1 00:00:00,000 --> 00:00:04,760 Use coconut oil use olive oil use petroleum jelly nice awesome cheap stuff 2 00:00:07,440 --> 00:00:13,640 Yeah, but if you have olive oil coconut oil just make sure it's not the cooking coconut oil the cooking olive oil 3 00:00:13,640 --> 00:00:19,960 You know, it's more the topical for skin type. Okay, and those are absolutely safety. In fact, they're recommended. It's good to know 4 00:00:19,960 --> 00:00:23,480 Yeah, I was hoping coconut oil that seems to fix everything. Yeah. Yeah 5 00:00:23,480 --> 00:00:28,040 I mean, I'm I use coconut oil on my face, you know, and I feel like a lot of the things you've said there 6 00:00:28,040 --> 00:00:30,320 It's like, you know, it's good for your face. It should be good for down there. Yeah 7 00:00:47,840 --> 00:00:55,960 Hello and welcome to the 40s formula your go-to place for insightful discussions on navigating your 40s and thriving in this transformative decade 8 00:00:55,960 --> 00:01:03,160 We're your hosts Amanda and Jasmine two women that are passionate about exploring the challenges and adventures that come with turning 40 and what lies ahead 9 00:01:11,720 --> 00:01:19,520 Dr. Jess Shirin-Sidhu actively incorporates the positive aspects of sexuality into her practice as part of an effort to decrease the stigma associated with sexual health 10 00:01:19,520 --> 00:01:27,280 Dr. Jess also keeps herself updated with latest treatment options and technology to help her patients restore maintain or improve optimal sexual health 11 00:01:28,080 --> 00:01:34,000 She is a regular participant in international sexual health means organized by the International Society of Sexual Medicine 12 00:01:34,480 --> 00:01:42,360 She is also well versed in aesthetic gynecology with certification from different procedural courses attended with the European Society of Aesthetic Gynecology 13 00:01:43,040 --> 00:01:45,040 Dr. Jess has acquired the only available 14 00:01:45,040 --> 00:01:49,600 Certification for sexual medicine the fellow of the European Committee of Sexual Medicine 15 00:01:50,080 --> 00:01:54,000 She has a special interest in menopause being a member of the Australasian Menopause Society 16 00:01:54,480 --> 00:02:00,000 She is a mother of two who divides her time between her kids her husband her clinic and her outreach work 17 00:02:00,640 --> 00:02:07,200 Today on the 40s formula. We are so excited to welcome. Dr. Jess Shirin-Sidhu here. So welcome 18 00:02:07,680 --> 00:02:12,240 Oh, thank you. I'm glad I'm here. No, we're so glad to have you. So Dr. Jess 19 00:02:12,240 --> 00:02:16,960 We often hear that as women enter their 40s, they start to experience perimenopausal symptoms 20 00:02:17,440 --> 00:02:22,480 and sometimes they face unexpected changes in their sexual health and 21 00:02:22,880 --> 00:02:30,720 Sometimes this can feel a bit isolating confusing and a lot of people don't openly discuss these changes 22 00:02:31,200 --> 00:02:34,720 So giving you experience as a GP who specializes in sexual health 23 00:02:35,200 --> 00:02:40,560 What would you say are the most important things women in their 40s need to know about sexual health? 24 00:02:40,560 --> 00:02:46,800 as they approach this time and how can they feel empowered to 25 00:02:47,760 --> 00:02:50,800 Make changes rather than feel concerned about what's going on 26 00:02:51,680 --> 00:02:53,760 It's such an interesting phase of your life, right? 27 00:02:53,760 --> 00:03:00,000 Because a woman we go through so many milestones and then when you hit your 40s is yet another milestone that you're dealing with 28 00:03:00,720 --> 00:03:03,680 and I often like to think of perimenopause like 29 00:03:04,400 --> 00:03:07,040 A light bulb that's about to dim itself out 30 00:03:07,040 --> 00:03:12,240 So you've got the huge glow in your 20s and your 30s and then come your 40s 31 00:03:12,240 --> 00:03:17,280 This flicker starts to happen and sometimes the flicker goes on for quite a while before the light bulb goes 32 00:03:18,160 --> 00:03:26,240 Gone, and that's when the menopause sort of kicks in and I suppose because the change can happen across such a long period of time 33 00:03:26,880 --> 00:03:32,080 And so many of the symptoms can be so subtle that we choose to ignore it 34 00:03:32,080 --> 00:03:37,920 And by general socialization messaging women are meant to deal with so much, you know 35 00:03:38,240 --> 00:03:43,040 We're the caregivers. So it's always others first me last 36 00:03:43,360 --> 00:03:48,400 So one of the things that I encourage women to do is, you know, even if you have symptoms like fatigue 37 00:03:49,040 --> 00:03:51,520 Body aches don't just accept it 38 00:03:51,760 --> 00:03:58,160 Just have this click moment or a light bulb moment if you might and go maybe this is this is perimenopause 39 00:03:58,160 --> 00:04:02,960 Maybe this is something because I can't in my 40s suddenly start to feel this 40 00:04:03,520 --> 00:04:09,940 Without a good acceptable reason there always is something to explain what i'm experiencing 41 00:04:09,940 --> 00:04:13,440 And I suppose many people do think that perimenopause is the hot flashes 42 00:04:13,520 --> 00:04:17,200 You know, it's got to be the hot flashes and if I don't have them then it's not 43 00:04:17,740 --> 00:04:19,740 perimenopause but there's such a 44 00:04:19,760 --> 00:04:25,920 broad spectrum of symptoms that women go through and the reason why i'm bringing up things like fatigue it's because 45 00:04:25,920 --> 00:04:30,080 Sexual health is not just things that happens in the department of the genitals 46 00:04:30,560 --> 00:04:37,200 It's all these other things and sex is complex and so interesting that way that biological factors social factors 47 00:04:37,900 --> 00:04:42,960 Interpersonal factors relationship factors intra-psychic factors how you feel about yourself 48 00:04:43,900 --> 00:04:46,560 Sociocultural factors all influence how you have 49 00:04:47,200 --> 00:04:52,720 Sex so if you're tired, you don't quite feel like it and you're frustrated with your partner 50 00:04:52,720 --> 00:04:59,280 It does impact your sexual life and those sort of symptoms mood disturbances all kick in a hell of a lot 51 00:04:59,600 --> 00:05:06,960 During that perimenopause period and in fact the genital symptoms don't kick in so much in the early perimenopause period 52 00:05:07,040 --> 00:05:09,040 It might happen a little bit later 53 00:05:09,440 --> 00:05:14,480 And mood factors influences also things like lubrication down in the genitalia 54 00:05:14,640 --> 00:05:17,540 So we go fine tune how you think about perimenopause 55 00:05:17,540 --> 00:05:23,220 Don't ignore the symptoms because this can then lead up to a sexual health concern 56 00:05:23,780 --> 00:05:27,780 And we all want to engage in some sort of sexual intimacy and it's only because 57 00:05:28,180 --> 00:05:33,700 It creates that sense of grounding for us the desire that i'm wanted i'm desired someone wants to hold me 58 00:05:33,700 --> 00:05:39,380 Someone wants to touch me and just keeps us humbled. It keeps us well into the experience that we're safe 59 00:05:39,620 --> 00:05:41,620 It creates a safety fencing for us 60 00:05:41,620 --> 00:05:49,140 And that's why the sexual health or sex is so important to then generate that sense of emotional intimacy and also gives us 61 00:05:49,940 --> 00:05:55,700 Clues us in into the idea that you know, we're still very much youthful. We're not aging. We're not out to pasture yet 62 00:05:56,500 --> 00:05:58,500 you know, I never really thought of the 63 00:05:58,660 --> 00:05:59,700 the 64 00:05:59,700 --> 00:06:06,580 Safety element with sex, you know, you do think of you know, the the desire the the basically the need to be wanted 65 00:06:07,140 --> 00:06:08,660 but the 66 00:06:08,660 --> 00:06:13,780 The whole safety thing actually makes sense, you know, like when you're hugging someone and and you're just you're 67 00:06:14,420 --> 00:06:20,100 You do feel secure and it's something I never would have thought of in a sort of you know, in a normal circumstance 68 00:06:20,500 --> 00:06:22,500 So you mentioned that obviously there's different 69 00:06:22,820 --> 00:06:28,420 aspects you've got the biological and the physiological when it comes to sex and how that can really sort of 70 00:06:28,980 --> 00:06:30,980 Make a difference in your desire 71 00:06:31,140 --> 00:06:35,780 So when you get to your 40s, I say as opposed to when you're in your 20s and your 30s 72 00:06:36,500 --> 00:06:37,460 is 73 00:06:37,460 --> 00:06:41,140 Is it more physiological versus biological? Is there? 74 00:06:41,940 --> 00:06:46,660 I don't know equal amounts. Like how do you know what it is? Is it your mind? Is it your body? 75 00:06:46,820 --> 00:06:53,220 How would you know and how would you then go ahead and I guess fix those if it's a way that you can do that? 76 00:06:53,380 --> 00:06:55,860 It's it's so it's so interesting because we get asked this question 77 00:06:56,500 --> 00:07:01,460 Every time by every person who walks in whether it's the woman who's asking this question whether it's a partner has gone 78 00:07:01,460 --> 00:07:08,820 No, i'm convinced it's in her mind. She's thinking about it. She's just obsessing over it and i'm going what is this fixation of us? 79 00:07:08,820 --> 00:07:11,380 trying to figure out whether it's biological or 80 00:07:12,000 --> 00:07:13,620 physiological because 81 00:07:13,620 --> 00:07:17,780 Just like our gut health, you know our gut and microbiome in our gut 82 00:07:18,820 --> 00:07:23,300 The the amount of it we have the type of it that we have this constant signaling back up to the brain 83 00:07:23,700 --> 00:07:25,700 And it influences things like our mood 84 00:07:26,180 --> 00:07:29,060 So it is inevitable that these two things 85 00:07:29,060 --> 00:07:35,560 Co-influence each other. So it's never a situation of whether it is more biological or whether it's more 86 00:07:36,640 --> 00:07:41,400 Psychological it is an interplay of both but often we go okay, which one's the weakest link? 87 00:07:41,400 --> 00:07:43,320 You know, what can I work on first? 88 00:07:43,320 --> 00:07:46,920 It actually doesn't matter what you work on first 89 00:07:47,400 --> 00:07:50,200 If you work and let's say if you work on the biological element 90 00:07:50,360 --> 00:07:52,840 It's going to have an impact on the psychological element 91 00:07:52,840 --> 00:07:59,240 And if let's say the psychological element was your weakest link you then become more motivated to go. Okay now 92 00:07:59,240 --> 00:08:04,120 I think I want to work on this part of it. It's it's how i'm seeing sex is my attitude towards sex 93 00:08:04,120 --> 00:08:08,520 It's how I feel about myself. Maybe I don't have such a good reflection of my own body image 94 00:08:08,840 --> 00:08:13,320 Maybe that's what's holding me back. I don't have vaginal dryness. I don't have pain when I have sex 95 00:08:13,320 --> 00:08:15,320 But why is it I don't want it? 96 00:08:15,400 --> 00:08:17,240 so then these are the 97 00:08:17,240 --> 00:08:19,320 This is the way I often tell women 98 00:08:19,320 --> 00:08:24,920 It doesn't matter where you start start somewhere because you will then auto identify 99 00:08:25,400 --> 00:08:28,840 Which one is your weakest link and then you will naturally veer towards 100 00:08:29,400 --> 00:08:34,680 Going down that path of trying to fix that more and sometimes we just need to find that weakest link so that we just get 101 00:08:34,680 --> 00:08:38,680 To just under that threshold such that we don't feel the symptoms anymore 102 00:08:39,960 --> 00:08:41,320 Are there any 103 00:08:41,320 --> 00:08:43,320 tips or 104 00:08:43,460 --> 00:08:46,120 suggestions that you can give to women who are 105 00:08:46,120 --> 00:08:52,520 Unsure as to whether it is physical or whether it's um psychological whatever it is 106 00:08:53,080 --> 00:08:59,800 Certain things maybe whether it's a lifestyle changes or whether it's a diet or exercise that you think can help women 107 00:09:00,120 --> 00:09:02,120 feel more 108 00:09:02,120 --> 00:09:06,120 Intimate or ready to be intimate. I think women are quite intuitive 109 00:09:06,760 --> 00:09:10,840 And generally when we are trying to suss out is it more physical is it more? 110 00:09:10,840 --> 00:09:15,960 Um psychological I think the the the base where you can start with is to ask yourself 111 00:09:16,200 --> 00:09:21,240 All right, let's go with something which is so simple very simplified when i'm having uh 112 00:09:21,720 --> 00:09:25,240 Intercourse or when i'm having sex regardless of whether it's intercourse out of course 113 00:09:25,560 --> 00:09:29,480 What do I feel down in those areas? You know, do I feel something negative? 114 00:09:29,880 --> 00:09:33,240 Is there is there pain is there discomfort? I don't exactly have pain 115 00:09:33,240 --> 00:09:36,440 But I just feel i'm not lubricating like I should it's kind of dry 116 00:09:36,440 --> 00:09:40,840 Or when i'm being touched in other parts of my body, I realize that my arousal is not quite there 117 00:09:40,840 --> 00:09:43,480 I don't get aroused the way I used to 118 00:09:44,040 --> 00:09:47,400 So once you sort of identify that no, I don't think i've got any of this 119 00:09:47,880 --> 00:09:53,240 But then it's a lot about my state of mind. I don't know why I can't explain why there's no other better reason 120 00:09:53,400 --> 00:09:58,600 I just don't feel like it and then we've got to go down and go. All right. Why don't I feel like it? 121 00:09:58,600 --> 00:10:04,760 Let's pull it back to general life. Am I motivated? Am I very stressed? Am I constantly anxious? 122 00:10:04,760 --> 00:10:07,400 Do I have a can I say shit? 123 00:10:08,440 --> 00:10:09,480 Yeah 124 00:10:09,480 --> 00:10:12,120 Do I have a shitload of things to do? 125 00:10:12,120 --> 00:10:17,560 Am I caring for kids in this part of my life and many of us have got very young children in our 40s? 126 00:10:17,880 --> 00:10:24,200 The caregiver role is not due until two more decades down the road and then you're thrown into perimenopause 127 00:10:24,760 --> 00:10:30,600 You're having this flicker light bulb moment and your hormones are not functioning the way it should it's kind of an unfair platform 128 00:10:30,600 --> 00:10:36,680 To raise kids on then some women are having an emptiness syndrome, you know, they might have had kids very early 129 00:10:37,000 --> 00:10:40,680 Then the idea here is what is my role now? What do I do? 130 00:10:40,680 --> 00:10:43,240 I'm done with these things that i've done over the last 20 years 131 00:10:43,240 --> 00:10:44,520 I don't know what to do 132 00:10:44,520 --> 00:10:50,520 Then you get a second lease of life and then again you're thrown into this depleted state of hormones and you go. Uh-oh 133 00:10:50,920 --> 00:10:54,440 Now I feel like I can live again, but I don't know how to live again 134 00:10:54,920 --> 00:10:58,280 So these are the the things women can go through 135 00:10:58,280 --> 00:11:03,640 Or can can sort of um tune into to figure out what's going on whether it's more physiological 136 00:11:03,960 --> 00:11:05,960 Whether it's more psychological 137 00:11:06,600 --> 00:11:09,240 Lifestyle changes are a big big thing because 138 00:11:10,040 --> 00:11:16,200 With the hormone depletion what then happens is that the way your body metabolizes things the way your body utilizes nutrients 139 00:11:16,840 --> 00:11:24,680 Changes big time it changes big time. So getting into exercise and it doesn't have to be something so vigorous 140 00:11:24,680 --> 00:11:28,840 like you know, just just some some sort of uh, um 141 00:11:29,400 --> 00:11:33,960 Aerobic exercise just twice a week has been the recommended thing and strength training 142 00:11:33,960 --> 00:11:38,760 And that's particularly important because the shape of the body changes and then how you feel about your body changes 143 00:11:38,760 --> 00:11:44,120 And then when you have this new lease of life, particularly for empty nesters, they feel really lousy about themselves 144 00:11:44,520 --> 00:11:49,640 So strength training is really one of those things we tell people to get into and really it doesn't have to be very frequent 145 00:11:49,640 --> 00:11:55,000 You know three times a week something very minimal is actually good enough to get women going 146 00:11:55,480 --> 00:12:01,720 And generally exercise has been shown to motivate people especially when you're exercising without an intended goal 147 00:12:02,360 --> 00:12:05,640 You're just exercising. It's like for the beauty of it 148 00:12:05,640 --> 00:12:09,400 You're not like I need to get to some sort of a purpose or some sort of a place with this 149 00:12:09,640 --> 00:12:16,520 Then it becomes work and stress oriented and for some people the choice of exercise can be very much anxiety venting 150 00:12:16,520 --> 00:12:19,960 Anger venting frustration venting 151 00:12:19,960 --> 00:12:24,280 Boxing, you know those sort of things are some are things that some women enjoy getting into in their midlife 152 00:12:24,280 --> 00:12:27,960 And it just allows them to just de-stress through a physical element 153 00:12:28,520 --> 00:12:35,160 So yeah, these are the these are the things that women have to pay attention to I mean food diet 154 00:12:36,040 --> 00:12:42,440 That's the sort of thing we tell people, you know, you do that from the get-go regardless of what part of your life you're in and 155 00:12:42,440 --> 00:12:48,200 We generally say, you know eat a variety of things, you know, don't calorie count, but maybe count what you're eating 156 00:12:48,840 --> 00:12:52,680 types of plants types of just variety of things 157 00:12:52,680 --> 00:12:57,160 And when you have so much variety, you can't possibly do one thing in a great quantity 158 00:12:57,160 --> 00:13:01,720 You're doing little bits when you have variety. So we go, you know get that into get that 159 00:13:02,280 --> 00:13:07,240 Make that a habitual thing from the get-go. So it's sustainable right through midlife 160 00:13:07,240 --> 00:13:12,600 And that's where it's going to be most useful because your body's more vulnerable at that point 161 00:13:12,600 --> 00:13:16,200 Your body's going to take quite a lot in your 20s and it's able to manage 162 00:13:16,200 --> 00:13:19,800 But once you're in your 40s and 50s, you're not going to be managing so well anymore 163 00:13:19,800 --> 00:13:21,960 Yeah, and I think I love that you said, you know 164 00:13:21,960 --> 00:13:26,600 Basically, there's not too much different that you would do in taking care of yourself 165 00:13:26,600 --> 00:13:32,200 It through menopause that you wouldn't do otherwise, right? It's not like oh, there's this magical menopause exercise that you must do 166 00:13:32,200 --> 00:13:35,080 There's this magical menopause exercise that you must do 167 00:13:35,080 --> 00:13:37,640 There's this magical menopause diet that you must do 168 00:13:37,640 --> 00:13:43,080 It's like, no, the fundamentals that work in your 20s and 30s still apply in your 40s 169 00:13:43,080 --> 00:13:45,640 It's simply that you need to be consistent with them 170 00:13:45,640 --> 00:13:50,520 And I think, you know, I work with a lot of women in this age group, right? In my practice 171 00:13:50,520 --> 00:13:56,840 And it's like, I see this, they're always like, oh, when I was 20 and 30, I could lose those 5 kgs so easily 172 00:13:56,840 --> 00:13:59,080 And now they're stuck around my midsection 173 00:13:59,080 --> 00:14:01,080 I hear you, right? I definitely hear you 174 00:14:01,080 --> 00:14:05,640 But you also have to be realistic with what's changed in your life otherwise, right? 175 00:14:05,640 --> 00:14:08,120 Are you as consistent with your exercise? 176 00:14:08,120 --> 00:14:10,120 Are you as focused on your diet? 177 00:14:10,120 --> 00:14:17,640 Or is it perhaps that these demands that you've been talking about so beautifully are actually piling up and those habits are sliding? 178 00:14:18,680 --> 00:14:21,720 Amanda, you know, I've been raving about the meat club for over a year now 179 00:14:21,720 --> 00:14:25,560 And for good reason, it's honestly made my life so much easier 180 00:14:25,560 --> 00:14:26,600 Oh, also mine 181 00:14:26,600 --> 00:14:28,600 I don't have to think twice about what I'm cooking 182 00:14:28,600 --> 00:14:34,120 Their grass-fed beef, organic chicken, wild-caught seafood are so fresh and ethically sourced 183 00:14:34,120 --> 00:14:36,680 It's food that I feel good about feeding my family 184 00:14:36,680 --> 00:14:39,160 And it's not just the quality, it's the convenience 185 00:14:39,160 --> 00:14:42,120 The subscription model is perfect for busy families 186 00:14:42,120 --> 00:14:45,640 Once you set it up, everything arrives fresh exactly when you need it 187 00:14:45,640 --> 00:14:49,480 Plus, you get up to 15% off with every subscription order 188 00:14:49,480 --> 00:14:51,720 And let's not forget the exclusive rewards 189 00:14:51,720 --> 00:14:55,400 They've got perks worth $140 for subscribers 190 00:14:55,400 --> 00:14:57,400 Things like a chef's knife 191 00:14:57,400 --> 00:14:58,840 A wooden chopping board 192 00:14:58,840 --> 00:15:00,520 And even a $30 voucher 193 00:15:00,520 --> 00:15:03,320 It's like they know exactly what all the home cooks need 194 00:15:03,320 --> 00:15:05,800 Honestly, I wish something like this existed years ago 195 00:15:05,800 --> 00:15:08,040 It's been such a lifesaver for planning meals 196 00:15:08,040 --> 00:15:10,040 And I know our listeners are going to love it too 197 00:15:10,040 --> 00:15:15,960 If you haven't tried the meat club yet, use code TFF12 for $12 off your first order 198 00:15:15,960 --> 00:15:17,400 There's no minimum spend 199 00:15:17,400 --> 00:15:22,520 Just visit themeatclub.com.sg and experience the difference for yourself 200 00:15:22,520 --> 00:15:26,520 And make sure to follow them on Instagram at The Meat Club SG 201 00:15:26,520 --> 00:15:28,520 For recipes and special offers 202 00:15:28,520 --> 00:15:32,360 The Meat Club, trusted by us, loved by families, and perfect for yours 203 00:15:32,360 --> 00:15:34,360 And now, back to the show 204 00:15:35,240 --> 00:15:39,240 You know, so sometimes I think there's a kind of perception issue 205 00:15:39,240 --> 00:15:42,520 In addition to the obvious physiological issue of menopause 206 00:15:42,520 --> 00:15:43,240 Yeah 207 00:15:43,240 --> 00:15:48,120 You mentioned a couple of times one of the physiological changes that can happen is vaginal dryness 208 00:15:48,120 --> 00:15:54,200 Can you explain what is going on and how that can impact comfort and pleasure 209 00:15:54,200 --> 00:15:57,560 And what can women do if they are experiencing vaginal dryness? 210 00:15:58,280 --> 00:16:01,720 Yikes, when you pull estrogen away from the vulva 211 00:16:01,720 --> 00:16:04,760 It's like this key thing that gels everything together 212 00:16:04,760 --> 00:16:08,440 And when that starts to dwindle in the perimenopause space 213 00:16:08,440 --> 00:16:09,720 It's not completely gone 214 00:16:09,720 --> 00:16:11,240 You know, it's like on off, on off, on off 215 00:16:11,240 --> 00:16:13,240 I choose to come to work when I want to come to work 216 00:16:13,240 --> 00:16:14,680 I love that metaphor 217 00:16:14,680 --> 00:16:16,120 When I want to 218 00:16:16,120 --> 00:16:18,520 And when it starts to behave that way 219 00:16:18,520 --> 00:16:21,880 What then happens is that you actually start to thin out 220 00:16:21,880 --> 00:16:24,600 The walls of the vagina, the glands that are there 221 00:16:24,600 --> 00:16:27,640 They're still there, but they just don't work so well anymore 222 00:16:27,640 --> 00:16:32,360 And the whole environment within the vagina starts to alter itself 223 00:16:32,360 --> 00:16:35,400 And when we speak about vagina, you're actually talking about the canal 224 00:16:35,400 --> 00:16:39,480 But what a lot of women experience is the dryness on the outside 225 00:16:39,480 --> 00:16:40,680 Which is actually the vulva 226 00:16:40,680 --> 00:16:42,680 So women are recognizing changes there 227 00:16:42,680 --> 00:16:47,240 And interestingly enough, there is what we call an autoimmune process 228 00:16:47,240 --> 00:16:49,800 A process in the body where the body makes faulty antibodies 229 00:16:49,800 --> 00:16:52,840 And it starts to sort of attack the skin a little bit more 230 00:16:52,840 --> 00:16:55,720 It tends to happen in this midlife phase 231 00:16:55,720 --> 00:16:59,400 And women start to thicken up the skin, dry out the skin 232 00:16:59,400 --> 00:17:04,520 And vaginal dryness or just sensitivity in the area becomes quite a profound issue 233 00:17:04,520 --> 00:17:09,480 In fact, I have to make it very clear that vaginal dryness is not a concern in just midlife 234 00:17:09,480 --> 00:17:12,360 A lot of young women experience it too 235 00:17:12,360 --> 00:17:16,200 And things that can be done when you experience vaginal dryness is 236 00:17:16,200 --> 00:17:17,720 Number one, just admit that it's there 237 00:17:17,720 --> 00:17:18,360 Right? 238 00:17:18,360 --> 00:17:19,960 It's there, right? 239 00:17:19,960 --> 00:17:23,000 And stop being so resistive to lubricants 240 00:17:23,000 --> 00:17:25,480 It's something we got to naturally lubricate 241 00:17:25,480 --> 00:17:29,640 And a lot of us who engage in sexual intimacy, sexual intercourse 242 00:17:29,640 --> 00:17:31,960 We don't have sex like animals 243 00:17:31,960 --> 00:17:36,520 Where it's just quick, fast, get the job done and then you're off 244 00:17:36,520 --> 00:17:38,200 You're making love in that process 245 00:17:38,200 --> 00:17:39,960 You're romancing each other in that process 246 00:17:40,600 --> 00:17:43,720 There's a lot more demand on natural lubrication 247 00:17:43,720 --> 00:17:45,320 So using lubricants 248 00:17:45,320 --> 00:17:48,600 And then we have a group of women who say, oh look, I've used lubricants 249 00:17:48,600 --> 00:17:49,480 It's not working 250 00:17:49,480 --> 00:17:50,440 I still feel dry 251 00:17:50,440 --> 00:17:53,880 And yes, the lubricants give you like a slip and slide sort of sensation 252 00:17:53,880 --> 00:17:55,720 Just takes off that friction at the surface 253 00:17:56,280 --> 00:17:57,880 But dryness is skin deep 254 00:17:57,880 --> 00:18:01,800 What about that feeling I get like, you know, things are stretching and it's just uncomfortable 255 00:18:01,800 --> 00:18:02,600 What do I do about that? 256 00:18:02,600 --> 00:18:05,640 Then we got, ah, do you moisturize your skin on a regular basis? 257 00:18:05,640 --> 00:18:07,880 Do you moisturize your face on a daily basis? 258 00:18:07,880 --> 00:18:09,320 Perhaps twice a day you do that 259 00:18:09,320 --> 00:18:10,680 Why do you do that? 260 00:18:10,680 --> 00:18:13,480 It's because our body's demanding that hydration 261 00:18:13,480 --> 00:18:17,400 That we're not otherwise going to make through that aging process 262 00:18:17,400 --> 00:18:19,320 So why aren't we being smart about it? 263 00:18:19,320 --> 00:18:21,720 Look into vaginal moisturizers 264 00:18:21,720 --> 00:18:25,880 Things that you use on a daily basis, not just before sex 265 00:18:26,680 --> 00:18:29,400 And people then ask us, okay, so many lubricant on the shelves 266 00:18:29,400 --> 00:18:29,640 Yeah 267 00:18:29,640 --> 00:18:30,440 How do I go about doing that? 268 00:18:30,440 --> 00:18:31,400 That was going to be my question 269 00:18:31,400 --> 00:18:33,080 So how would you even know what's safe? 270 00:18:33,080 --> 00:18:36,920 So, ah, generally most lubricants on the shelves are safe 271 00:18:37,880 --> 00:18:41,240 But if you want to look at long-term safety 272 00:18:41,240 --> 00:18:46,600 You want products that don't have a lot of parabens in it 273 00:18:46,600 --> 00:18:52,920 Because parabens have been associated with things like breast cancers, glycerin as well 274 00:18:52,920 --> 00:18:56,120 So those sort of things you want to reduce the doses in them 275 00:18:56,120 --> 00:18:59,000 Or you want to pick products that are parabens and glycerin free 276 00:18:59,000 --> 00:19:03,080 So they're made on moisturizers that are based on plant cellulose 277 00:19:03,080 --> 00:19:05,480 So those are the sort of things that are safer 278 00:19:06,200 --> 00:19:08,920 If you're walking into a standard supermarket like in Singapore 279 00:19:08,920 --> 00:19:10,440 You might not get a lot of that product 280 00:19:10,440 --> 00:19:10,680 Yeah 281 00:19:10,680 --> 00:19:11,400 That's get online 282 00:19:11,400 --> 00:19:11,880 Okay 283 00:19:11,880 --> 00:19:14,840 Get online and you will find no parabens, no glycerin 284 00:19:14,840 --> 00:19:16,680 And then you go bang, that's the one I want 285 00:19:17,240 --> 00:19:22,120 And for women who are engaging in intercourse still very comfortably 286 00:19:22,120 --> 00:19:24,920 They're going to go, okay, lubricants are a pain in the ass 287 00:19:24,920 --> 00:19:26,440 Because I got to keep reapplying them 288 00:19:26,440 --> 00:19:29,640 And I go, how about you go for lubricants that are water-based 289 00:19:29,640 --> 00:19:30,840 But meant for the back passage 290 00:19:30,840 --> 00:19:32,040 Oh, interesting 291 00:19:32,040 --> 00:19:32,920 In a lubricant 292 00:19:32,920 --> 00:19:33,480 Oh, interesting 293 00:19:33,480 --> 00:19:34,680 Because they're thicker 294 00:19:34,680 --> 00:19:36,680 The anus is not designed for intercourse 295 00:19:36,680 --> 00:19:41,960 And therefore they have very specialized much thicker longer lasting water-based lubricants for that 296 00:19:41,960 --> 00:19:43,000 Use that 297 00:19:43,000 --> 00:19:45,640 Use that for the vaginal area 298 00:19:45,640 --> 00:19:46,920 Or silicon lubricants 299 00:19:46,920 --> 00:19:49,560 Now the downside of silicon is that it does stain bedsheets 300 00:19:49,560 --> 00:19:51,960 If you've got expensive bedsheets, oh my god, that's a bummer 301 00:19:52,840 --> 00:19:55,640 But then try anal lubricants 302 00:19:55,640 --> 00:19:57,640 Because then they're a good alternative 303 00:19:57,640 --> 00:19:58,360 They last long 304 00:19:58,360 --> 00:20:00,360 You don't have to keep reapplying them every time 305 00:20:00,360 --> 00:20:01,640 It's not interruptive thin 306 00:20:02,520 --> 00:20:04,600 Other things that can be done 307 00:20:04,600 --> 00:20:06,200 When it comes to vaginal dryness 308 00:20:06,200 --> 00:20:08,360 Then you're going into slightly more novel territory 309 00:20:08,360 --> 00:20:10,120 Then you're going to something more medical 310 00:20:10,120 --> 00:20:13,480 So if we spoke about estrogen causing the problem, the lack of it 311 00:20:13,480 --> 00:20:15,480 Let's dump estrogen back 312 00:20:15,480 --> 00:20:16,120 You know 313 00:20:16,120 --> 00:20:18,200 Or let's dump what estrogen makes 314 00:20:18,200 --> 00:20:20,040 Which is hyaluronic acids 315 00:20:20,040 --> 00:20:21,640 You have so much in the aesthetic world 316 00:20:21,640 --> 00:20:24,120 People are injecting all sorts of things 317 00:20:24,120 --> 00:20:25,240 Like hyaluronic acid 318 00:20:25,240 --> 00:20:25,720 People 319 00:20:27,720 --> 00:20:30,200 But these hyaluronic acids are not in the form of fillers 320 00:20:30,200 --> 00:20:32,600 Not occupiers of space, right 321 00:20:32,600 --> 00:20:33,560 They're not filling up gaps 322 00:20:33,560 --> 00:20:36,600 But they're hyaluronic acids that just increase hydration 323 00:20:36,600 --> 00:20:42,120 So hyaluronic acid are stuff that drags water molecules to the area 324 00:20:42,120 --> 00:20:43,640 So you dump the thing in there 325 00:20:43,640 --> 00:20:46,120 The hyaluronic acids that drags water 326 00:20:46,120 --> 00:20:48,920 And they have got vaginal hyaluronic acids in the market 327 00:20:48,920 --> 00:20:50,680 So how are they applied? 328 00:20:50,680 --> 00:20:51,720 Is this a dumb question? 329 00:20:51,720 --> 00:20:52,760 Is it topical? 330 00:20:52,760 --> 00:20:53,720 Yes 331 00:20:53,720 --> 00:20:55,560 So you apply it on the vulva 332 00:20:55,560 --> 00:20:57,400 And then it's not injectable 333 00:20:57,400 --> 00:20:58,440 It's on the vulva 334 00:20:58,440 --> 00:20:59,560 And then it gets absorbed 335 00:20:59,560 --> 00:21:01,480 And also in the vagina 336 00:21:01,480 --> 00:21:05,880 But there are formulations that can be injected into the vulva 337 00:21:05,880 --> 00:21:08,120 So that's then done at a clinic level, right 338 00:21:08,120 --> 00:21:10,280 The doctors will have to inject it for you 339 00:21:10,280 --> 00:21:11,320 I don't know how I feel about that 340 00:21:11,320 --> 00:21:12,840 I like I hate injections 341 00:21:12,840 --> 00:21:13,640 Regardless 342 00:21:13,640 --> 00:21:15,560 Just fill up an injection down there 343 00:21:15,560 --> 00:21:16,360 Could be tricky 344 00:21:16,360 --> 00:21:18,040 But I've never heard that before 345 00:21:18,040 --> 00:21:20,040 So you don't really feel 346 00:21:20,040 --> 00:21:21,320 But I suppose the thought is 347 00:21:21,320 --> 00:21:23,000 Yes, the thought is for yeah 348 00:21:23,000 --> 00:21:25,800 Okay, speaking of topicals and moisture and vaginas 349 00:21:26,600 --> 00:21:28,680 HRT application down below 350 00:21:28,680 --> 00:21:29,720 So then that's the 351 00:21:29,720 --> 00:21:32,040 If you don't have the estrogen or if it's depleting 352 00:21:32,040 --> 00:21:35,720 And you don't have to test it to confirm that you're depleting estrogen 353 00:21:35,720 --> 00:21:37,960 It's very much a clinical diagnosis, right 354 00:21:37,960 --> 00:21:39,560 You know, oh, I'm having dryness 355 00:21:39,560 --> 00:21:43,880 There is no harm in using topical estrogens 356 00:21:43,880 --> 00:21:47,320 In fact, topical testosterone as well 357 00:21:47,320 --> 00:21:49,000 Down at the level of the vulva 358 00:21:49,000 --> 00:21:49,960 So many of us go 359 00:21:49,960 --> 00:21:51,560 I didn't know that was a thing 360 00:21:51,560 --> 00:21:54,680 So our vulvas respond not to just estrogen 361 00:21:54,680 --> 00:21:57,480 It is also very responsive to testosterone 362 00:21:57,480 --> 00:22:00,360 And these two hormones are in fact required 363 00:22:00,360 --> 00:22:02,680 To maintain a good sense of hydration in that area 364 00:22:02,680 --> 00:22:04,520 So you don't have that sticky dry feeling 365 00:22:05,080 --> 00:22:07,240 And that's what a lot of women want 366 00:22:07,240 --> 00:22:09,720 In fact, a lot of younger women on birth control pills 367 00:22:10,600 --> 00:22:12,360 And they're not even perimenopausal yet 368 00:22:12,360 --> 00:22:15,400 But what birth control pills do is that they deplete estrogen 369 00:22:16,040 --> 00:22:18,760 And testosterone at the level of the vulva 370 00:22:18,760 --> 00:22:20,200 And they'll say I'm on birth control 371 00:22:20,200 --> 00:22:21,160 I need it 372 00:22:21,160 --> 00:22:22,440 I don't want to get pregnant 373 00:22:23,400 --> 00:22:24,280 But I'm really dry 374 00:22:25,000 --> 00:22:26,120 And then we go, haha, all right 375 00:22:26,120 --> 00:22:27,640 Let's just replace 376 00:22:27,640 --> 00:22:30,040 I wonder if that also reduces desire as well then 377 00:22:30,040 --> 00:22:31,240 If it does 378 00:22:31,240 --> 00:22:32,520 Yeah, that's interesting 379 00:22:32,520 --> 00:22:35,960 And because birth control increases a certain protein in the body 380 00:22:35,960 --> 00:22:37,640 And when that protein levels are quite high 381 00:22:37,640 --> 00:22:39,960 It binds testosterone 382 00:22:39,960 --> 00:22:41,480 So testosterone becomes unavailable 383 00:22:41,480 --> 00:22:43,320 Because it's all stuck to this protein, right? 384 00:22:43,320 --> 00:22:45,240 And then I've got no free floating testosterone 385 00:22:45,240 --> 00:22:45,800 Yeah, and that's your libido, right? 386 00:22:45,800 --> 00:22:47,400 I need my testosterone to keep me 387 00:22:47,400 --> 00:22:48,680 Yeah, to keep my libido up 388 00:22:49,240 --> 00:22:52,600 And then that's what happens in perimenopause as well 389 00:22:52,600 --> 00:22:55,400 So the drop in the libido doesn't help 390 00:22:55,400 --> 00:22:57,960 Other things that we do do besides the hormones 391 00:22:58,600 --> 00:23:01,320 Are going to real novel territory here 392 00:23:01,880 --> 00:23:02,920 You're talking about lasers 393 00:23:03,480 --> 00:23:05,640 So we do play with quite a lot of lasers 394 00:23:05,640 --> 00:23:06,760 Lasers? 395 00:23:07,480 --> 00:23:08,360 Vaginal lasers 396 00:23:08,360 --> 00:23:09,000 Wow 397 00:23:09,000 --> 00:23:11,720 So vaginal lasers is becoming a territory that's 398 00:23:12,360 --> 00:23:14,440 More and more explored now 399 00:23:14,440 --> 00:23:17,640 Particularly in women who are thrown into menopause 400 00:23:17,640 --> 00:23:21,080 Because of things like breast cancers or cancer treatment 401 00:23:21,080 --> 00:23:23,720 So for them, it kicks in very prematurely 402 00:23:23,720 --> 00:23:27,080 And the thought of using hormones 403 00:23:27,080 --> 00:23:30,200 Although there's many studies that has been shown 404 00:23:30,200 --> 00:23:32,280 That topical estrogens are safe 405 00:23:32,280 --> 00:23:35,240 But I think a lot of doctors are still falling quite backwards 406 00:23:35,240 --> 00:23:37,480 It's the idea of survivorship 407 00:23:37,480 --> 00:23:39,480 You know, I've gotten cancer 408 00:23:39,480 --> 00:23:40,440 I've gotten through it 409 00:23:40,440 --> 00:23:42,040 I survived it 410 00:23:42,040 --> 00:23:44,360 But I'm too scared to even try anything 411 00:23:44,360 --> 00:23:46,440 Although the data says it's okay 412 00:23:46,440 --> 00:23:51,160 I feel it's not robust enough to go ahead and use it 413 00:23:51,160 --> 00:23:54,200 So it's actually very underprescribed 414 00:23:54,200 --> 00:23:57,240 Topical estrogens in our breast cancer survivors 415 00:23:57,240 --> 00:23:59,240 Which makes a very sad situation 416 00:23:59,240 --> 00:24:02,120 Because many of them are on medications 417 00:24:02,120 --> 00:24:04,200 That actually depletes the estrogen 418 00:24:04,200 --> 00:24:06,680 And they are extremely dry 419 00:24:06,680 --> 00:24:11,000 And in a dire state when it comes to their sexual lifestyles 420 00:24:11,000 --> 00:24:13,160 So lasers are a nice alternative 421 00:24:13,160 --> 00:24:14,840 For these group of patients as well 422 00:24:14,840 --> 00:24:16,280 This is not excluding other patients 423 00:24:16,280 --> 00:24:17,880 Who want to try things like lasers 424 00:24:17,880 --> 00:24:20,280 But we use carbon dioxide lasers 425 00:24:20,280 --> 00:24:22,360 We use erbium YAG lasers 426 00:24:22,360 --> 00:24:23,960 These are the two approved lasers 427 00:24:23,960 --> 00:24:26,520 And they actually remodel the collagen 428 00:24:26,520 --> 00:24:29,160 And force hydration to be formed in the skin layers 429 00:24:29,160 --> 00:24:30,760 They don't affect your pelvic floor in any way 430 00:24:30,760 --> 00:24:32,040 It doesn't reach muscles 431 00:24:32,040 --> 00:24:33,960 But that's the layer it works at 432 00:24:33,960 --> 00:24:35,080 Okay, I have another question 433 00:24:35,080 --> 00:24:37,720 You just brought this memory up to mind 434 00:24:37,720 --> 00:24:39,080 I get cupping quite regularly 435 00:24:39,080 --> 00:24:41,080 Oxygen cupping from my back 436 00:24:41,080 --> 00:24:47,400 My therapist was talking about using cupping for vaginal rejuvenation basically 437 00:24:47,400 --> 00:24:48,680 Have you ever heard of this? 438 00:24:48,680 --> 00:24:51,400 I haven't exactly heard about it 439 00:24:51,400 --> 00:24:54,040 But if you think back as to how it works 440 00:24:54,040 --> 00:24:55,640 It's actually tissue regeneration 441 00:24:55,640 --> 00:24:57,960 It's forced tissue regeneration 442 00:24:57,960 --> 00:25:00,840 And this is what the aesthetic field is all about now 443 00:25:00,840 --> 00:25:04,040 Applying, causing controlled damage 444 00:25:04,040 --> 00:25:06,440 To induced forced healing 445 00:25:06,440 --> 00:25:07,880 So like when a laser is applied 446 00:25:07,880 --> 00:25:10,200 You leave some healthy tissue in between the laser 447 00:25:10,200 --> 00:25:12,440 And then you force your body to repair 448 00:25:12,440 --> 00:25:14,920 Your body wouldn't otherwise repair at that rate 449 00:25:14,920 --> 00:25:16,200 And cupping is kind of like this 450 00:25:16,200 --> 00:25:19,400 All of these techniques are forcing repair 451 00:25:19,400 --> 00:25:21,960 And therefore creating regeneration 452 00:25:21,960 --> 00:25:24,120 So it's all regenerative technology 453 00:25:24,120 --> 00:25:26,200 People have been doing it from a long time ago 454 00:25:26,200 --> 00:25:27,480 Like vaginal steaming 455 00:25:27,480 --> 00:25:27,880 What's that? 456 00:25:27,880 --> 00:25:30,680 That's heat therapy to force regeneration 457 00:25:30,680 --> 00:25:31,960 So that's been going on for ages 458 00:25:31,960 --> 00:25:33,640 It's just that we are fine tuning it now 459 00:25:34,760 --> 00:25:38,040 And I'm guessing people shouldn't be doing this at home on their own 460 00:25:38,040 --> 00:25:38,840 I wouldn't advise 461 00:25:38,840 --> 00:25:41,880 Yeah, says UW 462 00:25:41,880 --> 00:25:43,560 Right, so let's say you know 463 00:25:43,560 --> 00:25:45,160 The kids have gone out 464 00:25:45,160 --> 00:25:47,240 And you're at home with your partner 465 00:25:47,240 --> 00:25:48,360 Things are getting steamy 466 00:25:48,360 --> 00:25:50,760 You haven't had a chance to go and buy some lubrication 467 00:25:50,760 --> 00:25:52,120 Or do any of these things 468 00:25:52,120 --> 00:25:54,120 Is there anything at home you can use? 469 00:25:54,120 --> 00:25:58,120 Coconut oil, olive oil, petroleum jelly 470 00:25:58,120 --> 00:25:58,920 I don't know 471 00:25:58,920 --> 00:26:01,080 Any of these safe? 472 00:26:01,080 --> 00:26:03,400 Or anything we should definitely be avoiding? 473 00:26:03,400 --> 00:26:04,840 Yes, yes, yes, yes, yes 474 00:26:04,840 --> 00:26:06,840 Use coconut oil, use olive oil 475 00:26:06,840 --> 00:26:08,200 Use petroleum jelly 476 00:26:08,200 --> 00:26:09,560 Nice, awesome, cheap stuff 477 00:26:09,560 --> 00:26:11,720 Yeah, yeah, household items 478 00:26:11,720 --> 00:26:12,520 It's easy 479 00:26:12,520 --> 00:26:15,640 It's easy, yeah, but if you have olive oil, coconut oil 480 00:26:15,640 --> 00:26:17,560 Just make sure it's not the cooking coconut oil 481 00:26:17,560 --> 00:26:19,160 The cooking olive oil 482 00:26:19,160 --> 00:26:21,800 You know, it's more the topical for skin type 483 00:26:21,800 --> 00:26:23,480 And those are absolutely safety 484 00:26:23,480 --> 00:26:24,840 In fact, they're recommended 485 00:26:24,840 --> 00:26:25,400 Oh, good 486 00:26:26,360 --> 00:26:27,240 It's good to know 487 00:26:27,240 --> 00:26:28,520 Yeah, I was hoping coconut oil 488 00:26:28,520 --> 00:26:29,800 That seems to fix everything 489 00:26:29,800 --> 00:26:32,920 Yeah, yeah, I mean I use coconut oil on my face 490 00:26:32,920 --> 00:26:35,320 You know, and I feel like a lot of the things you've said there 491 00:26:35,320 --> 00:26:36,520 It's like, you know, it's good for your face 492 00:26:36,520 --> 00:26:37,640 It should be good for down there 493 00:26:37,640 --> 00:26:38,680 Yeah, that's what it sounds like 494 00:26:38,680 --> 00:26:41,880 I've interestingly had a patient who told me that she was using ghee 495 00:26:41,880 --> 00:26:42,280 Wow 496 00:26:42,280 --> 00:26:44,600 Which is the clarified butter 497 00:26:44,600 --> 00:26:46,440 But I can't make a recommendation on ghee 498 00:26:46,440 --> 00:26:48,680 So if anyone's got tins of ghee at home 499 00:26:50,040 --> 00:26:51,640 I can't make that recommendation 500 00:26:51,640 --> 00:26:53,640 But for now, coconut and olive oil agree 501 00:26:53,640 --> 00:26:53,880 Yeah 502 00:26:54,520 --> 00:26:55,880 So you mentioned testosterone 503 00:26:55,880 --> 00:26:58,520 Now, I think a lot of people when they think of testosterone 504 00:26:58,520 --> 00:27:00,840 They think of it as a male hormone 505 00:27:00,840 --> 00:27:04,840 But how does testosterone apply to women? 506 00:27:04,840 --> 00:27:09,080 And, you know, like can we use this to help increase our desire? 507 00:27:10,280 --> 00:27:11,080 Absolutely 508 00:27:11,080 --> 00:27:15,240 Testosterone, you know, just like men have estrogen 509 00:27:15,240 --> 00:27:17,000 Women have testosterone 510 00:27:17,000 --> 00:27:20,760 Of course, the quantities in which we have them are far more minuscule 511 00:27:20,760 --> 00:27:22,440 Compared to what men have 512 00:27:22,440 --> 00:27:27,240 So in general, when we do prescribe things like testosterone 513 00:27:27,240 --> 00:27:29,160 It's still considered off-label 514 00:27:29,160 --> 00:27:33,480 And the only reason is that we till this day have not formulated 515 00:27:33,480 --> 00:27:38,760 A form of FDA approved testosterone that can be applied on the skin 516 00:27:38,760 --> 00:27:41,400 So that women, particularly postmenopause 517 00:27:41,400 --> 00:27:42,840 And there's lots of studies 518 00:27:42,840 --> 00:27:45,720 Testosterone use in postmenopause is now approved 519 00:27:45,720 --> 00:27:51,000 But we don't have a packet that says this is testosterone formulated by women 520 00:27:51,000 --> 00:27:53,160 Squeeze the contents out and just rub it on yourself 521 00:27:53,160 --> 00:27:58,040 So the formulations that we have to use are from compounded pharmacies 522 00:27:58,040 --> 00:28:02,120 Now, compounded pharmacies, the drugs there, are not FDA approved 523 00:28:02,120 --> 00:28:03,960 Because when you compound drugs 524 00:28:03,960 --> 00:28:08,040 There can be variability in the doses just with each bottle that you manufacture 525 00:28:08,040 --> 00:28:10,920 And it's something a pharmacist is just sitting there and preparing 526 00:28:10,920 --> 00:28:13,320 Based on a prescription that a doctor gives them 527 00:28:13,320 --> 00:28:15,560 So it's not as well studied 528 00:28:15,560 --> 00:28:18,280 So then you go, okay, it's questionable 529 00:28:18,280 --> 00:28:20,680 I think I'm applying this much of the dose 530 00:28:20,680 --> 00:28:22,440 But how much of it is actually getting into me 531 00:28:22,440 --> 00:28:24,840 And getting into my system to help with libido 532 00:28:24,840 --> 00:28:25,800 It does help 533 00:28:25,800 --> 00:28:30,280 Then the current recommendations from the menopause societies are saying 534 00:28:30,280 --> 00:28:32,680 How about we use the male formulations 535 00:28:32,680 --> 00:28:35,080 They come in little sachets or little pumps 536 00:28:35,080 --> 00:28:36,920 But we pump out one-tenth 537 00:28:36,920 --> 00:28:42,200 And then I am, as a doctor, I'm going, how in the world am I going to pump out one-tenth? 538 00:28:42,200 --> 00:28:44,200 It's like cutting pills, right? 539 00:28:44,200 --> 00:28:45,800 It's like one-fourth of this pill 540 00:28:45,800 --> 00:28:48,680 What do you think I have at home to make one-fourth of a pill? 541 00:28:48,680 --> 00:28:49,640 Do you know how I'm doing it? 542 00:28:49,640 --> 00:28:50,600 Because that's exactly what I'm doing 543 00:28:50,600 --> 00:28:51,960 So I've got the male version 544 00:28:51,960 --> 00:28:56,200 And one sachet is five milliliters, is that right? 545 00:28:56,200 --> 00:28:56,920 Five grams? 546 00:28:56,920 --> 00:28:57,960 Very, very small quantity 547 00:28:57,960 --> 00:28:58,680 Yeah, whatever it is 548 00:28:58,680 --> 00:29:02,440 And so I bought a five milliliter pump tube 549 00:29:02,440 --> 00:29:07,880 And then I was first using a syringe to figure out how much, you know, half a milliliter 550 00:29:07,880 --> 00:29:09,400 Or whatever it is the dosage is 551 00:29:09,400 --> 00:29:10,440 And then I eyeballed it 552 00:29:10,440 --> 00:29:12,440 I'm like, okay, it looks like it's about a pea-sized amount 553 00:29:12,440 --> 00:29:13,720 So I'm putting in this pump thing 554 00:29:13,720 --> 00:29:14,920 And then I pump it out 555 00:29:14,920 --> 00:29:16,120 It's like two or three pumps 556 00:29:16,120 --> 00:29:18,680 I'm like, aha, and this lasts me like 10 days 557 00:29:18,680 --> 00:29:20,360 So I've figured it out now 558 00:29:20,360 --> 00:29:21,160 I know how to get 559 00:29:21,160 --> 00:29:24,360 But think of the level of work you just described to do that 560 00:29:24,360 --> 00:29:27,800 I've got to tell you, it's messy when you're first putting it in 561 00:29:27,800 --> 00:29:29,720 Just can someone please invent 562 00:29:29,720 --> 00:29:31,240 Actually, that's a business idea 563 00:29:31,240 --> 00:29:32,840 Yeah, yes 564 00:29:32,840 --> 00:29:33,800 You should get into that 565 00:29:33,800 --> 00:29:35,160 An easy dispense 566 00:29:35,160 --> 00:29:38,600 An easy dispense for, yeah, for testosterone 567 00:29:38,600 --> 00:29:40,120 Because it would take off, really 568 00:29:40,120 --> 00:29:43,800 Because many, many, many women describe having a low libido 569 00:29:43,800 --> 00:29:46,600 And then of course so many other factors influencing that libido 570 00:29:46,600 --> 00:29:52,440 But hypoactive sexual desire syndrome is a real problem 571 00:29:52,440 --> 00:29:55,000 That one third of women in menopause experience 572 00:29:55,000 --> 00:29:56,520 Or midlife, forget menopause 573 00:29:56,520 --> 00:29:59,560 In your 40s already, you're starting to experience that 574 00:29:59,560 --> 00:30:03,000 That's just, so what you've just said 575 00:30:03,000 --> 00:30:07,000 Hypoactive sexual desire disorder 576 00:30:07,000 --> 00:30:09,160 I mean, that's like, it's a clinical term 577 00:30:09,160 --> 00:30:10,840 It's a proper diagnosis 578 00:30:10,840 --> 00:30:13,800 And I just would have thought, oh, this is a normal thing that happens 579 00:30:13,800 --> 00:30:16,280 But actually, is it normal? 580 00:30:16,280 --> 00:30:17,240 I mean, I don't know, like 581 00:30:17,240 --> 00:30:19,560 As humans, we're in the habit of labeling things, right? 582 00:30:19,560 --> 00:30:21,160 So we always want to give something a name 583 00:30:21,160 --> 00:30:22,600 And it gives us a sense of security 584 00:30:22,600 --> 00:30:25,240 All right, it's been labeled, this is what it is 585 00:30:25,240 --> 00:30:26,360 Because it gives us an idea 586 00:30:26,360 --> 00:30:27,880 I can now do something about it 587 00:30:27,880 --> 00:30:28,600 Show me the data 588 00:30:28,600 --> 00:30:29,480 What's the evidence 589 00:30:29,480 --> 00:30:32,040 If I have this, what can I do? 590 00:30:32,040 --> 00:30:34,680 So again, sense of safety that comes with labeling 591 00:30:35,320 --> 00:30:37,880 And the problem comes with mislabeling things 592 00:30:37,880 --> 00:30:41,560 So when you've been given a diagnosis 593 00:30:41,560 --> 00:30:43,960 Like hypoactive sexual desire disorder 594 00:30:43,960 --> 00:30:46,200 It's really a condition that's been there for weeks 595 00:30:46,200 --> 00:30:47,400 You know, it's been there for weeks 596 00:30:47,400 --> 00:30:50,200 And there's no better explanation for this lowered desire 597 00:30:50,200 --> 00:30:52,280 It cannot be explained by a relationship issue 598 00:30:52,280 --> 00:30:53,560 Meaning it's not situational 599 00:30:54,360 --> 00:30:57,640 I feel sexual desire with this other person 600 00:30:57,640 --> 00:30:59,000 But not with my partner 601 00:30:59,000 --> 00:31:01,880 Then that's not hypoactive sexual desire disorder, right? 602 00:31:01,880 --> 00:31:04,680 That's something's going on with that relationship 603 00:31:04,680 --> 00:31:06,360 And there's no other better explanation 604 00:31:06,360 --> 00:31:07,720 Like a medical condition 605 00:31:07,720 --> 00:31:09,000 Like a skin problem 606 00:31:09,000 --> 00:31:11,480 Like there's no other better explanation 607 00:31:11,480 --> 00:31:15,240 Other than for the impact of perimenopause or menopause 608 00:31:16,120 --> 00:31:17,240 Causing this problem 609 00:31:18,440 --> 00:31:20,040 And it's a real issue 610 00:31:20,040 --> 00:31:21,560 One third of women experience it 611 00:31:21,560 --> 00:31:23,480 But how many women actually come and speak about it? 612 00:31:23,480 --> 00:31:24,840 Many of us normalize it 613 00:31:24,840 --> 00:31:26,840 And the worst part is we might normalize it 614 00:31:26,840 --> 00:31:28,520 But when we approach our doctors about it 615 00:31:28,520 --> 00:31:30,680 It's number one difficult to speak about 616 00:31:30,680 --> 00:31:33,080 And when we do, it might be trivialized 617 00:31:33,720 --> 00:31:33,960 Right? 618 00:31:33,960 --> 00:31:34,760 And then they go 619 00:31:34,760 --> 00:31:36,600 No, it's quite normal for you to feel this way 620 00:31:36,600 --> 00:31:37,560 In this part of your life 621 00:31:37,560 --> 00:31:39,240 And then you go, hold on 622 00:31:39,240 --> 00:31:41,000 I'm at the peak of my life now 623 00:31:41,000 --> 00:31:44,040 Do I really need to feel this way at this point in my life? 624 00:31:44,040 --> 00:31:47,320 Because sex and just being sexually intimate with my partner 625 00:31:47,320 --> 00:31:49,000 Is something that I actually rely on 626 00:31:49,000 --> 00:31:51,160 It fills my intimate bank 627 00:31:51,160 --> 00:31:53,400 It fills up my emotional bank 628 00:31:53,400 --> 00:31:55,480 And I'm currently running on empty 629 00:31:55,480 --> 00:31:57,560 And that's why sex is important 630 00:31:57,560 --> 00:31:59,640 It's not the act or the mechanics of sex 631 00:32:00,200 --> 00:32:02,680 It's the reward system at the end of it 632 00:32:02,680 --> 00:32:04,600 And we are reward seeking beings 633 00:32:04,600 --> 00:32:06,600 We would do something because it's rewarded us 634 00:32:06,600 --> 00:32:08,760 We would dine at that same restaurant 635 00:32:08,760 --> 00:32:09,960 Because the food's good 636 00:32:09,960 --> 00:32:11,720 And it triggers off good hormones in us 637 00:32:11,720 --> 00:32:12,920 I like it, I'm coming back 638 00:32:12,920 --> 00:32:14,920 If I like sex, I'm coming back too 639 00:32:15,480 --> 00:32:18,840 But if I don't like it, I'm not gonna want it 640 00:32:18,840 --> 00:32:19,960 And if you don't want it, that's it 641 00:32:19,960 --> 00:32:24,040 It's like, you know, the whole purpose of humans is to procreate 642 00:32:24,040 --> 00:32:26,760 And you know, like it's kind of, yeah, it makes sense 643 00:32:26,760 --> 00:32:27,640 Totally makes sense 644 00:32:27,640 --> 00:32:32,440 Never would have put it in like that whole, you know, put it together 645 00:32:32,440 --> 00:32:34,040 But it totally does make sense 646 00:32:35,960 --> 00:32:37,880 We have loved your conversation with us today 647 00:32:37,880 --> 00:32:39,480 I think you've given us a lot of food for thought 648 00:32:39,480 --> 00:32:44,280 A lot of things to think about when it comes to women in their 40s and sexual desire 649 00:32:44,280 --> 00:32:46,040 But we do have one last question for you 650 00:32:46,040 --> 00:32:48,680 And that is, what's your 40s formula? 651 00:32:48,680 --> 00:32:52,120 What would you say to women who are in this phase of their life? 652 00:32:52,120 --> 00:32:59,080 What can they do to make them feel like they're living their best life within the 40s? 653 00:32:59,080 --> 00:33:02,200 Is there some kind of advice or mantra you'd like to share with us? 654 00:33:03,800 --> 00:33:08,520 I would normally say don't take the shit that's being thrown at you, you know 655 00:33:09,240 --> 00:33:12,600 And go, okay, so I've got rubbish being thrown at me 656 00:33:12,600 --> 00:33:15,160 Maybe I should get a better bag to catch that 657 00:33:15,160 --> 00:33:19,640 So don't let it just hit you and just go, you know, okay 658 00:33:19,640 --> 00:33:21,560 This is what I'm experiencing 659 00:33:21,560 --> 00:33:25,400 Just get into the acceptance mode and go, I'm experiencing this 660 00:33:26,440 --> 00:33:28,120 But I'm not taking it 661 00:33:28,120 --> 00:33:29,960 Can I do something about it? 662 00:33:29,960 --> 00:33:31,960 So just don't normalize it 663 00:33:32,520 --> 00:33:34,520 You know, a lot of people come to us, is this normal? 664 00:33:35,240 --> 00:33:36,520 No, it's not normal 665 00:33:36,520 --> 00:33:38,440 It's common, but it's not normal 666 00:33:38,440 --> 00:33:41,560 Common doesn't make something normal 667 00:33:42,120 --> 00:33:44,040 And that's what I tell my women, you know 668 00:33:44,040 --> 00:33:50,200 And then sometimes we find comfort in the fact that things are common 669 00:33:50,200 --> 00:33:52,280 And that's because then we don't feel alone 670 00:33:52,280 --> 00:33:53,960 But again, not normal 671 00:33:54,680 --> 00:33:56,040 Common, but not normal 672 00:33:56,040 --> 00:33:57,640 So that's the advice I'd give women 673 00:33:57,640 --> 00:33:59,400 I'd say, you know, that's the one thing you can do 674 00:33:59,400 --> 00:34:01,000 Just that acceptance 675 00:34:01,000 --> 00:34:06,920 And then with acceptance comes a potential proper labeling of what you're experiencing 676 00:34:06,920 --> 00:34:08,600 And then going, how can I make it better? 677 00:34:08,600 --> 00:34:10,920 Because then you can go down the therapeutic route 678 00:34:10,920 --> 00:34:13,880 Whether it's something medical or non-medical 679 00:34:13,880 --> 00:34:17,720 There is a route, there is a formula from that point 680 00:34:18,360 --> 00:34:19,800 Yeah, get shit done 681 00:34:19,800 --> 00:34:20,840 But don't take shit 682 00:34:23,240 --> 00:34:24,600 Thank you so much, Dr. Jess 683 00:34:24,600 --> 00:34:26,200 It's been wonderful having you here 684 00:34:26,200 --> 00:34:26,840 Thank you guys 685 00:34:26,840 --> 00:34:27,800 Thank you very, very much 686 00:34:29,320 --> 00:34:31,160 Want more from the 40s Formula? 687 00:34:31,160 --> 00:34:35,160 Every Friday we'll be sending our foreplay Friday newsletter direct to your inbox 688 00:34:35,160 --> 00:34:37,560 With four hot topics, tips and trends 689 00:34:37,560 --> 00:34:39,880 Personally curated by Jasmine and Amanda 690 00:34:39,880 --> 00:34:43,000 All you need to do is visit the40sformula.com 691 00:34:43,000 --> 00:34:44,600 And sign up with your email address 692 00:34:44,600 --> 00:34:50,200 That's the F-O-R-T-I-E-S formula.com 693 00:34:50,920 --> 00:34:52,840 This is Paul, our editor 694 00:34:52,840 --> 00:34:55,800 He's a 25-year-old unmarried Singaporean guy 695 00:34:55,800 --> 00:34:58,840 Listening to the ramblings of 12 older women on everything 696 00:34:58,840 --> 00:35:00,920 From menopause to weightlifting to sex 697 00:35:01,720 --> 00:35:04,280 So Paul, what's your thoughts on today's conversation? 698 00:35:05,480 --> 00:35:09,240 Sex, sex and sex, plenty of sex 699 00:35:09,240 --> 00:35:11,560 It's probably one of those aspects in our lives 700 00:35:11,560 --> 00:35:12,840 Which we often overlook 701 00:35:12,840 --> 00:35:15,960 Especially for you guys in probably the 40s bracket 702 00:35:15,960 --> 00:35:18,760 With different various bodily changes 703 00:35:19,960 --> 00:35:22,680 There's no shame in using some lube, you know 704 00:35:24,520 --> 00:35:28,520 And of course, stay healthy, stay hydrated, eat healthily 705 00:35:28,520 --> 00:35:30,040 And I'll see you guys in the next one 706 00:35:32,840 --> 00:35:34,360 Guys, you know how much we love coffee? 707 00:35:34,360 --> 00:35:36,920 And if you want to show us some love, you know you can get us one 708 00:35:36,920 --> 00:35:39,080 Just visit buymeacoffee.com 709 00:35:40,120 --> 00:35:41,000 The 40s Formula 710 00:35:41,000 --> 00:35:42,200 Cheers 711 00:36:11,000 --> 00:36:13,080 So please be sure to hit that follow button 712 00:36:13,640 --> 00:36:15,160 We appreciate your time and support 713 00:36:15,160 --> 00:36:16,920 Thank you for being part of this community 714 00:36:16,920 --> 00:36:20,520 And we'll be back next week for more empowering conversations with inspiring guests 715 00:36:20,520 --> 00:36:44,280 Bye 716 00:36:50,520 --> 00:37:02,360 Thank you. 717 00:37:02,360 --> 00:37:05,440 Awesome. 718 00:37:05,440 --> 00:37:06,440 That was amazing. 719 00:37:06,440 --> 00:37:07,440 Thank you so much. 720 00:37:07,440 --> 00:37:08,440 No worries. 721 00:37:08,440 --> 00:37:12,440 You know, like, I feel like we've had people talk about sex before, but this was like really 722 00:37:12,440 --> 00:37:15,120 specific and really to the point. 723 00:37:15,120 --> 00:37:18,080 And I feel like it's given a lot of great information. 724 00:37:18,080 --> 00:37:19,080 Yeah. 725 00:37:19,080 --> 00:37:20,080 Especially about the lubricants. 726 00:37:20,080 --> 00:37:23,240 I had no idea that you could use, you know, I don't want to say anything. 727 00:37:23,240 --> 00:37:26,320 Obviously there's like a limit, but you know, just, yeah, coconut oil, whatever you got in 728 00:37:26,320 --> 00:37:27,320 hand. 729 00:37:27,320 --> 00:37:28,320 And again, parabens and glycerin. 730 00:37:28,320 --> 00:37:29,320 Glycerin, yeah. 731 00:37:29,320 --> 00:37:30,320 Those are the two things to avoid. 732 00:37:30,320 --> 00:37:31,320 Yeah. 733 00:37:31,320 --> 00:37:32,320 Yeah. 734 00:37:32,320 --> 00:37:33,320 Amazing. 735 00:37:33,320 --> 00:37:34,320 Very, very helpful. 736 00:37:34,320 --> 00:37:35,320 Thank you so much. 737 00:37:35,320 --> 00:37:36,320 No worries. 738 00:37:36,320 --> 00:37:53,060 Awesome.