Sex on Call (Maddie & Larisa)

Do you remember when you learned where your clitoris was?
Is it hard for you to have an orgasm?
Have you ever used a vibrator?
Do you feel comfortable sharing your sex life (whatever it looks like) with a healthcare professional?

Often, the route to a better sex life for us as women should include a better understanding of our physical anatomy and the science behind how our bodies work in regards to pleasure.

This podcast is a space where we (Maddie and Larisa, who are both friends and nurse practitioners in women's health) unpack evidence-based research, talk to professionals, and share the occasional personal story as we seek to explore how women can improve their sex lives, better understand their bodies, and learn together.

Be sure to subscribe, so you don't miss an episode when we launch later this month!

In our first episode we're looking back to history to find the earliest mentions of a female orgasm. We'll share texts that date back to medieval times and even quote a nun! We'll also look at research exploring the subject of orgasm and discuss Masters and Johnson's groundbreaking research that is still relevant today!

Then we'll talk about why female orgasms are so important, the orgasm "gap", and types of orgasms. This episode is loaded with quotes from our favorite "sexpert" Betty Dodson. And lastly, we will clarify the myth of clitoral versus vaginal orgasm.

We can't wait for you to join us for our first official episode of Sex On Call!

In most episodes, one of us will take a deep dive on a particular topic. This week, Larisa is walking us through research and information all about the clitoris.

We'll walk through all the parts of the clitoris, those seen and unseen. We'll also discuss how the clitoris responds to arousal and why this small organ plays SUCH a crucial role in pleasure. In our conversation we'll help you rethink the "G" spot and how this is also most likely associated with the clitoris.

Even the clitoris, along with our hormones, changes during our cycle. We'll help explain why our clitoris may be more responsive to sexual experiences at different parts of our cycle. We hope that as you listen to this episode, you learn more about the anatomy of the clitoris and how it is uniquely made to help you experience pleasure.

“The most consistent sex will be the love affair you have with yourself. Masturbation will get you through childhood, puberty, romance, marriage, and divorce, and it will see you through old age.” - Betty Dodson.

We explore in this episode the often shameful discussions around the topic of masturbation (or "self-love"). Episode 3 highlights the benefits to masturbation—seen in one's mental health, physical health, and relationships. The benefits include being the safest sex outlet, lowering stress, helping with sleep, increasing the likelihood of achieving an orgasm, and much more.

Both of us share our "first" experience with masturbation and how our childhood homes and upbringing shaped the lens through which we saw masturbation. Our goal from this conversation is for women not to feel ashamed for exploring self-love but recognize and realize the value it can bring to many aspects of your life!

Plain and simple: Sexual activity should not hurt. With over 40% of women experiencing pain with sex (known as dyspareunia), this topic is an important one.

In this episode, we talk through what a diagnosis of dyspareunia includes, how we assess for this, what other things have to be ruled out, and how this affects far more than just your sex life. And to close, we’ll talk through the variety of treatment options available and what options are available to help sexual activity (whatever that looks like) feel pleasurable.  

We hope this episode helps you feel seen, supported, and empowered to seek any help you need.

This week, we're starting the conversation about our favorite pleasure tool: Vibrators. These “toys,” which were first created for doctors to help relieve women of “hysteria" (no joke), have become a staple for many bedside nightstands. It was even the fifth household appliance to electrified, and for good reason at that!

Remarkably, though, vibrators have proven to be beneficial for much more than just pleasure or orgasms.  The use of vibrators in multiple studies have shown to improve sexual function, decrease pelvic organ prolapse symptoms and pain scores, improve vaginal atrophy or any thinning of vaginal tissue, and significantly decrease rates of depression.

A small simple tool can dramatically improve a women’s life in many ways. It’s not just a sex toy, but a life hack!

At the end, we’ll even walk you through some simple tips of what to look for in a vibrator and where to start if you’ve never used one before.

We can’t wait to share more episodes on vibrators in the future, but hope you enjoy this intro episode on our favorite tool in the sexual pleasure tool belt.

Join us for our first guest episode with Dr. Elkattah. Dr. Elkattah was one of Maddie’s preceptors and biggest mentors. He is truly someone who has spent his career  illuminating the complexity of women’s health and helps to encourage other professionals to all of the component’s that can contribute to pelvic pain and pain with intercourse; More importantly the care and thoughtfulness that women deserve when dealing with these conditions. 

His career started with the desire to bridge the disparity in women’s health, particularly in the Middle East,  starting as an OB/GYN. He then pursued further specialty training in surgical gynecology. Endometriosis has been a huge focus of his career partially due to the lack of understanding and the many lingering questions surrounding this diagnosis. 

With 1 in 10 patients being diagnosed there are countless women affected by this. And statistically, this can take 8-10 visits before a patient even receives this diagnosis. 

We discuss how menstruation should be considered a “fifth” vital sign, meaning that it can tell us a lot about a woman's well being and by far impacts more than just our monthly cycle. 

Listen to hear answers to detailed questions about endometriosis including: 

What is endometriosis and how common is this condition? Theories as to why this condition occurs? Risk factors? What are the alarm symptoms our body shows as a sign of this condition?
What is the impact of endometriosis on the body and surrounding organ symptoms?Symptoms of sexual dysfunction and impact you see in your patients, and also their partners? 
What are women's treatment options? How is this diagnosis confirmed? Where do you see the role of surgical intervention ideally fitting into a women’s management plan? 
What should a woman look for in an endometriosis surgeon? What are current surgical techniques used for endometriosis treatment? Discuss common hypersensitivity symptoms that can occur?  In a woman with endometriosis, who are vital components to her care team? 

Endometriosis is an extremely complicated, untreatable disease. But what we learned from our discussion with Dr. Elkattah is the importance of early detection and treatment and considering a team approach to treating this to give patients the best outcomes possible. 

Another major takeaway for us in the episode, besides all the endo facts and deep dive, is the discussion revolving around the impact our mentors have on us. Amazing mentors are those that open doors for us, push for us to think more critically or bigger, and are by far the best teachers. 

We hope you enjoy this rich and informative discussion on endo and hope you learn something about this condition for yourself or a loved one!

Resources Mentioned:

• The Pelvic People Website
• Ohnut Depth-Limiting Rings
• Endo Warriors Facebook Group
• Beating Endo: How to Reclaim Your Life from Endometriosis
• Nancy's Nook
• Below the Belt Documentary

In this episode, we're breaking down research behind aphrodisiacs, which are natural substances that supposedly help with sexual desire and/or performance!

In our conversation, we break down the origin of the word aphrodisiacs and its reference to Greek mythology. We also mention evidence about “mainstream” aphrodisiacs including chocolate, alcohol, and marijuana. But to our surprise, a lot of the evidence and research led towards food alternatives and their effects on inflammation and blood flow, rather than sexual desire directly. (Don't worry, chocolate and red wine may still have their benefits! 😉)

Examples of these are foods high in L-arginine, which increases blood flow, quercetin which is an anti-inflammatory and also increases blood flow, and lastly omega 3 fatty acids, which also increase blood flow. You’ll even hear about creams that have incorporated these ingredients to help with sexual arousal that often include L-arginine which focuses on the "nitric oxide pathway"—the same pathway that Viagra focuses on for men’s sexual health!

We hope you find this episode interesting, along with our takeaway that this is all ultimately about fueling our body well. The healthier fuel we're putting in our body, the more likely we are to feel "in the mood" and to report more pleasurable sexual experiences.

We can't wait to hear your thoughts!

Here at Sex on Call, our personal expert on menopause is Maddie. She has her certification with North American Menopause Society and she is deeply passionate about all things menopause.

Today, we are focusing on pain with sex in connection to menopause. As women can spend up to 40% of their life in menopause, many experience side effects from the declining estrogen and androgen specifically in our vaginal tissues. The lack of these hormones can often lead to discomfort and pain with intercourse including dyspareunia.

The unfortunate reality is that 50% of women experiencing issues with their sexual function related to menopause never seek treatment or utilize therapy. Some common symptoms include irritation of the vulva, inadequate vaginal lubrication, burning, urinary urgency, decreased sexual sensation/pleasure, and more.

In a survey of women, this has led to a negative effect on their lives, adverse effects on sexual intimacy, feeling less sexual, feeling old, negative consequences on marriage/relationships, negative effects on self-esteem, and lower quality of life.

During our discussion, we share treatment options, why menopause doesn't have to include sexual discomfort, how often treatments usually take to be effective, and why estrogen is considered a safe and effective options for many patients.

We hope this conversation is valuable for you!

On this episode we’re focusing on dyspareunia in the postpartum period, which means pain with sex or penetration after birth. It’s important to remember that this condition can be really difficult given it is also associated with a life transition of welcoming home a newborn and navigating your relationship with your partner during this time.

We'll cover the difference between generalized pain in postpartum and pain with sex, risk factors of dyspareunia in postpartum, and treatment options. (A variety of treatment options are available including use of lubricants, estrogen cream to replenish lack of estrogen especially for breastfeeding patients, pelvic floor physical therapy, and even counseling may be beneficial if the women’s physical response is related to her emotional response or trauma from birth.)

Larisa also discusses things that she incorporates into her practice as a midwife to help decrease the amount of trauma to the pelvic floor, pelvic muscles, and vaginal tissue during birth.

We hope you find this episode helpful and share with any of your friends navigating postpartum!

Today, we're covering sexual interest and arousal disorder. This is one of the 5 different types of sexual dysfunction which include: female sexual interest/arousal disorder, female orgasmic disorder, genito-pelvic pain/penetration disorder, substance/medication-induced sexual dysfunction, and other specified or unspecified sexual dysfunction. It is not uncommon for one of these types to cause a domino effect and lead to others.

This topic can often be covered at a well woman’s yearly exam. Screening questions may include: Any pain or discomfort with intercourse? Concerns with orgasms or arousal? However, due to the uncomfortability of this topic, these questions may be avoided by some healthcare providers.

In this conversation, we will define sexual interest arousal disorder, discuss symptoms, and clarify what would trigger an official diagnosis. With approximately 40% of women experiencing sexual dysfunction, it's important to remember that the female sexual response is not linear, but rather circular.

We're breaking down treatment options, both cream and oral medications, and also consider male factors that may influence a woman's experience. Also, we will discuss the non-pharmacological methods women can be counseled on which may also be a great option! 

If any of this information may fit you, please seek out a healthcare provider that will listen to your concerns and help find the best treatment options for you.

We’ve got a big topic today on the podcast: Porn. Don’t let this scare you away because we have lots of research to present! This is another taboo topic that is not routinely talked about in the women’s bathroom or gossip circles, but something that is heavily consumed and not talked enough about.

Surprisingly, while porn is most often consumed by men, the research shows more benefits for women than men.

In this episode, we cover the percentage of men versus women who consume porn content, explore international perspectives from women on porn, the effect on sexual performance for both men and women in relation to the amount of porn consumed, more ethical porn sites you should know about, and how watching porn in a relationship affects the quality of connection and sexual intimacy.

Our conversation includes breaking down site visits for major pornography sites versus well-known sites such as Amazon, Netflix etc. We’ll share the percentage of men vs women who consume porn content and explore international women’s perspectives on porn. The research presented today also looks at men and women’s sexual performance in relation to the amount of porn consumed. And also porn watching in a relationship and quality of sexual intimacy.

Testosterone, a hormone often thought of as a male hormone, is surprisingly still extremely important for females. But it’s far more than just a sex hormone—it can affect the brain, muscle, fat, bone, and nerves.

Similarly to other hormones, we see testosterone levels decrease with age. Published studies have shown, however, the benefits of testosterone for low desire and arousal disorder in women. 

We’ll discuss the ages of women this is most recommended for, mild and adverse effects, and recommended routes for testosterone replacement.

Remarkably, this perceived male hormone may have more significant effects to a female’s health even beyond our sexual health!

When you search online or walk down a store and find yourself in the lube aisle, it can be overwhelming knowing which kind is the best for YOU. Our episode today focuses on the different types of lubricants and why some may be better for your lifestyle or sexual health. We talk through common lubricants like silicone and water-based plus “natural” lubricants like coconut oil and saliva, including the pros and cons. We even include a list of our personal favorites!

Plus, if you’re not someone who regularly uses lubricant, we’ve included a couple of studies describing why the use of lubricant in general may be positive. Lubricants, both with partners or without, are another tool in our tool box for improving our own sexual health journeys.

We’ve covered almost all the different disorders under the umbrella of sexual dysfunction. Today, we’ll be covering anorgasmia, which is the delay, absence, or reduced intensity of orgasmic sensations.

As you've likely heard in previous conversations, most sexual dysfunctions are interconnected and often one leads to another. It's important to consider other medical diagnoses that could impact someone’s sexual health as well. While our sexual health can improve our day to day and overall well being, there may be other dynamics at play that may prevent someone from achieving a consistent orgasm and other risk factors that may aggravate this.

Today, we're sharing studies that show improved outcomes for those with an orgasmic disorder with different interventions such as the use of a vibrator, and we’ll also explore other treatment options that may be better for others.

If you haven’t listened to our episodes on Vibrators, Masturbation, or Orgasm, you may hear us refer back to some of the information discussed in these episodes. Check them out!