Episode Transcript
Speaker 0
Oh, hey, Mish. You had another session with Coral while I was away. How was it?
Speaker 1
Oh, I did. It was so, so good, because we spent the whole time basically just talking about stress and anxiety. And, you know, it's it's been a lot. I've had a really tough fall, moving family health stuff and supporting Finn with some, you know, first year university anxiety stuff.
Speaker 0
And it's been a lot, like, a real lot.
Speaker 1
Yeah. And so the whole call, poor Nicole, I just vented.
Speaker 2
And yeah.
Speaker 1
It was a lot. I got everything off my chest. She listened. And and she had some really great ideas and some new, like, tools that I haven't tried yet. This, like, stop yeah. Like, I'm into breath work, but this new one, stop breath b has been, like, game changer the last few weeks. Sorry. Last few days. And, yeah, it's just every time I feel that tightness in my chest, I'm I'm using the stills. Right? Yeah.
Speaker 0
I love that it's not just about the physical symptoms. Right? The mental health stuff in this phase of life is a lot. And we have a lot going on. And, man, we need stuff that we can implement, right, in the moment right away. So that's great.
Speaker 1
Yeah. And it and the fact that they get like, she get she got that it was all connected. Like, yes, this is anxiety. It definitely is a perimenopause symptom, but I wasn't I don't know why I wasn't expecting that they were going to be supporting me through this as well. It's pretty awesome.
Speaker 0
It's a great approach.
Speaker 1
Yeah. Another cool thing that happened on the call, I found out I can sync my Oura ring with the Coral app, and you know how much I love my Oura ring.
Speaker 0
Yeah. I do.
Speaker 1
Yeah. Yeah. So super good because then she can also see my sleep scores and my HRV and my movement. When you've been drinking. Yeah. Yeah. Good and bad. There's the bad side is that she can tell when I've been fucking up and having fun and not not working out. So, yeah, we'll see we'll see how my next session goes.
Speaker 0
But that's that is definitely complete midlife care. Right? All the things. It's amazing.
Speaker 1
It's amazing. And now Coral is available in Ontario, in Quebec, and BC with more provinces coming all the time. So
Speaker 0
Hopefully, Alberta soon. Seriously, to our listeners, don't wait. This is the kind of personalized care we all deserve. Head to coral dot ca and use code tip five for five percent off. That's c o r a l dot c a, and use code t I p five for five percent off.
Speaker 1
Okay. So the other day, Jay and I were chatting. You know, we're empty nesters. It's, you know, all kinds of great stuff. And he made some comment that we hadn't had sex in a little while, and I could tell he was hurt. And I get it, but, you know, he was also trying not to put pressure on me. It was just, ugh, gross.
Speaker 0
Ugh. I've been there. It's tough when your libido just is not libido ing, and your partner is feeling the disconnect.
Speaker 1
Yeah. And, like, it's not that I don't wanna connect with him. It's just that, like, right now, sex is the last thing on my mind. Between selling this effing house and then trying to organize a move, like, moving our fifteen year life into, like, three different spots and been struggling with university. And I'm not sleeping, and I'm feeling exhausted all the time. And I'm just like, I'm not in the mood, man.
Speaker 0
I totally get it. And it's hard because I think sometimes our partners don't realize that it's a lot for women and that desire isn't spontaneous for us. We're definitely more about responsive desire. Like when my husband takes the initiative to plan a date night or he empties the dishwasher, super sexy.
Speaker 1
Without me. Yeah. Super sexy. Yeah. Yeah. Right. Yeah.
Speaker 0
It makes me feel but it does make me feel more connected to him. And that connection is key for me to get my libido libido ing.
Speaker 1
Right? Ugh. I libido. I like that. And you know what? And then, like, you definitely I think for Jay Jason loves to talk. And I I, you know, I I do think it's important to talk about these things, but let's be honest. Like, talking about sex can get awkward sometimes, especially if you're not on the same page. It's like, the conversations are just I don't know. And then, you know, throw in some vaginal dryness, maybe a little discomfort, which I think they like, Jace like, they can take it personally. Right? They they don't understand what's going on down there. I don't understand it, and they Yeah. And they feel like they take it personally. I don't know. It just makes it so much worse. It's such a hard thing to talk about, Meg.
Speaker 0
It's a lot. It's a lot. And I think, yeah, a lot of women in perimenopause are struggling with this stuff, but they're not talking about it because it's too it's too much. It's too embarrassing. It's too or they've tried and their husband has been hurt and not responded well. So so glad we're talking with Jean Lefebvre, who's a nurse clinician specializing in women's sexual health of the world.
Speaker 1
Yeah. Jean is going to be shedding some much needed light on how perimenopause affects our sex life and, more importantly, what we can do about it. Because we all deserve to feel connected. We all wanna have some good sex no matter where we are at what stage in life we're in.
Speaker 0
Amen to that. So let's get into it because this is perimenopause. Jen, welcome. So great to have you with us.
Speaker 2
Thank you for inviting me. I'm so excited to be here with you.
Speaker 1
Today's talk topic is gonna be super interesting and I think one that we've we had, a sex therapist on, but we haven't we haven't really breached the the conversation about sexual health and perimenopause and menopause and postmenopause. And so, I think this is gonna be one for that everyone's gonna be really excited about.
Speaker 2
Yeah. Everyone wants to talk about sex, so it's really a great topic. Yeah.
Speaker 0
Or doesn't and needs to be, you know, pro prodded a little bit to to talk about it. Yeah.
Speaker 1
And I think too because in perimenopause and menopause, like, there's a lot of things changing. And as Mikkel said, like, many of us are too embarrassed to talk about it, or, you know, it's uncomfortable. We've been brought up not to talk about it. But I feel like, you know, women are starting to have difficulty with their libidos or reaching climax. There's less sensation. There's all kinds of things happening. Let's just start there. What's what's going on? What's going on with our sexual health and and why?
Speaker 2
There's so much going on at the same time, and I think it's why so many women in perimenopause and in menopause and the years beyond that get some difficulties that they didn't get before. Like, so many women come to me in my practice and tell me I never had problems with sex in my life and now I just can't make it work with my partner. So it's something that we hear so frequently. And what's important to understand is that there's so many factors at the same time that's impacting, yes, the orgasm itself, so the body, but also everything going on in the head. So so much stress, so much responsibilities. Like in midlife, women are thriving usually in their careers, in their families when they have one. So it's so many things at the same time, and we add the hormones on top of that. So, yes, the the orgasm is something that's gonna be harder to get for some women, because of the hormones, the changes also that's gonna happen in the body. The first hormone that we usually talk about is the estrogen. So the estrogen really have some receptors everywhere in the body. So we don't necessarily think that it can cause all of these symptoms where when we're in perimenopause, we think hot flashes, we think brain fog, but we don't necessarily think about all of the vaginal and the urinary symptoms that can happen. And it's really linked to the decrease in estrogen. So when you decrease your in your estrogen, you can see that your vaginal walls can get really thinner with time. It can get more dry also, and and that can lead to pain and to difficulties with arousal. So that's something that we hear really often. And I think it's really important to make the difference between arousal and desire. Desire is more in the head. So as we said, more linked to libido and your how is your mental state? Do you feel comfortable in your relationship? But you also have the arousal that's really just the body. Like, even though you want to do it, sometimes your body just can't follow. And that's something that's really also important to talk about, I think.
Speaker 0
Yeah. Absolutely. Okay. So there's so there's a lot there's a lot to unpack there. Yeah. And I think it's probably I think most people are too afraid to say I can't orgasm as intensely or or does it does it even happen that it's not even happening anymore? Like, you can't orgasm? Mhmm. That that's distressing.
Speaker 2
Yes. Yes. And as you said, it's still so taboo to to talk about it. Like, we talk about sex more in general in our, in our day to day, but talking about our problems when it's linked to sex or sexual health, that's still a little bit taboo and we don't even talk about it with the people around us. So even another, another difficulty, even more when you go talk to a stranger about it or someone you see once a year, that's your health care provider, for instance. So that's really another, in another issue that women talk about us too. They they don't wanna talk about it if the health care provider don't talk about it first. But unfortunately, also, not all health care providers are trained to talk about it and to really be able to treat those types of problems. So that's a whole situation we've got here.
Speaker 0
Well, and and as well, a lot of providers are in a system, a medical system or a structure where it's a ten minute appointment max.
Speaker 2
Yeah.
Speaker 0
And that's not enough time to like, all of the things you just mentioned. Right? That that's more than a ten minute conversation to try to figure out what's happening, where do we start. So maybe so at Corl, in your role, where do you start? So someone comes in, and they're, you know, let's think back, Michelle, to the hot messes we were.
Speaker 1
Oh my god. No. Like, stop.
Speaker 0
Right? And we come another provider we've worked with says, you know, they comes you come skidding in, which I think is such a great visual. And you're like, oh my god. Nothing's working. I feel horrible. And my husband's gonna leave me because I don't wanna have sex with him. Okay. I'm I'm being dramatic. But it's a lot. So where where do you start?
Speaker 2
Yeah. So we usually do a first evaluation that's more global to see the whole situation and also to evaluate all of the factors we just talked about. So first, there's the hormonal part that we look at. So as I said, the estrogen can have a big impact on the libido, on the physical body also, but there's the testosterone also that we don't necessarily think about when we talk about women that is so important in sex drive in general. So the first part is really the hormonal and the more biological part of it. So the hormones, the symptoms that we can have then can lead to having a decrease in libido. So when you have, like, vaginal dryness, vaginal itching, some UTIs that keep coming back, you don't necessarily want to have sex. So that all of those things can have a big impact on the sex life of the person. So really the body first, and then we also look at the the psychological one. So we look at stress. How are you doing? Are you finding some pleasure in your day to day life? Not just in sex, but also in your activities. Are you taking time for yourself or you're always at work, always giving to others, your families? And, another thing that's really important is also the relationship. If the person's in a relationship, sometimes we can think, oh, nothing's working. It's because of the sex, but there can be other factors that have an impact also on the sex. So just intimacy in general in the relationship if there is one. So I think that's a big start. There's a lot of things to see.
Speaker 1
Intimacy and desire, I would say.
Speaker 2
Yes. You
Speaker 1
have both. Yeah. Yeah. Mhmm.
Speaker 0
Yeah. I I'd say it's probably rarely just the sex.
Speaker 2
Yes. Exactly. And sometimes it can be hard. Like, in perimenopause, all happens at the same time. So it's like a big shock, but it can go further than that. It can be a while that the couple has some difficulties, but they just keep pushing it aside because they're like, oh, it's gonna get better when the kids will grow a little bit. So that's also something that we see that it comes from a long way, but now it's just exploding because all is exploding at the same time. So that's why it comes up now, but it's not necessarily a a recent problem.
Speaker 1
Fair. That that's a oh, sorry, Mikael. Oh, no. I was just gonna say,
Speaker 0
is there a common approach, though, in terms of okay. Well, let's maybe look at some of these hormonal things as an example, and let's try to get you sleeping better. Right? Maybe stop having twenty hot flashes a day or whatever whatever those physical symptoms are that frankly make anything else impossible. Right? Like, you're just I know both Michelle and I were just basically surviving and just trying to get through the day, let alone worrying about orgasming or not or Exactly. Anything else. So
Speaker 2
Yeah. Yeah.
Speaker 1
What's not on my radar?
Speaker 0
Yeah. Is that so so is that do you tackle do you I'm I'm presuming you tackle those physical symptoms first to give someone the ability to, you know, explore the relationships and and
Speaker 1
Yeah. Like, yeah. Where do you start? Like because do you at Coral, do you also have, like, therapists? And, like, how does what does the complete care program even look like? Like, what am I
Speaker 2
Yes. So, as you said, there are so many things. It's really hard for a person alone to say, oh, what should I focus on first? Because everything seems like your priority. Everything is going wrong, and it's really hard to tell. So it's really important to have a whole team with you that sees the big picture and can help you find your priorities. So it really depends on everyone and what's causing the more pain, the more trouble in their lives. So it really depends. For some women, it's really the sleep. For others, they're like, oh, I'm sleeping well. But on the other hand, my stress at work, it's out of control. So we try to really focus on the first thing that's affecting all of the other, areas of their lives, but it really depends on on everyone. And some women are really good in all of these areas and they're just have genital problems. So we can focus also on that first and then sometimes we discover other things when we go larger. But I think, yeah, it's important to have both a medical team and people who are there to support more on the lifestyle, the stress management, the psychological part also. So at Coroll, to answer your question, we have the medical team, which are doctors and p's, nurses also. But we have the coaches that are there, and they each have their specificity. Like, they some work with the training, strength training, weight loss, some some work with the neurological help, sexual help. So it really depends and they all have their field of interest and passion. So we try to also make them see the right members according to the symptoms that they have. So the the approach is really to get many professionals to work together on all of these areas that have problems for their lives. Yeah.
Speaker 0
That's amazing. Wow. Yes.
Speaker 2
I really love what I do.
Speaker 0
It well, and it it shows just even this the short amount of time we've been chatting, it shows. So maybe, let's maybe tackle some of your expertise. Let's talk about the genital area issues. Right? So it's called genital urinary syndrome of menopause. Have I said that correctly? Yes. Or GSM.
Speaker 2
Yes. You do. Yeah.
Speaker 1
Wait. Let's back up. What is GSM for everyone that doesn't know yet? Michal, we know you're you're super smart. Sure.
Speaker 0
Absolutely. Sorry.
Speaker 2
So it's really hard to say the word. As you said, genitourinary syndrome of menopause. So it's really a syndrome because it's a whole condition. Like, when you go through menopause, as I said, your hormones are getting lower and then that has an impact on your urinary and genital systems. So there can be many symptoms that we don't necessarily think are related to that, but it can cause we talked about vaginal dryness pain, but there's also the UTIs that can come really frequently, like back to back UTIs, vaginal infections, and it can even lead, as I say, to vaginal atrophy. So when it doesn't get treated, it continues involving into a more serious problem. So that's why it's so important to talk about it because so many women don't make the link between menopause and those symptoms because they're just thinking, oh, well, I'm just having more UTIs. That that's it. But it can really have a big impact. And as I say, it's not everyone who's trained to to treat that syndrome correctly. Many pre person just prescribes some antibiotics and after other antibiotics and it just creates another problem when it could have been solved only with hormonal therapy, for instance.
Speaker 1
I have to tell you, my mom used to get UTIs like crazy. And I kept thinking, like, how much sex is this woman having? And now I know more now.
Speaker 2
Yeah.
Speaker 1
I was like, what is going on in that house, Megan? Anyway, yes. Sorry. Sorry. Sorry, mom.
Speaker 2
Sorry, Sarah,
Speaker 1
if you're listening. Yeah. Sorry.
Speaker 2
No. No problem. It's it's it's true. We hear those kinds of story often. And as I said, it's why it's so important to talk about it, I think.
Speaker 1
Yeah. Oh, absolutely.
Speaker 0
Yeah. So and and what are so and and do do you is there data what's the latest data on how many women that we know that are actually report this experience?
Speaker 2
It's really hard to say, like, the percentage of people who get I think it's almost all of the women, if not all of the women, will go through some type of changes there, but the intensity will very vary for each person. So it's really hard to say. There's also some women who will have no longer have orgasms that can have just problems with their urinary system. So it really is so much difference for everyone. So it's really hard to pinpoint on numbers. But yeah.
Speaker 0
How do we how do you treat it?
Speaker 2
Yeah. So there's so many ways to treat it. There's a hormonal therapy first that we can treat. There's vaginal, creams and comp and capsules that we can insert both with estrogen and DHEA, which is a precursor of testosterone. Both really works for those types of symptoms. It works really well. What's important to know is that there are many options that you can choose from if you want hormonal therapy on on those types of symptoms. Because so many women think like, oh, I have a solution. I'm gonna keep that one for the rest of my life. But your symptoms might change with time and your needs will also might change with time. So it's important that if you feel like your treatment doesn't fit anymore, we can try other things. So like the cream for instance, we can put it more on the on the outside, versus the capsule is inserted inside the vagina for so for some woman, it's not possible to think that they're gonna insert a capsule every night into their vagina until the rest of their life. So it's important to say it because some women just do it and then they come to see me and they're like, oh, I'm not having sex anymore. It's just impossible for me with that new routine. So so many things that are available. It's just important to to say it to your provider, I think.
Speaker 0
Right. And that's part back to or or not back to, but it's part of shared decision making. Right?
Speaker 2
Yes. You prescribe something,
Speaker 0
and that person is not gonna stick to, as you said Mhmm. The routine involved. Then there's yeah, there's a lot of options. Pick something that's gonna work for you.
Speaker 2
Yes. And if you don't want something hormonal, there are also some non hormonal solutions for that. So, there are the vaginal moisturizers that you can buy, which is different of the lubricants. The lubricants is really more for when you have sex itself, but the vaginal moisturizers is to use on a daily basis also. Those are two options for people who don't want hormones and the lifestyle also. So everything related to the products that you choose. Are you choosing products with perfume, no perfume? The the proper care of the vulva also. So many women think still that they need to wash their vulvar, their vagina even with soap when in fact, you should not do that definitely because you're gonna keep getting some more inflammation. And when you have all of these symptoms like abnormal, discharge, you have itching, you have pain, dryness. Some women think, oh, I have to wash myself more. But no, that's on the contrary when you start to wash it so much. And if you had products on that, it's just gonna get worse.
Speaker 0
Wow. So no pro is it better to, like, just use water? Or
Speaker 2
Yep. For the vulva, you should wash it only with water. So the best thing is to create the less friction possible. So if you want to wash it with your hands, it's something that's gonna be gentle on the vulva. It's better than using a big cloth for a towel, for instance. And, you should not use soap, especially not in the vagina. In the vagina itself, inside, it's self wash. So you don't need to put anything in there to for it to get clean. It does the job by itself.
Speaker 1
Wow.
Speaker 2
And, yeah, avoiding products the most possible, especially the ones with perfume that can create even more, infections or problems.
Speaker 0
That is great information.
Speaker 1
Yeah. I do I actually did not know that. Yeah.
Speaker 0
I didn't really either. So vaginal estrogen, if I'm not mistaken, is so the menopause society actually states it's the gold standard treatment for these symptoms. And maybe for whatever reason, it's not right for everyone, and and you've mentioned there are other options. But how how long does it take to work typically?
Speaker 2
So the estrogen treatments usually takes two to three months to get to its full effect. But that doesn't mean that you won't get any changes when you started. It can take a few weeks before you actually see some changes. But for it to get to its maximal, to its maximal capacity, it can take up to two to three months. And for the DHEA, it can take up to twelve weeks. So it's a while and you need to really take it consistently because many women also take it sometimes and then they're not taking it for a whole week after that. So that's something that can really impact the effect it can have.
Speaker 1
Well and I would say ladies, if you're listening, like, the DHEA one, I I haven't tried it or used it, but use it regularly because my girlfriend said that, like, she started using it. She's like, I feel things down there that I haven't felt, like, in forever. So, hey. That's gotta be motivation to keep going.
Speaker 2
Yeah. Exactly. So, yeah, it's a routine to take, but once you have it and if you feel like it works for you, you have to be consistent enough with it. But then some option, especially with the DHEA, for instance, you can take a booster dose and then after a few weeks or months, it really depends of the doctor's prescription, but some can take it less often. But it's still really important to really take it as prescribed to make sure that it works. Because as soon as you stop taking it, the effects are gonna come back and your your symptoms are gonna keep progressing towards a way worse state than it was before.
Speaker 1
So I have two questions here. One is, so my vaginal estrogen, I was prescribed a booster dose, like, two weeks on and then just twice a week. So is there a possibility that I might say in, like, a year or two, like, it's not working as well? And and my gynecologist might tell me to increase the dose to more frequently again?
Speaker 2
That can happen. You can also try other types of products. So as I said, your needs and your symptoms are gonna evolve as you go through the years, and you might need to switch to another molecule or another product because there are many options to treat also with the same symptoms.
Speaker 1
My next question. The DHEA version, what like, what symptoms would I come to you with? How how does that get prescribed versus just regular vaginal estrogen?
Speaker 2
The vaginal estrogen is more for dryness, irritation, versus the DHEA is more for painful sex, vaginal atrophy. So it's really gonna be, also trials to see what works best for that person because not all of the persons will react the same to the products. So but those are usually the indications for both.
Speaker 1
Thank you. We've talked a little bit about vaginal atrophy. I'd love to dive a little deeper there, and maybe even for our listeners who might not quite know what that is, what is that? And let's talk about the fact that, you know, some of these symptoms aren't treated, they could be permanent. I might be misspeaking. But
Speaker 2
Yes. It's true. Yes. So most of the big menopause symptoms that we hear such as hot flashes, once again, brain fog, memory loss, those types of things usually get better in a post menopause state because your brain eventually adjusts to the new levels of hormones.
Speaker 1
Let's hope so.
Speaker 2
Yes. But still, it doesn't mean that you should not treat those symptoms when they're there because they're still really bothering for so many women. But for the vaginal and the urinary symptoms, unfortunately, the body doesn't adjust to the new levels of estrogen and testosterone. So, the the condition just keeps getting worse. And if it's not treated, it's really hard to go back to the way it was. So that's why it's so important to treat those symptoms right away when you feel them coming to avoid them getting into a really bad state, later in life. So as you said, the the vaginal atrophy. So your vaginal walls can get thinner and thinner, which will lead to more micro micro fish how do you say fissure?
Speaker 0
Fissures, I think.
Speaker 2
Fissures. Yeah. So microfissures. So and more pain, more dryness, and it can also really the vaginal can, like, close itself. Also, that's really something that's a bit traumatizing when you look at that. There are some pictures where, like, it can get really bad and the women are suffering. So it's not to scare you that I'm saying this, but it's just really important to get it checked and get it treated. And the other thing also that's important to know is that there are other things that can cause those types of symptoms such as infections, other vaginal conditions also. So it's really important to talk about it with your health care practitioner just to make sure that you don't need other treatments also because there's, yes, the menopause, but there's also other things that keep happening even though you're in hormonal changes.
Speaker 0
Get on it, ladies. Get on it.
Speaker 1
Yeah. Seriously. Can I ask one more? Like, sorry. So if if I haven't had sex in, like, five or six years and I feel like it's maybe I've been neglecting my friend down there, like, it could be permanent. So, like, this this and I really am asking for a friend when I say this. I'd like it full totally honestly. I I this is not me, but I am
Speaker 0
Michelle has had sex within the last six years. I will I will confirm.
Speaker 1
Yes. I I am asking for a friend who said, like, I don't even know if it If it works anymore? I could have sex anymore. Like
Speaker 2
In those cases, that's another case that it's important to have many professionals in the team to work on it. So, yes, the hormonal therapy can really work wonders with those symptoms, but you can also be seen by a a pelvic floor therapist, for instance, that can really go work manually. They have some dilators that they can use also for the vaginal wall. So many options, like if this person's not feeling good and she feels like it's too late, it's never too late to get improvement. Like with a whole team, she could find to to be better again and to feel good again in that area.
Speaker 0
So so, Jen, for for people who aren't able to access, a practice like yours through through Coral Health, because they're somewhere where you're not licensed yet or what have you. What kind of questions should they ask knowing they're probably a little embarrassed, intimidated? But to make sure that they're getting the proper care and attention for their genital area, you know, vagina, vulva, urinary tract, all of those things, what what do you recommend they ask their their doctors to make sure that they're getting the attention and care they deserve?
Speaker 2
That's a great question because as you say, it can be so intimidating and you feel like the health care provider is the person who knows everything and should give you the answers. But it's so important to empower these women and to make them feel like they have some power in their health and they can do things to to feel better also. So, the first thing I'd say is to prepare before going into your consultation. So taking the time to reflect and to say what are my main symptoms right now? What are the things that are the most important to me? What do I want to talk about on on that consultation? So you can even get them on paper if you're afraid of forgetting something because in menopause, you can forget a lot of things also. So Yeah. Like, writing them down, it can be a a good first step. But then I think it's also important to ask the provider if they're used to treat women with those types of symptoms, with those types of condition, if they ever treated some patients who had similar cases before and if it worked well. And a good health care provider will be able to say that's not in my area of expertise. I'm gonna refer you to someone else. So I think it's important to ask the question and to see what's gonna be the answer and if that person is the right person to treat you and to support you through that stage of life.
Speaker 0
That's great advice.
Speaker 1
Yeah. That is great. And I guess depending on the symptoms, it could be referrals to a gyna gynecologist or to a pelvic floor therapist is kind of the main the mainstays.
Speaker 2
It really depends of the symptoms. So, yes. For more physical treatments, it's gonna be with the pelvic floor therapist. The gynecologist, we usually think that they're the person to go to according to the hormones, but it's not really, under their field. So it's a little bit of a conflict right now because we have endocrinologists and gynecologists and both are like, oh, it's not in my field. We don't learn that at school. So, yeah, a lot of them are getting trained and are going to seek that additional training to be able to provide care related to menopause, but it's not all of them. So the gynecologists are usually in the in the case for when it's for pain, when the people have, specific conditions such as endometriosis, fibroids, things like that. They're gonna get more on the physical examination of that part, but sometimes it can also be a general practitioner that specialized in menopause. So it's really about making sure that this person has the training to do the follow ups according to the situation more than just the title itself. But, yeah, the the pelvic floor therapist couldn't prescribe some hormonal therapy. So we we wanna make sure that it's a doctor or a nurse practitioner for those types of requests.
Speaker 0
Thank you. Excellent. So good.
Speaker 1
Yeah. What is the one thing that you want every every woman to know about perimenopause and sexuality?
Speaker 2
I think it's important to know that sexuality is moving in your life. So it's not gonna be the same at every stages of your life and it's something that's normal. So if you feel like right now you're having difficulty with that feel, your sex life is not as you would like it to be, it doesn't mean that it will stay that way and there are so many things that we can do, to help with that. So there are so many professionals that can help you. You can also look online to see good resources about how you can improve your sex life. So it can be seen as an opportunity to rediscover your body in the way that it is now and to even get to a better sex life than it was before. Because when you actually do the work and invest some time in your sexual health, in your sexual life, you can find things that you never thought of before and it can bring you really closer to both yourself and to your partner if you have one. So I think that seeing it on that side, it's a better way to keep continuing and not lose hope about having a good sex life and sexual health.
Speaker 1
So good. Thank you.
Speaker 0
Thanks so much for listening to the show. If you like what you hear, please subscribe and write
Speaker 1
a review. So more women can find us and get a better understanding of what to expect in perimenopause.
Speaker 0
This information is not intended as medical advice. The intent of this information is to provide the listener with knowledge to support more efficient and effective communication with their medical provider.
