Sex, Cancer and Aging Part 2: Things You’re Too Embarrassed To Ask A Doctor


[MUSIC PLAYING] You’re listening
to Things You’re Too Embarrassed to Ask a
Doctor, a production of Chicago Medicine. Each week, we’ll
feature one physician and ask them your most
searched questions in their areas of expertise. For more information
on our episodes, visit us at www.uchicagomedi
cine.org/podcast. Have something you’re too
afraid to ask your doctor? Tweet us @TYTEPodcast. I’m your, host Kat Carlton. [MUSIC PLAYING] Hello, and welcome back
to part two of our talk with Dr. Stacy Tessler Lindau. I will let the good doctor
reintroduce herself. I’m a gynecologist,
and I’m a specialist in helping women preserve and
recover their sexual function after cancer and in the setting
of other health conditions. Part one of our
talk with Dr. Lindau revolved around sex and cancer. This episode, we’ll
explore a few things related to sex and aging. Before we sat down
to record, Dr. Lindau shared some questions
she’s come across during her own research
and firsthand experience with patients. The first has to do with couples
having sex just by themselves. I’ll let the expert
take it from here. You know, I’ve been studying
sex and aging since 1993. And there are many
questions people ask. While this one might
not be the most common, your topic today is questions
you might be afraid to ask. It’s come up enough
times that I think it’s worth addressing here. The best available
evidence indicates that masturbation is a normal
human behavior across the life course. The instinct for sexual
pleasure or for masturbation begins in childhood
in boys and girls and is a behavior that
is normal and healthy under the right circumstances
across the life course. There’s no evidence to support
the idea that a marriage ceremony or a
marriage certificate inhibits a person’s interest
in or ability to enjoy pleasure from masturbation. There may be cultural
or religious rights around that behavior that
should be understood. But I reassure people who are
worried about whether it’s a normal behavior that for both
men and women, married and not, masturbating is just a
normal human behavior and not something to worry about. Another question
related to people who have maybe a long-term
partner is, I love my partner, but I no longer desire to have
sex with them, and I miss that. Will my libido ever come back? So libido or desire for sex
is an important component of the sexual response
cycle in men and women. And a person who
loses their libido or has a decrease
in their libido oftentimes feels
distressed by that. It’s bothersome. It can make a person feel
unwell or wonder, what’s wrong with me? What happened? Where did it go? It’s interesting, because
when it’s there, maybe we don’t appreciate it. But when it’s gone, it
can give a person a sense that their health isn’t good. And some people are driven
to see the doctor with that as one of their main symptoms. Something’s wrong. I’ve lost my drive for sex. There are a number of common
and reversible factors that can be addressed. Poor quality sleep is a very
important and reversible driver of low libido in men and women. Why do we have
poor-quality sleep? We’re stressed out at work. We have a newborn
baby, and we go– we have a period of
time of childbearing where mothers and
fathers can have accumulated sleepless nights. There are a whole
range of reasons why our sleep can be poor quality. Sleep apnea or snoring
is another factor, and it’s reversible,
oftentimes, with weight loss. So low libido is real. It’s distressing. It can be an indicator
of underlying illness. And the common causes of
low libido are reversible. A couple of years
ago, the US FDA, the Food and Drug
Administration, approved a new
prescription medication to treat low libido in
women, premenopausal women specifically. The generic name of this
drug is flibanserin. The drug has not
had quite the uptake I think the pharmaceutical
industry expected– not because women don’t want a
solution for their low libido, but I think there are
a couple other reasons. One is there are– women are now talking to their
doctors about this problem, and so we are starting to better
address the reversible causes that don’t require a drug. Another is that the
medication has side effects, and the clinical
trials around that drug have not shown
significant benefit. And so when you weigh cost
versus benefit or risk versus benefit, there just
hasn’t been much uptake. [MUSIC PLAYING] While we can’t get to
every issue related to sex and aging
in this podcast, I’d like to take a
moment to point out an incredible resource
spearheaded by Dr. Lindau herself. It’s called a Woman Lab. Woman Lab is a platform
for women and people who love women to access
information about libido, sex and menopause, incontinence,
and a whole lot more. So I’ve been
practicing specifically with a focus on helping
women preserve and recover their sexual function
since 2008 or 2009. I’m also a scientist, so I
see patients a half day a week for these problems. I came to realize
that– two things. One– a good deal
of what I’m doing to heal people’s sexual
function problems is basic sex education. Many people come– and people
across the education spectrum, highly educated people, even
medical doctors, and people with less education,
or less access to information about sex
education in particular. And a lot of what heals them is
understanding you’re not alone. This problem is expected. It’s a consequence
of the treatment you’ve had for cancer
or another illness. And there are things we can
do to address the problem. That information in
itself is therapeutic. The other driver of– or other discovery I’ve made
is that educational materials I want to provide my patients
to supplement or to reinforce what I share in the clinical
setting was just not available. So we created Woman Lab as
a knowledge dissemination platform. There’s a website, womanlab.org,
W-O-M-A-N L-A-B dot org. Facebook. There’s Twitter. We created this platform
with the help, thankfully, of philanthropy
to the University of Chicago and
foundation support so that all women, regardless
of where they are in the world, if they have an
internet connection, can get access to this basic
therapeutic information to address some of
their deepest concerns. And in fact, with very little
marketing and publicity, Woman Lab has been
used by people with an internet connection
in almost every country in the world in two years. We have almost 80,000
users of the information. And believe it or
not, my clinic volume has actually gone down over that
since we launched Woman Lab. I mean, I think there are
a certain number of people who can help themselves before
they need to come to a doctor. Woman Lab provides tools
not just for women, but for everyone who
loves and cares for women. So the tools we’ve
been publishing are intended to make it
easier for doctors and nurse practitioners and
others to deliver evidence-based clinical care
for women in this domain. And about 25% of Woman
Lab’s users are men. So most women do
have a male partner. Obviously, some women
have female partners, and the content would
be for them as well. But I think it’s interesting
that 25% of the people using this information are men
who love and care for women. We’re almost out of time. Is there anything else
you’d like to add, any other questions that maybe
people ask on their way out? They’ve been wanting to ask this
question for their whole visit. You’ve touched on
the big questions. I do have a group
of women who’ve been my patients who are
particularly activated around this issue, around just
the basic idea of preserving, helping to preserve and
recover sexual function, especially in the context
of medical treatment. We’ve created an
advisory board for women who participate in designing
and executing our research. They advise to the
Woman Lab effort so that the content
we’re producing is really addressing
their needs. And that’s been an incredibly
important component of the salience of our work
for women and of the ability to distribute or reach women. And I say this for two reasons. One, it’s unfortunate to me that
women who’ve survived cancer have to feel angry and
ignored in this domain. That’s not good. And while in this conversation,
I’m making a call out to women to be more active in asking
these questions and getting help in this domain. I also will repeat my call to
doctors and other health care professionals
taking care of women to please get up to speed
on addressing these issues. The other thing I’ll say is that
as a general matter, if you’re a patient feeling frustrated
or angry or with ideas about how care for your
condition could be better, engage. Ask how you can help. Ask your doctor,
ask the scientist doing the work if they could
use a patient advocate. There’s no question that
having the patient voice has accelerated our ability
to address these issues. And I think that’s a
general lesson that goes well beyond sex and
cancer, sex and aging. Well, thank you so
much, Dr. Lindau, for being on the show today. Thank you for talking
with me, and thank you for covering this
important topic. Until next time,
this has been Things You’re Too Embarrassed
to Ask a Doctor. Once again, I’m Kat Carlton, and
you’ve been listening to Things You’re Too Embarrassed
to Ask a Doctor. Music from today’s episode
is by Blue Dot Sessions. For more information on our show
or to submit your own question, visit
www.uchicagomedicine.org/podcast or tweet us @TYTEPodcast. [MUSIC PLAYING]

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