Testosterone Fuels Desire and Pleasure

In this episode, Dr. Jen welcomes special guest Sarah Knerl, co-owner of Core Essentials Physical Therapy. Together, they explore the sexual benefits of testosterone and the vital role it plays in sexual wellbeing. Sarah highlights the importance of pelvic floor physical therapy in assisting men and women with complex and challenging personal health concerns. 

To Make and Appointment with Core Essentials Physical Therapy 

1901 Vestal Parkway East Vestal, NY

607-444-3151

Jennifer Cobb PT and Sarah Knerl PTA

Transcript

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Okay, welcome back. This is Dr. Jennifer Hopkins, an integrative medicine specialist certified in hormone health with a passion for biohacking, the human body, diligent researcher, professor, health advocate, and wellness enthusiasts. This raw and real podcast explores holistic wellness and self-empowerment from a unique perspective. Join us as we embark on this transformative adventure. Turn the volume up and let's get real. I am grateful you are here. Okay, so today I am joined by Sarah Neural, co-owner of Core Essentials Physical Therapy, a specialty PT clinic in pelvic floor therapy, and I'm so grateful you're here, Sarah. I'm happy to be here. Thank you for having me. Absolutely. Can you tell listeners a little bit about what you do? Because I think pelvic floor is more of a new. Modality and I certainly have had it done on myself'cause I was having a lot of recurring urinary tract infections. So I don't know that I knew anything about it up until probably a couple years ago. Sure. It is fairly new and upcoming. Pelvic floor therapy deals a lot with the muscles that are within the pelvic floor and the hip muscles. They are impacted by a lot of things, though. They're impacted by spine movement, by your abdominals. And then specifically for women's health, we take a lot, we take care of a lot of women who deal with pelvic pain with intercourse interstitial cystitis, endometriosis it's huge in pre and postpartum care. And all throughout life stages such as going into puberty. Having babies and then into menopause. Your pelvic floor takes a toll as we age, so we deal a lot with men, women, children. Oh, tell'em specifically what you do for men. So for men, we typically see men post prostatectomy. They will have complaints of urinary leakage when that prostate is removed. So they get in to see us so we can work. On the pelvic floor muscles themselves, because men have the same exact muscles that we do. We have a couple more in there, but ideally we have the same. And we do a lot of pelvic floor training with them to help them regain continence. And then as well as men do have quite a bit of pelvic pain. We do have a ca like small caseload right now of men with pelvic pain pain in the testicles, pain with ejaculation. So we are dealing with looking at tight tissues around the hips again and releasing tension in the pelvic floor. Wow. So pain with ejaculation is, could be related to tight muscles in the hips. Absolutely. Oh, that's fascinating. I wouldn't have thought of that. Yep. Hip flexors and play a huge role in that. And abdominals muscles. Yeah. And we know people are so tight. Oh yes. We all love to do, the strength training, we love to do the running. We love to do all that thing, but the thing that we don't do a lot of is taking care of breathing and doing maybe some yoga and doing the stretching. We don't spend enough time doing that. Yes. So we do a lot of teaching people how to also lengthen their tissues. That's very smart. I think especially array athletes do more with we're more of we want the results. We don't worry about the stretching the muscle. The recovery is an important piece. Yes. That we're all missing. Yes. It's huge. And then you put on top of that, people are super magnesium deficient, which relaxes the muscle. And it's like the, it just keeps going on and on. Oh yeah. People are more tense, they're more stressed. So I think people's muscles are pretty tense, so I'm thankful that you guys are doing that work. Yeah, it's really exciting. We are, we just started two years ago in this area, so we're. Happy to be here and servicing our community. Where is your clinic located? So we're at on the Vessel Parkway, across from Planet pre-owned. We have a small clinic there. We treat one-on-one. And there's three practitioners there right now yeah. That's beautiful. And I did not go to you'cause I didn't know you. I think I actually went before you guys started. Yeah. And it was not that same experience. Yes. It was not really a one-on-one. It was weird. It was awkward. This is not that. So I really wanna encourage people if they are having any issues in the pelvic floor area to search you guys out, because I think what you're doing is miraculous. Yep. Jen, Jennifer Cobb, who's my business partner, and I really wanted to create a space that was comforting, more spa-like experience as much as you can and less medical office because you are dealing with a lot of. Trauma and, embarrassment. People come in and they're embarrassed. Of course, girl, no one wants to put to join out there. No, I know. So we really put a lot of thought into creating a very nice space for people and so far they've really enjoyed it. So That's amazing. Yeah. I wish I had gotten to experience you guys. Really? Yes. That's, I makes such a difference. Yes, it really does. And you are right. A lot of women and men have trauma in that area specifically, and I know that for me to sit there and to put my feet up, like it was just awkward. And I know that you don't make it that way. No. Everything is very much talked through and explain to the patient. And we always let them know it's your body, your decision. It's not necessarily that we have to look at the pelvic floor. We have many other things we can look at. The pelvic floor is impacted, like I said, from head to toe. So really it's not just about looking at one body part. Oh, that's smart. I get that. Like you said with the head flexers. Yep. Plays a huge role. That's so interesting. Yeah. Thank you for sharing that. Of course. I'm excited for the work that you're doing here and I know that it's helping a lot of men and women, so that's amazing. The one population I think that probably needs to come see you more are the postpartum women. Absolutely right. Yes. Ideally, in my perfect world I would see women prior to pregnancy. Or well, not prior to pregnancy, I would like to see them in their second trimester to specifically take a look at the pelvic floor, even if they're not having pain. Just to establish how their pelvic floor is doing, how they're coordinating because that gives us a good idea on how. We can help prep them for maybe an easier delivery, less C-section rate. Decreas, who doesn't want that decreased tearing? Who doesn't want that decreased tearing? Everyone should be signing up for that. Truly Sign me up. Goodness. And then, like you said, specifically postpartum I like to see all mama's two weeks postpartum. At that time we start working on mobility. Even if they're vaginal or C-section, we start working on mobility and body posture. And we just lend in extra support for mamas because the hormones are just. Oh, crazy. I feel so bad for mothers because I, you are one of the only practices that actually supports them. And I say that piece is really missing. People where we're so good about paying attention to'em before the baby comes, right? And during pregnancy. And then once the baby's here, you're right, their hormones are all over the place and they don't feel well. Everybody's attention is towards babies. As soon as well, being a newer mother too. Yeah. My goodness. Yep. I went through the experience myself 14 months ago for the first time, and Yeah, it is, it's a journey and it can be a lonely one. So to have a support system, even if that is going to physical therapy. You, it's important to have that, because it makes you feel like you don't have to suffer in silence. And I think a lot of women that are having babies do feel that way. Yes. I feel like they just are like, oh, this is normal. Or, Hey, this, I just have to get through this. And their moms, they're just pushing through because they have a small human to carry for. Exactly. And they're trying to heal their bodies at the same time, and they're not getting sleep and their nutrition is off it's just, oh girl. It's like the trifecta it of non nightmare for these poor women. It is. I always say women that have babies are superheroes. You really all are. Because it's a big deal. And if you look at, if you had any other injury, say you had an ACL injury, you had a shoulder surgery, you would be in a sling. You would be put on rest for six days, right? To take care of yourself. You would not be going back to work in six to 12 weeks. From an injury, and I tell all my mom is, and then they're always surprised to hear, I say, nine months in, nine months out, at least to feel wow. Start feeling your body is semi coming back to you. I love that. I'm gonna use that if that's okay. Yeah, absolutely. Yeah. I never thought of it that way, but you're right. It makes sense. Yes. Everybody just expects you to bounce back. You go to the doctor in six weeks and they're like. You're good to go. Yeah. That's absurd to me. That's absurd. You grew a human in your body. Yes. It's no small feat. Yes. Nine months in, nine months out. And I think it really puts in perspective for them that this is a journey and this is a healing journey, and it is an injury. You did a big thing. A heal. Really, probably the biggest thing you could do. Essentially. As a human. Yeah. You grew a human. Oh, wow. It's ama. The whole process is me. It still amazes me to this day. I know, but I think in our culture, we're so used to, oh, it's so big, congratulations. Oh, the baby's cute. See you later. Exactly. It's just we don't. We don't think about the recovery. It really does take Right. And the hormones are everywhere. Oh my gosh. You wanna share your experience a little bit? I absolutely do, because that's how we met, right? That is how we met. So after I delivered my daughter I was in a bad place. I was having a lot of anxiety, postpartum anxiety. On the verge of probably some postpartum depression. I had a lot going on in my life anyways. I had lost my dogs around the same time that my daughter was born. And I just felt like somebody took my brain and removed it from my body. Like I couldn't really make these decisions that I know I'm an intelligent human. I've been around kids, but as soon as somebody handed me this baby, I was like, oh my gosh, what do I do with it? Which probably a lot of women feel that way. Yes. And so you're just. You go into a survival mode. And then as I went, down my journey a little bit I was working on my pelvic floor stuff and I was like, something just feels off. I just, and my hair started to fall out after I stopped breastfeeding. Like six, nine months in my hair started to fall out. And I was like, they're, and they're like, oh, take some postpartum. Prenatal vitamins. Prenatal vitamins. That's their answer, literally. And they tried to put me on some antidepressants and I did it for a little bit, I just didn't feel any change. So I weaned myself off of that stuff and I was like, good for you. I really don't think one postpartum pill, prenatal pill is cut for everybody. I was like, what? What if my hormones are different than somebody else's hormones? And of course they are. And through. She does myofascial like stuff, release, release for I just met her through Facebook, but she had recommended you. Oh, I'm so grateful that she had a patient that had gone to you and had a wonderful experience. So I read a little bit about you. You worked in hormones, you really worked on like taking care of the whole body and what is going on? So then I made an appointment and we dove into the realm of. Not just hormones, but Oh my gosh. The amount of blood work and everything like that, like deficiency in immunity and like everything like that. You really get a clearer picture. Yeah. You get, you really get to see the whole body. You get to see the whole body. Yeah. And you get tested for things like. That nobody will test you for. Yeah. Simple things like B12 D, vitamin C, coenzyme Q 10. These are all important things and a lot of us are extremely deficient in minerals and vitamins because it's just not in our food and or people are eating packaged items that have really no life or vitality to them. Yeah it's been a journey. So starting on some hormone things, my life has completely changed and I've been somebody who has dealt with some anxiety my whole life. It started in childhood. I use sports and running and. Athleticism as like my outlet, it always helped calm me. I've done therapy on and off for years and that helped. It gave me, of course, wonderful coping strategies, but it always lingered. And then when I started working with you and I started taking some of this. These things that you have offered me with, based off my blood work. It has completely changed that for the first time in my life. Really? I didn't even know that. That's beautiful. Yep. And so my anxiety, I was like. As an at all time low that it's ever been like, I feel like I can focus and have energy and I wanna give you a high five. I don't wanna cry high five. I'm giving you an air high five. That's you know what, that's what makes doing what I do worth it when women and or men tell me that. It's oh, thank God. Because it's always a journey for everyone. It is. And everybody, like I said, there isn't one cocktail that fits all. No. And that's why it's very difficult to practice this kind of medicine. Absolutely.'cause every woman and or man's hormones are different. And I can imagine they're changing throughout the lifetime. Of course. A woman's hormones change literally every day for 28 days. And that's if you have a perfect 28 day cycle. So it's, you have to really be able to play with things and you wanna tell people what you did specifically for hormones. Sure. I am taking a testosterone. So I'm doing the testosterone pellet which has increased. So I originally also came to Jen because my sex libido life was not there so postpartum. Everybody tells you, good luck with that. You won't be interested. And I believe that for a little while, but things that I specifically noticed. Was that I didn't have very much feeling to my clit horse. And I was like, which by the way sounds like a nightmare. What? I like, you're like, what is happening right now? I was like, alright, the tissues are healing down there. And that was fine. I gave it the time. I did the healing, I did the things. But man, let me tell you, it was like nobody was home. Yeah. I love how open you are about it, and that's why we really wanted to talk about this, right? Because I'm too very open about those things. And I think it's important for women to know specifically and men, because if you are in a heterosexual relationship, they're on the other side of this. But I think it's important for women to understand that. They're not alone. Things are happening to their body. And honestly, even women that haven't had babies, I've had a lot of women say to me, I've never had an orgasm. How tons. I'm like, what? Tons? What are like, how are you living? Really what is good about, how are you living? What is good about being an adult other than having a healthy sex life? And thankfully I have a wonderful husband who is very supportive and we had a wonderful relationship before. My daughter and I work in pelvic floor therapy, so I. I think the only reason that I really went down this rabbit path and just didn't put it, push it aside. Like I feel like the majority of women are like, nah, whatever. It doesn't matter. It doesn't matter. It goes on the back burner. So putting. You're putting yourself on the back burner, right? You're putting orgasms on the back burner. Yeah. Forget that girl. Why would you ever do that? And in a way, you are putting your relationship on the back burner. That's, I think, the part that women don't, again, this is if you're in a heterosexual relationship, right? But I think that big thing is that when you put your relationship on the back burner, I don't think men necessarily. If you're with another woman, they may understand more, but if you're with a man, I don't think they get it. They do not get it right, because they don't go through any hormone changes really. Yeah. Until later in life. Their cycle's 24 or it's 24 hours. So even as they're pulsing through, it's not like us where it's different every single day for 20 Ts. They're going through their cycle in 24 hours. That's really for them. They don't have the ups and downs emotionally that we have, but they also have not had the trauma of birth. And or being a full-time, working full-time, being a full-time mom, being a full-time wife, whatever it is, that's a lot of stress for women. Women really carry a lot of weight. They really do. And yeah, so noticing that my sex life was. Non-existent really. And I wasn't feeling any sense of pleasure really. And my, it wasn't on my husband because I was like, it was there before. So I was like, I have to get help and working in pelvic floor therapy. That's why I had that knowledge and I was like, this can't be right. There are other things that are contributing to this. I'm not dead. Yeah, so that's what really. Made me seek you out as well, is that I need my sex life back because orgasms are so important to releasing tension, right? Stress management, all of these things. Exactly. Orgasms play a huge role in your body. And so yeah, we have, I've started on a testosterone pellet and my libido is come back full force. That's amazing. My sex life is great. My orgasms are wonderful. I love that. But here's the interesting part. So before that, testosterone, you weren't feeling that way? I was not feeling that way. Wow. So it really was the testosterone and the big thing with the pellet is that I feel like it works really well when you're in your thirties and forties, specifically because your other hormones are all over the place. And most of us are so low in testosterone. If you say to women, what is the hormone you have the most of? They're gonna say estradiol a lot of times. Yep. Not true testosterone. Really? We have more testosterone than anything else. It's just we have less than men, obviously. But we need it. And it's the get shit done hormone. Yeah. You know what I'm saying? It's the, I wanna have sex. I feel sexy. It just makes you feel better about yourself and you give less of a shit about all the dumb stuff you do. And I feel like. It also allowed me to wake up in the morning and be like, let's go energy. Not just Oh, the energy. Yeah, the energy that comes with it. Huge. I didn't realize how much I was suffering, like waking up every day and feeling fatigued, like I was like, ah, I didn't get enough sleep. I had a good sleeper. Like my baby is a good sleeper and so I would get good for you. Yeah, I would get some, I would get eight hours and I'd still wake up and I'd be dragging ass. Yeah. I take some testosterone and I'm waking up. I'm cheery. I'm happy to be, I love that up. I'm like ready to start my day. You're telling everyone my secret now. Yeah, I'm, they're like, you have so much energy. You're so happy. I'm like, it's called testosterone. Testosterone. Now. I think the pellet works well because you and I were talking about this. It puts you up to such a high level that you really get the sex drive of a 17-year-old man. It's wild, right? Oh yeah. We and I were talking about the mindset. Yes. But I think the thing that I liked about experiencing that was it gave you some insight into men. And how they feel about sex and like what the thoughts actually are. You'll probably explain it better than I do. Yeah. So what I experienced was it was almost worse than hunger. Yeah. Like you had a feeling that you had, or a scratch that you had to itch. You have to satiate this orgasm. You need to have sex, you have to do something for it. So I even told my husband, they're not just, these sexual beings that are horny and like just perverted all the time, you're not being a pervert. They're literally having that testosterone. Yeah. Which is, it's a normal feeling. It should, you have to scratch the itch though. No, you and I talked about that was so interesting. It gave me so much insight into how men think and feel, and I was like, oh, you're always like, oh, come on, stop. And you always think, oh, that's all men have on their mind. It really is on the forefront of your mind. It really is. And you have to take care of every, or you can't do anything else. And I even said, I apologize for, being cranky when you're like that, because now I understand. You know what? That's so beautiful. That's why you have a really good relationship with your husband. He's now you get it. And I, and same thing for me. I'm like, Ooh, that's fascinating. Right? And women wouldn't get that unless they experienced it. And then, thinking of it vice versa, like men don't know what you're going through with hormone changes and things like that. That's why the communication piece is so important. I think a lot of us lack that in our relationships, even if it's just friendships. But we have to take the time to communicate with other people because even in our romantic relationships, if they, our partner doesn't understand how we're really feeling or what's going on, we just tend to be short. It's the time, we don't take the time to explain. I just really don't have any sexual desire. I don't know where it went. I don't know what happened because you know what ends up happening? That person thinks that we have no interest in them and it has nothing to do with that. It has nothing to do with that, really. And that's the hard part, especially I think because men have this desire, right? And that this thing that they have to feed, so they really don't understand. Yeah it's interesting. You wonder how many relationships suffer as you go into perimenopause, things like that. There's no. Literally there's I a hundred percent believe that this is why divorces happen at this age. I would agree with you going through all of this experience and men, if you have to get that experience, that scratch that itch, then you, they need to do that. Exactly. And you have to be that partner. Yeah. You have to step up. But also you need to take care of yourself. Like why, at what point did you say, ah, who cares about an orgasm?'cause listen I don't understand that. I'm gonna be honest. Again, I don't have kids, so probably for me, I don't have that level of stress. Or that responsibility. But I'm like, what else is good about being an adult? It's all bills and responsibilities. And what were you like in your twenties? Girl, talk to yourself. What were you like, I was fun. Yeah, you were fun. And you're not dead. Like you're not dead. So I feel like we just, we do, we get thrown into a busy life, whether that's kids work, paying the bills. We get into relationships. We get married, we're with our significant others for 10 plus years. And so you just think it's this normal process. Everybody goes through it because we've normalized it so much over so many years. Yeah, but it's a new time. There is help and people need to seek it. Take care of yourself. Take care of yourself. I love that. If you're not feeling optimal, I would encourage you to seek out bioidentical hormones. Absolutely. Seek out peptides. I think at the end of the day, it's like saying to someone, oh, you have diabetes. Don't take medication well as you age, your hormones decline. We know that. We've seen that. We see the research. So if we're telling men and women not to. Help themselves supplement and feel optimal. Like why would we do that? We're not telling other people not to take medications or to help themselves with their diabetes or their heart disease, whatever it is. And these actually help you prevent those things. And I think the other part is that people have fear around hormones because of the previous research. Yes. Which is all nonsense. Can you talk a little bit more about that? Yeah, I'm happy to. Thank you. So the Women's Health Initiative that came out years ago really talked more about synthetic hormones. That's really the research that was being done. Yes. Synthetic hormones are not good for you. They may potentially cause breast cancer, but that's not what we're doing. By the way, Les are literally made out of yams. A little bit of soy, they're made out of plants essentially. So the body is very intelligent, but it doesn't understand when you are chemically compounding something to look similar. For example, the estradiol is chemically compounded from a yam to look similar to the estradiol compound in our body. So when you're putting that estradiol cream on, or getting that pellet or whatever it is, your body doesn't know the difference. So it really feels good taking it. And I have to be honest with you, a lot of these you can simply take in a cream form. The pellets are amazing as far as the testosterone goes for the sex drive. And I'll tell you, I've done them and I was like insatiable to have orgasms. And it was like the best time of my life. Truly. I'm not gonna lie about that. And I'm very open about that because I feel like it's important. It is. It is very important. It's so important. You can take a cream, I'm on the cream of testosterone just because it's hard for me to go get a pellet. I have to go to town for the day. Can't do it to myself. I haven't figured that out yet. But yeah, it's, the cream is still fantastic and or the injection. So it, for testosterone specifically, it really depends on whatever the woman wants to do and the man for that matter. But men and women feel so much better because it's not just women that are lacking a sex drive. It's men too. And you know who a lot of times it is the young men. Really interesting. I had a patient last week, he was young, like 27, and he's I have no sex. I've had multiple young men. I have no sex drive. And when I look at their testosterone levels, they are lower than a 70-year-old man. What do you think is great impacting that question? It's all the the disruptors, the endocrine disruptors, like the plastic the phthalates. The parabens. It's all the poison basically. And I think across the board, what we're seeing is. This is purposeful to some degree. If you have humans that are assertive, that want to come together to uprise, to say, Hey, stop poisoning us, or whatever, that's a problem for those that wanna make us sick and or wanna keep us down, essentially. But if you, because if we look at the research, testosterone levels are down almost 50% really. Yes, in men and women. Wow. If you have a 27-year-old that has a testosterone level of, I think it was three 11, again, a seven. I have 7-year-old patients that have testosterone levels that are 500. Wow. Now, every person's different, right? Every human is different, and some men may feel good at 700, or some men may feel good at 1200. So that's where that individualized medicine comes in. But it's dumbfounding to me that young men are so low. That is amazing. And so when you go to, so say I went to my gynecologist and I had them run a hormone panel. Why does it usually come back normal compared to what I have experienced here? Great question. So when you look at those quote unquote reference ranges that any of the labs will have. They are so wide that anything looks normal on their scale. In all seriousness, when you come here, I have optimal levels because we know generally where people feel good, where we start to lose symptoms and we feel optimal specifically to the hormones Well as. As well as all the vitamins and minerals too, right? And the thyroid and everything in between. But the big thing is that we don't want you just to be on that range. We want you to be. Optimally in that range at the top of it generally, so that you are feeling good. So my levels are very different in that regard because if you are S, my range starts very high a lot of times. Because based on the research of what men and women feel good, right? So a lot of my values are based depending upon the sex, because obviously our hormones make a big, a difference, right? We have different testosterone levels than men. So obviously theirs is a lot higher than ours. But men go through andropause too, so they start to lose testosterone as they age, which is interesting because. It's fascinating to see how their sex drive starts to decline too. What age does their start compared to women usually? That's a great, yeah, that's a great question. Usually what I've seen is around probably forties, okay. Forties and fifties. So similar around some women. Women, but I believe that there is a instance of women go possibly going into perimenopause earlier in life. Oh my gosh. I had someone the other day a patient, she was like 32 and she was frantic'cause she wanted to have more kids. And of course she went to the GYN office and they were telling her she had polycystic ovaries. Yeah, ovarian insufficiency. Yeah. S. Yeah. And this is a little different than the PCOS. Yeah. This is where she's actually not making enough estradiol and progesterone, so she has an insufficiency and I thought, oh my God, she's so young. That diagnosis isn't exciting to me. And I told her. Don't allow this to upset you because, she felt totally defeated. Sure. Which is terrible. You're in your early thirties and you wanna have kids and they're basically like, I don't know. Yeah. You better start praying. Really? Yeah. And they didn't do anything for her other than give her guess what they gave her? What? Birth control stop. Yeah. And I'm like, wait, she wants to get pregnant, right? But they're like you don't have enough hormones, so we're gonna give you the synthetic birth control. God bless America. Anyway, don't get started with birth control. It's very early in the morning. It's scary because I said to her, this actually does the opposite. When you are taking synthetic hormones, you are not gonna build any of your own. Your body again, doesn't know the difference. So I told her, let's just look at your baseline levels. Let's go to the lab. I'll order the stuff and let's do a full panel. The other thing they don't look at is testosterone for women a lot of times. So how can you look at a woman's fertility when you're missing an entire hormone panel? Makes no sense to me. No, they all have to be in balance. And I think that in women testosterone drops in their early thirties. Okay. Yeah, it's, it starts to drop pretty early. Now again, we tend to see that, that progesterone starts to decrease first, but then that testosterone is really noticeable. Like I would say none of my 30 year olds have ever been optimal in testosterone. That's just sad. It's sad. But then you see the correlation with. Now we know why people's sex drive is much lower. Because if you don't have that get up and go that spritz, spa, whatever you wanna call it, uhhuh, that desire to have an orgasm, you don't care. You don't care. And I do feel like a lot of the symptoms that present are fatigue. They anxiety, just like normal things that we think are, oh, I'm just stressed, or I'm just busy. So because that, and that may contribute to women not seeking help as well. I gotta be honest with you, most people are not busier than me in all seriousness, right? Yeah. So when they say to me, I'm too big, I may not have children, but I have three jobs, right? Yeah. Yes. And, a lot of responsibility, but when they say, I'm too busy, it's that's an excuse. That's not really what it is. You really should get your hormones checked, right? And, or maybe you're not in a relationship where it feels safe. Or whatever. That part,'cause I think that's a big piece of it too. I do, I feel like you have to have a supportive partner. Absolutely. And you have to feel comfortable in your relationship. Oh, because you have to have those, you have to have those conversations. You have to have those conversations. Because like I had with my husband, I was like, it just doesn't feel right, like there, and it's not you and I. And there was a point during that now that I'm thinking back, that he was like, is it me? Of course, every any sane person would think that, right? Why doesn't she wanna have sex with me, right? Like, why doesn't she like me anymore? Does she not love me? Is she not finding me attractive? Like you get all of you, you spin, right? You spin and you think it's you, of course, and you blame yourself. And it absolutely had nothing to do with him. And I feel like men experience that as well. Why doesn't she want me? Why? She doesn't love me. No. We're not in this. I think it's worse for men. I do, in my experience, I do. It's interesting. I think it's worse for them and then they spiral quicker than we do. I agree. I feel like as women, we just put it on the back burner. It's not really that important. We don't, we know we don't prioritize ourselves because we're so busy. Take, we're caretakers of course. We take care of everyone else, of course. And because possibly we've maybe never had. An orgasm. Maybe we've been low in testosterone our whole life, or maybe we've never had that. I feel like a 17-year-old boy. So you don't get it. You don't get what they're going through, right? You just find'em annoying. You just find them annoying. You just find'em annoying. You're like, leave me alone. Stop. Yeah, stop looking at me. Stop touching me. Yeah, stop it. Yeah, you can't touch my butt. Can't touch my boob. Leave me alone. So I do feel. Bad for males and I hope this reaches them and reaches women to seek Me too assistance. Absolutely. And giving men some grace, right? Telling the women to give men some grace. My God, because you and I both know what it feels like to think like a 17-year-old and just wanna have an orgasm. Yes. I don't care what I have to do right now. I'm gonna go have an orgasm. Yep. That's the wildest like thought in the world.'cause you're right, it's worse than hunger. It is. Because I don't give a shit about food. It's just sitting there nagging. Until you fix it. Until you really get, give yourself that orgasm. Yes. And I was telling a patient the other day. I have a patient who, she's been in a marriage for a long time, has kids they've been through a lot of trauma, she's had cancer, things like that. Oh gosh. And I was telling her the other day about hormones and she is in a place where she is finally into her husband again and things are looking up for her. And her relationship is great. She was sharing this all with me and I was telling her that my experience with testosterone and how, you feel like a 17-year-old boy. So I was saying how I totally get how men feel, and she was like, I think you just validated my husband. See, so I'm gonna go home and I'm gonna validate him. Oh, I love that. So it's really important because I never talked to anyone about that until I had that conversation with you and I, and that's why you and I essentially wanted to do this together. Yes. And have this conversation because women really don't get it. They don't. Unless you get a testosterone level that's really optimal and understand how a guy thinks, you just won't understand it. And that's why we're encouraging women to, number one, have your hormones tested. Yes. Let's see where you're at. I feel like in your twenties, should you probably get a baseline of where you're absolutely at. 20 year olds are not Well. Not well across the board. They're outrageously anxious. They have, their gut health is terrible. They're just not doing well. Listen, I actually feel bad for this generation because I don't know the year that wifi actually came out, this causes DNA damage. It's, even though we don't see it and it's invisible, people forget being exposed to these, your entire life is a problem, especially when you're in your developmental years. I unplug my wifi at night. I've said that a hundred times. There's no reason people need security cameras unless they're in a bad section. Or they're worried or they're scared of like maybe violence or something like that. But patients all the time will say my, my ring doorbell. Who cares? You are more worried about that ring doorbell being online at night than your health, right? It's causing DNA damage that is an issue. And you see'em walking around with like air pods, air, oh yeah. Take those outta your ears. Oh, take those outta your ears. You're microwaving your brain. It's terrifying. You literally are microwaving your brain when you use those things. People just need to, we're just not mine. Life is so busy and I think people are, they're just like just trying to get through their days. And I get that.'cause there are some days where I'm like, Ooh, I just need to get through this day. Absolutely. And I'm sure you felt that too. Oh, absolutely. But you need to connect more with your body and understand what you're doing every day. The choices you're making do affect your health. So yeah, the 20, I just feel bad for the 20 year olds and needless and the food has been poisoned for a very long time now. Like you and I at least grew up, probably those first, 15, 20 years, we were not exposed to the amount of plastics. We were not exposed to the poison and the food, and we were not exposed to wifi. That makes a, that's a big difference in our DNA and our resilience. And then you look at, so baseline twenties and then tracking all throughout thirties. No, definitely tracking. Yep. Because ideally you want to supplement anywhere that you need to. And what we've seen, a lot of the 20 year olds and even the 30 year olds, they have a lot of anxiety like you were talking about earlier. Absolutely, yes. And that is progesterone most of the time. So if I can give you a little bit of progesterone and I call it happy cream, literally, I'll have it compounded in a cream and you can carry it with you. And you put that on if you need it throughout the day and it does calm you down. I would so much rather see people using that. It's natural. You can't get too much when you're in, in, when you're either pregnant or in your mother's womb. You have huge amounts of progesterone. So we've all been exposed to very high levels, and that's why women say that they feel really good when they're pregnant. Yes, you have that happy glow. Yes. And you feel great. That's progesterone. Yes. So it's interesting when we give it to women as a quote unquote, a happy cream, they're like, oh, that. I literally got a text message yesterday from one of my patients, she's in perimenopause, and she went for an interview and she said, I have you to thank, because I went to that interview and I was able to, number one, recall everything that I wanted to say. Number two, I was sharp, so I was able to like, answer the questions appropriately and because of balancing her hormones huge. So not only does it impact your sex life. Oh, your brain. Your brain and how you can relay information, how you interview, how you can work your work efficiency, everything. Your focus. Your focus. That's a big deal too. Your focus.'cause you'll get that, Hey squirrel, oh, over there. And a lot of people call it mom brain. Yes, mom brain, right? I'm like that. That's the hormones. It's just the imbalance of the hormones. When I'm taking estradiol, I have so much an easier time focusing. I never had a problem until I hit perimenopause, but I would be like, Ooh, I just need to do this, and I'd be all over the place, and I'm like, no. That estradiol is huge, and a lot of people will go to, they'll say, oh, I have a DHD, or whatever the case is. And I'm not saying people don't have that, but try the estradiol first. Try the, let's balance your hormones first right before you go to those pharmaceuticals. Okay. And so you were also talking about how when you're in your mother's womb, you're swimming and progesterone, you're swimming and progesterone. What does that do to males? Oh, that's interesting. It's the same thing I give men progesterone. If men can't sleep at night or their progesterone is really low, I'll give them progesterone. I'll give it to them for anxiety, and it works extremely well. It's just like any of the other hormones. You have to have a balance. Now, men don't need as much progesterone as we do, but they need a decent amount and they just don't have enough. A lot of them. Interesting. Yeah. And in Europe, they've been giving men progesterone for a long time, and a lot of bodybuilders use it because as they raise their testosterone and their testosterone's optimal, you have to remember, you have to have that triad, you have to have that balance. So you, if you're giving someone a lot of testosterone, they may need progesterone to offset. And to balance them out. Interesting. And most of the time their estradiol is actually okay because of all of the plastics and all of that stuff. And you will metabolize some testosterone into estradiol. So you know, their estrogen is usually okay. Just because of our environment, unfortunately. That's amazing. Yeah. Or they're too high. Okay. See now that's the other piece of it. Like a lot of the young guys that their testosterone is low, it's because their estradiol is too high because of all the plastics.'cause of the plastics and the endocrine disruptors. Okay. Yeah. So then you're putting them on testosterone and seeing Yes. And hoping to get rid of some of that that estradiol and matter of fact, putting them on progesterone because I need to be able to balance that estradiol. Okay. And are there things people can do so say you have some, a young man in their twenties low on testosterone, and can they. Undo some of the damage, like Oh, absolutely. If they start getting rid of the plastics and really paying attention to the toxins that they're surrounded around. Yeah. And like eating better. Can, is that something that they can naturally do, or do you feel like they will need to supplement? No, absolutely. I think that's always the first thing is we gotta get you out of that estrogen dominance, because that's where cancer comes as estrogen dominant. So we need to get you outta there anyway. But the other piece of that is that when we're giving them progesterone, we're blocking some of that estrogen because we're balancing it. So if they're not, if they don't have enough progesterone, their estrogen just is do, it keeps climbing up that ladder because it's not, it's estradiol is like its sister and it needs its sister to stay in balance. Okay. And without that, they just keep, so it's not just enough to give men testosterone. And really the young guys, if they still wanna have kids, we're not giving them testosterone. We're giving them, it's called ine is one of the things that you can give them. So it promotes them to actually build more testosterone on their own. Okay. So just helping their body help itself. Helping their body help itself. Because at the end of the day, we want them to produce as much testosterone on their own. Because it's almost castrate a boat. And you give a testosterone, their fertility definitely decreases, which older men don't care, they don't care as much. But maybe somebody in their twenties, thirties, of course, if you wanna still have kids, then that's not the right option for you. So we need to be mindful of that too. That makes a big difference. Yeah. Interesting. And for women doesn't affect our f fertility. Being on testosterone doesn't, yeah. Doesn't affect it. I just say to'em, obviously if you're on it then and you conceive, you wanna come off, you wanna come off. You don't want a big bodybuilder in there. Building big babies. Nobody wants that for your pelvic floor either. I was gonna say, you wanna give birth to that no. And yeah, so in my clinic I see a lot of women who come in as well, and they have. They're later in life. They have a lot of de estrogenized tissues in their vaginal area. Tell people about that. So they have a lot of vaginal dryness. Their tissues have changed. They may have more urinary leakage. They have pain with intercourse, so they're staying away from it. And one thing that I do recommend is that estradiol. Yes. Because not only does it make I tell'em it's like a moisturizer. It is. And correct me if I'm wrong, I'm like, it's a moisturizer for your face, but it's for your vagina. Absolutely. Your vagina needs Absolutely. The estol. To plump up the tissues. Yes. To make those tissues strong and healthy. So if you take away that estrogen, which happens when we go into menopause, right? Then if you're taking away that, then it's. Your tissues are shriveling almost. Or that's a great visual for people. They're wasting. They're wasting, yes. Yeah. So it's like muscle wasting basically. It's like muscle wasting for the vaginal tissue. Yes. And can you, so I know most of the time it's prescribed just two times a week. I've noticed sometimes it's not enough for women. Is it something that you can just use? Oh, use it every day. If you need to, really what those women probably need, they can start with the vaginal estradiol, but they probably need one systemically. So a cream that's made where they can put it on the rest of their body, because ideally you, yes, the vaginal symptoms are extremely important, right? But also we're gonna get brain symptoms, right? That's where that, like that recollection comes in short-term memory impairment. So we also wanna do that. So it prevents us from getting strokes. It protects our heart, protects us from getting dementia. So yes, the vaginal tissue is. Outrageously important as you said, because it thins and people have painful intercourse, and that's another reason women aren't having sex. Absolutely. Absolutely. If it's painful, why would you wanna do it? Yes. You definitely don't. You definitely don't. Yeah, and that's where it's great to go see Sarah because she can help you through that process, but you can honestly take that vaginal estradiol every day if you needed to. And is the cream that you put elsewhere for your brain and things like that, is that different than the estradiol? It's the same. It's estradiol, it's just, or estradiol. Yeah. It's just made, it's not made differently. It's just that you're putting it on and it's going systemically. Through the whole body versus just the vaginal tissue. Okay. Now some women will say, oh, I've had breast cancer and I just and that part I understand'cause they're gonna be nervous, so I get that. But the vaginal piece of it, that's not going through your whole body systemically. And if it, if a little bit's going through, it's a teeny bit. But women need to start using that vaginally, especially if they're having any pain or symptoms. Yeah. And I feel like it doesn't get to them soon enough. Of course, most of the time. And Yeah, I think one of the things that I've had patients bring up is they're like, oh, they hear me talk the word estrogen, and they are freak, freak out because they're like, Nope, I have a history of breast cancer in my family. There's no way. And it's that misinformation that's been printed many years ago. Yes. And also with women, the fear of testosterone. Like you're gonna grow hair all over your body. You're going, your clits gonna be swollen shock's. Darn it. I was gonna say, I'm upset about that. I was gonna say I'm okay with this. So if it needs, so my pori is more sensitive, I'm gonna more orgasms. Okay. So be it. Yeah. Darn. Which actually is not a bad thing. And if you have more blood flow to your clitoris and to your labia, that's a good thing. You're more sensitive. That's not a bad thing. People are thinking about this all wrong. Yeah. But I do get the sense of this being scared about the estradiol, if you have a history, but listen, genetics just because you have a family history, genetics are, with epigenetics coming out, we know that a lot of it's based on lifestyle. It's like the gun or the genetics. The bullet is your lifestyle. Are, how are you really living your life? A lot of women, there's a breast surgeon, she was a previous oncologist. Or again, I guess she is a breast oncologist, Jennifer. Oh, I can't, I think Sullivan is her last name. She has a clinic down in Philadelphia, and she will be the first to tell you that she absolutely does not. She'll give her patients that had breast cancer, estradiol all day long. Really all day long. She's someone's gotta treat these women. They're suffering. Suffering. And they're we've scared them so badly that we're not giving them anything. And I have to be honest with you, I'm not opposed to that, in a very controlled, monitored manner. So if you just keep yourself monitored or you have a good provider, you need, that's the important part. Exactly. You have to have that good provider to, guide you. And it's really not fair to say to women. That have had cancer, whatever it is. You can never have estradiol, right? Are you kidding me? If it's gonna protect you from getting dementia, it's gonna protect your bone. So that you don't fall and you're frail as you age. It's, I say to women, what do you wanna look like in the, what do you want the next 10 years of your life to look like? Do you wanna be frail and weak? And sexless sounds terrible. Yeah, sounds terrible, right? Yes. We have to stop being so scared of bioidentical hormones. And I say to women, this is made out of a yam, this bioidentical estradiol. If a yams gonna give you cancer, we got way bigger problems. You know what I mean? What about what are you doing? You know what I mean? What about that food that you're eating? So I think people aren't really connecting the dots. What are they doing in their lifestyle that may, maybe they're not handling their stress at all, maybe they're not exercising. Those things put you at a much greater risk for getting the seed. Then a little vaginal cream, then a little vaginal cream. Yeah. And really let's, we need quality of life. We do. We do, and it doesn't end at 30 and it doesn't end at 40 and it doesn't end at 50. No. No. And I put women in their seventies on estradiol. Absolutely. I've had 90 year olds come into my clinic and they're like. So I need to get rid of this urinary incontinence because girl, I'm not dead. I'm having sex. I love it. I love it. And she's I don't mean to embarrass you. I was like, you're not embarrassing me. I'm clapping for you. I love that they, because that generation was not that open. No. So I love that they talked to you about that and it's far and few in between, but when I meet those women, gosh, they are so spicy. They're amazing. Love them. I was gonna say, those are like, those are your tribe, right? They are. They are the CY women. I love older adults. Me too. They're my tribe for sure. Me too. Especially when they say stuff like that because good for the night. I'm, listen, I hope I'm just like her. Me too. I was like, I wanna be you when I grow up. That sounds amazing. I love that. I love that for women. Yeah. Yeah. But I think it, it is just overall just bringing awareness. I agree. Awareness that it shouldn't be scary. Do the research, find the right person Absolutely. To help guide you in this journey and. And please get help. Please. Yeah. Stop. Stop suffering. I think that's always my message to men and women. Yes. Stop suffering. If you don't feel optimal. Let's you know, let's look at what's going on. There's no magic bullet for anything. No. We'd be billionaires if there was. And I think the other thing is that people have to start taking responsibility for their own health as well. Absolutely. I'm here to guide you. Correct. I'm not gonna fix you. I'm here to guide you. It really is dependent upon what you're doing on your end as well. And I'll tell patients the same thing. I don't have a magic wand or else I would make a million bucks, right? You have to put in the work always. If you are not putting in the work, you are not gonna see the results. Exactly, so you, it is all about what I do, I feel is mostly education. I'm here to educate you on my piece of knowledge, and that's the beautiful thing that I'm also finding in building these relationships with you. I've referred patients to you. Oh, and let me tell you, they're all coming back and they're so happy. They're so happy. They're, thank you for seeing that. But really I find the people that, they're ready to they know they want change, right? They want to change and they're gonna do the things. And that's the key, right? Because it's okay to seek help as long as you're ready to do it right. If you're not, then it makes it a little frustrating for you and the other person. And I too refer people to you because I think it's so important. The pelvic floor does not get nearly enough attention, but I think it's starting to. I think so. Oh, definitely. It's starting to, and then the hormone thing is not getting enough attention, and I'm seeing it. Skyrocket. I think in the next, I'm hopeful in the next 15 plus years that Oh, absolutely everybody is getting the treatment that they deserve as they as they should. Right? Because it's simply, it's putting back into the body what makes you feel good. And who doesn't want that? Yeah, stop chalking it up to stress and I have a busy life and I'm tired. Oh my God. Because the hormones actually probably will help you with that, right? Absolutely. Stop being tired. You don't have, you can be tired. We're all tired. But it's a symptom. It is truly a symptom. You're right. It's very much a symptom. And do you just need some testosterone? You just need a little testosterone. That's right, girl. Thank you so much for coming on today. Absolutely. Thank you for having me. You are very welcome. So if you have any pelvic floor issues, you need to go see Sarah because she's amazing and I know that her partner Jennifer, is amazing too. So thank you very much. Thank you. Wishing you love light and abundance, and remember, true health is wealth. Until next time, shine your light bright. The opinions and medical advice shared by Dr. Jennifer Hopkins or her guests are not meant to replace traditional medical device services. If you believe you may have a medical issue, contact your healthcare provider immediately. The information provided here is not intended to diagnose, treat, or cure any illness, disease, or medical condition. Always consult your healthcare provider before beginning anything new.