Healthy Sex Drive, Healthy You by Diana Hoppe, MD

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(Full disclosure, I was given a copy of this book by the publisher to review for my blog. Fuller disclosure, most of my friends will tell you that if I don't like something, I'm not shy about letting everyone know, you you can be assured my review of this book is truly how I feel about it!)

Lack or loss of libido is the third most often heard complaint I hear from women in the peri/menopausal transition (hot flashes first, disrupted sleep second). While I am firmly convinced that (bioidentical) hormone balance goes a long way in restoring the libido of both men and women, sexuality is a complex topic and is influenced by physical, emotional, spiritual, and perhaps even financial aspects.

Dr. Diana Hoppe has written a book entitled Healthy Sex Drive, Healthy You. She is a board certified OB/GYN practicing in Southern CA. Her book covers a myriad of topics, including:

Eight Reasons Why Sex is Good for You

First thing that struck me in this chapter is the question "What exactly is sex?" You might be surprised. Dr. Hoppe gives us a number of reasons to want our sex lives to be healthy. Best line in the chapter (page 27)--sex is a form of exercise! We all know how important it is to exercise, right? The second part of the chapter discusses ways to keep your libido in top shape, and one of the things I like about this book is that there are tips that apply to most women, not a bunch of crazy ideas about ropes in the bedroom and exotic oils.

What is Libido, and Why Is It Erratic?

Important discussion about the differences in libido in men and women --- not just the level of libido (and I know, insert your own joke here), but a good explanation of how the libido in men and women work. Learn about how a woman's sex drive ebbs and flows with the different stages, of her life, and how hormonal changes can affect her libido.

Self Esteem

Our society is so bombarded in the media with what we should think of as the "perfect" body, skin, hair, and oh, yeah, you have to be young! No wonder as we enter our middle (I prefer to think of them as wiser) years, we see ourselves and our changing bodies as dumpy, unattractive, useless, dried out, and so on. Who wants to have sex when you don't even want to be with your own body? A discussion of enabling a healthy self esteem (no, you aren't going to read this and suddenly love yourself, but there are important points in this chapter that will make you think), and how self esteem affects your libido.

His and Her Sex Drives: What Was God Thinking? (love this one!)

I loved this chapter and learned so much! There are truly differences in men and women's brains that affect sexual desire, function, etc. There's even a chart! Why women's brains are more susceptible to depression (and no, it's nothing to do with being stronger or weaker).

Fueling Desire: Aphrodisiacs and Scents that Charge Libido

Foods and scents that may have an effect on female and male sexual desire. Somewhat interesting reading, but likely my least favourite chapter in the book.

The Stress-Libido Connection: is Stress Killing Your Libido?

Stress is a libido killer, probably more so for women than for men. We live in a 24/7, full on busy society, which of course makes stress a bigger problem. At the peri/menopausal life stage, women our age are often dealing with children, elderly parents or other family members, busy careers, changing bodies, huge life changes (children going away to college, empty nest syndrome, having to deal with constantly changing technology), and it wears us out so much that sex gets way, way down on the list of priorities. This is the chapter to be read with a highlighter in hand, and hopefully will make you want to examine your life and see if there aren't some changes/tweaking to be done to reduce your stress levels.

FSD: The Female "Erectile Dysfunction"

Female Sexual Dysfunction is real, it's important, and is far too often blown off by practitioners as an unavoidable consequence of aging. It makes me SO angry that zillions of dollars have been spent on research to come up with Viagra, Cialis, and other erectile dysfunction drugs, but I am convinced that the FDA does not take female sexual dysfunction seriously. (I am also convinced that bioidentical hormone balance will go a lot further than drugs to treat FSD in women, but that's another subject). In this chapter, Dr. Hoppe discusses different types of sexual dysfunction, causes and treatments. You will come away from this chapter empowered that there is hope if this is a condition that affects you.

Medications and Health Conditions that Can Shelve Your Libido

Wow, this is a subject I know first hand. Before I got my hormones balanced 4 1/2 years ago, I was on 8 different medication. Yep, 8. The combined list of side effects made it a wonder I could function at all (and believe me, I wasn't living functioning would be an optimistic term.) I was able to get off five of those meds in the first two weeks of hormone therapy (under a doctor's supervision----do not EVER discontinue a med without checking with your doctor first), and within 6 months, I was off another two, including the antidepressant I had taken for years. There are a number of medications that can affect your libido, as can any number of health conditions--this is another chapter to read with a highlighter in your hand so you can emphasize important points.

Heart to Heart: Using Communications Resuscitate Your Libido

You'll see a lot of articles out around this time of year (Valentine's Day) about how important communication is to your sex life (well, duh!), but it's true and too often overlooked. Women often blame this as a "male issue" and say that it's the spouse's fault. Some excellent questions listed in this chapter to answer yourself and to share with your partner. One of my favourite parts of this chapter (wish it was a bit longer) is communicating with your doctor.

The book is well laid out, I found it easy to read (there are a few parts that necessarily get a little technical about how the body works, or how chemicals work in the body, but even those are presented more clearly than in many books). There are some helpful charts, and some highlighted areas that cover important points. One of the best parts of the book is that at the end of every chapter, there are questions for reflection---answering the questions will reinforce the important points in each section. Overall, this is a book I feel comfortable recommending to my readers.

I do, however, have one complaint. For a book on libido, I think very little attention was paid to the role of hormone balance in achieving optimal sexual health. Only about 3 pages were devoted to hormone replacement therapy, and Dr. Hoppe obviously is not a fan of bioidenticals. She is a proponent of taking hormones for relief of menopausal symptoms, at the lowest dose and shortest time possible. Although she does not come right out and say so, she is clearly speaking about estrogen replacement only, no mention was made of progesterone or testosterone. "Vaginal health" was only mentioned once specifically-----and I am here to tell you that bioidentical estriol (weakest of the three estrogens) cream has worked well for me in alleviating vaginal atrophy. So, overall, although I do like the book and see it as a good resource for women experiencing libido issues, do not expect to learn much about hormones in this book.

Have a great weekend, everyone, hope you all wore red today in honour of Women's Heart Health Awareness Day. Don't forget (I just had to throw this in here given the topic of today's post) that Valentine's Day is coming up in just 10 days!

Penis Envy

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Well, it's been an uneventful last two days for me since I last posted. I spent some time off line and not really doing much of anything. I sort of felt like after Sunday, that I really didn't have any interest at all in helping my husband. His words just constantly bombarded me in my head, so it's been rough trying to shake all the nasty things he said. While my head says, all of that on Sunday wasn't directed towards me, and the comfort of knowing I am not alone in dealing with all of this....it really didn't help the hurt to go away. We haven't said a whole lot to each other and I have to admit....I have been awfully withdrawn and indifferent towards him. I don't mean to be but, I just am really sort of broken after Sunday if that makes any sense. This morning I came across another blog for Veteran Caregivers which is fairly new it looks like. This, even though I have been there and done that, reminded me again that whatever the hell that was on Sunday....wasn't my husband. It kind of gave me a little bit more sense of belonging and gained my focus back. However, the hurt is still there and he hasn't said anything about it.



My husband's shows were on last night and it was Top Shot on History Channel. I sat and watched it because although I would adamantly say the show sucks to my husband...I secretly want to be able to shoot like those competitors do. Yes, the Mistress would like to be a legendary gun slinger or Amazonian female warrior. However, admittance of such a thing would probably excite him and there we go back to having guns in the home. This would lead to buying my own gun because I know my husband and he would obsess over my not having one. After January, I don't want any type of weapons in the home which was also heavily advised upon from doctors and such.



Out of nowhere, he starts talking about this Veteran Group meetings he was thrusted into right out of the gate upon his completion of the PTSD rehab he was in. As you know, this didn't help him at all and really...only made him worse. I listened to his ranting and raving of course, figuring this would allow him to vent and get it off his chest. This particular first meeting had set him off in a number of ways..and I have to agree that it's not really making him all warm and fuzzy being there or helping him. That conversation led into being strapped for money, which led into us discussing the possibility of tightening the budget.....which led him into discussing his issues. Although he was somewhat hateful, snarky and angry...he complained he hated not being his old self and then started complaining about his buddies. He complained about the men in the commercials driving the cars, and then he started in on the competitors on Top Shot. I wasn't really upset, I wasn't really anything...I was just there and trying to grasp why he was so mad at these strangers on tv.



I listened, commented, tried to be understanding and then he just got quiet as if suddenly, someone just threw the circuit breaker on his fuses. Here I was kind of on the edge of my seat thinking any minute now, I will see the exact scene from the movie the Exorcist where her head starts spinning around, and all hell is going to explode in my living room. He just stopped. He was watching Top Shot with such deep interest, that I could have walked in the room completely naked with 50 other men and he wouldn't have even noticed. I realized then...my husband is suffering from a form of penis envy of the "normal" guys.



Ok, now I know I am going to get some emails stating psychology facts and what they have learned in school about the term Penis Envy and "do you know who Sigmund Freud is?". Save your breath because this gal is a little educated too and yes, I did refer to my husband having a form of penis envy...not that he is suffering from Freud's exact definition of it. Let's just say this is the Mistress's definition from our "The Things You Learn From Living with PTSD and TBI" dictionary. So you are probably asking yourself "what does she mean when she is talking about penis envy"? It's simple. From the conversation last night and his complaints, my PTSD Combat Veteran doesn't bang on his chest anymore. He feels like he has had everything taken away from him, and I have been forced to take on so much because of him and for him. He is not allowed to have his guns, which for manly men...is like taking their testicles. He has to have someone help him with basic necessities, basic needs like reminding him about bathing or medicines. He has a time limit of how much time he can go out and when he is expected home, is not able to drive or perform normal every day tasks like he used to be able to. He struggles with reading, with normal every day tasks and is constantly fighting off the demons in his head at the same time. My husband was a McGuiver, give him a tool and duct tape...the man could fix anything. Now he struggles with simple tasks like changing the guts out of the toilet, something he could have done blindfolded.



I realized he wasn't angry or his complaints were without merit, just that he envied being a normal guy. He kept saying "You don't understand what it's like. I can't explain it. I have had everything in my life taken away from me. My job. My lifestyle, my body and hell, I can't even have sex without help from pills." I wanted to argue on all of this but I kept my mouth shut about it. I just listened. I realized last night when I went to bed and thought some on his conversation with me, that he felt like he didn't belong anywhere with the old crowd. He doesn't feel normal beside them, can't seem to find his place with any of his old buddies, and is envious that they are normal. It isn't envy of body,muscles,how much money they have, jobs or cars...its the fact that they are just normal and don't struggle with simple tasks. They can come and go, not get lost, and can perform like a man.



I told him that sex wasn't a serious issue with me. It really isn't. Not that it was bad, or he has serious troubles with that department downstairs. He says he has problems, I say it's fine...he says "No the hell it isn't. It's not fine with me!". He was given a prescription for cheap cialis, which I was concerned about since he has a long family history of heart problems and the possibility of it counteracting with his regular PTSD meds. However, I felt if it makes him bang on his chest a little, and it was safe, so be it. I don't want him thinking I am unhappy and worried that he was going to all this trouble just for me...but mostly it was just for him. To feel normal once again, somewhere...anywhere.



I felt sorry for him. I really really did. Not so much pity, but genuine sympathy for him because yes, I do understand. We as the caregivers of our Veterans find ourselves outcast-ed unintentionally by our friends and well, society in its whole. THEN you feel like an outcast or leper in your marriage. I may not know what it's like to have to depend on someone like he does, but I do envy other women. I don't fit in anywhere anymore. We as families of PTSD really kind of fall into our own category and we are constantly on the search for people like us so we do fit in. When we finally do find that someone, we don't care about who they are or what they have...it's all about "getting" it. Now I have non-PTSD friends, but sometimes I feel like they really don't get me or perhaps they really don't understand.



I also lost too. Maybe not in the sense that he has but loss is still loss no matter how you look at it. I find that I struggle finding my place not only on the outside, but here at home. I am constantly waging a battle with myself trying to figure out whether I am wife, caregiver or the evil mama who won't let him spend every dime we have, or let him go out and "play". He has his demons, I have mine. He wants to be normal, and so do I. Somewhere between all of this...I need to find a way to help him "belong" somewhere. Too I realized, I need to find a place too. I can totally understand his longing, his envy and the battles he is enduring.



I tried letting up on some of the control and allow him to do things on his own...but sometimes that backfires on us and it turns into one huge mess. I try to be supportive, encouraging and allow him room to strut those feathers...but it's not what he needs. He needs to feel that on the outside with his friends or society. I know one time he told me that it wasn't the outside that scared him, keeping him freaked out or scared all the time of getting attacked. It was the people. When he feels not-so paranoid, he feels like people are staring at him or judging him because he is sweaty, nervous, jumpy and has outbursts. I really don't know how to fix all that. The VA doesn't give us manuals on how to help in these departments and in the last four years, never really heard anyone refer to these self-esteem type of issues.



So I guess the purpose of this blog is to find out what all of you are doing to combat "penis envy" with our Veterans. Anyone else finding themselves in this situation? From the men, what could the women do to help you to make you feel more manly? Lots of questions for this Wednesday I know.  I wish sometimes that we were equipped with a magic go to guide for all of this. There isn't anything I can do to protect him or anything I can say to make it any better in this area of jealousy that he has. I don't want him to shut himself off from the few friends he has left just because he feels like he doesn't fit in. I am afraid this will cause an increase in the already high amounts of depression he has. I so hope that we can eventually find a family like ours, and perhaps feel like "normals" again. Who would have ever thought four years post-war, we would find ourselves jealous of those on the outside who are normal with no issues and longing to be anyone else besides ourselves. We were totally happy with who we were and what we had......

Sexual Health Medicine-1

Viagra purchase cialis (Sildenafil) or stop cheap cialis spam was approved by the Food and Drug administration (FDA) in 1998 and was the first drug for the treatment of erectile dysfunction. Given as an oral medication, 9 tablets are dispensed every second worldwide and Pfizer, the manufacturer of the drug says that millions of men have been helped to improve their sex lives. Impotence, or erectile dysfunction, is a problem that affects most men at some time in their lives. Viagra is a drug for those whose problem is not resolving in the short term and who have been advised by their doctor that it is a safe drug for them to try.





How Viagra Works

Originally studied for the use in people with high blood pressure and cardiac problems the drug was found to have a very interesting side effect. Viagra increases the blood flow to the penis and enables a man to maintain an erection for at least 4 hours. It only works if the man is sexually stimulated so will not cause an erection by just taking the pill.





Cost Viagra

Viagra costs about anywhere from $5 dollars per pill, but market forces and source can vary the price considerably.





How to take it

The medication is taken in pill form by mouth. One Viagra tablet can be taken in 24 hours, it will usually work within 30 minutes to 1 hour and lasts about 4 hours.





Common side effects

The most common side effects are headache, facial flushing, dizziness, visual problems such as blurred vision, bluish vision and sensitivity to light, nasal congestion, an upset stomach.





Viagra can be dangerous

Do not take Viagra if you use nitrate drugs. These types of drugs used to treat cardiac problems such as angina can if used in combination with Viagra cause the blood pressure to drop to unsafe, sometimes life threatening levels.





People with cardiac problems, anatomical malformations of the penis such as Peyronie's disease, men with a predisposition to prolonged erections caused by sickle cell anemia, multiple myeloma (a form of cancer), leukemia, liver problems (especially severe liver disorders), kidney problems and people taking certain medications used for HIV or those over 65 should NEVER take the drug unless prescribed by a medical practioner. Deaths have occurred during sexual activity in men using the drug.





Viagra is one of the medications that has revolutionized the treatment of erectile dysfunction. It has allowed those who where unable to maintain an erection or only able to have partial erections enjoy a better sex life.