Low Libido

I had a woman come in to my office this week wanting a prescription.  (That never happens, right? LOL!)  In this case, she wanted a prescription for a topical cream to treat low libido.  Low sex drive is a common symptom in women that doesn’t really have effective treatments.

In this lady’s case the cream she wanted was suggested by a compounding pharmacist.  On looking up the ingredients I found no research to support their effectiveness and safety, so I didn’t prescribe it.  Just because this cream had no evidence to support it, that doesn’t mean there’s nothing we can do about low libido.

Quite frequently I see women in my office who tell me they have no interest in sex.  Often they don’t bring it up themselves, it comes up in the context of their annual physical and well-woman checkup.  I always ask whether a woman is sexually active.  Sometimes she perks right up and says “Yes!” with a smile.  Often she says “Sometimes” or “Not really.”

On further discussion many women say they’re too busy, the kids are always around, their husband or mate works a lot, or that they have pain with sex.

It’s a fact that female sexual function is VERY complicated.  Interactions between hormone status, cultural factors, relationship issues and stress levels make for a difficult problem to treat.  Many things cause low libido, including strained relationships, stress, sleep deprivation, changing hormone levels and childhood cultural conditioning.

Any attempts to simplify libido or sex drive into a pill or cream really has the potential to cause more problems than it solves because it ignores all the possible causes of low sex drive to create an artificial oversimplification of the female sex drive.

If you or your mate are having problems with low sex drive it’s important to explore 3 areas:

Is there pain with sex?

This one is fairly simple to address.  Speak to your doctor if you have pain with sex.  With menopause it is common for the loss of estrogen to cause vaginal tissues to become thin and fragile with loss of lubrication.  There are a number of safe and effective options for fixing this problem.  Younger women may have a problem called vaginismus which is a muscle spasm in the strong muscles of the pelvic floor.

How is your relationship with your mate?

Do you love your mate?  Do you like him or her?  Do you enjoy spending time together?  Do you actually make time to spend together and be romantic as a couple?

Is there resentment or anger between you?  Many long relationships accumulate baggage that can stifle sexual desire and romance.

Most couples have a very hard time teasing out and correcting relationship factors on their own.  Couples therapy is usually needed.  It is very hard work and requires a lot of trust and openness but I have seen amazing recovery for couples who seemed sure to break up.

It may also be that depression, stress and anxiety are standing in the way of a healthy sex life.  If your whole life is go-go-go and you fall into bed exhausted every night and never see your mate, who has the energy to have sex?  Your doctor can also address and treat mood problems that may be contributing.

What were you taught as a child about women and sex?

You would think that in this day and age women would be comfortable with their sexuality.  However, women heading into their 50s today were born in the 1960s to parents born in the 1930s and 1940s.  Childhood conditioning for little girls at that time was pretty restrictive.  In many ways, it still is.

Messages received as a small child are very powerful.  Little girls were taught to be quiet and ladylike, to keep a clean house and take care of their husband and family.

Horrible words were (and still are) used to describe girls and women who like to have sex.  Even within the boundaries of a loving marriage or long-term relationship, many women struggle with the messages of danger and distrust we were taught as children.  “Good girls” don’t ride in cars with boys, keep their clothes on, don’t let boys touch them “down there.”

And for Heaven’s sake you NEVER agree to have sex just because “he” wants to!

Unraveling and coming to grips with childhood teaching that may be standing in the way of sexual enjoyment as an adult also usually requires therapy.  Those messages may be buried so deep that patience and persistent effort is required to bring them to light.

If you or your mate have a low sex drive, please see your doctor.  There may be simple treatments to remove roadblocks that stand in the way of a happy sex life.

However, if pain is not a factor, and mood is good, chances are there are deeper factors at work.  Ask your doctor for a referral for counseling.

How important is it to you to have a happy sex life?  Is it worth working for?  I hope so!

QUESTION:  Do you remember being taught things about sex when you were a child that may be standing in the way of healthy enjoyment of sex as an adult?


Zika Virus

It’s summer!  Time to travel!  Do you have plans to travel anywhere?  If you are traveling to Mexico, the Caribbean or other parts of Central or South America you should be aware of Zika virus and take steps to protect yourself.

Zika virus is a virus that is spread through mosquito bites.  It infects humans and usually causes no symptoms at all.  When a person gets sick after infection they generally have a fever, body aches, a rash and red eyes (conjunctivitis).  The illness is not very severe and lasts a few days to a week.

The scary thing about Zika virus is that it can infect unborn babies and interfere with their brain development, causing a condition called microcephaly (“small head”) and other birth defects.

The best way to prevent Zika virus infection is to avoid getting it.  This includes avoiding travel to countries with ongoing Zika virus infections.  Unfortunately that includes pretty much all of the Western Hemisphere except for the US and Canada.  You can see a map with the most up-to-date information about affected countries here.

If you must travel to these countries (such as for required business or Olympic athletes competing in Rio this summer) take steps to prevent being bitten by mosquitoes.  This includes wearing long sleeves and pant legs, staying indoors when the mosquitoes are biting, and using an effective mosquito repellent.

What do you do if you get mosquito bites in one of these countries?  First, don’t panic!  There’s no need to rush to the doctor to be checked for Zika virus if you’re not sick AND you’re not pregnant.  If you DO get sick with a fever, body aches, rash and red eyes, definitely go see the doctor to get tested.  The health department is watching carefully for cases of Zika virus in the USA.

A woman who becomes infected with Zika virus must avoid getting pregnant until the virus is cleared from her bloodstream.  Current recommendations are to wait at least 8 weeks before trying to get pregnant.  Until that 8 weeks has passed, a woman should take all necessary steps to prevent pregnancy, including avoiding sex altogether and using birth control correctly and consistently if she chooses to be sexually active.  If you travel to a country with Zika virus, even if you’re not sick, it may be smart to wait the 8 weeks before trying to get pregnant.

What about women who are already pregnant?  First of all, do what you can to avoid being infected.  Don’t travel to countries with Zika virus, and avoid getting mosquito bites if you must go.  If you do travel to a country with Zika virus, whether or not you got mosquito bites and whether or not you get sick, see your doctor to talk about getting tested for Zika virus.

Men who get infected with Zika virus can pass the infection along to their sex partners (male and female).  There are no documented cases of female-to-male or female-to-female sexual transmission.  If a man travels to a country with Zika virus, even if he gets no mosquito bites and does not get sick, he can transmit Zika virus through semen to his partner(s).

This means that a man with a pregnant partner should wear a condom every time he has sex with his partner for her entire pregnancy.  Vaginal, anal and oral sex are all possible routes of transmission.  If he cannot wear a condom he must not have sex with her.  Period.  This is to protect the baby from the birth defects associated with Zika virus.

A man with a nonpregnant female partner should wait at least 6 months before trying to get pregnant after traveling to a country with Zika virus.  This is because it’s not certain how long a man with Zika virus infection will shed virus in his semen.  Couples should use effective birth control consistently and correctly for at least 6 months or avoid having sex altogether.

Babies and children can get Zika virus through mosquito bites.  Just like anyone else, parents should carefully consider whether their children should travel to countries with Zika virus and how to protect their children from mosquito bites and Zika virus infection.

If you or a loved one does get Zika virus, beyond seeing the doctor to confirm the infection, there’s not much else to do about it.  Zika virus disease is generally a mild flulike illness and doesn’t generally need treatment.  Symptom relief with fever reducing medicine, rest and plenty of fluids usually do the trick.  Symptoms last a few days to a week.

There’s a lot of buzz in the news lately about Zika virus and I’ve been fielding a lot of questions about it.  If you’re not pregnant and not intending to get pregnant, Zika is generally considered a nuisance rather than a big health threat.  However for women of childbearing age and their male partners it has the potential to have life-changing consequences for an unborn baby.

QUESTION:  Have you changed travel plans due to concerns about Zika virus?  Do you feel you have the information you need to protect yourself and your family?


Healthcare Spending And Retirement

Karen is a lady I take care of who is facing a terrible dilemma.  She is in her late 60s and has some medical problems.  She is diabetic and has high blood pressure.  Recently she’s had to have some testing on her heart and found an unexpected complication after the testing.

She can’t afford to stay retired.

She has to go find a job, because her health care is costing more than she thought it would when she first planned out her retirement.

This is a huge problem and is going to get worse.  As reported in US News And World Report in 2013, healthcare spending in retirement is going to be a BIG chunk of the budget.  On average, estimates are that for folks who were 70 in 2012, 8% of their incomes went to healthcare costs.  But for those who are in their 20s and 30s now, healthcare spending at age 70 is projected to take up to 28% of their income.  And that’s the average.  Sicker seniors can be expected to spend much more.

With the current move in healthcare, led by the government and health insurance companies, to shift more of the cost of healthcare to the patients, it is more and more important that people start NOW to get and stay healthy in an effort to decrease their healthcare spending and protect their savings and income and ability to maintain their lifestyle in retirement.

How can we do that?  There are 3 main ways to impact your health.

Fix your diet

It is estimated that 80-90% of illness is directly related to what we choose to put in our mouths every day.  More and more research points to a whole-foods plant-based diet as the healthiest diet for humans.  Even the head of the American College of Cardiologists, Dr. Kim Williams, writes that the science behind the health benefits of a whole-foods plant-based diet is compelling.

If you aren’t ready to ditch animal-based foods like beef, pork, chicken, dairy and eggs altogether, you can make positive steps in that direction by reducing portion sizes and experimenting with meatless meals.  Don’t fool yourself by thinking chicken is better than pork or beef.  It’s not.

I am also a big fan of smart supplementation, given that the American food supply is substantially less nutritious than it was 50 years ago.  Ask yourself, do you get 5 servings of different fruits and vegetables every day?  Do you eat whole grains, nuts, seeds, beans and legumes?  If not, you are likely to be missing out on important nutrients and would benefit from a good-quality multivitamin (more on that later).

Get the weight off

Obesity is the number-one risk factor for so many chronic diseases in the United States.  Diabetes.  Heart disease.  Stroke.  Cancer.  Name a disease, and I bet obesity increases the risk.

The purpose of this blog is NOT to tell you how to get the weight off.  There are lots of options and you can click the “Weight Control” category link in the right sidebar for some ideas.  You can also check this link for my personal recommendations and information on the program I personally recommend and use to maintain my weight.

Move your body

People tend to think that the purpose of exercise is to lose weight.  This is not true.  Weight loss and weight maintenance are 90% dependent on what goes in your mouth.

The purpose of exercise is to have your body do what it was DESIGNED to do.  Our bodies evolved to move.  To walk 20 miles per day, finding food along the way.  To work in the fields like early agriculturalists did.  NOT to sit in front of a computer for 8 hours, then come home and sit in front of the TV for another 2 hours before going to bed.

It is clear from scientific studies that people who move more are healthier and have lower mortality.  The simplest and most accessible form of exercise is walking.  The more you walk, the healthier you are.  This holds true for people of all ages.  Even if you’re older and unwell, get walking, it’s never too late to start!

I recommend that folks new to exercise get a pedometer (a good one will cost about $25 at WalMart or a sporting goods’ store) and start the 10,000 steps per day program.  Here’s a good article on how to get started.  Remember, it’s a marathon, not a sprint, and the last thing you want to do is hurt yourself.  Start slow!  Anything you do today that is more than you did last week is a step in the right direction!

I want you all to be as healthy as it’s possible for you to be, for as long as you can.  I want you to feed your body healthy food and move your body in a way that you enjoy.  I want you to be free of cancer, heart disease, joint pain, poor sleep and all the other ills that obesity brings.

I want you all to live long and healthy lives with a happy, stress-free retirement.  That starts NOW with the choices you make today.

QUESTION:  How close are you to retirement?  Do you worry that your savings and retirement income won’t be enough to support you due to healthcare expenses?



Sun Damage: How And Why To Protect Your Skin

Happy summer!  Time to dig in the yard, mow the grass, play in the swimming pool, throw the football and Frisbee in the park, and participate in all sorts of other outdoor activities.

Time to also start thinking about how to protect your skin from sun damage this summer!

Your skin is your largest organ.  It keeps “you” in and “everything else” out.  It conserves water, fights germs, helps you keep track of the world around you, keeps you warm, cools you down, gets rid of toxins and does many other functions we don’t even understand.  It replaces itself every 35 days.

What an amazing organ our skin is!  It is particularly vulnerable to damage from the strong ultraviolet rays of the sun we receive in the summer.  Here are two reasons and three ways to protect your skin.

Skin Cancer

Skin cancer is the most common cancer that both genders experience.  Every year well over 3 million people are treated for skin cancer.  There are more cases of skin cancer than cases of breast, prostate, lung and colon cancer combined!

Skin cancer kills.  Over 10,000 people die every year from melanoma skin cancer.  If you have over 5 sunburns in your life it doubles your risk of malignant melanoma.

Skin cancer is one of the only cancers we know how to prevent.  It’s estimated that over 90% of nonmelanoma skin cancer, and 85% of malignant melanoma, are caused by UV radiation from the sun.

Skin Aging

Do you want to have fresh, young-looking skin?  Protect it from sun damage!  It’s estimated that 90% of skin aging is due to damage from UV exposure from the sun.

Sun damage is also cumulative.  Even if you were a “sun worshipper” when you were younger, you can slow down the progression of skin aging by starting now to protect your skin.  After all, your skin replaces itself every 35 days, so if you take good care of it, its appearance and youthfulness can improve.

So how do we protect our skin from sun damage?  There are 3 main ways.

Avoid Tanning Beds

The World Health Organization classifies UV tanning devices (tanning beds and tanning booths) as Class 1 carcinogens, the same class as plutonium and cigarettes.  In fact, more people develop skin cancer because of tanning than develop lung cancer because of smoking.  Yikes!!

Indoor tanning significantly increases the risk of early-onset skin cancer.  Basal cell carcinoma is 69% more likely to develop before age 40 if a person uses an tanning bed or booth EVEN ONCE.  It’s estimated that 43% of basal cell carcinoma before age 40 in women could be prevented if women did not use tanning beds or booths.

Tanning beds cause skin cancer.  Don’t do it.  Don’t let your family (especially your teenagers) do it.

Stay Out Of The Sun During Peak Hours

The hours between 10 AM and 3 PM have the most intense and direct UV radiation delivery.  If possible, stay in the shade during those hours.

Another part of avoiding sun exposure is to wear light-colored, loose-fitting cotton clothes (preferably with long sleeves and long pants) and a broad-brimmed hat.


People who use sunscreen daily with SPF 15 or higher had 24% less skin aging than those who did not use sunscreen daily.  The most important parts to apply sunscreen to are ALL the sun exposed areas!  That’s face, neck (all the way around), chest, back, arms, hands, legs and tops of the feet.  Don’t forget your ears too, a lot of nonmelanoma skin cancers in particular are found on the tops and the backs of the ears.

There’s a lot of controversy right now about chemical sunscreens like oxybenzone and retinyl palmitate.  Some groups are claiming they are “endocrine disruptors” and dangerous to young children.  As I posted on my Facebook page, those claims have been pretty well debunked.  Your children get exposed to a lot more exogenous hormones from drinking dairy milk (even organic) than from a lifetime’s use of chemical sunscreen.

The sunscreen my family and I use is Shaklee’s Enfuselle SPF 30 For Body.  It is a patented unique formula which is paraben-free, hypoallergenic and tested by dermatologists.  Shaklee products are NEVER tested on animals!

That reminds me!  I need to order some more and stock up!  LOL!

A Word About Vitamin D

There has been a lot of hype about vitamin D deficiency, especially in these more northern latitudes where we don’t get enough sun in the winter to make vitamin D.  Should we be voluntarily exposing our skin to sunlight in order to make vitamin D?

I wrote about this a few years ago, and the general advice is to let your skin get 10-15 minutes direct sun on the bare torso (where the most vitamin D is produced) and then apply sunscreen for any more time in the sun.  Also, if you are vitamin D deficient to begin with, you’re more likely to burn, so supplementing with vitamin D can help protect your skin.

As you plan your summer fun, make sure to plan to protect your skin from sun damage leading to burns, premature aging, and increased cancer risk.  Limit your exposure, wear protective clothing, use your sunscreen and take your vitamin D!

QUESTION: Do you tend to burn easily?  Do you wear sunscreen regularly?