Orgasm After Menopause: Vibrators, Testosterone & Solutions with Dr. Lauren Streicher (Pt. 2)

Yeah, sex, I'd be always all about how not to get pregnant or get an STI or something to do with pleasure But the guys are not taught that the guys are taught you should have pleasure So this part of the problem is that there isn't the expectation So are they upset? I think the ones that expect pleasure are the ones who know how to have pleasure Mm-hmm. So older women different story So we have an older patient who comes into your clinic and she says I Am struggling with orgasm. I used to have them. They're great and I still want them What's your first step? Walk me through the first step is unless you're running a sexual medicine clinic the likelihood of that happening is about zero Let's be honest how many of patients when you were doing general OBGYN walked in your door and said hey Dr. Haver I can't have an orgasm will you help me? The Views and opinions expressed on unpossed are those of the talent and guests alone and are provided for informational and entertainment purposes only no part of this podcast or any related materials are intended to be a substitute for professional medical advice diagnosis or treatment Welcome back to unpossed. I'm Dr. Mary Claire Haver in our last episode Dr. Lauren striker and I started an in-depth conversation about orgasm sexual function and why these topics are still so difficult to talk about Even in doctor's offices There was so much ground to cover on this topic that we decided to split this conversation into a two-part episode So today we're picking up right where we left off If you're just joining us, let me tell you about Dr. striker She's a professor of obstetric synchon ecology at Northwestern University Fineberg School of Medicine the host of Dr. striker's inside information podcast and the creator of come again a 30 episode audio series on Sexuality and sexual function for decades She's been leading the conversations that most clinicians still won't have today We're talking about vibrators and what the research shows Non-hormonal arousal creams and whether they work the role of neurotransmitters and FDA approved libido drugs like Adi and Vilece and why testosterone is often the preferred option for women Dr. striker breaks down the problem with pellets Explains the orgasm gap between men and women and why it narrows with age and walks us through her actual Clinical approach when a patient comes in struggling with orgasm We also talk about how to find a sexual medicine expert why pain must be addressed first and what gives her hope for the future of this field If you missed part one I encourage you to go back and listen But if you're ready to learn what actually is possible when it comes to sexual function in midlife and beyond let's continue the conversation Talk to me about vibrators devices we you touched on them earlier, but why does vibration work so well? I call vibrators tools not toys Because toys implies that it's gonna give you additional pleasure and it's gonna make pleasure Passable the tool is something that makes having an orgasm possible So let's call them tools because I think that also really is Kind of just empowering to women to say you know if I can't swim and I'm gonna go on a life raft to get me to have fun in the water Well, if I can't have an orgasm then I'm gonna use this tool to facilitate my ability to have an orgasm Lided vibration work when nothing else does let me be a cup because so often a woman will come to the clinic and say I can't have an orgasm anymore and I'll say well how about when you use your vibrator and so say well Of course if I use my vibrator I can but I didn't use the heft to use my I write vibrator So what's changed? Well before I talked about those little nerve endings in the clitoris and Turns out we have different types of nerve endings and different sizes of nerve endings some of them respond to Soft touch Licking stroking some of them respond to vibration it turns out that the little nerve endings in the clitoris that respond to stroking and licking and touch are the ones that tend to deteriorate with age The most quickly so even if you have the best liquor and stoker in town Those nerve endings are just dead. They're just not functional But there is a god or goddess the nerve endings that respond to vibration are not only bigger but they have a thick myelin coat Which is the last time soon around them. They are good to go and they are going to last and last and last and last So what that means is that Vibration will often work when nothing else does and I think if people are gonna listen to come again If they're only gonna listen to one episode The vibrator one. Yes, okay, and then my daughter who also joins in in that episode She says a sex therapist she talks about how to get the partner in your life on board with the vibrator because a lot of times women Are embarrassed to bring it up. They think that the guy's gonna feel like a failure Partners gonna feel like a failure if you need to bring the vibrator in the bedroom So she gives the script the language that how to approach that because that's just as important Does not mean it's fine when you're on your own But if you're looking to have an orgasm with partner sex you need to get your partner to to be in on it So has anyone done ahead to head comparison of different vibrators because there's you know I guess I lump them into only on the outside or Optional you know penetration and so people feel very strongly about what kind of vibrator they should have and now There's the ones with the little suction which is a whole different thing the suction is different because what the suction is Well, it's a lot is pretty intense and not necessarily in a good way But but what the suction is doing is it's drawing in blood flow It's amazing blood flow. So that's not working with vibration Have people done this study? Oh you bet. There's a lot of vibrator companies out there who are really On a mission to find out what is the pulsation speed what is the level of vibration and there's data There's the other I don't think I put that in come again because it just got too sciencey But when I do have a lecture I have a lecture that I give to doctors on vibration and I talk about That how you get different levels of vibration and what seems to work better for example Pulse to tile is better for a rousal, but study is better to actually trigger the Orgasm. Okay, because I have these conversations with my girlfriends and It's all very different. They most of them feel like the least complicated the better like all these extra buttons and whistles and He's exactly And then you have to go back through the cycle So you got to try to lie sound Do you know what is one of the strongest vibrators out there? Your Santa care toothbrush I'm just got almighty. We just shot the stock of sonic hair Okay, I want to be clear do not use your brush directly You get like abrasions of your clitoris that would be a disaster Okay, so I have a sonic hair. How would I use it as a Big travel thing of course because people are worried about the TSA find their vibrator in their suitcase Which trust me it won't be the first vibrator they found this a matter of fact It's really funny because when I come home from conferences and people are just throwing vibrators at me right and left You know, this is great to be my friend because this is a gift that I give to all my friends because I have more vibrators And any human being would know it to do it So I go through TSA and they're like holding them up one after another saying wow What does she do for a living purple blue and then they find of course my podcast microphone and they think there's some kind of really Super duper special vibrator, but I digress so but travel travel vibrator a lot of people do rely on their toothbrush You need to put something Over it like a gym sack at a minimum at a minimum and be really really careful I don't I'm just be clear. I'm not recommending a toothbrush I'm just saying this is what a lot of people do I'm gonna check the stock of sonic hair right now We're gonna invest today okay, so someone I have a YouTube right next to my you I have it's called guinea hacks and I have seven right YouTube videos on interesting hacks to solve problems, which is why I have the hands-free vulva review how to get your a string out if you have one else Well, let me through this. I'm so fascinated. Can you explain to our listeners how they would have a hands-free view of their vulva Is it possible? Oh, yeah, and with things you have at home Okay, but I will say it's kind of hard to describe without a video, but I'll tell you what it is and then I'm imagining I'll give you the link no, no, it's actually much more innovative than that What you do is you take one of those magnifying makeup Fold up round mirrors checks on a hinge ideally with a light Okay, you lift up the toilet seat You put the unmeared part under the toilet seat and you put it down now you're gonna sit on the toilet seat Because now it's holding it in place. Can you picture this yeah, so the mirror is now Coming out from the toilet seat. Yeah, and you can adjust the mirror to get the perfect view if you don't have a mirror with a light, you know, you can use a ring light or you can use your phone whatever And suddenly you are sitting on it is holding it into place and you've got a hands-free view That's amazing. So this is right after my guinea-hack and how to get your femurine or your s-string out if you have long nails dental floss you try a long ring of unmented dental floss just like a tampon string Push it off and then it's time to take out your ring Oh, and you like it's time you made a string you just pull it down it comes down to the opening of the vagina and you just grab it out So I have fun with this. So I have about 15 guinea-hacks. I haven't put all of them on YouTube People are gonna be running to YouTube. This is hilarious. Let's go through Non-hormonal arousal creams. Do we have any evidence? This is also a data-free zone However, there are a lot of them out there. These are also compounded products. I've seen scream cream Yeah, we try not to call it scream cream because we think that's kind of offensive Yeah, you know women having pleasure shouldn't be labeled as we want you screaming We want them anyway. I call it just arousal cream arousal cream arousal cream arousal cream or a guesome cream What are these? Well, there's different combinations of products that are all basically vasodilators. Okay, they all increase blood flow and And do they work anecdotally for a lot of women they do seem to make a difference again The instructions usually say use it just prior to sexual activity I think you're better off using it on a regular basis to increase the health of the clitoris It can be irritating to some women and in that episode of course I go through all the ingredients to look for All the things that might help the the other arousal cream that is out there that a lot of women are using CBD really Well think about this. Okay Again, data free zone although I've done some research on that which I have not published yet But the use of CBD on the clitoris CBD canibal dial is Number one of vasodilator Number two, it's the anti-inflammatory Number three, this is where it gets interesting in diabetics who have peripheral neuropathy CBD cream has been shown to increase nerve sensitivity Wow, now clitoral nerves are not foot nerves However, nerves are nerves and I will tell you anecdotally that women who use CBD oil on their clitoris appear To have enhancement of their ability to have an orgasm again rubbing it in for a long time helps A lot of this might be placebo. We don't know this is a data free zone But whenever I I recommend something that we don't have data at a minimum I want to recommend something that is not going to be harmful And we know that this is not going to be harmful with the information that we do have because CBD is used in large amounts all over the body Not the same as using systemic cannabis. That's a whole another discussion A lot of women will use that for orgasm too And without getting into the biology and the science a lot of that is about disinhibition It's working more in the brain in terms of maybe helping with generalizing pains Maybe just waking up your neurotransmitters. We don't know. We don't know But that's not getting the same local application Talk to me about neurotransmitters and kind of brain forward strategies Yeah to help with orgasm So we know we know that those neurotransmitters are critically important in terms of not only arousal But in sending messages down to the pelvis It's kind of you know that's the brain like everything else is in charge of what's happening all over your body We also know and I know you've talked about this mericler again and again and again that we have estrogen Receptors antisastroen receptors throughout our brain. What do they do? They prime the pump They make those neurotransmitters work better and they enhance the release of those neurotransmitters So if you have something that's going to get in the way of that You are going to lose the benefit of the brain Talking to your pelvis. What's going to get in the way that we'll be already talked about If you don't have estrogen right not only are you going to have problems in terms of what's happening right down at the level of Your ball of a giant and clitoris But you're also going to have some problems in terms of the function of your neurotransmitters They're not going to be primed as much which is also why when people take systemic estrogen even if they're not putting it Directly on their clitoris for a lot of women in addition to getting rid of their menopause symptoms That can in some cases also enhance sexual function. So there's that We already talked about the SSRIs and the impact that they have when we talk about how else can we enhance The function of these neurotransmitters while there are two libido drugs that are FDA-proof One is flabancerin the other is brimilanetide and these are FDA-proofed for using young women Of course, but we do have data in older women And it's important to keep in mind that while we don't think of those drugs as being orgasm drugs They really are because they are working on those transmitters specifically dopamine dopamine is the one we really want You know when you're dopey with love that's how I was remembered stop him I teach the medical students I always say dopamine is dopey with love Serotonin is stop stop stop. We got to go work into laundry So we we know that those drugs enhance enhance the release of dopamine So most things can help with the rouse of which in turn is going to help with our guess So we we have a terrible PR campaign around these drugs and I'm near a villa I don't think most women even know what they are that they're available and what they could do So I think just let's take two minutes to go over them again You know Perry menopause is not early menopause It is its own distinct biological phase And it has been largely ignored My new book the new Perry menopause is about the seven to ten years before your period stop A transition that is anything but gentle hormones fluctuate wildly and for many women this is when the anxiety brain fog sleep disruption weight changes mood shifts joint pain and that unsettling feeling of I don't feel like myself anymore begin long before anyone says the word menopause Perry menopause often starts quietly it shows up in the brain first Then the body then everywhere else and too often women are told nothing is wrong I wrote the new Perry menopause because you deserve answers before things spiral You deserve care before burnout and you deserve a clear roadmap for a transition that medicine has ignored for far too long The new Perry menopause is now available for pre-order everywhere books are sold Learn more and pre-order your copy at the pauselife.com For the answer and it's been FDA-proved now for I think it's boys it's ten years almost ten years The trade name is Addy Addy Addy and this is a pill that you take a non-on on demand you have to take it on a regular basis It's like a vitamin. I can't take it at night because it might make you a little sleepy Which is a good thing For most women but other than that it really has very few side effects There was a concern initially about alcohol which didn't really pan out But for most women it is a safe drug and it does help with libido is it is FDA proof specifically for Hypoactive sexual desire disorder which is Decreased libido in women who want to do something about it not everybody does And we know the decreased libido is actually the number one sexual problem that postmenopausal women have And so but of course this is not FDA-proved in postmenopausal women But we have studies that show that it's in our clinically used it off like that it is you had to pay for it That's the problem. So how well does it work? It works in about 50% of women at best at best And when people say well, why is it so few? It's because desire is so multi-vectoral You know, this is not the only thing happening here The the other drug Bremenlana Tide the trade name is Vilece And this is an on demand drug and the way Vilece works is that this is a pen like a little epipen kind of thing And you plunge it into your thigh about 30-40 minutes before you would like to have sex And again, it's going to modify those all important neurotransmitters kick them into action So that you are suddenly in the mood and also works in about 50% of women the number one side effect which is a problem It's not the fact you've got an auto injected. It's the nausea You know something bombomiting on your partners of real libido killer But most women that doesn't happen and actually sometimes it happens initially and then it gets better Jellot of women use these drugs. No, they do not. Do they use them postmen oposely? No, they do not to cyber the fact that a lot of people especially with adi they don't like the idea of taking something every day I tell them about the nausea they're kind of scares them off And when I talk to women who want something pharmacologic And and I offer them these two and then I also mentioned testosterone and when I go through the options of flabancerin remalana tide and testosterone most women opt to give testosterone a try and I and I think same reason why that is We have the same clinical exposure. Yeah, and the reason why is There's a comfort level with testosterone when I explain to women to just like estrogen This is something that is in their body naturally that we are giving them a little boost of their testosterone to help with their libido And that just sits better It's it's better. There there is more of a comfort level with that But when we look at how well testosterone works for libido specifically it's about the same. Yeah, it's about 50% Again, because it's so multi-tactorial Lot of talk about pellets Don't get me started on pallets. I have an entire episode called the problem with pallets So um the problem is not your the pellets it's the pellet. Yeah, I'm like I don't want to demonize a method of delivery to the human body We have FDA approved pellets for certain medications like it's just a way to get medicine in your system But the way it's marketed the way that they teach I even went and signed up To do a poll your brave to get no just because I wanted to see what are they teaching these these clinicians as you said It's not the method of delivery. It's what's in the pallets and they are these Super physiologic meaning much higher doses. Yeah, I have a post-pilot patient come to me We check everyone's levels who was ever in a physiologic range sky Hi sky high, and you know we could go on it and we could spend hours just talking about pallets So let's cut to the chase and say that women should not use pallets because not only are they getting unnecessarily high Levels of testosterone, but when we look at the side effects Aside from the cosmetic side effects like losing your hair where you want it getting here where you don't want it Like all over your face getting enlargement of the clitoris getting oily skin getting pimples We look at more serious side effects long-term such as a build up in the lining of the uterus increasing risks of uterine pre-cancer and even cancer And we have very good data which I talk about in my episode And come again about the increased number of hysterectomies in women on pallets Because the levels are so high now one of the things that's confusing for women is that the biggest sellers of pallets Of course are women who have them who tell all their friends how incredible they feel and there's no question That a big Bolus of testosterone is going to make you feel amazing huge huge amounts of energy Feeling sexy feeling alive feeling productive. The problem is that's the initial It's the initial feeling over time people require higher and higher doses The side effects get to be a huge problem and it's not like you can just say stop taking it you they sit there under the skin For mom you cannot take the money you have to wait for them to dissolve and there have been some very serious problems Women think their FDA approved. There's a study that they were shocked to find out that they're very expensive Dr and a lot of women it's all they're offered. They're not given the cornucopia of options Correct, and why is that there are a lot of doctors that are making a lot of money off of pallets Because because they're not FDA-proved. It's a cash business and along with the pallets They're not only selling pallets. They're doing unnecessary blood work They're doing these panels that touch panel a lot of things that are not only extremely Extremely expensive cash only but are not helpful in any way not necessary in any way I love when they tell you this is custom compounded just for you They're given everyone the same thing for you know, but they're drawing your blood every 10 minutes and charging you for it to make you feel Like you're special and this is just for you So what I say to people is if someone is pushing pallets don't walk Run go to someone who is going to prescribe to sass around in a responsible way in appropriate dosages Do we watch levels we do when we prescribe estrogen? We don't because we generally don't need to their exceptions But in general, we're not getting levels to sass drone You need to start with a baseline level because if your levels already high I can tell you taking testosterone is not going to help and infect you are more likely to get side effects And then because they're compounded that means that the levels of testosterone that you're getting may not be consistent So it is always a good idea at least in the beginning until you're on a steady stable dose To to watch those levels to make sure that you're getting the right amount and also I just have to throw out there for people that we lie on their voice professionally we're talking Actors voice over artists singers You need to know that if you take testosterone even in the normal physiologic low doses That for some people and we can't predict who that's going to be there will be a change in your voice It is not reversible. Yeah, it's not reversible and already and that's a whole nother topic is the impact of menopause on the voice because you have estrogen receptors Of course in your voice box, which is why opera singers very often will use estrogen and Why there is a change as women go through menopause lots of questions from our audience One is and this is also very curious to me is the orgasm gap between males and females and between heterosexual couples and same sex couples for women all right orgasm gap This is The realization that men are far more likely to have orgasms than women because of course they know how They're able to have orgasms and we see this orgasm gap starting very very young 20s 30s 40s Well, I have good news for all the pairing postmenopausal women out there the orgasm gap narrows as people get older because the guys are losing their ability Not that we get better. They get worse exactly. We're not getting better. They get worse But actually in some ways let's just talk about the woman who's not having difficulty with orgasm If you look at a 20 or 30 year old who has no clue where her clitoris is or what to do with it Most women hopefully by the time they hit 50 Do know where their clitoris is and do know what to do with it and are well aware that if they stimulate the clitoris Either manually or earlier with a vibrator and they're not relying on in the course anymore or partner because they know better They're actually able to have an orgasm So I know this sounds crazy and you don't expect me to say this necessarily and no one's really studied this But the orgasm gap in my mind Absolutely nero's For two reasons one women are better at knowing how to elicit orgasm Whether with a partner around their own and men are losing their ability to orgasm So it's a level playing field. Well, and I feel that women are not willing to sacrifice their own pleasure anymore You know, yeah, they're not just gonna do it to do it They if they're like if I'm in I'm in you know, and we're gonna is we're gonna do this until I also have an orgasm Rather than then just putting themselves second. They're really putting themselves first I think in for their pleasure one of my favorite books and it's an old book is Ian Kernard's book Called she comes first. And this is a book that's intended for men Because men need this education to say Okay, dude She comes first Take care for orgasm first and then you can have your orgasm and this is Very very important for people to be knowledgeable. Let's talk about the men for a second Well I when the first divorce happened in our friend group. Yeah, I think that book went around the guys freaked Yeah in our big giant friend group and I think the guys kind of like uh, and I think that book went around Because I noticed a definite you know more attention to making sure that I was gonna be okay And there's sometimes I'm just like it's fine. I you know, I'm sick or I'm just not it you know Whatever, but and I think it was born of that fear of that first of worst that happened and like what can I do to like hang on to this Relationship so right we were very appreciative of that book in my friend group I think I read the data It's like 70 to 80% of men will have an orgasm with intercourse and women It's like more like 40 or 50% each time when you look at the raw numbers like that's how big big app is But then we see now you're talking about young women young women correct correct But then again, we do not have data on the orgasm We have this one of the studies I want to do with kinsie. I've been talking some about that But we do not have data on the orgasm gap as you get into older folks Do you think it bothers women that there's an orgasm gap? Because I see these like very you know politically slanted articles written about it. Yeah of like you know It's not fair and da da da and most of my patients are okay. Are you talking about younger women or older women younger? Yeah, really younger when they're coming to meet older they're coming with a problem they need to fix. Yeah You know if you they say that it's okay It's because culturally there's this expectation that men expect pleasure when they have sex and women do not another wonderful book that That addresses this is girls and sex And and it really talks about how young girls are not really educated in Pleasure. Yeah sex ad we know is all about how not to get pregnant or get an sci There's nothing to do with pleasure But the guys are not taught that the guys are taught you should have pleasure So this part of the problem is that there isn't the expectation So are they upset? I think the ones that expect pleasure are the ones who know how to have pleasure. Mm-hmm So older women different story So we have an older patient who comes into your clinic and she says I I'm struggling with orgasm. I used to have them. They're great and I still want them What's your first step walk me through the first step is unless you're running a sexual medicine clinic the likelihood of that happening is about zero Let's be honest. How many of patients when you were doing general OBGYN walked in your door and said hey Dr. Haver I can't have an orgasm will you help me maybe one and thank god There's now because more common for them to complain about desire desire Well, first of all, it's easier to spit out and second of all it is more common It is more common So when you when you talk about across the board If you look at women between the ages of 18 and a hundred most of them are not gonna bring that up Even though 40% of women across the board have these issues with sexual problems Doctors are not gonna ask because They're not gonna be able to help them The only time that we have a flip in that script of course is if you're running a sexual medicine clinic Okay, because that's why they're there So if a woman comes to a sexual medicine clinic and comes to see an expert and says I'm not able to have an orgasm What are we gonna do? Well number one we are going to take a very detailed history. We need to know it all And in fact, I have the history form in come again that I use for clinicians So they don't even have to make it up. They can just use my history form because it goes through all of the things that might impact And the ability to have an orgasm. We're talking, you know Menopause symptoms. We're talking medications. We're talking diabetes medical problems surgery radiation chemotherapy I mean, there's a very long list of things that we need to go through and then depending What their issue is and it's never one thing. It's always multiple things then we're going to set up a treatment plan But the number one thing that we generally have to get rid of in almost every woman is pain Pain pain pain if someone says I have no desire for sex and if I do have sex I don't have an orgasm my next question is well when was the last time you hit sex? So it was a couple months ago how to go well hurt like hell well your vagina is not stupid And if sex hurts like hell it's gonna take your tell your brain don't go there You're not gonna get aroused and if you don't get aroused you're not gonna have an orgasm So until we fix painful sex We've got nothing to talk about So you've got to do that you've got to look at the medications You have to get rid of the menopause symptoms if someone is is flashing all day and all night They're not going to be aroused Keep in mind and I keep circling back to this in order to have an orgasm you must have arousal You must that's your clitoris that's your polvice that's your brain getting primed to trigger those nerve endings to do their job Right right so almost every treatment I have is going to help a rousal get rid of the symptoms get a decent night sleep Eliminate pain look at your drugs show someone the map to their clitoris So is everyone going to be successful with having an orgasm? I would like to say yes, but that would not be honest the answer is no, but that's okay What's important is we need to rewrite the script? There's this idea that sex is not successful unless you have an orgasm Which is why quite frankly so many women fake it because they want them to stop trying already So oh my god, please I just want to go to sleep and part of that script is that sex isn't over Until you have an orgasm sex is over When you're ready for it to be over Because you've been having pleasure stop having orgasm as the end game There is a new normal very often for women to say I don't need to have penis and vagina sex I don't need to have an orgasm If I am in a relationship, I need to have someone who is loving Who is kind and who touches me in a way that's pleasurable. I was once on a I think it was a today's show or something and I was on with the sex therapist and and we were asked the question How often should people have sex what's the right number? How many times a week and the other person who was on this episode with me? I thought gave such a beautiful answer He said the number of how often you have sex is unimportant What's important is how often you are sexual meaning that you touch someone you kiss them You speak to them in a way which is kind and loving and let's them know that you are attracted to them That's great sex What is a sexual medicine clinic and how would you find one? It's a really hard question Who is a sexual medicine expert? It's not something that there is a fellowship in the international society If the study women sexual health they do maintain a directory I don't even know if I'm on that directory or not or if my clinic is it's not complete It's a starting point I will tell you that we'll put it in the show notes For people looking up stuff For a parry and post menopause woman for a lot of them They're starting place is going to be with a menopause expert While all menopause experts are not experts in sexual medicine We've already established that you've got to get rid of the hot flashes You've got to get rid of the menopause symptoms You've got to treat your genital urinary syndrome It's a decent place to start Absolutely And for a lot of women that is going to be not only the best place to start It may be all that they need They may not need to go to that next level But once they go see their menopause expert and get rid of all of those things If they are still having trouble Then you may need to find a sex med expert And some of the major medical centers have them Most do not I will say that I'm in Northwestern We have a sexual medicine center there that I found it I'm no longer there But I have excellent, excellent clinicians Who are using all the protocols that I put into place When we open the center And there are a number of places that do that Interestingly where you'll see it more than any place else It's sometimes in oncology departments Because we haven't talked about that But certainly when we look at people who are having a great deal of difficulty With sexual function It is young women, all women of all ages Who are dealing with not just a cancer diagnosis But chemotherapy, radiation, surgery So that's a whole different world And very well recognized by a lot of the top oncology centers University of Chicago has a wonderful, wonderful center For sexual function post-cancer So that's another place to look What is in the future for you? Where do you see this going? Do you feel like access to this kind of care is getting better? I do have hope One of the reasons I have hope is I am the mentor for a medical student organization That is all about sex education There's a wonderful, wonderful, now she's a resident When she came to me, when she was a first or second year medical student Jennifer Rallon, I don't know if I've come across her I think you brought her to a conference I did I brought her to a conference Yes And this is a young woman who said, wait a minute Wait a minute How come we're not getting this education? And she is one of those people that puts words into action And she put together a medical student consortium Which started in Chicago but I encouraged her Because it was during COVID I said you might as well get medical students from all over the country So now we have medical students Hundreds and hundreds of medical students From all over the country that are part of this medical student consortium For education, we'll put the link in Because if there are any students out there listening They have to get involved And we have events and we have lectures And we do all kinds of things They're doing research They're working with Rachel Rubin She's another faculty mentor And because it was COVID One of the few advantages of COVID Is that I said, hey, this is all virtual Let's get the best to the best to the best And we got like the tap 15 sexual medicine doctors To get on board for their board of advisors And these medical students are loving it They are all over it We bring them to conferences We get them involved in research And it gives me great help In terms of what kind of fields are they going into Because this is a discussion They're medical students Well, if I want to do this What field should I pursue And there are many ways to being a sexual medicine expert You could be in OBGYN You have to like doing surgery And other things if you do that I'm wondering a lot of them going to psychiatry The talkers, the ones that want to keep their clothes on And don't really want to do those Examples of the glitterists Internal medicine Internal medicine Family medicine There's a urology There's a lot of ways for people to become sexual medicine experts If they're interested So yes, I do have hope Because we have this very large group of students Who are very excited about this Wrap it up with come again What it is How to find it Who it's for Come again is for everyone It is for healthcare clinicians Meaning doctors, advanced pray Just nurses, anyone who's taking care of patients Not just gynecology But in all aspects of medicine There's not one single medical specialty It doesn't need to know about this Come again is for women Who at a high level want to understand What's going on What's changing And most important What they can do about it Come again is for men Who want to understand what's going on With the women in their lives 30 episodes sounds like a lot But I promise you it's entertaining Some of them are sure Some of them are 10, 15 minutes Some of them are longer It started out as 50 or 60 episodes And you do it little bites You little bites And I throw in there a lot of history of this stuff Like we talked earlier about Princess Maria Bonaparte I love that stuff I would love to write about it The history of Bonaparte So I throw a lot of it Sponsed stuff I'm at really is for everyone Who has a curiosity about this And even though it's skewed towards women Who are a pairing postmenopause Because let's face it Those are the women that are having the biggest challenge It is really for all age groups Because these are problems that can happen At any time in life And the most important is I'm solution driven It's not enough to talk about the problem Let's talk solutions Well it feels like You know Menopause is having this renaissance And that it's this new topic But you've been doing this work For a long time You know Whenever we talk about how menopause is having a moment And that makes me a little crazy Because I'm thinking It's not having a moment I've been talking about menopause for 23 years But no one wanted to talk about Right And I used to do a ton of media You know, Good Morning Maricons Today's show And I don't know all these shows And I would always pitch to the producers Let's talk about menopause And they'd be like No No, we're not going to No, no, give me another topic And now of course That's all they want to talk about And I would like to think it's because You like the groundwork I'd like to write Well, there's that But I would like to think That there's this interest in menopause Because people are acknowledging that it is important And there is some of that A lot of it is We know there's a lot of money To be made in menopause Which is why people have to be careful With where they're getting their information But I am glad that this somewhat taboo topic Is now being talked about Not just in the doctor's office But with your manicurists With your friends With your brother You know what I'm going to say As it should be That's as it should be When women talk to their daughters About their first period They should also be talking about their first half-lash Yeah Their last period Under last period Yeah I'm guessing you could retire If you weren't here Well officially I have Because I'm not saying patience anymore But you're always working on Somehow My husband keeps saying to this He said Wait You've retired But you're working harder than ever What keeps me going Why are you paused? Oh gosh I don't think you're working on pause No I'm not I'm paused I've been people say You're retired and I'm like no I'm rewired I'm now going on So the next thing to the next chapter Because my passion has always been education I mean let's face it I started off thinking I was going to be a journalist I started off writing I have five books I have another one in the works I've created this come again series I have my podcast Nothing gives me pleasure Like getting out there And talking to people And making a difference Because whenever someone says Why this? Why not something else And I've always been driven to go towards What is no one else doing? What is the unmet need? No one else is talking about Alternatives to his react to me I'm going to be that person No one's talking about menopause I'm going to be that person No one's talking about the inability to have an orgasm I'm going to be that person That's what keeps me going To be the one who's out there Talking about the things that are going to make a difference That are really going to make a difference in someone's life And what I also realized is I've always been in both worlds The very academic worlds I'm lecturing to doctors And medical students And I still do that And then also in the consumer world And they're equally important to me And I would like to see those two worlds come together more Because this is a conversation that needs to happen And whenever I'm thinking I just I can't do this anymore I'm overwhelmed I have to stop And then something will happen A stranger will come up to me on the street I hit a stranger I work on a treadmill desk And my treadmill and that desk broke And I called the company They tried to troubleshoot over the phone And they couldn't do it And they said, that's talk to the owner of the company The owner of the company gets on And he said, are you Lauren Striker that wrote Sex Rx And I said, yes, I am He said, your book saved my marriage I'm sending you a new treadmill desk And you just go Stop it, you're like, okay And you're like, okay, this is why I do what I do Because it makes a difference We want to make a difference I feel the same We want to make a difference And make a difference It gets overwhelming This applies to you This applies to you And then someone will say Something I wrote or said Or did made them find a doctor You know, changed their life Whatever and I'm like, that's why I'm doing this Like I told you at the beginning This is for the ladies on the couches in Ohio In middle America who don't have a sex med doctor Who don't have access Who don't know where to go or what to do And are feeling so alone And for those women what I want to tell them Is that not only do we have solutions But if you don't have a doctor It's okay Because I'm going to give you the roadmap I'm going to give you the script Of to go to the doctor that you do have You may not have a choice But you can go to the script You can go to that doctor And you can say Dr. Haver told me That it might help me to use A local vaginal estrogen Will you prescribe one for me Dr. Striker said That if I use that estrogen on my clitoris It might help with my orgasm Will you prescribe it for me They will They will They're not going to say no They will not say no Well thank you so much for coming on the podcast It was an honor having you on today Thank you for having me It's been great fun As a reminder to our audience You can follow Dr. Striker on Instagram At Dr. Striker On substack at Drstriker.substack.com And on our website at DrStriker.com She is also the host of Dr. Striker's Inside Information Podcast And she has released a 30-episode audio series On Sexual Function Called Come Again That is available for purchase through her website I'd love to hear from you About this topic And anything else that's on your mind You can find me on Instagram At Dr. Mary Claire And get honest, accurate information on health Fitness and navigating midlife at thepaslife.com My new upcoming book, The New Perry Metapause Is available for preorder on Amazon If you're loving this podcast Be sure to click follow on your favorite podcast app So you never miss an episode While you're there Leave us a review and be sure to share the show With the women you love We would be so grateful You can also find full episodes on YouTube At Dr. Mary Claire Unposed is presented by Odyssey In conjunction with Pod People I'm your host Dr. Mary Claire Haver The views and opinions expressed on unposed Are those of the talent and guests alone And are provided for informational And entertainment purposes only No part of this podcast Or any related materials Are intended to be a substitute For professional medical advice Diagnosis or treatment