Question 1

Should I use a lubricant for sexual activity?

Accepted Answer

Most people benefit from using a lubricant for sexual activity because the lubricant can make sexual encounters more comfortable and more enjoyable. Women who experience vaginal dryness or discomfort with sex should definitely use a lubricant, and even those who do not have vaginal dryness may still benefit from a little lube.If using a condom, lubricants decrease the chance of the condom becoming displaced or broken and leading to unintended pregnancy or STI exposure. In addition, the clitoris is not self-lubricating. Only the vagina produces its own lubrication and sometimes not enough. The clitoris and labia majora (outer lips) do not produce any lubrication, so using a lubricant will make stimulation of these vital areas much more pleasurable and arousing. We even have research to show that using a lubricant increases the chance of reaching orgasm 50%.

Question 2

If I use a lubricant, does it mean that I am not aroused?

Accepted Answer

No, using a lubricant does not indicate a lack of arousal. Certain circumstances such as perimenopause, menopause, breast feeding, breast and other cancer treatments,chronic health conditions, smoking,and medications can lead to vaginal dryness. Birth control pills, patches and rings cancause vaginal dryness in younger women. These situations have nothing to do with your arousal or lack of it. You can have a healthy desire and feel aroused but still not experience self-lubrication.  There are two types of arousal: genital arousal and subjective arousal. Genital arousal is the response to sexual stimuli when the genitals become engorged with blood, which then leads to lubrication.  Subjective arousal is the mental engagement during sexual activity, and both types of arousal do not always occur during sexual activity. A woman may feel aroused mentally and enjoy the sexual encounter in the moment but not experience genital arousal or lubrication. In this case, a lubricant would be very helpful and allow for greater enjoyment of sex.

Question 3

Which lubricant is best for me?

Accepted Answer

Choosing a personal lubricant often comes down to personal choice, and there are a few considerations regarding the different types to keep in mind when making your choice.  The various types of lubricants include water based, silicone based, hybrid, and oil based.

Water Based Lubricants: 
Water based lubricants are most affordable and most commonly used.  They are safe to use with vibrators, sex toys, and condoms.  They are easy to clean up and available in a variety of consistencies, from thin liquids to thick gels.  Water based lubricants dry up quickly and may need reapplication or a few drops of water or saliva to keep them slippery.  They often contain preservatives that can be irritating, especially for those with sensitive skin.  You will want to avoid any products that contain parabens, glycerin, and propylene glycol.  None of the products at Intimate Focus contain any of those ingredients.

Options: Slippery Stuff, Sliquid Organics Natural Lubricant, Sliquid Organics Natural Gel, Sutil, and Coconu Water Based Lubricant

Silicone Based Lubricants: 
Silicone based lubricants typically stay slippery longer than any of the other types of lubricants.  They are not water soluble, so they are great for play in the bath or shower.  They are considered to be hypoallergenic because they usually do not soak into the skin, and they do not need preservatives.  Silicone lubricants are compatible with condoms, but they are not always compatible with solid silicone sex toys.

Options: Uberlube and Pjur Basic Silicone Lubricant

Hybrid Lubricants: 
Hybrid lubricants are a combination of water and silicone.  They are less likely to cause irritation than water-based lubes, but they are not considered to be hypoallergenic. Hybrid lubes last longer than water-based ones, but not as long as silicone-based ones.  Hybrid lubricants are safe with all sex toy materials and condoms.

Options: Sliquid Organics Silk Hybrid Lubricant

Oil Based Lubricants: 
Oil based lubricants hydrate and improve the elasticity of sensitive tissues and thinning skin. Only plant oil-based lubricants are recommended for internal use because petroleum-based oils, such as Vaseline and Aquaphor, can contribute to infections and should never be used internally.  Oil based lubricants are compatible with all non-toxic sex toy materials, but they are NOT compatible with condoms made with latex or polyisoprene.  They also take longer for the body to clear them, so they are not recommended for people who have chronic, recurring vaginal infections or urinary tract infections.

Options: Coconu Oil Based Lubricant

Question 4

What is the difference between a vaginal moisturizer and a lubricant?

Accepted Answer

Vaginal moisturizers are an over-the-counter treatment for vaginal dryness. Moisturizers do not have any hormones in them and work by replenishing moisture and increasing elasticity in the vulvar and vaginal tissues. Vaginal moisturizers must be used consistently, at least 3-7 times a week, and it may take 2 months before you notice the benefit.  If they are only used sporadically or right before sexual activity, they will not be effective.

Vaginal moisturizers are available with various ingredients, and you should avoid products with irritants and things you are allergic to.  Common irritants to avoid are glycerin, parabens, and propylene glycol.  Vaginal moisturizers also come in various formulations such as creams, ointments, gels, and suppositories. Intimate Focus offers two vaginal moisturizers: Honor Everyday Balm by Rosebud Woman and Enchanted Rose Balm by Intimate Rose.

Lubricants reduce friction and discomfort on a short-term basis and do not have a long-term effect. They should be applied right before and during sexual activity to increase pleasure and arousal. They may be used with vaginal dilators and other sexual aids. Lubricants do not have long term effects.

Question 5

What are the benefits of having an orgasm?

Accepted Answer

Orgasms can boost mood –the brain releases several neurochemicals that provide many benefits. The main ones are oxytocin and dopamine.

Oxytocin - also known as the love hormone and the bonding hormone. It is released 500 times the normal amount with orgasm and plays a role in sexual arousal and ejaculation. It also increases when you are hugging someone. Oxytocin has other non-sexual roles. It causes uterine contractions in labor and childbirth, and it is involved with breast feeding and allows the milk to be released. It also impacts human behaviors and social interactions such as recognition, trust, and romantic attachment.

Dopamine – is the feel-good hormone. It allows you to feel pleasure, satisfaction, and motivation, and it plays a role as the “reward center.” When you do something pleasurable, your brain releases a large amount of dopamine, so you feel good and seek more of the feeling, whether it is sex or junk food.  
Other benefits of orgasm:

Strengthen relationships and help couples feel closer 
Improve sleep and decrease insomnia  
increase body confidence,  
reduce stress and anxiety – by release of dopamine 
Promote relaxation 
strengthen pelvic muscles 
help relieve pain – by release of endorphins

Question 6

What is perimenopause?

Accepted Answer

Perimenopause is the transition phase from regular periods during our reproductive life to the cessation of periods, which is menopause. It may begin 8-10 years, and possibly up to 14 years, before menopause. It often starts in the early to mid-40's. Menstrual cycles become irregular and unpredictable, and the only predictable part is to expect it to be unpredictable. Periods may become heavier, lighter, closer together, or farther apart. Heavy and frequent periods can lead to excessive blood loss and anemia, so you should see your provider if this is happening.

Other symptoms can also include psychological and physical symptoms.  
Psychological symptoms may include:  
anger  
Irritability 
mood swings 
depression  
anxiety  
difficulty concentrating  
brain fog 
mild memory problems 
trouble with word finding

Physical symptoms may include:  
hot flashes 
night sweats 
decreased libido 
weight gain 
urinary problems such as urgency, frequency, and incontinence  
Vaginal dryness and painful intercourse

These symptoms may be due to fluctuating and decreasing levels of estrogen. Treating with systemic estrogen can be helpful, if you do not have any contraindications, such as breast cancer, history of a heart attack or stroke, or blood clots.

Question 7

What is menopause?

Accepted Answer

Menopause is defined as 12 months after the last menstrual period, and it is a normal, natural event in a woman’s life. It can occur naturally or due to surgery (removal of ovaries). Sometimes we don’t know exactly when menopause occurs if a woman does not get her period due to continuous birth control pills, an IUD, or a gynecologic procedure such as an endometrial ablation or hysterectomy. The average age is 51, and it usually occurs between the ages of 45 and 55. Menopause is associated with the reduced functioning of the ovaries and decreasing levels of estrogen and progesterone. It also marks the permanent end of fertility. Postmenopause is the time of life after menopause, or after you have been without a period for 12 months.

Many women experience symptoms and physical changes associated with menopause, and these symptoms are like the ones associated with perimenopause. Symptoms may include hot flashes, night sweats, sleep problems, mood changes, weight gain, slowed metabolism, thinning hair, dry skin, loss of skin elasticity, loss of breast fullness, and mild memory problems.

Hot flashes and night sweats can be very disruptive, especially if the night sweats do not allow you to get a good night's sleep. They tend to be at their worst in perimenopause and early menopause. Hot flashes affect 50-80% of women and are more common in black and Latina women. Cigarette smoking increases frequency and severity. Hot flashes resolve in 85% of women within 5 years, and 10-15% of women have persistent flushes throughout their lifetime. Median duration is 7.4 years, and 1/3 of women have them for 10 or more years.

Many women experience changes in sexual function and urinary problems in perimenopause and menopause.  This is called genitourinary syndrome of menopause (GSM), and it is a common condition that affects up to 85% of menopausal women. GSM is a chronic, progressive collection of symptoms caused by a lack of estrogen during menopause and affects the vulva, vagina, and the urinary system. Vulvovaginal symptoms may include vaginal dryness, loss of elasticity, painful intercourse, vaginal atrophy, tightness and shortening of the vagina, vaginal itching, thinning of vaginal tissues. It can affect sexual function with decreased arousal, decreased sensation, trouble with orgasms, tearing of the tissues which causes pain and bleeding. Urinary symptoms may include urinary urgency, frequency, painful urination, urinary incontinence, and UTI’s. While hot flashes and night sweats usually improve with time, symptoms of GSM only worsen with time.

The good news is that we have great treatment options for GSM, so it does not have to happen. Over-the-counter vaginal moisturizers can be helpful for vaginal dryness and painful intercourse. Moisturizers do not have any hormones in them and work by replenishing moisture and increasing elasticity in the vulvar and vaginal tissues. Vaginal moisturizers must be used consistently, at least 3-7 times a week, and it may take 2 months before you notice the benefit.  If they are only used sporadically or right before sexual activity, they will not be effective. Intimate Focus offers 2 vaginal moisturizers: Honor Everyday Balm by Rosebud Woman and Enchanted Rose Balm by Intimate Rose.

Vaginal estrogen is highly effective and extremely safe. Vaginal estrogen acts locally on the vulva, vagina, and bladder, and it does not affect the whole body. More importantly, it does not cause breast cancer, heart attacks, strokes, or blood clots. The package insert for vaginal estrogen usually says that it increases these risks, but the pharmaceutical companies take the risks associated with systemic estrogen (pills, patches, and gels that increase blood levels) and apply the same risk to the vaginal treatments as a class effect, but this is not the case. Vaginal estrogen is extremely safe and can be used until you die. There is no recommended amount of time or age when you must discontinue it. You should talk to your medical provider if you are interested in vaginal estrogen.

This is a time of life when we can embrace change. Some women feel a sense of loss when we no longer have a menstrual cycle or reproductive ability. We are also likely to experience changes associated with aging. Society places a lot of pressure on women to stay youthful and vivacious, and losing our youth may make us feel undesirable or less valuable. Obviously, this is a harmful and false narrative, so we must look at aging as a gift and embrace it as such.

Menopause offers a time to reevaluate ourselves and our lives because it is a new chapter or new season. Many women feel a renewed zest for life and look at this time of life as an opportunity to try new things: hobbies, interests, ministries, or goals that had been previously elusive.

Question 8

What is genitourinary syndrome of menopause (GSM)?

Accepted Answer

Many women experience changes in sexual function and urinary problems in perimenopause and menopause.  This is called genitourinary syndrome of menopause (GSM), and it is a common condition that affects up to 85% of menopausal women. GSM is a chronic, progressive collection of symptoms caused by a lack of estrogen during menopause and affects the vulva, vagina, and the urinary system. Vulvovaginal symptoms may include vaginal dryness, loss of elasticity, painful intercourse, vaginal atrophy, tightness and shortening of the vagina, vaginal itching, thinning of vaginal tissues. It can affect sexual function with decreased arousal, decreased sensation, trouble with orgasms, tearing of the tissues which causes pain and bleeding. Urinary symptoms may include urinary urgency, frequency, painful urination, urinary incontinence, and UTI’s. While hot flashes and night sweats usually improve with time, symptoms of GSM only worsen with time.

The good news is that we have great treatment options for GSM, so it does not have to happen. Over-the-counter vaginal moisturizers can be helpful for vaginal dryness and painful intercourse. Moisturizers do not have any hormones in them and work by replenishing moisture and increasing elasticity in the vulvar and vaginal tissues. Vaginal moisturizers must be used consistently, at least 3-7 times a week, and it may take 2 months before you notice the benefit.  If they are only used sporadically or right before sexual activity, they will not be effective. Intimate Focus offers 2 vaginal moisturizers: Honor Everyday Balm by Rosebud Woman and Enchanted Rose Balm by Intimate Rose.

Vaginal estrogen is highly effective and extremely safe. Vaginal estrogen acts locally on the vulva, vagina, and bladder, and it does not affect the whole body. More importantly, it does not cause breast cancer, heart attacks, strokes, or blood clots. The package insert for vaginal estrogen usually says that it increases these risks, but the pharmaceutical companies take the risks associated with systemic estrogen (pills, patches, and gels that increase blood levels) and apply the same risk to the vaginal treatments as a class effect, but this is not the case. Vaginal estrogen is extremely safe and can be used until you die. There is no recommended amount of time or age when you must discontinue it. You should talk to your medical provider if you are interested in this treatment.

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