Dr. Rena Malik

testosterone can decrease and that can really affect desire overall so in and also in women who are taking some some subset of women who are taking oral contraceptives can also develop a low testosterone because a lot of that testosterone gets bound up by something called sex hormone binding globulin which goes up and that can then affect desire so certainly like i said medications you're taking can affect you and then lifestyle and then of course physiologic issues so

Difficulty orgasming, probably the number one reason we see is that women are not getting sufficient clitoral stimulation. So when people see sex on TV or wherever, it's always vaginal penetration. But some women don't climax. In fact, 15% of women, 15-20% probably don't climax through vaginal penetration. Only 15% of women climax through vaginal penetration alone.

Difficulty orgasming, probably the number one reason we see is that women are not getting sufficient clitoral stimulation. So when people see sex on TV or wherever, it's always vaginal penetration. But some women don't climax. In fact, 15% of women, 15-20% probably don't climax through vaginal penetration. Only 15% of women climax through vaginal penetration alone.

Difficulty orgasming, probably the number one reason we see is that women are not getting sufficient clitoral stimulation. So when people see sex on TV or wherever, it's always vaginal penetration. But some women don't climax. In fact, 15% of women, 15-20% probably don't climax through vaginal penetration. Only 15% of women climax through vaginal penetration alone.

The remainder needs some sort of clitoral stimulation in order to penetrate or to climax. And that's basically because the clitoris is the homologue of the penis. And so a lot of people don't know that. It's very simple, but they just don't know that that is the area that needs to be stimulated for women, just like the penis needs to be stimulated for men.

The remainder needs some sort of clitoral stimulation in order to penetrate or to climax. And that's basically because the clitoris is the homologue of the penis. And so a lot of people don't know that. It's very simple, but they just don't know that that is the area that needs to be stimulated for women, just like the penis needs to be stimulated for men.

The remainder needs some sort of clitoral stimulation in order to penetrate or to climax. And that's basically because the clitoris is the homologue of the penis. And so a lot of people don't know that. It's very simple, but they just don't know that that is the area that needs to be stimulated for women, just like the penis needs to be stimulated for men.

Absolutely.

Absolutely.

Absolutely.

So this is a long answer, but generally speaking, when we talk about hormones for women, you think about systemic hormones. So things that will affect the levels of hormones in your blood versus vaginal hormones. And so we'll start with vaginal hormones. It's a little bit of a more concise discussion, but vaginal hormones. So when women go through menopause, a lot of changes happen.

So this is a long answer, but generally speaking, when we talk about hormones for women, you think about systemic hormones. So things that will affect the levels of hormones in your blood versus vaginal hormones. And so we'll start with vaginal hormones. It's a little bit of a more concise discussion, but vaginal hormones. So when women go through menopause, a lot of changes happen.

So this is a long answer, but generally speaking, when we talk about hormones for women, you think about systemic hormones. So things that will affect the levels of hormones in your blood versus vaginal hormones. And so we'll start with vaginal hormones. It's a little bit of a more concise discussion, but vaginal hormones. So when women go through menopause, a lot of changes happen.

their labia actually shrink, their clitoris can get smaller, they can get atrophy, and they can get thinning of their vaginal epithelium. And so that I can see on exam, but women may come saying, it feels dry down there, I'm not getting as much lubrication during sex, or I'm getting recurrent urinary tract infections.

their labia actually shrink, their clitoris can get smaller, they can get atrophy, and they can get thinning of their vaginal epithelium. And so that I can see on exam, but women may come saying, it feels dry down there, I'm not getting as much lubrication during sex, or I'm getting recurrent urinary tract infections.

their labia actually shrink, their clitoris can get smaller, they can get atrophy, and they can get thinning of their vaginal epithelium. And so that I can see on exam, but women may come saying, it feels dry down there, I'm not getting as much lubrication during sex, or I'm getting recurrent urinary tract infections.

So those are sort of the very common things that people will complain of, and that can be very easily addressed with hormones. Vaginal estrogen is very, very safe. There's a lot of misinformation, but vaginal estrogen is not absorbed systemically. Not a lot of it. Very, very minimal amounts get absorbed systemically. Most of it is just local for the tissues.

So those are sort of the very common things that people will complain of, and that can be very easily addressed with hormones. Vaginal estrogen is very, very safe. There's a lot of misinformation, but vaginal estrogen is not absorbed systemically. Not a lot of it. Very, very minimal amounts get absorbed systemically. Most of it is just local for the tissues.

So those are sort of the very common things that people will complain of, and that can be very easily addressed with hormones. Vaginal estrogen is very, very safe. There's a lot of misinformation, but vaginal estrogen is not absorbed systemically. Not a lot of it. Very, very minimal amounts get absorbed systemically. Most of it is just local for the tissues.

And so if you're having those symptoms, vaginal estrogen, either in a cream, a pill, or a ring can actually, a ring that goes in the vagina can all help support the normal vaginal epithelium and the tissues to keep them healthy. And so one, it's really great for recurrent urinary tract infections. A lot of people don't know this and are getting antibiotic after antibiotic after antibiotic.