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The Girlfriend Doctor w/ Dr. Anna Cabeca

Nov 18, 2021

Understanding the seven key areas of health and sexual health are key to knowing what your next right step is and to unburden you from some of the guilt, grief, and self-sabotage in your life. Learn about the pillars of sexual health and what solutions women can access that will go beyond just dealing with their reproductive hormones to allow them to regain their sex life and enjoy sex again.

  • [1:00] Dr. Anna has been practicing in the field of women’s sexual health for years and today’s episode deals with hot topics around sexual health, sexual function and dysfunction, and what you need to know to have a healthy and happy sex life.
  • [3:25] The vagina is essential for life and it’s vital to take care of your vagina as you age because our physiology drives our behaviour.
  • [3:45] Testosterone affects our behaviour in various ways and its use has risen and fallen in favor as a therapy over time. Dr. Anna tells the story of a patient that was undergoing testosterone therapy and how high testosterone could have resulted in a major relationship issue.
  • [5:45] Physiology affects behaviour, especially when it comes to sex. There are seven key areas of health that need to be in place to have normal sexual function.
  • [7:45] Dr. Anna’s story begins at the age of 39 when she was diagnosed with early onset menopause and infertility. She struggled with a number of health issues until she took a healing journey around the world.
  • [9:55] PTSD reared its ugly head around the age of 48 for Dr. Anna and she experienced all the symptoms of menopause again. It takes more than hormones to fix a hormone problem. There are three additional hormones beyond the reproductive hormones that need to be brought into balance for optimal sexual health.
  • [12:50] Dr. Anna’s experience led her to try the keto diet, and she found the ketogenic lifestyle to be very powerful in treating and correcting her hormone imbalances. After adding in more alkalizing foods, Dr. Anna felt sharper and more focused than ever.
  • [15:20] A research paper showed a direct correlation between glucose metabolism in the brain and endocrine and neurological symptoms. Glucose metabolism in the brain is an estrogen-dependent process, but the use of ketones for fuel is not hormone dependent.
  • [16:30] The keto diet is very acidic and men tend to adapt more quickly to it due to their higher testosterone levels. Women need to address those differences, and the keto green diet works well for both genders.
  • [18:00] On average, women in their 50’s are on two or three different medications.
  • [19:25] Hot flashes were recently linked to cardiovascular disease and cognitive decline. This is partly due to the loss of estrogen but that’s not the whole picture. Insulin resistance is also linked to hot flashes.
  • [20:50] We as women can do it all, just not at the same time. Research has shown that a large percentage of women over the age of 30 suffer from issues with arousal, vulva dryness, discomfort during or after sex, or urinary leakage.
  • [22:50] One of the key underlying issues of sexual dysfunction are the underlying psychological causes. This dysfunction can then lead to emotional and self-confidence issues.
  • [24:50] Only 17% of adults discuss their sex life with their doctor.
  • [25:20] There is also medication-induced sexual dysfunction. There are a number of common medications that can have a negative impact on your sexual health.
  • [26:15] A healthy vagina has an acidic pH. That acidity is the vagina’s first line of defense and as women age the vagina tends to become more alkaline. Gut health and vaginal health are closely linked; if one is healthy, the other usually is too.
  • [29:15] The human vagina is an underappreciated organ that is not merely a passageway for vaginal discharge, menses, sperm, and neonates, but can profoundly affect the health of a generation.
  • [30:45] Many women power through uncomfortable sex despite being in pain. One of the most energetic and intimate things we can do is have sex, and if she isn’t enjoying it, chances are he won’t either.
  • [32:10] Dr. Anna breaks down the case of a patient experiencing a variety of sexual health issues and what their treatment entailed.
  • [34:55] Studies looking at the effects of vaginal DHEA found considerable hormonal benefits.
  • [39:30] Estrogen replacement therapies were found in studies to not have any negative effects in cancer patients when compared to alternative therapies.
  • [42:05] Another of Dr. Anna’s clients was having trouble with orgasm. After Dr. Anna worked with her on the seven areas of sexual health and with focused therapies, she was able to regain the ability to orgasm.
  • [43:25] About 10%-15% or women never achieve climax. Up to 75% of women never experience climax through intercourse. This emphasizes the differences between climax and orgasm and why it’s important to communicate with your partner about the experience. The female sexual experience is also more complicated than a male’s.
  • [47:20] Reproductive hormones play a role, but cortisol, adrenaline, and insulin also have major impacts on sexual health. If you’re stressed, you can be eating the best food and your urine pH will still be acidic because of the cortisol. This is why the oxytocin/love hormone is one of the most powerful.
  • [48:30] Orgasm is one of the best ways to increase oxytocin, and oxytocin comes with a number of benefits including anti-aging effects, pleasure, happiness, appetite and pain reduction, and muscle mass.
  • [49:35] We need a whole body approach to sexual health. It’s not just about testosterone.



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Always seek the advice of your own physician or qualified health professional before starting any treatment or plans. Information found here and results are provided for informational purposes only and are not intended to replace a one-on-one relationship with a qualified healthcare professional and are not intended as medical advice.