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We talk about orgasm and climax all the time, but have you ever wondered what actually happens during orgasm? During an orgasm, there are several physiological and psychological changes that occur in a woman's body. Keep in mind that individual experiences can vary, but here are the general physiological responses associated with a female orgasm: Increased Heart Rate and Blood Pressure: As sexual arousal builds and intensifies, the heart rate and blood pressure increase. This is due to increased blood flow to the genital area and throughout the body. Muscle Contractions: The muscles of the pelvic region, including the uterus, vagina, and anus, undergo rhythmic contractions. These contractions are a central part of the orgasmic experience. They typically occur in a sequence of rapid intervals. Release of Sexual Tension: The peak of sexual arousal during an orgasm results in the release of built-up sexual tension. This release is accompanied by a pleasurable sensation and a feeling of relief. Elevated Breathing Rate: Breathing becomes faster and more irregular during sexual arousal and reaches its peak during orgasm. This increased oxygen intake contributes to the overall physiological response. Pleasure and Euphoria: Orgasms are often characterized by a feeling of intense pleasure and euphoria. This sensation is a result of the release of neurotransmitters like dopamine, oxytocin, and endorphins, which contribute to feelings of happiness and relaxation. Changes in Blood Flow: Throughout sexual arousal and orgasm, there are changes in blood flow to various parts of the body. Blood flow to the genital area increases, leading to engorgement and sensitivity. Clitoral and Vaginal Changes: The clitoris swells and becomes more sensitive during sexual arousal, and this sensitivity can increase during orgasm. The walls of the vagina may also contract rhythmically. Contraction of Uterus: The uterus contracts during orgasm, and these contractions can contribute to the pleasurable sensations experienced. Tingling Sensations: Many women report experiencing tingling sensations or waves of pleasure that spread from the genital area to other parts of the body during orgasm. Emotional and Psychological Responses: In addition to the physical changes, there are significant emotional and psychological responses associated with orgasm. These can include feelings of intimacy, connection, and deep satisfaction. It's important to note that the experience of an orgasm can vary widely among individuals. Some women may have multiple orgasms in quick succession, while others may have longer or more intense orgasms. Furthermore, factors such as individual anatomy, hormonal fluctuations, emotional state, and overall health can influence the experience of orgasm.

When the word "vibrator" comes up in conversation, there is often silence, raised eyebrows, or even a little giggle. Why is that? One major reason is that like many things associated with sexuality, using a vibrator isn't discussed and this lack of discussion makes is seem less "normal". The lack of conversation regarding vibrator use is surprising considering 69% (I promise I didn't make up this statistic just to be funny) of women ages 18-60 report using a vibrator. Vibrators actually have an interesting medical history dating over a century ago when physicians used to perform pelvic massage to treat a woman's "hysteria" . Hysteria was a catch-all diagnosis attributed to many women for a variety of reasons including headaches, anxiety, and abnormal periods. (If I was a woman in those times I'd probably be hysterical too having to wear long dresses and be at my husband's mercy for everything.) Back then, pelvic and genital massage was not considered to be sexual in any way, and in 1899 a well-known medical reference, the Merck Manual, even listed listed this as a treatment for hysteria. After the industrial revolution, mechanical medical vibrators were developed likely to save time and to avoid the physical difficulty of manual massage on the increasing number of female patients who drove the market for vibrating massagers. In the1920s, pornographic films started including vibrators, and that's likely when they turned from being an accepted medical treatment to something associated with pornography and sexual deviancy. Now that you know the medical history of genital vibrators, you may reconsider trying one if you haven't or use it more often if you already do. The pelvic health benefits that a vibrator can potentially provide are reason enough to use a vibrator: Benefit number 1. Genital vibration can improve overall sexual function. Using a vibrator can increase pelvic floor blood flow and in turn enhance arousal, sensation, and ultimately orgasm. When this happens it's no surprise that overall sexual function improves. Vibrator use may even decrease time to orgasm and facilitate multiple orgasms. Benefit number 2. Increase pelvic floor strength and urinary incontinence. Use of a vibrator can decreased urinary symptoms and urinary incontinence by increasing pelvic floor muscle strength. When urinary symptoms, especially incontinence is improved, quality of life also improves. Benefit number 3. Improvement of genital pain. Although only one study showed that vibrator use can help with vulvar pain (vulvodynia), it's definitely a promising treatment as vibrators can help with muscle relaxation that also improves genital pain. Less pain means less sex related distress and that's good for you and your relationship. So now that you're ready to use one, how do you choose the best vibrator for you ? If you click the link there will be a set of questions to answer to get you going (no pun intended...or maybe it was intentional. Check it out -- doctor's orders. PS. Water-based lubes are best for toys so it's a good thing Glissant has our Sea Salt & Caramel Intimate Lubricant for you!

There is a lot of talk about the vagina and vulva these days, and while these terms are often used interchangeably they are actually two different parts...that are treated differently in terms of hygiene and even hormones. Starting on the outside of our female bodies is the vulva, derived from Latin for wrapper or covering. The vulva is considered the external female genitals and includes the mons pubis, labia majora, labia minora (pronounced just like the candles), clitoris, urethra, and opening of the vagina with all its glands (Skene's glands and Bartholin's glands). (Note: does not include the vagina). The mons pubis is the tissue covering our pubic bone (lovingly referred to by some as FUPA (Fat Upper Pubic/Pu**y Area). This fat cushions the area during intercourse, otherwise the people who love to refer to it as FUPA would be jabbed by our pubic bone. The labia majora and minora are the large (outer) and small (inner) skin folds, respectively, that cover everything up down there. These are often called the lips. The labia majora and minors are the embryologic equivalent of the male scrotum and penis shaft, respectively. The clitoris is the organ that most women get the greatest amount of sexual pleasure from. The clitoris is analogous to the head of the male penis and even has a cute little covering of its own called the clitoral hood (equivalent to a man's foreskin). When a woman is aroused the clitoris engorges and pushes the hood back. The function of the clitoris is purely sensory with over 10,000 nerve endings...no more explanation needed. The urethral meatus is the opening where the urine comes from and sits right below the clitoris at the top of the vaginal opening. This is one of the three holes women have: urethra, vagina, anus. While all of the above are considered part of the vulva, the vagina itself is not. The vagina is the muscular tube that connects the vaginal opening to the cervix (opening to the uterus) and its main functions are intercourse and childbirth. The upper part of the vagina also does not have a male equivalent part. So what does this mean in terms of how you care for your vulva and vagina? In general, since the vulva is external it can be cared for the same way you would other parts of your body (but maybe a little gentler). If you have sensitive skin, chances are the skin of the vulva will be sensitive so you should use washes and moisturizers suitable for sensitive skin. On the other hand, the vagina is its own little ecosystem and is a self-cleaning oven so washing internally (douching) is discouraged. As far as hormones, the vulva can respond to both estrogen and testosterone (remember the vulva has equivalent male parts) while generally the vagina responds best to estrogen. Take home message: your vulva and vagina are different parts.

The short answer to the question is yes. While the concept of male ejaculation is nothing new, female ejaculation is a lesser known, and even less well understood, phenomenon. To understand how a woman ejaculates, we need to know how ejaculate is even made. In men, the majority of ejaculate fluid is from the prostate. Since women don't have a prostate, how can they make ejaculate fluid? Women have glands in the urethra called the Skene's (or paraurethral) glands, that are homologous to the male prostate. The Skene's glands secrete fluid to lubricate the urethra and vagina, and this fluid has been shown to contain PSA (prostate specific antigen) which is a protein made by the prostate. Some people believe that the Skene's glands are near the G-spot and stimulation of the G-spot results in female ejaculation, although the existence of the G-spot is controversial (see my prior blog " G-spot: Ero"G"enous zone or sexual myth?" ). While some women ejaculate fluid made by the Skene's glands, other women likely have involuntary loss of urine during sexual activity. How can it be differentiated? Female ejaculate has been described as a milky fluid and is only about a teaspoon of fluid while urine will look, well, like urine. The term "squirting" is often used when referring to loss of urine, or at least loss of fluid that is not considered to be ejaculate. How many women actually ejaculate? A lot more than you might think. One study indicated that over 70% of women ejaculate while others report less than 50% of women ejaculate. Whatever the case, the fact that so many women report it and it's actually been studied means that it's a thing...and whether you ejaculate or squirt it doesn't matter as long as you enjoy yourself!

Most of my patients are well-educated women who take interest in their health, but many of them are unaware of things that women should be informed of but rarely are -- like removing the uterus alone in a premenopausal or perimenopausal woman doesn't affect her hormones. Quick anatomy review: the cervix sits at the top of the vagina and is the entrance of the uterus. The cervix is normally closed except during menstruation and childbirth. During a woman's reproductive years, the uterine lining builds up every month and the lining is shed (that lovely thing called a period) unless a woman is pregnant. The ovaries, and not the uterus, are what mainly produce hormones that result in the menstrual cycle, which is why removing the uterus alone (hysterectomy) does not result in hormonal changes. Hysterectomy does, however, result in no more menstrual bleeding (most of us say "yay" to that). Now, to make things a little more confusing, technically the definition of menopause is no period for 12 months which means hysterectomy does result in menopause in the sense that there are no more periods. BUT, if a woman is premenopausal or perimenopausal and doesn't have her ovaries removed (oophorectomy) then she will still experience her typical hormonal cycle symptoms, like mood swings, and eventually have symptoms of perimenopause and menopause such as hot flashes, difficulty sleeping, and everyone's favorite -- vaginal dryness. (Note: there are a lucky few who don't have symptoms of menopause but those are more the exception than the rule.) Last little bits of trivia involve terminology. The term "subtotal" hysterectomy is used when a woman has a hysterectomy but her cervix if left behind, also called a supracervical hysterectomy (versus total hysterectomy if the uterus and cervix are removed). A total or supracervical hysterectomy alone will end a woman's periods if she is premenopausal, but it will not affect her hormones. If the uterus is removed with ovaries and tubes, the surgery would be called total or supracervical hysterectomy and salpingo-oophorectomy (salpingo referring to tubes). In this scenario, a premenopausal or perimenopausal woman would likely experience menopausal symptoms essentially overnight and is termed "surgical menopause." That was a lot of info just to debunk a myth, and I'm sure you're wondering when a woman would want to keep her cervix and not. That will be in another blog...

It's a real medical term, so why is it censored? Vag, vajayjay, kitty, hoo-ha, box. These are just a few of the alternative ways society refers to the vagina. When I am talking about my arm or leg, I don't call them "stick" or "crutch." So why are people often embarrassed, or even worse not allowed, to use the word vagina? Since I am obviously one of those people who use the word vagina on a regular basis (um, like every minute), it never dawned on me that vagina might be considered a bad word. Then I tried using it in paid advertising on social media for an FDA-cleared lubricant created by a physician (yes, me). As a doctor whose job is to make the vagina the best it can be, I assumed an advertisement for lubricants that I helped create specifically to improve women's sexual function on social media would go viral. Instead, the ads were repeatedly rejected. At first our team thought maybe the photos on our website were too racy or we forgot to make our target audience adults only, but that wasn't it at all. Since it's impossible to actually talk to anyone who on social media advertising side, we finally figured out it was the word vagina (a medical term) preventing us from advertising. Not being able to use an actual medical term for a woman's body part sends a message that it's shameful and propagates the taboo surrounding sexuality and anything associated with the vagina. Why is a body part that is integral in sexuality and reproduction stigmatized? I was a guest on a talk show's medical segment and the topic was incontinence, but I wasn't allowed to say the word vagina. It seemed so silly and unprofessional to only be able to say "down there" when referring to the vagina. Ladies, it's time for us to change the narrative surrounding the word vagina. Until we do, we can never really normalize conversations around sexual health, masturbation, and anything else the vagina is involved with. #vaginaisnotabadword A HUGE thank you to my colleagues Dr. Una Lee, Dr. Shreeya Popat and soon to be Dr. Rainey Horwitz for taking on the task of uncensoring "vagina".

but you might need to. It's the perfect Valentine's Day. You arrive at work to find a dozen roses and a card that reads like soft porn. Dinner is at a romantic venue, and the champagne you splurged on is working its magic on your libido. At home you slip into the lingerie you ordered weeks ago. You're finally ready to consummate the evening and...you're dry. You do it, but it hurts. With all the planning for a perfect Valentine's Day, you didn't factor in vaginal dryness. Welcome to middle age. Almost 20% of women aged 18-50 years experience vaginal dryness, and this number jumps to a shocking 85% for menopausal women. Why does it happen? 1)Declining hormone levels, 2) declining hormone levels, and 3) declining hormone levels. Other causes include medications, breastfeeding, and diseases that cause overall dryness, to name a few. The big problem is that most women don't realize how common this problem is and what can be done about it. Hormone replacement and discontinuing any medication causing dryness can improve the situation, but a relatively simple (and usually effective) option is using a lubricant. It can be hard to convince your partner the reason you're not lubricated isn't because you're not turned on. You can have a great libido (being turned on) but have poor arousal (the body's response to being turned on). It's not your fault your body doesn't always do what it's supposed to, but the inability to adequately lubricate often leads to guilt. Back to Valentine's Day -- what started out as what should have been a night of hot sex turned out to be two unhappy people with backs facing each other. You love your partner and want to have sex with him/her, but if sex hurts it's extremely difficult to get motivated to do it. You can improve pain related to vaginal dryness and avoid your partner wondering why you're dry by using lube -- and not being embarrassed to use it. Fun fact: up to 70% of women use lube and report it makes sex more pleasurable. Less friction means less tearing and less irritation and potentially fewer infections. And while some women use lube for dryness, many use it simply because it feels good. Happy Valentine's Day!

If you've had a baby or two or even more, you may be the one in four women who experiences involuntary loss of urine (urinary incontinence) or part of the over 3 million women who has vaginal prolapse (falling bladder, uterus, and/or rectum). And if you have incontinence or prolapse, it's also likely that you've been putting up with these symptoms for a while wondering how and when you can take care of these bothersome issues. Well don't wonder anymore -- the new year is the perfect time to finally take care of your intimate parts. Vaginal rejuvenation is not one medical procedure but an all-encompassing term that includes things like procedures to treat incontinence, lifting of the bladder, vaginal tightening, and reshaping of the labia. Regardless of how the term is used, the basic premise is tidying up things down there so that you can have a happy, healthy, functioning vagina. It's very important to keep in mind that a happy, healthy, functioning vag is relative. How you view your vaginal health should be compared to the old saying regarding beauty -- it's in the eye of the beholder, i.e. if you are happy with your vagina and as far as you're concerned nothing is wrong down there, then stop reading and find another New Year's resolution; but if you aren't happy with what's going on in that area, then read on... There are two main types of urinary incontinence : stress incontinence and urge incontinence. Stress urinary incontinence is leakage of urine with physical (not emotional) stress such as coughing, laughing, and jumping and is commonly caused by vaginal childbirth. Treatment options include observation (keeping an eye on things) if the incontinence isn't that bothersome, Kegel exercises or pelvic floor physical therapy, and surgery. Thankfully surgery for stress incontinence has improved over time so that it's typically a same-day (outpatient) procedure and you can resume exercise within a few weeks of surgery. Urge incontinence , also known as overactive bladder, is loss of bladder control associated with an overwhelming urge to urinate. This is most commonly due to aging, hormonal changes, certain neurologic conditions, and pelvic surgery. The non-surgical treatment options of observation, Kegel exercises, and pelvic floor physical therapy are the same as for stress incontinence, but urge incontinence is often treated with overactive bladder medication, Botox injections into the bladder, and neuromodulation (pacemaker for the bladder). Pelvic organ prolapse is when one or more of the pelvic organs (bladder, uterus, colon) falls into the vaginal canal. Like stress incontinence, this is also usually due to vaginal childbirth. A woman might feeling pelvic heaviness as the day progresses or even see or feel a bulge coming out of her vagina. Also like incontinence, this is not life-threatening just potentially alarming and annoying. Prolapse that is mild can be observed, Kegel exercises and pelvic floor physical therapy can be helpful, and a bonus of surgery for prolapse is that invariably the vagina gets tightened when the organs are lifted. During childbirth, the muscles and connective tissue of the pelvic floor get stretched and torn which allows the pelvic organs to "fall" and also makes a woman's vagina feel larger. Prolapse repair brings the muscles and tissues back together and thus "tightens" the vagina. And while prolapse and incontinence procedures are considered elective, meaning they have a medical necessity but are not urgent conditions, they are not considered cosmetic and are usually covered by insurance; however, if a woman just wants vaginal tightening and there is no prolapse diagnosis then the procedure could be considered cosmetic and not covered by insurance (although this would be very unusual as a woman's vagina almost always becomes lax due to prolapse). And what if you don't like the appearance of your labia? Join the club since very few women look like Barbie down there. Unless there is a lot of extra labial/vulvar tissue that is causing pain or interfering with sexual activity, labiaplasty or labial reduction is generally considered a cosmetic procedure and not covered by insurance. The good news is it's a minor procedure so the cost can be reasonable. What are you waiting for? 2022 is the year to celebrate you by taking care down there.

It's not that you don't appreciate gifts your friends and family give you, but when's the last time you got something that you were REALLY excited about? Or that actually got you excited? You can keep on waiting for someone to give you a gift that makes you want to "Come all ye faithful", or you can make your own Christmas miracle -- gift yourself something that will make you want to be on the naughty list. Let's face it, with all the time and effort spent making holidays special for those around you, getting sexy and using the last little bit of energy you have on being someone else's stocking to stuff doesn't sound all that appealing. Realistically, another holiday will pass with the most excitement being watching a champagne cork pop unless you make an effort. (Yes, I am aware that women are generally the ones making all the effort as I too have two X chromosomes. My girlfriend told me that the Y chromosome is a defective X which explains a lot, but I digress.) Why can't we get in the sexy holiday spirit? A few reasons and solutions: Did you know that up to 75% of women experience pain with intercourse at some point in her life, and for many of these women it's because of vaginal dryness? If you're already exhausted because of holiday demands, going to sleep instead of doing something that hurts seems like a no brainer. But the holiday season is a time to BELIEVE you can have enjoyable sex. If you're dry, don't be shy and pull out the lube. GLISSANT lubes come in chic, discreet packaging so you can keep it on your nightstand without your kids knowing what it is. If pain is the main issue, I recommend our CBD & CBG Huile d'Amour. If you just need extra lubrication and prefer a water-based lube, then try the Sea Salt & Caramel Intimate Lubricant. Pain with intercourse can also be due to increased muscle tone which can be aggravated by stress. Plan a pre-holiday party for yourself starting with a relaxing bath. I suggest GLISSANT CBD & CBG Sels et Huiles de Bain that as one person put it "made her body feel high when she got out of the tub." (Clarification: you can't really get high from CBD, it's just a figure of speech). Add a glass of wine or egg nog (or two), and then go back to the advice in #1 and get lubed. Exhaustion is a libido killer. Don't feel bad about buying a dessert rather than making it from scratch, and take advantage of all the on-line shopping you can do. While you're at it, order yourself some lingerie--feeling sexy almost always puts you in the mood. Just imagine yourself in your hot lingerie reaching for the GLISSANT lube on your nightstand... So just like the Christmas tree doesn't decorate itself and the holiday parties don't plan themselves either, you can't get on the naughty list without some effort...but the holidays and getting in the mood are worth the effort.

Speaking from personal experience, pregnancy is one of the most amazing experiences a woman can have. The thought of growing another human inside of you is absolutely mind boggling -- almost as mind boggling as the first time you feel the baby moving. (Come on, admit it, the movie Alien crossed your mind when it happened). From other people touching your belly and confidently telling you the gender of your baby to being told what foods to eat to bring on labor, pregnant women are given a TON of (mostly unsolicited) advice. But I bet no one ever told you what to expect down there after you deliver the baby. Women just aren't given much insight into the fact that after delivery it's likely her vagina won't be the same...and that's normal. BIG DISCLAIMER: I am not an ob-gyn, but I do have over 20 years' experience treating women's pelvic floor disorders that are often the result of vaginal delivery. I have treated thousands of women immediately post-partum and years later, and think I have some good information to share. For the record, by no means do I think women should stop having vaginal deliveries. I just think women need to be informed of what to expect down there after delivery. In fact, my colleagues interviewed women during their first pregnancy and asked what their birth plan was. As expected, most women planned on a vaginal delivery. Even after being told of the risks of vaginal delivery such as incontinence and pelvic organ prolapse, most women still planned on having a vaginal delivery, but they were extremely appreciative of knowing what to expect after delivery. What can you expect down there? Let's start immediately after delivery. Up to 34% of women report some degree of urinary incontinence in the first three months postpartum . Likely the same percent or higher number of women have some degree of pelvic organ prolapse (bladder or uterus "falling" into the vagina). How can incontinence and prolapse occur so often? An easy to understand analogy I often use with my patients: if I took a golf ball and forced it through your nose, you wouldn't be surprised if your nose didn't look or function properly for a while, if ever. What happens to your pelvic floor after delivery makes sense if you think about it this way. Women who don't know that incontinence and prolapse are common after delivery feel ashamed and abnormal since these conditions aren't openly discussed. I have had many women shed tears of relief in my office after hearing the words "this is normal." Fortunately for most women, the vagina returns close to its pre-pregnancy state. If a woman's vagina/pelvic floor doesn't function the way it should, there are things she can do such as Kegel exercises . If she needs instruction and/or motivation, home biofeedback devices and pelvic floor physical therapy can be very helpful. There are also vaginal devices, such as a pessary , that can be used to provide support to the pelvic organs. While all of these things are great, sometimes they aren't effective. A woman shouldn't feel badly that she didn't do enough exercises or blame herself in any other way. When the baby comes through the vaginal canal, the ligaments that attach the pelvic floor muscles to the pelvic sidewalls can get stretched and torn. If there is excessive damage to the ligaments, pelvic muscle exercises aren't as effective because a woman is exercising muscles that aren't attached properly. In this case, surgery may be the best option. Women are strong, resilient and can handle the truth which is why I think we need to tell women what to expect down there after delivery.

Probably not. Have you ever wondered why you feel irritated after sex? If you use condoms regularly, the irritation might be due to the type of condom you're using. Many people have latex sensitivity or allergy, but more likely the irritation is due to what the condom is lubricated with. Want to know what is used to lubricate condoms? Good luck trying to find out. Ironically, while the FDA requires personal lubricant packaging to disclose all ingredients, condom manufacturers are not regulated the same way and do not have to list all additives. Whether that makes sense or not, that's the way it is. A common ingredient used with lubricated condoms is the spermicide nonoxynol-9. Repeated exposure to nonoxynol-9 can cause inflammation of the vagina, cervix and rectum. If you have oral sex, nonoxynol-9 can even make your tongue feel numb. While a few condom manufacturers have removed nonoxynol-9 from their products, many others continue to use it without providing information regarding possible side effects. Parabens and glycerin are also commonly found in condom lubricants and have been linked to certain types of cancer and vaginal infections, respectively. And although you might be using a condom to avoid pregnancy now, that might not be the case later. Phthalates, one of the "forever chemicals", has been linked to male infertility and is often used in lubricants. One suggestion to get around not knowing what a condom is lubricated with is to use non-lubricated or "dry" condoms. Using dry condoms allows you to be in control of what the condom is lubricated with, and you can use as much lubricant as you want and need. When using a condom, lubricated or not, it's recommended to use extra lubrication because the condom itself creates more friction. This friction can result in tearing of vaginal or anal tissue resulting in increased irritation and increased risk of infection. And when using lubrication with a condom, it's important to use lubricant that is compatible with the type of condom you're using. Oil-based lubricants should be avoided with latex condoms because they can degrade latex and increase risk of breakage. GLISSANT water-based lubricant is compatible with latex, polyurethane, and polyisoprene condom based on FDA standards. Another added bonus of using GLISSANT water-based lube with dry condoms is that it has a subtle and delicious sea salt & caramel taste to overcome the otherwise pretty disgusting taste of most condoms. But wait, there's more! GLISSANT FDA-cleared Intimate Lubricant isn't just safe for use with condoms, it's actually good for your vagina . GLISSANT Intimate Lubricant is made with natural ingredients that all serve a purpose. Hyaluronic acid hydrates, lactic acid maintains normal vaginal pH which means less infections, l-arginine increases vaginal blood flow for increased arousal so that a woman can increase her own lubrication, and aloe soothes irritation. All of this is brought to you in chic, discreet packaging. What else would you expect from a product that was made by women for women ? Do yourself a favor. Use a lubricant when using condoms, whether you use lubricated condoms or not, and MAKE SAFE SEX SAFER and more enjoyable .

Normal is relative when it comes to how often you are or aren't in the mood... but it's not normal if your libido (or lack thereof) is negatively affecting you and/or your partner. Sometimes a woman is in the mood, and sometimes she's not. No one would consider this abnormal. What isn't normal is if a woman has persistently low desire that causes her personal or relationship distress. Hypoactive sexual desire disorder (HSDD), also known as female sexual interest/arousal disorder, is the lack or absence of desire and sexual fantasies or thoughts that causes distress and interpersonal difficulties. The distress is an important aspect of HSDD as some women who might be considered to have a low libido have no personal distress or relationship problems. The Society for Women's Health Research estimates that one in ten women has HSDD , making it the most common female sexual dysfunction disorder. The causes of HSDD can be physical, psychological, or a combination. The main hormones influencing libido are estrogen and testosterone, so anything that impacts these hormone levels can affect libido: perimenopause and menopause, hormonal birth control, breastfeeding, and medical conditions such as hypothyroidism can affect libido. Medications that can decrease libido are antidepressants and antianxiety medications. Psychological causes include relationship issues, history of sexual abuse, anxiety, and depression. It's ironic that if someone's libido is low because of anxiety and depression, the medications used to these conditions can lower libido even more. The good news is HSDD is treatable: Stress reduction. Stress can not only impact your mod, it can disrupt your hormone levels. Regular exercise. A study on exercise-induced arousal showed that just 20 minutes of exercise could boost arousal by 169% (and GLISSANT lubricants can increase arousal too). Maintain ideal body weight. Obese women have lower libido both because of potential effects on hormone levels an negative body image. Hormone replacement. If estrogen and/or testosterone levels are low, hormone replacement can be extremely beneficial. Medication. For premenopausal women with HSDD, there are two FDA approved medications medications flibanserin (pill) and bremelanotide (injection) that may improve desire and the number of satisfying sexual events. Sexual experimentation such as different positions or introducing sex toys. Couples/sex therapy. The bottom line is normal libido varies among women, but if your wanting to want it is causing you and your partner distress, then it's probably time to seek help.