WEBVTT 00:02.113 --> 00:07.458 [SPEAKER_00]: Welcome to Sexology, a podcast that untangles the science of sex and pleasure. 00:07.979 --> 00:15.146 [SPEAKER_00]: And now, with this week's episode, your host, Clinical Psychologist, Dr. Naseneen Moali. 00:17.064 --> 00:21.826 [SPEAKER_01]: Hello there, you are listening to another episode of The Sexology podcast. 00:22.447 --> 00:31.871 [SPEAKER_01]: What if the reason so many women feel exhausted, disconnected from desire, and unlike themselves after 40 isn't just aging? 00:32.051 --> 00:37.814 [SPEAKER_01]: But the fact that medicine was never really designed around female pleasure in the first place. 00:38.094 --> 00:44.497 [SPEAKER_01]: Today's guest is Deborah Durst, nationally recognized physician, regenerative medicine expert 00:45.117 --> 00:50.159 [SPEAKER_01]: founder of Revitalized Me and wildly known as a sex MD. 00:50.720 --> 01:01.925 [SPEAKER_01]: Dr. Ders is challenging outdated medical models by bringing sexuality, pleasure, hormones, and vitality back into women's health care conversations. 01:02.465 --> 01:08.586 [SPEAKER_01]: In today's episode, we explore what actually works when it comes to biohacking your sex life. 01:09.247 --> 01:21.690 [SPEAKER_01]: After 40, we talk about hormones, cortisol, libido, arousal, orgasm quality, regenerative medicine, and the growing conversation around peptides and sexual wellness. 01:22.070 --> 01:27.771 [SPEAKER_01]: Doctors also explained how stress, burnout, inflammation and hormonal shift 01:32.612 --> 01:43.277 [SPEAKER_01]: Women and men, and before we begin, if you're someone who wants to feel more connected to your body, pleasure, and desire again, make sure to download our free guide and increasing desire. 01:44.017 --> 01:50.500 [SPEAKER_01]: It's packed with practical tools to help you reconnect with intimacy and arousal, naturally. 01:50.760 --> 01:55.722 [SPEAKER_01]: You can find the link in the show notes, it's completely free, it's my locker to you. 01:56.002 --> 01:58.603 [SPEAKER_01]: Here's my conversation with Dr. Deborah Durs. 02:03.231 --> 02:07.493 [SPEAKER_01]: Hello and welcome back to another episode of the six-ology podcast. 02:07.674 --> 02:13.557 [SPEAKER_01]: I'm Dr. Molly and you have Dr. Deborah Derson, our show Dr. Deborah, welcome to show. 02:14.197 --> 02:15.438 [SPEAKER_01]: Thank you so much. 02:15.618 --> 02:16.899 [SPEAKER_01]: Thank you for having me. 02:17.459 --> 02:19.961 [SPEAKER_01]: We're looking forward to our conversation. 02:19.981 --> 02:22.702 [SPEAKER_01]: I know that many of our listeners constantly 02:24.243 --> 02:30.866 [SPEAKER_01]: Best ways to optimize their sexual health and I know that right now many people looking into biohacking. 02:30.906 --> 02:39.350 [SPEAKER_01]: What in the last I would say like at least they cater so many people are looking for different ways to improve their sex drive. 02:39.390 --> 02:48.995 [SPEAKER_01]: So can actually biohacking based on your experience can help people sex drive after 40 years just their wellness marketing hack. 02:49.255 --> 02:50.296 [SPEAKER_02]: No, absolutely. 02:50.416 --> 03:01.747 [SPEAKER_02]: Everyone can have on the, the same sex that they've always had at any age, honestly, you know, Perry, menopause and menopause doesn't have to change it, hormone to climb for men does not have to change it. 03:01.807 --> 03:04.549 [SPEAKER_02]: So, now it is not a myth. 03:05.230 --> 03:07.372 [SPEAKER_02]: It is a comprehensive health plan. 03:07.812 --> 03:11.733 [SPEAKER_02]: you know, I think sexual health is part of health overall. 03:12.353 --> 03:14.774 [SPEAKER_02]: And it's a marker, but it doesn't have to change as we get older. 03:15.474 --> 03:26.657 [SPEAKER_01]: What are some of that a more successful ways kind of like hacks bio hacks treatments out there for improving the sex drive of mobile the owner. 03:26.997 --> 03:54.734 [SPEAKER_02]: So I think that if we are looking for women and I almost I think that what we've done over time is we have done like a female reproductive system for women and so we have focused in our reproduction instead of sex and so a female sex system is much better because that's going to address things that we are experiencing on a regular basis for women so we have thousands of sexual experiences and a couple of reproductive experiences throughout our life 03:55.875 --> 04:02.279 [SPEAKER_02]: I think just knowing the the function and the physiology that's related to good sex is important. 04:02.879 --> 04:09.664 [SPEAKER_02]: So when you're talking about sex drive, that's one part of it and that's probably more of a hormonal, you know, optimization. 04:09.684 --> 04:14.627 [SPEAKER_02]: So the only thing that is really going to affect a low sex drive as we get older, especially for women. 04:15.427 --> 04:17.768 [SPEAKER_02]: medications or low testosterone. 04:17.968 --> 04:24.230 [SPEAKER_02]: And so I think hormone for sex drive, but then there's all kinds of other things that we make experiences we get older. 04:24.710 --> 04:28.571 [SPEAKER_02]: There's arousal issues, there's orgasmic, there's lubrication, there's pain. 04:29.452 --> 04:37.754 [SPEAKER_02]: And so those are the other things on the spectrum of sexual, you know, I say female sexual dysfunction, but any kind of changes that we might have. 04:37.934 --> 04:38.354 [SPEAKER_02]: And so 04:43.576 --> 04:53.962 [SPEAKER_02]: local treatments, like in the vagina and the ball da region, that focus on blood flow and increasing nerves and sensitivity are definitely it's a complete picture of it. 04:54.382 --> 05:05.929 [SPEAKER_02]: So being very comprehensive in how we address it for women, so it takes it from a reproductive focus to a female sexual focus because that's something we're experiencing every day and we want to see that improved. 05:06.449 --> 05:10.652 [SPEAKER_02]: We want to have great sex throughout life, not just when we're young, 05:11.252 --> 05:16.494 [SPEAKER_02]: but after children through Perry menopause, the menopause and it does not have to change at all. 05:16.814 --> 05:18.975 [SPEAKER_01]: You're thinking about hormones, right? 05:19.015 --> 05:20.435 [SPEAKER_01]: You mentioned testosterone. 05:20.475 --> 05:23.456 [SPEAKER_01]: What was an woman come from a owner comes to you? 05:23.476 --> 05:25.477 [SPEAKER_01]: They want to kind of like look into the hormones. 05:25.877 --> 05:33.060 [SPEAKER_01]: What do you often look for and what are some of the key factors that can help people optimize in hormones? 05:33.260 --> 05:39.662 [SPEAKER_02]: So I think that I would say when there's a few different ways to look at that. 05:39.682 --> 05:53.146 [SPEAKER_02]: So when I think about women in things that they might be experiencing, if they don't feel like themselves or they feel different and that's why the number one reason why women come to us is that they don't feel like themselves anymore. 05:53.786 --> 06:01.349 [SPEAKER_02]: And so I think if they don't, and they're not getting answers with their primary doctor, then it is time to look at hormones for sure. 06:02.069 --> 06:14.813 [SPEAKER_02]: And so just going to a person that, you know, or an office that is definitely very experienced with hormone optimization or treatments for women, you want to look for that. 06:14.853 --> 06:21.074 [SPEAKER_02]: And so there's ways to look for offices that have that kind of experience and then you want to get your hormones checked. 06:21.114 --> 06:26.596 [SPEAKER_02]: So you want to meet with them when we meet with patients, we're going to go over all the symptoms that they might have. 06:26.636 --> 06:30.437 [SPEAKER_02]: So there's a whole list of questions, you know, can be brain fog, it could be energy. 06:31.117 --> 06:32.538 [SPEAKER_02]: sex drive and might be waking. 06:32.878 --> 06:35.980 [SPEAKER_02]: They're doing all the same things, but they are getting weighed. 06:36.000 --> 06:46.826 [SPEAKER_02]: And so we want to go through all that and focus on the biggest goals that they would like to see and prove because as a hormone's decline or fluctuate in parent menopause, we will as women notice changes. 06:47.026 --> 06:50.408 [SPEAKER_02]: And so we want to focus in on getting them results. 06:50.748 --> 06:52.890 [SPEAKER_02]: But doing a whole hormonal picture. 06:53.890 --> 06:57.632 [SPEAKER_02]: and a laboratory panel that's comprehensive is the start of that. 06:57.652 --> 07:07.616 [SPEAKER_02]: So meeting with the woman, talking to them about what kind of symptoms are having, what they want to see improvement in, and then doing blood work that helps us put that in perspective. 07:07.776 --> 07:10.257 [SPEAKER_02]: Those are the first couple steps that we want to do. 07:11.037 --> 07:22.081 [SPEAKER_02]: And I think with women or really even men, as we're starting to do her mental treatment, you really want to make sure, I mean, you got to get to know the patient well. 07:22.361 --> 07:23.962 [SPEAKER_02]: And so it's not a one in done. 07:24.402 --> 07:25.962 [SPEAKER_02]: We see patients every three months. 07:26.022 --> 07:26.903 [SPEAKER_02]: We're optimizing. 07:26.923 --> 07:28.143 [SPEAKER_02]: We're talking laps again. 07:28.183 --> 07:32.685 [SPEAKER_02]: We're adjusting because our goal is to get them feeling better. 07:33.286 --> 07:34.909 [SPEAKER_02]: Whatever that means to the patient. 07:34.949 --> 07:43.447 [SPEAKER_02]: So in everyone's different and in the symptoms that they feel So again, we're gearing that towards what we need to improve for that patient 07:44.080 --> 07:53.488 [SPEAKER_01]: So, why do you think so many women think they've lost attraction to their partner when sometimes it's just like to burn out, cortisol, or hormonal shift? 07:53.788 --> 07:55.109 [SPEAKER_02]: Well, I think they just don't know. 07:55.149 --> 07:56.911 [SPEAKER_02]: I don't think we've educated women a lot. 07:57.071 --> 08:02.515 [SPEAKER_02]: And I think that what we have focused in on medicine is, again, the reproductive system. 08:02.575 --> 08:08.360 [SPEAKER_02]: So, you have your reproductive years and then you are, like, you're leaving your reproductive 08:12.884 --> 08:18.429 [SPEAKER_02]: children and they have hormonal changes and they're noticing some changes in function or attraction. 08:18.849 --> 08:30.660 [SPEAKER_02]: They don't know where to go to get answers and even OBGYNs and we hear this on a regular basis will be like, you know, again, maybe it's the spouse, maybe it's the partner, you know, it's part of aging. 08:31.060 --> 08:37.105 [SPEAKER_02]: This is something that our patients will say on a daily basis and so I don't think they get the solutions. 08:37.425 --> 08:38.847 [SPEAKER_02]: I don't think we've talked about it enough. 08:39.307 --> 08:50.395 [SPEAKER_02]: So I think once they understand that there will be a decline in hormones with age, sometimes it's a fluctuation first before it's a decline, that they're going to notice some changes. 08:51.196 --> 09:00.242 [SPEAKER_02]: And so if they do, there are other answers besides just the fact that the sizzle has faded or that they're not attracted anymore. 09:00.882 --> 09:08.448 [SPEAKER_02]: And so I think that that is something that we just need to open the conversations and you're doing a great job of this by talking about it on a podcast. 09:08.748 --> 09:09.328 [SPEAKER_01]: Thank you. 09:09.529 --> 09:11.470 [SPEAKER_01]: Thank you for saying that I appreciate that. 09:11.530 --> 09:16.313 [SPEAKER_01]: So beyond, like, you know, people having given us, like, for our listeners, they have their awareness. 09:16.393 --> 09:22.318 [SPEAKER_01]: I know there are, like, a great movement right right now, around panicking across menopause and challenges. 09:22.338 --> 09:31.364 [SPEAKER_01]: When people have those challenges, when they go to their, like, gynecologist or maybe through their primary care, they often get pushback. 09:31.784 --> 09:53.794 [SPEAKER_01]: Right, then I hear from my clients and when they go through menopause, premenopause all kind of like HRT may be kind of like a meeting and consultation with the physician, they get pushed back that all yourself young, like they are mid 40s or they saying that, oh, but you haven't lost your period or people say, oh, when did your mom lost their period of 50s? 09:53.854 --> 09:56.896 [SPEAKER_01]: So you're at 46 years too long to do HRT. 09:57.276 --> 10:05.545 [SPEAKER_01]: So tell us a little bit about what can people do, what can they advocate for beyond having the conversations about these things? 10:05.745 --> 10:11.471 [SPEAKER_02]: So I think they should always advocate for finding solutions no matter what, because there's solutions that exist. 10:11.491 --> 10:12.472 [SPEAKER_02]: So I would just say that 10:13.333 --> 10:30.320 [SPEAKER_02]: no matter what, everyone listening should know that if you are not feeling, again, like yourself, or your sex drive isn't there, or your orgasmic strength isn't there, lubrication, whatever it is, and it can be erections for men, that you should know that there's ways to improve that. 10:30.560 --> 10:35.522 [SPEAKER_02]: And so without medical problems, obviously causing it, there are solutions that exist. 10:35.542 --> 10:39.404 [SPEAKER_02]: So if you go to traditional doctors and they don't give you answers, 10:40.304 --> 10:45.488 [SPEAKER_02]: Then I think you just have to step back and say, I need to find somebody that's specializes in this, right? 10:45.729 --> 10:50.512 [SPEAKER_02]: And so when we talk about parametipized menopause and yes, there's a movement for the act, right? 10:50.532 --> 10:53.575 [SPEAKER_02]: And there's a lot of talk on podcast on social media. 10:53.995 --> 10:56.457 [SPEAKER_02]: And so it's great that we're getting the word out there. 10:56.918 --> 10:59.180 [SPEAKER_02]: But that has been going on for about 10 years plus. 10:59.220 --> 11:03.243 [SPEAKER_02]: So if medicine just thinks that's just hitting now, it's not. 11:03.483 --> 11:06.606 [SPEAKER_02]: And so yes, we have an FDA that lifts a black box, 11:07.126 --> 11:11.928 [SPEAKER_02]: You know, we think that the doctors and traditional, you know, medicine are going to change overnight because of that. 11:12.028 --> 11:12.308 [SPEAKER_02]: No. 11:12.388 --> 11:17.910 [SPEAKER_02]: I mean, this movement was created by women forcing the system to change. 11:18.130 --> 11:21.611 [SPEAKER_02]: But the doctors that are in front of patients, that's going to take a little while longer. 11:21.992 --> 11:27.994 [SPEAKER_02]: But we're always behind in traditional medicine and we're about 10 years behind before this hit the main strength, right. 11:28.574 --> 11:29.614 [SPEAKER_02]: This has been going on. 11:29.815 --> 11:42.420 [SPEAKER_02]: Susan Summer started this way back with hormones and so this movement has been going on for a long time, but because medicine didn't change, there are doctors that had to branch out of traditional medicine such as myself. 11:51.283 --> 11:55.764 [SPEAKER_02]: And so you realize that there's solutions that are there, but no one's offering them. 11:55.864 --> 12:00.185 [SPEAKER_02]: And then when you start doing them, and then you have to branch out into a whole other field of medicine. 12:00.845 --> 12:09.006 [SPEAKER_02]: And so I would get pushback that if they're not giving them the answers, that they should seek the solutions elsewhere. 12:09.367 --> 12:12.567 [SPEAKER_02]: And so you may not get the answers from your traditional doctors. 12:12.987 --> 12:16.968 [SPEAKER_02]: If you're married to a traditional medicine, you want insurance to pay for everything, 12:17.528 --> 12:32.053 [SPEAKER_02]: You want that to include the kind of colleges, you know, the primary care and you expect them to give you the solutions they haven't and 20, you know, plus years and it's not as if they don't want to it's just not what we received and training. 12:32.593 --> 12:35.376 [SPEAKER_02]: And so you really have to seek solutions elsewhere. 12:35.416 --> 12:48.788 [SPEAKER_02]: So I would just advocate for the fact that if you don't want to accept, you know, decline or aging or, you know, your partner, you're not attracted to your partner anymore or that success to be different or that we had to feel different. 12:49.249 --> 12:51.671 [SPEAKER_02]: If you're willing to accept that, then that's traditional medicine. 12:51.691 --> 12:55.755 [SPEAKER_02]: If you're not, you really have to just seek somebody that actually, and there's, you know, again, you can 12:56.215 --> 13:09.960 [SPEAKER_02]: search hormone replacement or sexual wellness stuff and do we can at the end of it talk also about how they can find some of those like physician directories that they can find somebody in their area that actually does specialize in it. 13:10.040 --> 13:15.162 [SPEAKER_02]: So I would just push back to go elsewhere for solutions advocate for yourself. 13:15.462 --> 13:15.782 [SPEAKER_02]: For sure. 13:16.197 --> 13:17.839 [SPEAKER_01]: Well it is very challenging. 13:17.899 --> 13:19.260 [SPEAKER_01]: I wish it was as easy. 13:19.300 --> 13:31.634 [SPEAKER_01]: I know you know that as well, but I can imagine people kind of like after waiting for several months to school see their kind of colleges and they kind of get pushed back and they have your another another several months to see someone else. 13:31.714 --> 13:38.121 [SPEAKER_01]: I can be very frustrating for women, but I know that as you mentioned, people's effort, their body, their 13:38.621 --> 13:48.969 [SPEAKER_01]: Joy, their health, what the efforts in your practice, that you guys are doing, Rejuvenation, treatment, what are some of the things that you see people see benefit from? 13:49.110 --> 13:55.935 [SPEAKER_01]: Like, what are some of the better treatments out there for people restoring their sexual health? 13:56.135 --> 14:17.134 [SPEAKER_02]: Yeah, and I would say that even back to that first part of it, I agree with you and we do see it in the office on a daily basis that there is a lot of frustration and there is a delay, but I think that when somebody kind of realizes that it may not happen in a timely fashion unless if they're proactive. 14:17.634 --> 14:27.601 [SPEAKER_02]: I think those proactive patients, if you look for like an A4M physician that does hormones, or you look for somebody that does like a no shutter patient, we'll talk about that with this last question. 14:28.262 --> 14:35.527 [SPEAKER_02]: Then you will find directories of patients or up physicians that actually do provide those solutions that we're about to talk about. 14:35.607 --> 14:41.971 [SPEAKER_02]: And so they really just are probably going to continue to get frustrated if we are trying to force the kind of colleges 14:44.333 --> 14:48.837 [SPEAKER_02]: you know, get immediately up to speed on regenerative procedures for men and women. 14:48.897 --> 14:50.518 [SPEAKER_02]: So that's your question. 14:50.578 --> 15:05.690 [SPEAKER_02]: So for women, so when we're talking hormones and optimization, if we're talking in general, if patients like in general systemically feel brain fog energy, low libido, body composition changes weight gain, even depression, anxiety, sleep issues. 15:05.870 --> 15:09.853 [SPEAKER_02]: You know, those are more systemic and so hormone optimization might be the 15:11.214 --> 15:22.019 [SPEAKER_02]: And about 50% of our patients, probably even a lot less than that, will get complete resolution of everything they're feeling, just with hormone optimization. 15:22.520 --> 15:24.401 [SPEAKER_02]: So that's the good first step to that. 15:24.941 --> 15:36.767 [SPEAKER_02]: But then if you have anything such as low sex drive or rousal, anything that spans that female sexual dysfunction spectrum, which again is low desire, low arousal. 15:37.827 --> 15:50.856 [SPEAKER_02]: orgasmic strength, urinary incontinence, pain, vaginal dryness, then you're probably going to need some regenerative procedures to address local regeneration because we have hormones that decline or tissue will change. 15:50.916 --> 15:59.562 [SPEAKER_02]: We have childbirth, you know, in pregnancies that change tissue and just the weight of pregnancies will sometimes obliterate some of that supportive tissue. 16:00.202 --> 16:17.854 [SPEAKER_02]: And so we look then to regenerate to get better blood flow and better nerve function in the areas of what I say is again the female sexist system because it's a rousal like if we look at the vulva as you talk about vulva owners and again I 16:18.614 --> 16:32.041 [SPEAKER_02]: referred to that in general a lot of times as the vagina, not in general, but like I know technically it's the vulva and the outside in the vagina is on the inside, but when we're talking about sometimes women are just in general talking about, you know, the vagina. 16:32.742 --> 16:36.043 [SPEAKER_02]: But the vulva is a landing zone with lots of androgen receptors. 16:36.103 --> 16:43.787 [SPEAKER_02]: So if you don't have more men optimization, then you're not going to have those receptors functioning completely normally or optimally. 16:46.829 --> 16:50.494 [SPEAKER_02]: And so it's the same thing as the penis is a rectile tissue. 16:51.095 --> 16:52.797 [SPEAKER_02]: So there's blood flow that's needed in. 16:53.178 --> 16:55.781 [SPEAKER_02]: The clitoris is technically the female version. 16:55.881 --> 16:57.824 [SPEAKER_02]: And that is the female penis. 16:58.004 --> 17:00.247 [SPEAKER_02]: It's the equivalent of the penis for a man. 17:00.267 --> 17:02.871 [SPEAKER_02]: And it's a lot bigger, as you know. 17:03.772 --> 17:11.177 [SPEAKER_02]: than just the part the glands that we're seeing, and that's a rectile tissue as well with also hormone receptors. 17:11.517 --> 17:14.479 [SPEAKER_02]: So we have to focus in on that tissue down there. 17:15.019 --> 17:17.081 [SPEAKER_02]: If it's a rectile, we need better blood flow. 17:17.141 --> 17:19.822 [SPEAKER_02]: So hormones alone isn't going to cause better blood flow. 17:20.443 --> 17:26.667 [SPEAKER_02]: So we have to actually communicate with the tissue to get a better blood vessel regeneration and better blood 17:32.010 --> 17:39.827 [SPEAKER_02]: In the vaginal canal, it's really a smooth muscle, so it's muscular, but it's very responsive to blood flow hormones. 17:40.455 --> 17:43.458 [SPEAKER_02]: And so that area just needs to be regenerated. 17:43.498 --> 17:47.442 [SPEAKER_02]: So we talk about laser regeneration, laser or vaginal regeneration. 17:47.462 --> 17:49.544 [SPEAKER_02]: And a lot of people don't understand what that means. 17:50.504 --> 17:55.409 [SPEAKER_02]: And I think recently I found out that they also think it means something that is a blade of. 17:55.849 --> 18:01.214 [SPEAKER_02]: So if we're a bladeing a surface, we're taking away the top layer of the surface. 18:01.655 --> 18:04.698 [SPEAKER_02]: And that can sometimes result in some downtime. 18:05.278 --> 18:08.322 [SPEAKER_02]: But a lot of the lasers are just surface heating. 18:08.862 --> 18:11.065 [SPEAKER_02]: And so radio frequency will do that. 18:11.085 --> 18:16.191 [SPEAKER_02]: But TV is one of those, you have radio frequency micro-needling you do in the vaginal canal. 18:16.291 --> 18:19.074 [SPEAKER_02]: And there's also lasers that you can do that are non-oblative. 18:19.154 --> 18:21.077 [SPEAKER_02]: We have one called the photon that we do. 18:21.417 --> 18:28.581 [SPEAKER_02]: But their surface heating, and when we do that, you're communicating with the tissue that it is injured into repair. 18:29.321 --> 18:39.907 [SPEAKER_02]: And so we're going to get better blood vessel repair, better blood flow, lubrication is blood flow, better nerve regeneration, better orgasmic strength, sensitivity arousal. 18:39.967 --> 18:44.809 [SPEAKER_02]: So if we can focus in on that tissue and communicate with it, give it back something 18:50.472 --> 18:53.934 [SPEAKER_02]: Not a medication proven to be safe, proven to be effective. 18:54.374 --> 19:01.458 [SPEAKER_02]: It just if we're looking for big studies, those laser companies are approved for use, but they're going to focus on our incontinence. 19:01.898 --> 19:07.381 [SPEAKER_02]: But honestly, even the incontinence indications for those lasers are not on any guidelines. 19:07.622 --> 19:16.446 [SPEAKER_02]: So the American-Urologic Society, like all of those, none of those lasers are actually recommended for incontinence improvement. 19:16.847 --> 19:18.628 [SPEAKER_02]: We're talking about drugs because again, 19:19.268 --> 19:23.231 [SPEAKER_02]: You're talking about big pharma influence on society and guidelines. 19:23.251 --> 19:27.674 [SPEAKER_02]: So basically, we look at laser regeneration as part of that. 19:27.834 --> 19:32.737 [SPEAKER_02]: And then if you ever heard of the OSHAAT, yeah, I'm going to call this as talking about it here, too. 19:33.218 --> 19:33.478 [SPEAKER_02]: Yeah. 19:33.558 --> 19:37.401 [SPEAKER_02]: And so a lot of them will call some some places will call it something different. 19:37.861 --> 19:38.381 [SPEAKER_02]: The OSHAAT. 19:38.401 --> 19:42.564 [SPEAKER_02]: And again, that's another directory of providers that provide that kind of service. 19:43.145 --> 19:47.448 [SPEAKER_02]: And a lot of times, if you look for on that, those directories, you might find it OSHAAT. 19:48.088 --> 20:01.836 [SPEAKER_02]: provider, you might find one that also talks about lasers, and sometimes if you can cross reference that with A4M, A4M is something that is hormonal, training, and torments specialists actually are listed on that. 20:02.157 --> 20:05.719 [SPEAKER_02]: So if you can cross reference them, sometimes you will find somebody that actually just hormones. 20:06.359 --> 20:27.785 [SPEAKER_02]: And also does the sexual wellness piece of it as well, but basically what we're doing is we're drawing blood and we're spinning it down and then we get the platelets which have growth factors in and then platelets we re-inject into an area to communicate with stem cells again to get regeneration better blood flow better nerve regeneration so again the same thing we're talking about so I love to do. 20:28.645 --> 20:31.666 [SPEAKER_02]: We do all of our lasers with an O shot. 20:31.766 --> 20:33.607 [SPEAKER_02]: That's our recommended treatment protocol. 20:33.627 --> 20:35.468 [SPEAKER_02]: And then we will do a series of lasers. 20:35.908 --> 20:38.990 [SPEAKER_02]: But you want to just basically heat all the tissue tell it is injured. 20:39.010 --> 20:40.670 [SPEAKER_02]: You're doing a diffuse regeneration. 20:40.690 --> 20:44.012 [SPEAKER_02]: And then you're dumping a bunch of growth factors and they're by injecting the PRP. 20:44.712 --> 20:46.775 [SPEAKER_02]: and so that works great in combination. 20:46.815 --> 20:50.441 [SPEAKER_02]: So again, I don't think there's too much in the way of regeneration. 20:50.661 --> 20:57.611 [SPEAKER_02]: It's fully safe and it's effective in patients know that, you know, which is why they seek those solutions. 20:57.831 --> 20:59.634 [SPEAKER_02]: And it does help with incontinence, both of those. 20:59.922 --> 21:05.506 [SPEAKER_01]: For women that are kind of going through this journey of finding love would be a good fit, right? 21:05.546 --> 21:15.874 [SPEAKER_01]: I would imagine I'd mention they started HRT, how would they make the decision of which, which of course it's with collaboration with their physician, but I know that as you mentioned that, 21:16.154 --> 21:21.215 [SPEAKER_01]: Sometimes they have to add, but it unfortunately I find Nick right now it's the Alachar that you have to go find though. 21:21.275 --> 21:44.360 [SPEAKER_01]: I need this find a position that provided versus like managed care giving them options because women's sexual health is not prioritized, but how can women decide like okay and or have information about after HRT what are some of the steps that they need to take in order to what are some of the steps in between that and also getting their laser or oh shots like who is it suggested 21:46.293 --> 21:52.236 [SPEAKER_02]: So basically, I say that again, when I were very comprehensive, but now we address women or men. 21:52.296 --> 21:56.118 [SPEAKER_02]: So basically, they come in, it doesn't matter. 21:56.138 --> 22:00.360 [SPEAKER_02]: Like, it's really what is bothering them that they want to see improvement. 22:00.440 --> 22:02.221 [SPEAKER_02]: And sometimes that's just hormones. 22:02.261 --> 22:05.142 [SPEAKER_02]: You know, sometimes they're young and it's a hormonal and they're completely better. 22:05.663 --> 22:09.565 [SPEAKER_02]: Sometimes it's sexual dysfunction in some way if we're men or if we're women. 22:10.165 --> 22:11.966 [SPEAKER_02]: And the hormones alone may not 22:12.826 --> 22:13.267 [SPEAKER_02]: fix it. 22:13.647 --> 22:19.810 [SPEAKER_02]: And so the next steps, it doesn't actually not part of the next steps and that initial consult. 22:20.410 --> 22:29.816 [SPEAKER_02]: And when we sit down and talk about blood work, we're pretty comprehensive just saying that if they have something that typically isn't improved, like low orgasm, 22:32.477 --> 22:38.521 [SPEAKER_02]: urinary and continents, you know, those are things that are unlikely to be improved just by hormonal optimization alone. 22:38.942 --> 22:47.428 [SPEAKER_02]: So we do talk to them upfront, you know, just saying that at a significant proportion of our patients will not get improvement in these symptoms just based on hormones alone. 22:48.028 --> 23:01.799 [SPEAKER_02]: And again, there's lots of women that are fearful of hormones, there's lots of women that have a contraindication with breast cancer history, and there's still vaginal hormone, you know, treatments that you can do to improve their quality of life and their symptoms. 23:02.219 --> 23:05.782 [SPEAKER_02]: But I think there's always lots of different things, just so you know, also, 23:06.382 --> 23:10.668 [SPEAKER_02]: that there's peptides, like PT-141 is a peptide that will use. 23:11.069 --> 23:16.136 [SPEAKER_02]: Those are things that we can address with them, both men and women, nitric oxide. 23:16.176 --> 23:21.023 [SPEAKER_02]: So, if we're talking about, you know, again, the female sex system is really what I like to call about. 23:21.383 --> 23:42.358 [SPEAKER_02]: call that only because again we're dressing it from an overall standpoint to get the woman to have optimal sexual experiences and you know I think that matters throughout life and program and and for men in so addressing it comprehensively but erectile tissue is part of it in nitric oxide plays a huge role so even taking supplements that help. 23:42.898 --> 23:43.379 [SPEAKER_02]: with that. 23:43.819 --> 23:47.082 [SPEAKER_02]: So we're always looking at some supplements with that lab work. 23:47.342 --> 23:52.746 [SPEAKER_02]: But nitric oxide we use something called Berkeley life frequently because it has nitrates in it. 23:53.067 --> 23:56.249 [SPEAKER_02]: And there's two pathways to convert to nitric oxide in the body. 23:56.349 --> 23:58.351 [SPEAKER_02]: One's amino acids and the other is nitrate. 23:58.431 --> 23:59.172 [SPEAKER_02]: Irres nitrates. 23:59.912 --> 24:04.654 [SPEAKER_02]: And so this product also has like a salary stick that you can test. 24:04.914 --> 24:06.535 [SPEAKER_02]: And so you can actually see it's low. 24:06.915 --> 24:08.316 [SPEAKER_02]: But the key is it's just nitrates. 24:08.336 --> 24:11.057 [SPEAKER_02]: So we don't frequently get enough of that in our diet. 24:11.417 --> 24:15.319 [SPEAKER_02]: And if we actually then take nitrates, we convert to nitric oxide. 24:15.339 --> 24:19.101 [SPEAKER_02]: That pathway doesn't exhaust with age or decline. 24:19.501 --> 24:20.882 [SPEAKER_02]: And so that is better blood flow. 24:21.422 --> 24:34.016 [SPEAKER_02]: That's better work out, it's better blood flow to the muscle, better recovery, better brain fog, like all of that, but also better blood flow to those erectile tissues we talked about in the balva and the clitoris and so better arousal. 24:34.056 --> 24:37.680 [SPEAKER_02]: So there's some things you can do before just jumping, too. 24:38.421 --> 24:58.379 [SPEAKER_02]: a vaginal laser and then even the radio frequency, the Vativa treatment that we do is a pretty gentle just you know quick and office that it's a service heating you don't have to necessarily jump to injections or a shot and then also there's a treatment that doesn't EMS signal to the pelvic floor 24:59.399 --> 25:09.765 [SPEAKER_02]: that also will strengthen the pelvic floor, which, again, helps with incontinence, but also helps with orgasmic strength because contractions of the pelvic floor are important with that as well. 25:10.305 --> 25:17.149 [SPEAKER_02]: And that's like maybe entry level thing that you can do it's a small device you put in the vaginal canal, but it sends those M.S. 25:17.169 --> 25:22.992 [SPEAKER_02]: signals to the pelvic floor and it's a less intimidating procedure for some. 25:23.512 --> 25:24.593 [SPEAKER_02]: women to do first. 25:24.613 --> 25:26.854 [SPEAKER_02]: So there's lots of different options. 25:27.034 --> 25:34.719 [SPEAKER_02]: I just think that being comprehensive in how we address them and I don't think there's enough offices kind of doing that. 25:35.259 --> 25:37.541 [SPEAKER_02]: I think that we're opening conversations. 25:38.341 --> 25:39.282 [SPEAKER_02]: And I think that's good. 25:39.383 --> 25:54.443 [SPEAKER_02]: I think the Perry Minipos Minipos conversations that we're having is good, but I think that we haven't yet pivoted to really talking about how to have better sex or have the same sex, you know, and have that not change for us as we get older. 25:54.463 --> 25:54.664 [SPEAKER_02]: So. 25:55.142 --> 26:04.825 [SPEAKER_01]: There are, as you mentioned, there are tons of great treatments, like, even as a simple dementia supplement, I'm sure there are so many that are coming out of the out in the market. 26:05.305 --> 26:12.127 [SPEAKER_01]: I think what I hear from many of my patients is that they feel like they try a couple, right, maybe they go to HRT, maybe they 26:12.387 --> 26:37.467 [SPEAKER_01]: laser, maybe they do the vaginal cream and they feel like it's not going to work and then other parties like thinking about okay overall women's sexual health is also undermined as well so they can in a way that they lose hope so it's good that like as you mentioned that there are clinics like including yourself that people can go and kind of get more of kind of like more options and more information about it. 26:38.368 --> 26:43.554 [SPEAKER_01]: You think that you were mentioned, like you know peptides are very more popular right now, at least in LA. 26:44.154 --> 26:50.501 [SPEAKER_01]: See, can you tell people a little bit about how they work or what are some of the things that you're seeing in that area? 26:50.662 --> 26:52.984 [SPEAKER_02]: Yeah, it really is a big area. 26:53.044 --> 26:54.946 [SPEAKER_02]: It's a hot topic right now, right? 26:55.567 --> 27:03.456 [SPEAKER_02]: And I will go again back to, I love when you say, you know, again, I feel like people were frustrated with, you know, the answers that they get. 27:03.736 --> 27:08.802 [SPEAKER_02]: And so yeah, I can get that they get almost and depressed by not being listened to. 27:08.882 --> 27:10.844 [SPEAKER_02]: And so when we see women in the office, 27:11.264 --> 27:17.205 [SPEAKER_02]: a lot of times they're tearful with that first consult because they finally feel like somebody's listen to them. 27:17.285 --> 27:34.489 [SPEAKER_02]: So I just would say that there are providers like that and so I would continue looking, if ever it's affecting your quality of life such that it's something that you are unwilling to accept that there are solutions there and just finding the right person to address that of the right offices important. 27:34.529 --> 27:36.629 [SPEAKER_02]: And then that kind of changes that despair. 27:37.289 --> 27:40.951 [SPEAKER_02]: You know, that they might be experiencing when it comes to peptides. 27:40.991 --> 27:42.051 [SPEAKER_02]: So we love peptides. 27:42.071 --> 27:44.952 [SPEAKER_02]: We've been doing peptides for in seven years. 27:45.352 --> 27:49.294 [SPEAKER_02]: And, but we didn't bring them on like a weight loss peptide. 27:49.374 --> 27:52.655 [SPEAKER_02]: So that was actually one of the last that we brought on. 27:53.096 --> 27:58.478 [SPEAKER_02]: We started it with all the different things like again, even down to the symbol of like the tanning peptide. 27:59.118 --> 28:01.759 [SPEAKER_02]: The healing peptides like BPC 157 and TB500. 28:03.960 --> 28:09.186 [SPEAKER_02]: the growth hormone peptides, some more lens, CJC, 1295, Tessa Moreland, all of those. 28:09.847 --> 28:11.329 [SPEAKER_02]: You know, there's immune modulators. 28:11.349 --> 28:14.633 [SPEAKER_02]: There's all kind, but, and again, the tanning peptide is a really good one. 28:15.213 --> 28:21.441 [SPEAKER_02]: But all peptides, and then PT141, is a subset of that melanotan peptide. 28:21.821 --> 28:23.203 [SPEAKER_02]: And so that one, 28:23.623 --> 28:36.270 [SPEAKER_02]: was found to be the active component of that one that causes the increase in sex drive, and it does work for both men and for women, and even for erectile dysfunction or better erections and better arousal for women too. 28:36.951 --> 28:47.517 [SPEAKER_02]: But peptides are amino acid sequences, and so they are a little unstable for that reason because their amino acid sequences, they mimic a neurotransmitter or hormone in the body. 28:48.297 --> 28:54.462 [SPEAKER_02]: that are going to give the body back what it needs and they're going to give the body the back that signal that it needs to repair itself. 28:55.063 --> 29:06.913 [SPEAKER_02]: There's a lot of peptide stuff on and again a lot of mixed messages and so a lot of times when you hear they're also dangerous or they're net FDA approved or they're illegal. 29:06.973 --> 29:09.455 [SPEAKER_02]: All of that is not the case. 29:09.976 --> 29:11.097 [SPEAKER_02]: Again it depends on 29:11.477 --> 29:20.223 [SPEAKER_02]: What the peptide is, where we are in the regulation process, you know, some of them have all been on the market through compounding pharmacies, some of them are conventional products. 29:20.784 --> 29:26.728 [SPEAKER_02]: And some of them have coming gone from the FDA approval list for compounding substances. 29:27.409 --> 29:29.370 [SPEAKER_02]: That is more political than anything else. 29:29.810 --> 29:32.352 [SPEAKER_02]: You know, the safety concerns are not there. 29:32.993 --> 29:39.578 [SPEAKER_02]: And but you do need to have a compounding pharmacy, which are highly regulated both on the state and the federal level. 29:40.318 --> 29:54.631 [SPEAKER_02]: And so as long as you trust your provider and your provider is working with the compounding pharmacy, that is above board and FDA approved, you're all good, you should not be doing this stuff online in ordering it and for research only and all that and compounding pharmacies are not that. 29:54.751 --> 30:04.279 [SPEAKER_02]: So a lot of times I'll hear people talk about peptides and they act as if and it was recently again another big one on the major news, somebody that's on YouTube and it's a 30:06.141 --> 30:15.304 [SPEAKER_02]: but talking about almost as if the compounding pharmacies are the scientific only peptides in that's not the case. 30:15.844 --> 30:19.225 [SPEAKER_02]: There are FDA-approved compounding pharmacies that do peptides. 30:19.265 --> 30:21.026 [SPEAKER_02]: You just need to get it as a physician. 30:21.066 --> 30:23.907 [SPEAKER_02]: It is a prescription, so you don't want to do it online. 30:24.627 --> 30:28.028 [SPEAKER_02]: And then it depends on what the patient wants the peptide for. 30:28.409 --> 30:32.450 [SPEAKER_02]: Most of them are injectable because they are unstable in the oral form. 30:33.010 --> 30:35.351 [SPEAKER_02]: There's BPC that you can use in the oral form. 30:35.411 --> 30:46.037 [SPEAKER_02]: There's some with the nasal spray-like salon can see max that are great for ADD, also just, you know, come psychiatric disorders that will be helpful. 30:46.497 --> 30:55.462 [SPEAKER_02]: So anyhow, it just depends on what the patient has that they want to see improved and then what peptide would be indicated and whether that patient is the same candidate for them. 30:56.022 --> 30:57.863 [SPEAKER_02]: But they're definitely not illegal. 30:58.244 --> 31:00.725 [SPEAKER_02]: They're not unsafe if you're doing it the right way. 31:00.985 --> 31:07.070 [SPEAKER_01]: For a specific video around sexual health, especially for Bullwona, we're talking about, do you see results? 31:07.131 --> 31:11.474 [SPEAKER_01]: It's peptide, the specific and prescribing them and people kind of seeing increased libido. 31:12.075 --> 31:13.016 [SPEAKER_02]: Yes, absolutely. 31:13.596 --> 31:16.018 [SPEAKER_02]: Everyone, I say everyone loves VT141. 31:16.379 --> 31:17.119 [SPEAKER_02]: Everyone that doesn't. 31:17.420 --> 31:18.380 [SPEAKER_02]: It just depends on when. 31:19.041 --> 31:30.726 [SPEAKER_02]: Because, and I say that because there's some nausea with those firstists, it's a firstists effect of depends on how high you go and it depends on how long that last and usually does dissipate they get used to that. 31:31.166 --> 31:36.048 [SPEAKER_02]: But you wouldn't want to use it if you're going on your honeymoon and then you end up nauseating so you want to try it out. 31:36.549 --> 31:40.030 [SPEAKER_02]: And then there's timing issues and might work in 30 minutes and might work in five hours. 31:40.090 --> 31:42.031 [SPEAKER_02]: So I think everyone loves them. 31:42.391 --> 31:43.752 [SPEAKER_02]: It just depends on when they love them. 31:44.552 --> 31:51.654 [SPEAKER_02]: And because they got to get over that nausea fact, but men and women love PT141 and absolutely it's effective. 31:51.954 --> 31:52.274 [SPEAKER_00]: For sure. 31:52.414 --> 31:56.755 [SPEAKER_02]: And that does have a conventional product, but that conventional product is expensive. 31:57.055 --> 32:02.116 [SPEAKER_02]: It's a one kind of size fits all for an injection standpoint where you have a compounding pharmacy. 32:02.556 --> 32:04.337 [SPEAKER_02]: We can do different doses. 32:04.377 --> 32:05.217 [SPEAKER_02]: We can tie trade up. 32:05.237 --> 32:06.097 [SPEAKER_02]: We can tie trade down. 32:06.137 --> 32:07.517 [SPEAKER_02]: We can do different things with it. 32:07.537 --> 32:10.738 [SPEAKER_02]: And so I think compounding pharmacies just allow us the 32:14.319 --> 32:15.481 [SPEAKER_02]: a product, which is great. 32:15.741 --> 32:18.083 [SPEAKER_02]: But absolutely effective, men and women love it. 32:18.424 --> 32:27.014 [SPEAKER_01]: When we talk about nausea, you know, for other peptides, people say sometimes they get used with and they don't feel kind of much nauseous. 32:27.034 --> 32:35.243 [SPEAKER_01]: Is that what your experience is with these type of peptides or you think it's going to be a kind of like side effect that most people kind of have to deal with or manage. 32:35.443 --> 32:37.644 [SPEAKER_02]: know I think most people do acclimate to it. 32:37.704 --> 32:39.846 [SPEAKER_02]: So I think that that results with time. 32:40.306 --> 32:52.534 [SPEAKER_02]: It's definitely more common with first dose, more common with the higher dose, if they're taking a higher dose at first, especially with, you know, rectum dysfunction that they start on a higher dose based on severity. 32:53.334 --> 33:02.561 [SPEAKER_02]: then they may get more nausea, but I would say that 99% of our patients, that nausea resolves and pretty quickly into the treatment. 33:02.581 --> 33:10.066 [SPEAKER_02]: There will be an occasional exceptional patient for a GLP-1 or weight loss or for PT-1-41 or melanotans. 33:10.106 --> 33:15.090 [SPEAKER_02]: But it's very rare that a patient has to discontinue a peptide due to nausea. 33:15.570 --> 33:27.696 [SPEAKER_01]: Well, if there are tons of great options, what I'm hearing, what it comes to sexual health challenges, libido issues, so I'm grateful that clinics get yours are offering those options. 33:27.756 --> 33:30.257 [SPEAKER_01]: So if you aren't listeners, they want to learn from you. 33:30.277 --> 33:35.840 [SPEAKER_01]: You mentioned you have a podcast, that the products that you have, what are some of the places they can find you? 33:36.180 --> 33:40.846 [SPEAKER_02]: So if you look for my name on YouTube, we have podcast located. 33:40.866 --> 33:42.909 [SPEAKER_02]: We're on all the audio ones as well. 33:43.450 --> 33:51.621 [SPEAKER_02]: We have had, we started this in 2021 and at the time, BD aesthetics and wellness podcast, and then we had RevMD, which was the sexual wellness. 33:51.641 --> 33:53.163 [SPEAKER_02]: We are now combining it into just 33:54.184 --> 34:01.234 [SPEAKER_02]: podcast because we're really just talking about wellness and sexual wellness and sexual wellness is like my passion. 34:01.915 --> 34:11.908 [SPEAKER_02]: So but Deborah Durst, MD as well, that is we have videos of all of our podcasts going back to 2021 and that those are all found on my YouTube channel. 34:12.468 --> 34:22.596 [SPEAKER_02]: And so those are those same podcast videos, but Deborah Dirst MD would be how you find that and that's on YouTube and so again those are just good it goes way back. 34:22.676 --> 34:31.802 [SPEAKER_02]: So again, they were simple videos and and the quality is improved with time, but it's always good information and that information is still valid five years out. 34:31.882 --> 34:35.105 [SPEAKER_02]: It's still the same stuff that we're saying on a daily basis. 34:35.165 --> 34:35.385 [SPEAKER_02]: So. 34:35.858 --> 34:36.338 [SPEAKER_01]: Yeah. 34:36.458 --> 34:37.439 [SPEAKER_02]: That would be the best way. 34:37.479 --> 34:37.699 [SPEAKER_02]: Yeah. 34:37.859 --> 34:41.840 [SPEAKER_02]: And then revitalize MD is the name of my practice and Knoxville. 34:42.360 --> 34:43.801 [SPEAKER_02]: And again, we do see patients. 34:43.841 --> 34:46.101 [SPEAKER_02]: We're very comprehensive and how we address things. 34:46.181 --> 34:54.664 [SPEAKER_02]: I don't know that there's another practice like ours just because we're so comprehensive with the HRT and all the sexual wellness treatments. 35:06.048 --> 35:14.471 [SPEAKER_02]: So that is another thing that you can think and but revitalize MD and Knoxville, Tennessee, is how to find the actual practice and website gem. 35:14.951 --> 35:15.611 [SPEAKER_01]: Well, wonderful. 35:15.631 --> 35:24.314 [SPEAKER_01]: Thank you so much, Dr. Deborah, to coming under our show and sharing your expertise with us and we enjoyed learning from you and thank you and have a wonderful time. 35:24.714 --> 35:26.315 [SPEAKER_01]: Thank you so much for having me. 35:30.322 --> 35:48.459 [SPEAKER_01]: so often the message women receive is simply to normalize the changes except the loss of desire, except the fatigue, except the disconnection from pleasure, and while acceptance can absolutely be healthy and important, I also deeply believe that women deserve interventions, 35:53.604 --> 35:57.666 [SPEAKER_01]: what's possible, and therefore they can make the decision for themselves. 35:58.206 --> 36:03.748 [SPEAKER_01]: We deserve informed choices about our bodies, our sexuality, and our well-being. 36:04.349 --> 36:11.692 [SPEAKER_01]: I hope today's conversations help listeners feel more empowered, more curious, and less alone in navigating these changes. 36:12.472 --> 36:22.157 [SPEAKER_01]: And if you like more practical tools for reconnecting the desire and intimacy, make sure that you're downloading our free guide and increasing your desire. 36:22.417 --> 36:23.898 [SPEAKER_01]: The link is in the show notes. 36:24.018 --> 36:25.719 [SPEAKER_01]: Thank you so much for listening. 36:26.339 --> 36:29.921 [SPEAKER_01]: I'll see you next week for another episode of The Sexology Podcast. 36:30.609 --> 36:51.073 [SPEAKER_01]: Thanks for listening to Sixology Podcasts for more great content visit www.sixologypodcast.com Please be advised that information presented on this podcast is not a substitute for seeking help from a licensed mental health provider