. Improving Libido with Natural Supplements: Menopause

• DIM
• Genistein : minimizes the incidence and duration of hot flashes and night sweats.
• Chrysin: a natural, biologically active flavonoid compound that decreases aromatization of testosterone to estrogen and dihydrotestosterone.
  • Keeping higher levels of testosterone improves libido
• Magnesium : helps with relaxation and blood flow, which can improve sexual function.

III. Improving Libido with Natural Supplements: PMS / Peri-Menopause

•  DIM 
• Chaste Berry extract : supports normal prolactin levels, hormone balancing and healthy reproductive function in women.
• Vitamin D3 : a fat-soluble vitamin that plays a role in numerous health functions, as well as aids in intestinal magnesium absorption. There is scientific evidence for vitamin D supporting cyclic fluctuations during the menstrual cycle that may help explain some features of PMS.
• Magnesium : noted to fluctuate across the menstrual cycle and is involved in many cellular pathways and neuromuscular activities which effect PMS.

IV. Improving Libido with Natural Supplements

There are several studied and documented products shown to improve libido.

Recent study has indicated

• Lepidium Meyenii (Maca) : mimics testosterone, supports sexual function, and alleviates SSRI-induced sexual dysfunction
• Epimedium Sagittatum (Horny Goat Weed) : promotes testosterone production. It also increases sexual response

References:

• Rowland DL, Tai W. A review of plant-derived and herbal approaches to the treatment of sexual dysfunctions. J Sex Marital Ther. 2003 May-Jun;29(3):185-205.

• Sahoo HB, Nandy S, Senapati AK, Sarangi SP, Sahoo SK. Aphrodisiac activity of polyherbal formulation in experimental models on male rats. Pharmacognosy Res. 2014 Apr;6(2):120-6.

• Bucci LR. “Selected herbals and human exercise performance.” Am J Clin Nutr 2000;72(2 Suppl):624S-636S

• Adimoelja A. “Phytochemicals and the breakthrough of traditional herbs in the management of sexual dysfunctions” [abstract]. Int J Androl. 2000;23:82-84.

Proven Ingredients to Improve Low Libido

• Tribulus Terrestris : increases sexual desire in women by releasing nitrogen from endothelium and nitrergic nerve endings
• Trigonella Foenum-Graecum (Fenugreek) :  increases sexual cognition, sexual arousal, sexual experience, and orgasm/ sexual drive in women

References:

• Puri D, Prabhu KM, Dev G, Agarwal S, Murthy PS. Mechanism of Antidiabetic Action of Compound GII Purified from Fenugreek (Trigonella foenum graecum) Seeds. Indian J Clin Biochem. 2011 Oct;26(4):335-46. 

• Sreeja S, Anju VS, Sreeja S. In vitro estrogenic activities of fenugreek Trigonella foenum graecum seeds. Indian J Med Res. 2010 Jun;131:814-9.

• Brooks NA, Wilcox G, Walker KZ, et al. Beneficial effects of Lepidium meyenii (Maca) on psychological symptoms and measures of sexual dysfunction in postmenopausal women are not related to estrogen or androgen content. Menopause. 2008 15(6):1157-62

• Shin BC, Lee MS, Yang EJ, Lim HS, Ernst E. Maca (L. meyenii) for improving sexual function: a systematic review. BMC Complement Altern Med. 2010 Aug 6;10:44. doi: 10.1186/1472-6882-10-44. Review.

Hormones & Nutrients

• Certain Key Nutrients are crucial for absorption of specific hormones
• Without these, our hormones will not be absorbed nor function adequately

I. Nutrients for Estrogen Support

1. Calcium : assists to break down estrogen in liver, making it less toxic
2. Cysteine : prevents oxidation of estrogen that can lead to breast cancer
3. Vitamin B6 : protects genes from estrogen-induced damage
4. Vitamin D : enhances estrogen’s positive effects on bones
5. Vitamin K : lowers ratio of estradiol to estrone

II. Nutrients for Testosterone Support

1. Vitamin D : regulates the synthesis of testosterone
2. Vitamin C : may help protect patients from prostate cancer
3. Carnitine : increases dopamine which boosts testosterone
4. Magnesium : raises free and total testosterone levels in men and women

III. Nutrients to assist the Thyroid

1. Choline : stabilizes mood and cognition in Hypothyroid patients
2. Vitamin C and E : assist in restoring thyroid function if liver is compromised
3. Vitamin A : activates gene that regulates TSH production
4. Zinc : increases T3 in patients who are zinc deficient
5. Selenium : converts T4 into T3

C. Psychological/ Emotional State

Psychological Effects

• Depression and Anxiety decrease Libido
• Anti-Depressants & Anti-Anxiety medications also decrease libido
• Credible links between nutrient deficiency and depression and anxiety have been established

Depression Statistics

• Major depressive disorder is very common, with a lifetime prevalence of  17%.
  • This is almost twice as high in women compared to men.
• Treatment Success:
  • Between 19% and 34% of depressed patients still do not respond to acute antidepressant treatment.
  • 29–46% may fail to achieve and sustain a full remission.
  • Between 15% and 50% will have a recurrence of depression despite continuous antidepressant treatment.

Relationship Issues

• The health of a couple’s relationship plays a very crucial role in a woman’s libido
• Basic Requirements :
  • Respect
  • Communication
  • Love and affection
  • Similar values and goals

Treatment for Improved Emotional State

• Thyroid and Hormonal Balance
• Neurotransmitter testing
• Meditation
• Therapy (Individual or Couples)
• Balanced Lifestyle
• Replace Nutritional Deficiencies

I. Nutrients to Improve Anxiety

1. Folate : helps produce dopamine and serotonin which have a calming effect
2. Copper : calms feelings of anxiety
3. Magnesium : regulates HPA which controls reaction to stress
4. Vitamin B6 : Assists with synthesis of GABA

II. Nutrients to Improve Depression

1. Chromium : elevates Serotonin levels
2. Folate : is a building block for serotonin, dopamine and norephinephrine
3. Carnitine : increases serotonin and noradrenaline
4. Inositol : influences signaling pathways in the brain
5. Serine : regulates brain chemistry

D. Vaginal Atrophy & Relaxation Syndrome

Vaginal Relaxation Syndrome, Vaginal hyperlaxity, “loose vagina” :

•  Loss of the optimal vaginal structure — is usually associated with vaginal childbirth and natural aging
•  Loss of vaginal tightness — is directly related to the reduction of friction during intercourse and thus to a decrease or loss of sexual gratification
•  The syndrome worsens with:
  • multiple pregnancies and deliveries
  • onset of menopause
  • a decline in hormone levels
  • vaginal atrophy

Ultra femme 360

Ultra Femme 360 is an innovative, safe, and effective non-surgical alternative to vaginoplasty and labiaplasty procedures. Ultra Femme 360 is the only technology of its kind providing complete vaginal rejuvenation including labial remodeling (labia reduction) and vaginal tightening with a single device. It uses the body’s natural processes to stimulate collagen production and restore the vaginal and vulvar areas to a more youthful state.By stimulating collagen production and increasing blood flow, the Ultra Femme 360 can reduce stress incontinence, lift and firm the labia minora, firm the vaginal canal, plump up the labia majora, tighten the perineum and improve blood flow to the Clitoris.there is no pain or irritation during the procedure only warming sensation. Treatment time is short, usually 20-30 minutes, though the entire process may take up to 45 minutes. Typical treatment plan consists of 3 treatments a week apart for optimal results. Some improvements can usually be seen and felt immediately after treatment, with the full results being achieved one to three months after the final treatment since collagen remodeling takes approximately 90 days.. The continued improvements are felt as the collagen continues to remodel. We recommend patients get a touch up treatment every year in order to maintain their results.

How does Laser Treatment work? 

•  Both lasers are non-ablative laser for non-invasive photothermal tightening of the vaginal canal.
• Stimulation of collagen remodeling and the synthesis of new collagen fibers in the vaginal mucosa tissue and collagen-rich endopelvic fascia
•  The final result of collagen neogenesis and remodeling is tightening of the vaginal canal.

Non-Ablative Laser

• For the treatment of Vaginal Relaxation Syndrome “loose vagina”.
• Stimulation of collagen remodeling and the synthesis of new collagen fibers in the vaginal mucosa tissue and collagen-rich endopelvic fascia.
• The final result of collagen neogenesis and remodeling is tightening of the vaginal canal.
• Patients experience an average shrinking of vaginal canal of 12 mm (or 17%).
• Patients experience an average thickening of vaginal wall of 1.5 mm (or 56%).
• 95% assessed the change of their vaginal tightness as strongly or moderately improved after this procedure.

Why Erbium : YAG Laser ? 

Water is the major constituent of the mucosal tissue.

• Er:YAG laser has the highest absorption in water, its wavelength of 2940 nm being located at the peak of water absorption.
• The optical absorption depth of the Er:YAG laser light in mucosal tissue is very low, cca 3 µm, making this laser the perfect candidate for the superficial heat treatment of vaginal walls.

Scientific Results 

Clearly show great improvements in vaginal tightness and sexual gratification

• 95% assessed the change of their vaginal tightness as strongly or moderately improved after treatment
• The average shrinkage of the vaginal canal after treatment was 17%.
• Patients reported a high level of satisfaction with the procedure (97%)
  • Long term result (12months) sustain in 77%
• No adverse events were noted

Laser Treatment Advantages:

•  Ambulatory procedure, walk in/walk out
•  Minimally invasive (no cutting, no bleeding, no ablation)
•  Virtually painless, no anesthesia needed
•  No special pre- or post-op preparation
•  No consumables
•  Quick and easy procedure
•  High success rate