Podcast Drop Date: 8/21/2024
In this episode, host, Amber Warren, PA-C, is joined by Tammy Hadfield, WHNP-BC, to explore the important yet often overlooked topic of sexual wellness. Tammy brings her extensive experience in women's health and functional medicine to discuss the complexities of sexual health across all stages of life. They dive into topics such as hormonal balance, the impact of stress and lifestyle on sexual function, and holistic approaches to improving sexual well-being. Whether you're dealing with common challenges like low libido, menopause, or seeking to enhance your overall sexual health, Tammy shares actionable insights to help you reconnect with your body and thrive. Tune in to discover a comprehensive view of sexual wellness that integrates both mind and body for lasting vitality and fulfillment.
Transcript:
Amber Warren, PA-C: Hi friends! Be aware because we are discussing sexual wellness in this episode. Please take a listen for yourself before you decide to share it with a younger audience.
Amber Warren, PA-C: Welcome to the Functional Medicine Foundations podcast, where we explore root cause medicine, engage in conversation with functional and integrative medicine experts, and build community with like minded health seekers. I'm your host, Amber Warren. Let's dig deeper. Hi, everyone. Welcome back. Thanks so much for joining us today. I'm here with Tammy Hadfield, our newest women's health nurse practitioner with a lot of other credentials behind her name. With over 30 years in women's health, Tammy began her journey as a registered nurse, eventually earning her master's in nursing and becoming a board certified Women's Health Nurse practitioner. Her impressive career includes military service, where she earned accolades as the Meritorious Service Medal and pioneering work in hormone replacement and age management medicine, specializing in bioidentical hormone replacement therapy for men and women, gynecological health, and age management medicine Tammy founded Embrace Wellness in 2009. Now she joins the FMI Center for Optimal Health, continuing her work in hormone optimization, sexual wellness, and more. Outside of her professional life, Tammy enjoys traveling, gardening, cooking, and spending time with her family. Welcome to the podcast. We're so glad to have you and I'm so excited about today's topic. Um, it's just been such a joy to have you in clinic and, um, be just talking and nerding out all things, all things, hormonal health and really functional medicine all day. So today we're going to talk about sexual health. And this is we have not really gone there on our podcast yet. Oh um, yeah we just haven't. But also because we haven't had a practitioner like you where this is your focus and kind of your area of expertise and specialty. So it's wonderful. So what what inspired you to kind of take a deeper dive and start to focus on sexual health for men and women?
Tammy Hadfield, WHNP-BC: Well, I think it probably started at the very beginning of my career. Um, just dealing with I always was a focus on women's health. But, you know, as time goes on, being a wife and a mother and, um, you know, trying to have a career and everything else. We know that our sexuality changes. I mean, it's always kind of an evolutionary thing that's happening as we go through the stages of hormonal changes throughout our lifetime. So it started to become because I think the biggest thing was, is women started finally asking about it. Or maybe it was that I was asking about it. I'm not sure how that kind of transpired, but I finally started like, are you are you having a climax? Are you are you having pain with intercourse? So we started asking those questions and it was almost like women felt a little bit relieved, I think when I first started asking it, because you would ask basic things but not get into the nitty gritty of things. Yeah. Um, but when I started asking, like, actual questions and then they were it was almost like giving them permission to actually talk about it. Yeah. And they were.
Amber Warren, PA-C: There is still so much taboo and almost shame about just the conversation of sex.
Tammy Hadfield, WHNP-BC: Absolutely. Absolutely.
Amber Warren, PA-C: It's it's really too bad. And doing a big disservice to our marriages, right?
Tammy Hadfield, WHNP-BC: 100%. It's too bad.
Amber Warren, PA-C: Yeah, we were joking a little bit in the hallway earlier. The nurses, some of the nurses were asking what we're talking about on the podcast this evening. And I said, well, I'm really excited. We're doing an episode about sex. And they were all kind of like, oh, that's fun. And I'm like, you girls just wait. Like, you should make you very excited to get married because it is like men are very simple creatures. They really just need sex. Yeah, it just keeps them happy and sustained.
Tammy Hadfield, WHNP-BC: And and it helps their hormone balance and it helps.
Amber Warren, PA-C: Their hormone balance, which we can get into. Yeah. That's so wonderful. So, um, we know and for those of you that haven't heard kind of the initial episode with Tammy on general hormone health and hormone balancing, we know how much bioidentical hormone replacement can help with libido. We kind of talked about the nitty gritty of that. Um, but there's a lot of different ways we can replace hormones. And so you've kind of started this recent transition from, you know, maybe the transdermal topicals to pellets? Absolutely. So what are pellets? Let's talk about what pellets are.
Tammy Hadfield, WHNP-BC: So pellets are a way of delivering hormones in a more sustained manner. Basically, it's putting a little implant of a small amount of hormone underneath. Usually in women, it's done in sort of their upper buttocks area. And it releases those hormones over the course of like 3 to 4 months. So they're not having to take estrogen or testosterone. Those are the two pellets that we use on a daily basis because their body is getting it slowly absorbed. So just give us another delivery system, something another option. And that's the beauty of doing bioidentical hormones, especially with the fact that we've used compounding for so many years. But the use of pellets is more it's newer to me as a practitioner. Not that I haven't been studying it for 20 years, and the problem had always been is that I would go to a pellet education. I've also done training with two other pellet companies, and I was there was always something that was Not exactly settling well with me. Like I didn't like certain things. Or, um, the unfortunate thing in the community is I became known as the train wreck fixer. So if somebody had a really bad experience with a pellet, they would end up in my office. And of course, I would put them on what I had available to them. But then I started getting patients that were coming in and going, actually, I did go see another practitioner.
Tammy Hadfield, WHNP-BC: I'm like, that's okay. You're not cheating on me. It's okay. And really loved it. But they wanted me to be able to give them their pellets. They didn't want to go see somebody else for it. So I was really excited when I came to work with FMI that you guys were using the pellet company that I was already looking at. Great. And because it's a totally different, uh, a different product that has something that's very uniquely patented to it that helps prevent it from being expelled, there's a lot less expulsions of the pellets, because we basically put a little incision into the hip and place these pellets in, and one of the side effects or risks can be that those pellets can come back out. But the technique that we use with this particular company and the type of pellets that we're using for them, which again, has a very different patented system to it helps prevent that from happening. So there's less scarring, there's less pain. Um, and these release more slowly. And I could get into all the details with the patient if they really wanted to get into that. But they're just a much better product. The first one that I could actually get behind and like I said, in 20 years and go, yeah, this is the company that I want to work with.
Amber Warren, PA-C: And so if I come to you and say, I know I need bioidentical hormone replacement, but why should I do pellets over what my other practitioner was doing? Right? Transdermal both estradiol and testosterone. What would you say?
Tammy Hadfield, WHNP-BC: Well, I would usually turn the question around to them and ask them, what are you actually looking to get out of your pellet or out of your hormone therapy? Because it may be that simply what they're currently using just needs a fine tune. But if it's where they're, you know, I really want to optimize my testosterone because I'm now at a time in my life where I want more drive both personal or sexual drive. I know that I or women who come in who have had a diagnosis of osteopenia, a weakening in their bones where they're starting to get some bone loss, well, we may want to think about using testosterone. Um, the delivery systems for testosterone that we have available to women are very limited. And there is not an FDA approved product that's out on the market for women, for testosterone. So we see an array of different things where women are. We either get it compounded, they can use it topically, vaginally, vaginal suppositories, vaginal cream. Um, we have some practitioners who are giving it as an injectable, but using the male dosages. Um, so we run into a little bit of some issues with those. And so the pellets are another delivery system that just gives us another option that's a more consistent blood level with them. And a lot of patients like not having to do something every day. Yeah.
Amber Warren, PA-C: So that's one of the benefits.
Tammy Hadfield, WHNP-BC: One of the big benefits of.
Amber Warren, PA-C: No creams, risk of transmission, things like that.
Tammy Hadfield, WHNP-BC: Yeah. Because with testosterone that's an even bigger risk is transmitting testosterone to a partner. Not so much of a big deal if they're transmitting it to their husband because it's such a small amount. But I mean, if they have young daughters or young children in the house, you certainly wouldn't want to be transmitting it to them.
Amber Warren, PA-C: So on the topic of sexual health, do you feel that testosterone pellets are one of the best ways to improve libido?
Tammy Hadfield, WHNP-BC: It's one of the ways to help,
Amber Warren, PA-C: But not necessarily the best.
Tammy Hadfield, WHNP-BC: No, because here's the thing about libido. Libido is never one thing.
Amber Warren, PA-C: Ooh, I like that.
Tammy Hadfield, WHNP-BC: And so it's really hard because patients do come in with the expectation that they're just going to get put on testosterone, as if it's some magic pill that's going to help fix their libido. That becomes more of a conversation with them. Because I always tell women you had mentioned about men. They're very simple creatures. I love my husband, but he is kind of a simple creature in that aspect, and I think.
Amber Warren, PA-C: They all take pride that they do.
Tammy Hadfield, WHNP-BC: Right? That is them good.
Amber Warren, PA-C: Food, good sex.
Tammy Hadfield, WHNP-BC: And they're happy.
Amber Warren, PA-C: Sometimes football, hunting, video games, whatever, whatever it may be.
Tammy Hadfield, WHNP-BC: But we we joke about the fact that anybody who's taken a human sexuality class has seen the diagram where they show men as an on off switch. Totally. And a woman is a circuit board. Yeah. So when I talk about libido with women, I, you know, testosterone is one of the hormones that's going to help with it. Estrogen can also help with it. Progesterone can help with it. Dhea can help with it. Sometimes thyroid. If they're so freaking tired by the time they get ready to go to bed at night, maybe it's a thyroid issue. Right. So there's so many hormones that play into it. And then there's environment. And that's where I really have to get into big conversations with them, because it's also about do you feel loved and nurtured in your relationship? Do you are you still in love with your husband? When was the last time you had a date night with him? And then we get into the more detailed stuff. Like when was the last time you had an orgasm? Have you had one? Do you even know what one is? It's so sad to me to get some women in my practice who are in their 30s and 40s and go, I really don't know if I've ever had one. I'm like, okay, let's talk about that.
Amber Warren, PA-C: Well, yeah, that's important.
Tammy Hadfield, WHNP-BC: Because it's a very important part of intimacy, regardless of how it's achieved because of the fact is, is that when we have an orgasm, we release oxytocin, and that is a loving, nurturing hormone. And if we're not getting that, we're not going to have that drive. But then it also goes in so many different layers. Are you stressed? Stress is the biggest killer of libido, both in men and women. Totally. And so stress. I always explain it to like this to a woman. If you're under stress, what is the last thing your body thinks it needs to do? It doesn't want to procreate.
Amber Warren, PA-C: Make babies.
Tammy Hadfield, WHNP-BC: Make babies because we're stressed. All our hormones shift and our drive goes down. And until we can get rid of the stress, you probably won't have a libido, right? Then we get into logistics of things. Is your bedroom connected to your child's bedroom? I mean, how many times I talk to women and go, oh my God, yeah, my kids on the other line or when kids. And this is when I talk about the evolution of how things change. Is that different stages in our life, like when we're dealing with toddlers and we're caregiving all day long with them, we're using all that oxytocin up with them. Don't touch me!
Amber Warren, PA-C: Yes.
Tammy Hadfield, WHNP-BC: Yes, exactly. Don't touch me. I'm done. I'm done for the night. Don't touch me. I don't want anybody hanging on me one more time. And then as we have teenagers, well, teenagers start knowing what mom and dad is doing in the bedroom, and they're up.
Amber Warren, PA-C: Till midnight and they're not going to bed at 8:00 at night.
Tammy Hadfield, WHNP-BC: Exactly. So there's all those logistics of it, and then I tease them and I says, well, what turns you on about your husband? They're like, I had it was the cutest gal. I just recently saw her. And she goes, she was talking with her girlfriend, and her husband started emptying the dishwasher, and both of them were like, that is such a turn on. Yeah, like.
Amber Warren, PA-C: We say, foreplay.
Tammy Hadfield, WHNP-BC: Right?
Amber Warren, PA-C: Like, when he does something, I'm like, that's great foreplay. And he looks at me like I'm crazy, but he's like, noted, right?
Tammy Hadfield, WHNP-BC: Did he take out the garbage for you that night? Did he do the dishes for you? I mean, those are things that kind of get us in the mood, but.
Amber Warren, PA-C: Oh, my gosh, that's so funny.
Tammy Hadfield, WHNP-BC: So many layers. I wish that libido was. If. Here's the thing. If libido was so simple for women, we really would. I mean, we do have a pill that's out there and we can talk about that at some point. But the reality is it doesn't always work. And there's so many kind of restrictions with it. I mean, the length of time they have to be on it, they have to avoid alcohol, they can't be on any antidepressants. But there really isn't. It isn't as simple as just taking one thing to fix the libido. It's a multitude of things.
Amber Warren, PA-C: Yeah, that's such a good point. Casting that wide net. And I think you're I love how you're trying to differentiate. Is it really low libido or is it anorgasmia. Right. Right. And those are two very separate issues that are treated very separately.
Tammy Hadfield, WHNP-BC: Absolutely.
Amber Warren, PA-C: So how do we see, um, libido sex drive change through different transitions in a woman's life. So pregnancy perimenopausal post-menopausal premenopausal. How do we see that shift?
Amber Warren, PA-C: That's a big question.
Tammy Hadfield, WHNP-BC: It's a big question. No, no, but it all has to. It also has to do. It's your hormones that are shifting, and it's the changes in your environment and what's going on with your relationships. So whether that's, you know, if you get divorced I funniest thing is I always laugh at women who tell me they get a divorce and man, did it fix their libido for the better because they're dating again. It's the newness, the newness of it. And that's why I always the other question I always ask patients, well, how long have you been married? And they're like, oh, um, and they'll tell me. And I'm like, so how was it when you were first together? Well, it was lights and, you know, it was sparkles and it was, you know, I was feeling the flutters and we lose that newness because in actuality, what happens in relationships is, is that and the newness of a relationship. Your blood pressure will go up, your pulse rate goes up, and your heart rate goes up when they come into the room. And that is i.e. the flutters, right? And the longer we are with our partner and the more secure we are with that partner, it has the opposite effect. Our blood pressure comes down, we're more comforted, our blood pressure and our pulse goes down and our breathing goes down. And that's what it was kind of funny when I worked labor and delivery, I could always tell if there was some, maybe some issues going on at home, watching the blood pressure and pulse as the whoever came into the room. And it was very interesting because you could tell what was going on and you know, how they were responding. But one of the things that we always talk about with patients is that I want you to do a sort of a homework assignment, if you will, with your partner. I want you to discuss what things turn you on and what things you think. Turn him on. And I want you guys to do it for each other just as reminders of what what it was. Because sometimes we just need a reminder. We forget. We get so comfortable. And as we age and as those hormones change and of course, as we get into menopause and we get the big declines in hormones, such an impact on our libido. And it's hard because that's usually at the time in our life where we're becoming empty nesters and we want to be chasing each other around the house. And so it's.
Amber Warren, PA-C: Chasing each other around the house. No kids, no, no kids. Chase me naked. That's so funny.
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Amber Warren, PA-C: We've optimized hormones because we're really good at that here. There's still a hypoactive sexual hypoactive sexual desire. Low libido. What are some other tools? This is where I think we can get into, like the treatment. What are other things we look to to use to improve libido? Peptides. Peptides. I'm not as well versed on some of the.
Tammy Hadfield, WHNP-BC: There's there's some newer ones that are out there that I'm kind of dabbling in at the moment. Cool. Yeah. So those will be kind of rolled out to patients as time goes on, but there is one that I really like to use in patients that isn't. It's used off label. Okay. And that is oxytocin. I was going to ask.
Amber Warren, PA-C: That was actually if you weren't going to mention actual peptide, I was going to say.
Tammy Hadfield, WHNP-BC: I love oxytocin.
Amber Warren, PA-C: Yes. Okay.
Tammy Hadfield, WHNP-BC: So again oxytocin is a naturally occurring hormone right. We get it released usually in labor and delivery to contract the uterus to in order to have a baby. When baby goes to breast, we produce oxytocin to love and nurture our child. And we produce oxytocin when we are intimate. Um, oxytocin sometimes downregulates, meaning that we have less receptors in the body for it. So it becomes increasingly more difficult to have an orgasm. And so sometimes women, it can be both physical or it can it can be biochemistry wise. We're having this difficulty with it. I had a beautiful client that I had been working with for years who finally retired, and she came to me and she did not look like herself. She kind of lost her sparkle, is what I said. She was kind of. She she quit. She was. She was in the hair. She was a hairdresser. And she always had her hair beautifully done. Well, she came in and she was kind of a little frazzled, not her typical self. And I was like, what is going on? She goes, I don't have a drive. Like I have no drive whatsoever. I'm like sexually. She goes, any kind of drive. I was like, okay, we got to fix this. And so what we did was we used oxytocin off label. It is considered off label when we use it for sexual response. There are many different ways of getting it into the system. There's everything from sublingual meaning underneath your tongue. Um, there's a nasal spray. We there's some vaginal creams that we can use sometimes with it. That one's been kind of hit or miss, but just kind of depends on the patient. Um, but, uh, probably the favorite one that we've been using is mainly the nasal spray. It's a mucosal membrane. It gets absorbed very well. Um, but we went ahead and did Oxytocin. And I remember walking through the the waiting area and it's been several months later and, and I looked at her and I'm like, oh my God, you have your sparkle back. She goes, I'm having sex again. I was waiting. She's like, I'm so excited. She was so excited. It's so funny because when you think about that, it's just kind of a we forget what what sex does for us and how it helps with our neurotransmitters and how it helps with our society. And it helps with just rebooting our hormones. There's some interesting studies that have been done about, um, sexual activity and the delay of menopause or the earlier onset. Yeah, it was really interesting. It was I don't know, I mean, just a couple of them that I looked at, but it was just very fascinating. But it is interesting that one of the things that I, I quote to patients is that 1 in 3 women between the ages of 30 to 59 has had some degree of low sexual desire. And that's that's a third of us. And I think it's probably underreported for sure. Um, but that that whole getting our sparkle back is always it's it's interesting to watch, but we can use oxytocin to kind of upregulate that to happen. And then over time they don't need to use it anymore.
Amber Warren, PA-C: So they get it back because it helps everything to kind of reset.
Tammy Hadfield, WHNP-BC: They're starting to have sex. So now they're they're producing it themselves. Oxytocin. Absolutely. One of the resources that I usually point patients to is John Gray had, um, wrote another book called Venus on Fire, Mars on Ice, about the changes in life for us. And in the back of that book is 100 Ways to raise, um, oxytocin naturally.
Amber Warren, PA-C: So cool.
Tammy Hadfield, WHNP-BC: And one of the ways is doing what we're doing right now. Women listening to women intently and feeling listened to and heard. And so that's why in my couples, I always teach the husband, I says, I need you to do something with your wife. And that is, I want you to not be fixing her when she comes to you. Yeah. Just listen. Just listen. And that helps her oxytocin. And it relieves him of having to try to fix it.
Amber Warren, PA-C: So how do men increase oxytocin?
Tammy Hadfield, WHNP-BC: Same way. Um, so we eye on oxytocin as far as dealing with men, usually is more tied to what we're dealing with, with testosterone. So men have to use testosterone in order to build more testosterone. So we know that with men, if they are not engaging in sexual activity, their testosterone will gradually decline. And around day seven of no intercourse, it'll try to spike itself to get him to physiologically have sex, because every time that he is having sex, he's using up testosterone and rebuilding testosterone. But oxytocin is really interesting because oxytocin does two separate things in men and women. And when I explain this, you're going to go, oh yeah, okay, I get it. So in women it causes us to kind of have a burst of energy wanting to get things done. And men, it makes them roll over and want to go to sleep. Sound familiar?
Amber Warren, PA-C: Totally. Hundred percent.
Tammy Hadfield, WHNP-BC: And I just always laugh about how oxytocin affects us so differently. Well, years ago, my husband and I had gone to a conference and there's Dr. Thierry Hertoghe actually has written a book on oxytocin. It's just oxytocin is the name of the title. And there he had talked about the fact that he always tries out new things on himself. So I told my husband, I said, we're going to go home and we're going to try out some oxytocin. He goes, okay, so we did. It is not the best thing for a man to be taking extra oxytocin, in my opinion. I can imagine it makes them very clingy. He wanted to paint my toenails, stop it and take me shopping, I was good, I mean, I had ulterior motives. I was thinking I was going to slip him some all the time. Yeah, yeah, but. And even Doctor Hertoghe says that too. He goes, I was very clingy to his. He was very clingy to his wife. He didn't want her to leave the house because he just wanted to love and nurture her. And that's just not it's not always comfortable for a man's masculinity to be in that feeling that. So we didn't use it much after that. Don't use it again. No. No.
Amber Warren, PA-C: So interesting. So, is it true that there are levels of oxytocin so that it would be the highest after intercourse? Exactly. And that's why they want to snuggle. Yeah. Right after intercourse. Yeah. Okay. That makes a lot of sense. Oh my goodness. So interesting. So I you are bringing such, I think, a wonderful resource to the table here at center for Optimal Health. Vaginal PRP, we have to go there. Okay. Tell us more.
Tammy Hadfield, WHNP-BC: Okay. I love PRP. I know you do. I, um, I did not realize that I have been doing vaginal PRP for ten years. Oh my goodness. Yeah. I got trained in 2014 and I did not realize that. So PRP is platelet rich plasma and most people don't understand what that means. But what those are are cells that are are there like I call them, the super cells. Because PRP, if you want to understand what it is, is look at a cut the next time you cut yourself or you scrape yourself, all that yellow goo that comes to the surface to create the scab is is platelet rich plasma and it's. And wherever it goes, it knows how to re or heal whatever skin it's going to. So it's not going to create a mucosal membrane on your knee. If we get a scab there right. So we take PRP which we take blood from our patients, spin it down in a specialized centrifuge which just spins it down to separate it. And then that platelet rich plasma gets reintroduced into two key areas for sexual response. And, um, women get a little nervous when I tell them that I'm going to inject it, because God knows we do not want to have needles in that area, but we use a very strong, numbing agent that's actually used for like, um, laser resurfacing. So it's really strong. And I've very rarely do I ever have a patient ever tell me that they can feel it. They usually say it feels like a little bit of pressure, but what we're doing is reintroducing those key cells into certain areas. That one I knock on wood, we've always gotten vaginal lubrication back. So if everything is filled with vaginal lubrication, or for some reason the patient doesn't want to use some kind of hormonal cream to help with lubrication, like some of my breast cancer patients, for example, we've gotten vaginal lubrication back within about three weeks, so their own natural production comes back. We also introduce it into the clitoris because 70% of women achieve orgasm through clitoral stimulation. And as we age, it atrophies. Everybody always thinks it's that cute little button that's just very at the top. And nobody there like.
Amber Warren, PA-C: Did you just call it a cute little button?
Tammy Hadfield, WHNP-BC: Cute little button. The female anatomy is lovely. It's magical. Think about the uterus. Uterus is a magical organ, is it not?
Amber Warren, PA-C: I 100% agree.
Tammy Hadfield, WHNP-BC: So the clitoris, the cute little clitoris is not just that little button or nub at the top. It actually extends back into the body a couple about an inch, inch and a half, and then it has horns that go down through the labia. Most people don't realize how big the clitoral organ is, the gland. And so what we do is we're reintroducing platelet rich plasma into the area to improve sexual response. Now there is homework that has to go with that. You just can't get things to start coming back. So I'm very, very adamant with my clients that they need to be active at least every other day, if not maybe daily for a little while, so that we get the brain body connection back together again. Because it's so important, because sometimes that connection between our brain and our body is just as important in our sexual response as the organ itself.
Amber Warren, PA-C: Right. Amazing. So you see improved desire.
Tammy Hadfield, WHNP-BC: Improved. Well, here's the thing about it. We can't fix a broken relationship. So there's always conversation that we have about like one in particular. Expectations. Yes. Expectations. If being able to achieve a climax more easily becomes less work for her, and she's able to enjoy it again. Usually she has more of a desire for it. Right. So we have to get rid of kind of that stumbling block that's preventing her from being able to enjoy intercourse. Intensity of orgasm can improve for a lot of women. Um, and that lubrication part. I mean, that's just it's key. We just kind of put up with it and deal with all the products that are over-the-counter to help deal with it. But, um, desire can come back by improving the quality of the sexual experience for her. And she deserves that. Every woman deserves that. Every couple deserves it.
Amber Warren, PA-C: Oh, for sure. 100%. Is there, um, male PRP?
Tammy Hadfield, WHNP-BC: There is male PRP.
Amber Warren, PA-C: Do you do that? Do you offer that?
Tammy Hadfield, WHNP-BC: I currently do not. I've been trained to do that. Okay. Um, with men, it's a little bit different because they have to have a repeat of it once a month for three months before they get the full results.
Amber Warren, PA-C: Most men would probably struggle with that. Yeah, because where is it injected directly.
Tammy Hadfield, WHNP-BC: There's five locations on the penis itself.
Amber Warren, PA-C: They have five injections.
Tammy Hadfield, WHNP-BC: Sites, whereas a woman has two.
Amber Warren, PA-C: Oh, gosh. Yeah. I can't see many men being super excited. Yeah. Okay. So is that part of why you don't offer it? Because you just popularity?
Tammy Hadfield, WHNP-BC: Yeah. When we first started offering it, we were getting very, very few phone calls for men to actually come in for it. Yeah.
Amber Warren, PA-C: I just can't fathom a lot of men would be jumping up and down to get that done.
Tammy Hadfield, WHNP-BC: The interesting thing with the female side of it, though, it lasts anywhere from about 12 to 22 months, is what I'm seeing on average, which is really good. We can't stop the aging process. That tissue is going to constantly be aging, right? So, um, a several of my clients just come in on yearly, like I don't want it to go away. So I'm just going to come back every year. I'm like, okay, send me.
Amber Warren, PA-C: Up an ear. Let's do the annual dentist appointment. Let's just go.
Tammy Hadfield, WHNP-BC: Ahead and get.
Amber Warren, PA-C: It done.
Tammy Hadfield, WHNP-BC: Absolutely.
Amber Warren, PA-C: Oh, that's so, so, so important, I love that. Um, anything else regarding sexual health you'd like to share with our listeners? Low libido. Intimacy.
Tammy Hadfield, WHNP-BC: I think the biggest thing with low libido is, is that women get a little embarrassed about it. They get feeling like somehow something's wrong with them. And that really makes me really sad that they don't want to bring him or they've brought it up, usually to a male provider who says, oh, that's just normal. That's part of aging. It's surprising to me how many female providers will also tell their clients that that's just normal part of aging, versus really kind of digging deep into maybe why she's having low libido. So I, I, I see most of my clients. It's it's an environmental thing in addition to the hormones. So there's.
Amber Warren, PA-C: Multifactorial.
Tammy Hadfield, WHNP-BC: Absolutely. So I always ask them, I say if I can give you a prescription for a romantic vacation away from your family, away from the kids, away from your job. Would you have sex with your husband? There's only ever been one client who told me no. Everybody else has told me. Of course I would. And so then it's like, you know what? It's it's not. It's not you. It's the environment right now. And it's okay, and it's okay to plan sex if you want to. Right. Um, and kind of put it on the books, so to speak. We always joke about the fact that if you can not joke about it. But if you can commit to twice a week, a lot of times the spontaneity will start to come back more for clients. Um, but we also have to figure out if there is other issues that are going on. My biggest one is that other biggest one is if there's pain associated with intercourse, because that'll just shut things and that's easy to fix.
Amber Warren, PA-C: We can fix that. That's pretty simple. Absolutely. So the sex twice a week. Is that enough physiologically to help keep the hormones in check? No, I was gonna ask. So if we're looking to help naturally raise for men and women. So levels, I.
Tammy Hadfield, WHNP-BC: Always wonder what was the motivation.
Amber Warren, PA-C: That's a great prescription. Let's talk about that.
Tammy Hadfield, WHNP-BC: Well, sometimes I do ask them what they want me to write that as a script.
Amber Warren, PA-C: Most men would be like, absolutely.
Tammy Hadfield, WHNP-BC: Well, sometimes we put it on the fridge, right? But sometimes it's the other way around. Which, yeah, another reason why it led me into seeing male clients, too. Because you fix the wife and she's feeling like, hey, I need intimacy, and and you have to make sure that he's on the same page. So it's part of the, you know, the whole intake process is like, if I, if I do ramp up your libido? Do we have an outlet for that? For sure. For sure. You know, you don't want to make anybody frustrated, right? Well, in.
Amber Warren, PA-C: Frustration. And I actually thought about this when you were talking about that. What happens to the testosterone after day seven of no sexual intimacy? And I think about this often, Tammy. And I think I've talked about this on this podcast. Like how many marriages could be safe. How much infidelity could we I mean, this if you really start to expand this topic and get people to start becoming educated patients and health care practitioners alike, world changing with the current divorce and infidelity rates?
Tammy Hadfield, WHNP-BC: Absolutely. Well, because of the fact that we're resetting hormones too. It's so interesting in working with couples and I, I can usually tell when things have changed because their hormone levels start to become more optimal, more consistently. And I'll ask them, like, have things changed in the bedroom for you guys? Oh yes. Thank you very much. I'm like, oh good. And so, you know, we I also I in dealing with both men and women I always especially the women, because we we tend to not be selfish. We're always trying to make sure that the kids are taken care of, make sure our husband's taken care of, and we oftentimes put ourselves last. But I always tell them, you need to have sex for selfish reasons for you, because we know that it it helps to stimulate serotonin. We know that it helps with the satiety hormones. We know that helps boost your your your hormones.
Amber Warren, PA-C: Yeah.Because I think so often the conversation is keep your husband happy. Yes. What is the male need but forgetting like what physiologically it does for us. Absolutely. Is really a good tidbit. Okay. So what's that prescription? Is there a general one that you can give to males and females for how often they need to be having intercourse? To boost hormones.
Tammy Hadfield, WHNP-BC: I ideally recommend three times a week. Okay. Yeah. I mean, it's totally manageable. Yeah. The average is like, what, one point something per week.
Amber Warren, PA-C: Is that what it is?
Tammy Hadfield, WHNP-BC: It really is very low.
Amber Warren, PA-C: One and a half times a week. Yeah. That's. That is too low. Well, that's that's our world.That's culture.
Tammy Hadfield, WHNP-BC: But, you know, even if you have to, I there's all kinds of things. And I think that, um, we are planning on having an open house night. Yes. We are. And there are some of those tidbits that we can include in that about ways to help with signaling and and allowing our kind of giving some hints that we're in the mood because guys get a little bit shy about it if they get turned down. So there becomes this whole turn down thing that happens, and so they won't pursue it. But we also have to remember there's well, as we age, there's a big phenomena that goes on that women get very frustrated with. And this goes back to managing expectations about returning the libido, and that is that we always expect to have desire in order to have arousal. But as we age, it's the other way around. Usually we have to have arousal first and then desire comes second because it's like we get into the motions of the intimacy and then we're like, oh my God, this is so great. I don't know why we're not doing this more often. And then the desire comes out after engaging in it, but we think that that's a that's being broken. That's not being broken. That's just a shift in how our aging process is going.
Amber Warren, PA-C: And that makes bioidentical hormone replacement, oxytocin, vaginal PRP, all those things so much more important as we age. Absolutely.
Tammy Hadfield, WHNP-BC: Yeah, absolutely.
Amber Warren, PA-C: Well, we can't wait for your open house where you can share even more details in person, so stay tuned for that. Um, thank you so much for spending our time tonight. I think this is a really important conversation to have, and hopefully we can continue to have more dialog around the topic of just sexual health and sexual intimacy for men and women alike.
Tammy Hadfield, WHNP-BC: Thank you.
Amber Warren, PA-C: Thank you, Tammy.
Tammy Hadfield, WHNP-BC: Thank you.
Amber Warren, PA-C: Thank you for listening to the Functional Medicine Foundations podcast. For more information on topics covered today. Specialties available at the FMI Center for Optimal Health and the highest Quality of supplements and more. Go to funmedfoundations.com.
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