FEMALE SEXUAL HEALTH
A woman's sexuality is a complex interplay of physical and emotional responses that affects the way she thinks and feels about herself. A woman's sexual health has major impact on her overall health. Sexual problems are associated with feelings of isolation, low self-esteem and depression, and frequently impact patients’ relationships, mood state and quality of life.
When a woman has a sexual health problem, it can impact many aspects of her life, including her personal relationships and her self-esteem as well as her overall health.
It is estimated that 43% of American women suffer from sexual health issues. One third of all women, regardless of age, have diminished sexual interest. In addition, nearly one fourth of all women do not experience orgasm, while one fifth of women suffer sexual pain disorders.
EXPLORE YOUR OPTIONS WITH CSRH!
Despite significant progress in basic sexual medicine research and clinical therapies in recent years, sexual problems remain among the most frequently overlooked and mismanaged patient complaints.
Few healthcare professionals have the opportunity to be trained in the diagnosis and treatment of sexual dysfunction. This is where Dr. Bahnmiller takes a dedicated special interest in helping women with their sexual issues in order to heighten their relationships and overall health. Dr. Bahnmiller has and is currently continuing extensive training in the evaluation, diagnosis and treatment of women and their sexual health.
Most frequently overlooked and mismanaged patient complaints.
SEXUAL HEALTH ISSUES FOR WOMEN
Hypoactive Sexual Desire Disorder in Women (HSDD)
Hypertonic Pelvic Floor Muscle Dysfunction
Female Orgasmic Disorder
Enlarged Labia Minora
Enlarged Labia
Clitoral concerns
Dyspareunia
Arousal Disorder
Lack of Lubrication
Vulvar and Vaginal Skin Disorders
Vulvar and Vaginal Atrophy
Vestibulodynia
Vaginismus
Lichen Sclerosis
Decreased Genital Sensitivity
Persistent Genital Arousal Disorder in Women (PGAD)
Pelvic Floor Muscle Dysfunction
Orgasmic Anhedonia (PDOD)
Many women experience a problem with sexual function from time to time. However, when the problems are persistent, they can cause distress for the women and her partner, and can have a negative impact on their relationship
IDENTIFYING POTENTIAL SEXUAL HEALTH RISK FACTORS
There are many reasons why a woman may experience a sexual health problem. Certain medicines (such as oral contraceptives and chemotherapy drugs), diseases (such as diabetes or high blood pressure), excessive alcohol use or vaginal infections can cause sexual problems. Depression, relationship problems or abuse (current or past abuse) can also cause sexual dysfunction. You may have less sexual desire during pregnancy, right after childbirth or when you are breastfeeding. After menopause many women feel less sexual desire, have vaginal dryness or have pain during sex due to a decrease in estrogen (a hormone in the body). The stresses of everyday life can also affect your ability to have sex. Being tired from a busy job or caring for young children may affect your sexual desire. You may also be bored by a long-standing sexual routine.
There are several types of sexual dysfunctions. They can be lifelong problems that have always been present, acquired problems that develop after a period of normal sexual function or situational problems that develop only under certain circumstances or with certain partners. Causes of sexual dysfunctions can be psychological, physical or related to interpersonal relationships.
Sometimes determining what is causing the issue is as important as treating it, in case the risk factor can be eliminated and the sexual health concern disappear. Learning that something you are doing or a medication you are taking may cause a problem in the future may mean you want to modify the activity now or talk with your doctor about an alternative medication. You may have several sexual health concerns from the same risk factor or from multiple risk factors. It is best to come in for a consultation, so we can help you identify what may be limiting your sex life, and improve sex life and satisfaction. Call us at (509)572-2130 or book here online.
STOP SUFFERING IN SILENCE
Many women are hesitant to talk about their sexuality with their health care professionals, and many health professionals are reluctant to begin a discussion about sexuality with their patients.
DIAGNOSTIC TESTS
Diagnosis of women’s sexual health concerns begins with identification of the sexual health problem. This includes undergoing a sexual, medical and psychosocial history and physical examination, independent psychological evaluation, completion of psychometrically validated outcome questionnaires, and laboratory testing. The next phase involves educational discussions with the patient and the partner, if possible, concerning relevant topics such as physiology of sexual function and pathophysiology of sexual dysfunction based on the pertinent information identified during the identification phase. Specific individual patient (and partner) educational needs and goals of sexual health care management need to be addressed.
Vulvoscopy
Neurologic Testing
Genital Biopsy
Endothelial Function Testing
Duplex Doppler Ultrasound
Diagnostic Nerve Block of the Vestibule
Cotton Swab Test
Blood Tests
Flibanserin (Addyi)
Vibrators
Vestibulectomy
Treatment of painful intercourse
Vacuum Device
Testosterone Therapy
Sling Surgery
Sex Therapy
Physical Therapy
PDE5 inhibitors
Oxytocin
Lubricants and Moisturizers
OFFERING STATE-OF-THE-ART TREATMENTS
About one third of women experience sexual dysfunction, which may lead to women's loss of confidence in their sexual lives. We offer state-of-the art treatments to help you enjoy a happy and healthy sex life
TREATMENT OPTIONS
Treatment of women's sexual health concerns follows a step-care process that begins with modification of reversible causes and then proceeds to first-line, second-line, and third-line treatment strategies. Maneuvers to modify reversible causes include sex therapy, cognitive behavior therapy, physical therapy, lifestyle changes including exercise and diet, alteration of prescription medications, discontinuation of recreational drugs, management of partner sexual dysfunction, and other behavior modifications such as relaxation therapy. First-time therapies include hormone therapy (androgens, local and/or systemic estrogens, progestins), dopamine agonist therapy, oral phosphodiesterase type-5 inhibitors and vacuum clitoral device therapy. Second-time therapies include invasive maneuvers such as reconstructive surgery. The most logical, efficacious way to restore sexual function in women with sexual health problems is to manage the sexual problem with multiple disciplines, proceed in a step-care process and, whenever possible, to engage the partner.
Labia Minora Reduction (Labioplasty, Labiaplasty)
Labia majora reduction
Female genital Aesthetic Surgery
Clitoral Hood Reduction
Exercise and Diet
Estrogen Therapy
Dorsal Slit Surgery
Dopamine Agonists
Clitoral Hood Reduction
Arousal Oils and Creams
Anticholinergic Therapy
WE ARE EXCITED TO WORK WITH YOU TO HELP YOU ON YOUR SEXUAL HEALTH JOURNEY
HORMONE THERAPY
By correcting age-related hormone decline with appropriate doses of key hormones like testosterone, estrogen, and progesterone, at Columbia Shores Regenerative Health we can help you optimize your well being. This will not only relieve symptoms related to the natural decline of these hormones, but also promote better overall health and function in the body.
Facts About Bioidentical Hormones
At Columbia Shores Regenerative Health we primarily utilize bioidentical hormones to give you the optimal hormonal balance. Because bioidentical hormones are molecularly identical to your body’s own natural hormones, they fit the hormone receptors in your body like a key fitting into a lock. When administered correctly, they will give you the best results with the least risks.
Synthetic hormones are not identical to bioidentical hormones and are not absorbed as well.
What to Look for in a Quality Treatment Protocol
Not all bioidentical hormone treatments are created equal. In order for treatment to be safe and effective, the bioidentical hormones must be administered as part of a quality treatment protocol that includes:
Treatment for all hormones affecting aging
Personalized dosages tailored to your exact needs
Safe delivery methods
Ongoing monitoring of symptoms and blood levels
Oversight by a board-certified Physician
At Columbia Shores Regenerative Health, our bioidentical hormone therapy includes these safeguards and more. Using the results of lab tests and your description of your symptoms, we’ll work hard to optimize your hormone levels so you can look and feel your best. Unlike some treatment providers, we don’t just give you hormones and abandon you. Instead, we will stay in close communication with you to make sure your treatment remains safe and works for you. We are always available to answer questions and make any necessary adjustments to your treatment.
Menopause
At Columbia Shores Regenerative Health we believe that women entering menopause deserve to feel fantastic.
Women seeking hormonal help receive it only 6% of the time. Menopause is a normal part of a woman’s life, but suffering should not be. Our passion at Columbia Shores Regenerative Health is to help assist you with hormones and life’s changes, thus giving you the most fantastic and exciting feelings of being alive.
We go by the science, not the trends.
Our clinical solutions are created specifically for women as they age and address their unique and individual concerns. We customize your care with both traditional medical treatments as well as bioidentical. Each hormone replacement for menopause treatment(safe! safe! safe!) is customized to you. Along with hormonal treatments, we also offer treatments that improve your sex-life (from creams to vaginal rejuvenation). These treatments not only relieve vaginal dryness and painful intercourse but revive your sex life.
These treatments do not end there. They also improve your skin health and beauty as well as improve your bladder function.
Menopausal Therapies Offered
Bioidentical Hormones
Estrogen
Testosterone
Progesterone
Hormone pellet therapies
Non-hormonal therapies
Insomnia (sleep difficulties)
Sexual concerns
Progesterone therapy
Weight changes
VAGINAL REJUVENATION FAQS
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Vaginal rejuvenation is a broad term that describes various vaginal corrective procedures to treat causes ranging from childbirth, menopause and aging to genetics. Your vulva and vagina may become dry, sensitive and may lose elasticity and strength. This leads to several issues like incontinence (leaking urine), vaginal dryness, sagging skin, painful sex and lack of sexual sensation and pleasure. Many women look to surgical and non-surgical options of vaginal rejuvenation to improve these conditions and restore the look and function of their vagina.
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Loose skin around the vaginal opening
Leaking urine when jumping, sneezing or laughing.
Not being able to hold your urine.
Decreased libido (sex drive)
Excess dryness.
Painful sex.
Loss of sensation and sexual satisfaction.
Lack of confidence or low self-esteem.
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Vaginal rejuvenation procedures can be surgical or nonsurgical. Treatment affects the vulva (the outer part of the female genitals) and the vaginal canal (where penetration occurs during sex).
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Non-surgical options of vaginal rejuvenation are great since they allow significant improvement without surgical intervention and compliment any surgical intervention you may choose.
Nonsurgical methods of vaginal rejuvenation are noninvasive with a short recovery time. They help tighten and tone your vaginal area without needles or surgery. Nonsurgical vaginal rejuvenation involves the use of energy (laser or red-light) to stimulate your bodies healing mechanism to bring in new tissue growth, blood vessels to improve lubrication, nerves to improve sensation and restores your bodies collagen/elastin and vaginal flora.
Other non-surgical treatments involve using your bodies own stem cells (PRP) (Lady Spot Shot) to stimulate healing processes.
Non-surgical options include Mona-Lisa Touch Vaginal Rejuvenation, The Sweet Spot Shot PRP, VFit, Yag laser and Micro needling with or without radiofrequency. All of these options we are happy to provide for you.
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Surgical methods of vaginal rejuvenation typically involve sedation or anesthesia. Some common surgical procedures for vaginal rejuvenation are:
Labiaplasty: Reshaping your labia or the “lips” of your vagina.
Vaginoplasty: Tightens or repairs the vaginal canal after childbirth.
Clitoral hood reduction/separation: Removes extra tissue that covers the clitoris to allow improved sensation of clitoris.
Vulvoplasty: Reshapes the vulvar area (external genitalia).
Perineoplasty: Strengthens the perineum (space between your vaginal and anus).
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Improve the tightness of your vagina.
Help with incontinence (leaking urine).
Increase lubrication and moisture.
Increase vaginal sensitivity and sensations.
Strengthen weak vaginal and pelvic muscles.
Improve painful intercourse.
Enhance the appearance of your vulvar area (labia, clitoris or vaginal opening).
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Pelvic floor exercises are recommended to maintain pelvic floor muscle strength, once you have healed from your surgery. You can do them on your own, with Kegel weights/exerciser or we can send you to specially trained pelvic floor physical therapists.
To maintain tissue health and collagen strength it is recommended to take Vitamin C supplement, red light vaginal therapy Joylux V-Fit at home and Mona Lisa therapy. Before menopause it is best to do Mona Lisa at least yearly and after menopause at least every 6-12 months.
Good vaginal hygiene is also important. Externally it is best to apply a daily moisturizer, such as olive oil, coconut oil or V-magic (a compounded vaginal moisturizer).
After 4 weeks, it is also important to maintain vaginal intercourse frequency, since intercourse stimulates your bodies healing process. During intercourse it is best to use a silicone lubricant, such as Uberlube. Most over the counter lubricants dry out your vagina and are bad for vaginal health.
If you need to schedule consultation for evaluation and possible vaginal rejuvenation or need any of the above mentioned products (Kegel Cones,V-Fit, Uberlube, Vitamin C, V-Magic), please visit our website or call our office to schedule or order products.
Columbia Shores Regenerative Health
Office (509)572-2130
Address 138 Keene Road
Richland, WA 99352
Website: ColumbiashoresRH.com
MONALISA FAQS
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Patients who present with gynecologic changes due to decrease in estrogen
Natural or induced pre and post menopausal women
Patients with a history of breast cancer, thrombophlebitis or other contraindications to estrogen therapy
Women who cannot or do not want to undergo risky hormone replacement
Women with inadequate response to estrogen therapy or decline of treatment results with estrogen
Women who experience soreness or pain during sexual activity
Women who do not want to undergo major surgery but want relief from their symptom
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Dr. Bahnmiller has carefully evaluated all of the devices currently on the market and ultimately chose the MonaLisa Touch®.
The MonaLisa Touch® treatment is a CO2 fractional vaginal laser treatment specifically designed and FDA approved for vaginal atrophy. The other devices on the market (ex. Femilift and ThermiVa) do not have approval for vaginal laser treatment, and their probes are not FDA approved.
The MonaLisa Touch® is the only one with a clinically proven track record for safety, efficacy and patient satisfaction and the most studied in medical literature.
The MonaLisa Touch® treatment offers significant advantages over current treatment involving medications.
The MonaLisa Touch® creates longer-lasting relief (1-2 years) than current treatments with other modalities.
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Description text goes here
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Pregnant or within 3 months postpartum, or nursing
Have had an abnormal pap smear
If you are under evaluation for issues related to gynecologic, urologic or gastrointeral diseases
History of reconstructive pelvic surgery with “mesh kits” or mesh in use for restoration surgery
Vaginal, cervical, or other lesions in the treatment area that have not been evaluated and diagnosed
Active vaginal or vulvar infection (herpes, candida, HPV, STDs)
Prolapse beyond hymen
History or radiation to vaginal/colo-rectal tissue
History of impaired wound healing
History of keloid formation
Known anticoagulation treatment or thromboembolic condition
Developing tumors or cancers in the area
Women who are treating post chemo or radiation therapy should wait at least 6 months after therapy has finished and will require a written authorization from their attending physician to treat with the MonaLisa Touch®.
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We already have extensive experience in women’s general and sexual.
The MonaLisa Touch® is the International Gold Standard in technology for laser vaginal rejuvenation. Created specifically for vaginal treatments, and all studies in this area have been performed with this laser. This is an important consideration as science must always prove the success of a treatment before it should be used on patients.
The MonaLisa Touch® is life-changing for women everywhere. We are so thrilled to be able to offer this amazing vaginal laser treatment & procedure to help women everywhere get back to a pain-free and more enjoyable lifestyle.
This procedure is done exclusively by Dr. Bahnmiller.
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The MonaLisa Touch® procedure uses a fractionated CO2 laser to stimulate the body’s own regenerative processes, creating more hydrated and healthy cells, and improving the circulation and nutrient supply to the vaginal mucosa.
This has a direct effect on the integrity and elasticity of the vaginal wall and returned the internal vaginal environment to more normal levels.In as a little as 30 days after treatment, the regeneration of new tissue in the vaginal wall builds a naturally stronger structure and the protective mucosa recovers volume, hydration and elasticity.
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There is no anesthetic required as the procedure itself is relatively quick and most patients don’t have any pain before or after the procedure. Some patients may experience some slight discomfort, but this is usually more from their initial symptoms rather than the treatment itself.
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The vaginal laser treatment is generally well tolerated and patients do extremely well following the MonaLisa Touch® treatment & procedure however some patients may experience some mild irritation and vaginal discharge after the procedure.
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The MonaLisa Touch® requires no downtime. The only restriction is to refrain from intercourse 2 days prior and 7 days after and avoid any rigorous exercise for 4 days following vaginal atrophy treatment.
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Many patients report a noticeable difference in symptom relief after just one treatment, however, an initial series of three treatments is recommended, spaced at four to six week intervals, to achieve optimal and longer-lasting relief. In order to maintain results, a yearly treatment is highly recommended.
The Life Changing Laser Treatment for the Prevention and Restoration of your Vaginal Health
The MonaLisa Touch® is a painless and minimally invasive laser treatment for vaginal atrophy. This unique CO2 fractional laser was specifically created for the vaginal mucosa. The MonaLisa Touch® prevents and resolves estrogen drops in the vaginal tissue (typically occurring during menopause or after child birth) by gently acting on tissue of the vaginal mucosa which reactivates the production of new collagen, and reestablishes the functionality of the treated area, restoring the proper trophic balance to the mucous membrane.
This is a medical treatment and not for cosmetic purposes. A full evaluation of your medical history and physical exam by your Gynecologist is required 3-6 months prior to undergoing vaginal atrophy treatment with the MonaLisa Touch® at Columbia Shores.
The MonaLisa Touch® treats:
Post menopausal issues
Vaginal dryness
Urinary urge incontinence
Itching and burning
Vaginal tears
Loss of elasticity and tone
Painful intercourse
"SWEET SPOT SHOT" VAGINAL INJECTIONS
DO YOU OFTEN WISH YOUR SEXUAL LIFE WAS HEALTHIER?
HAVE YOU EVER WORRIED ABOUT URINARY INCONTINENCE?
HAVE FACTORS SUCH AS AGING, MENOPAUSE, OR CHILDBIRTH CAUSED A CHANGE IN SEXUAL CONFIDENCE?
Dr. Bahnmiller offers a wealth of experience in female sexual health, and dysfunction. Now providing The Lady Spot Shot, helping women find their sexual confidence through non-invasive Vaginal Rejuvenation.
The Lady Spot Shot is an all-natural, non-surgical procedure that can rejuvenate and revitalize vaginal and clitoral function, giving you dramatically improved sensitivity and significantly enhance your sex life.
Many women lose urine while coughing, laughing, sneezing or exercising. It can be an embarrassing and frustrating problem. Because The Lady Spot Shot offers rejuvenating capabilities, there is help available without the need for invasive surgery.
The entire process has minimal pain, takes less than 30 minutes and in some patients, the results are immediate. The Lady Spot Shot procedure for incontinence and sensitivity is a revolutionary approach to restoring the sensations patients may have.
WHAT TO EXPECT
The Lady Spot Shot is an in office procedure that uses a centrifuge and special method, isolating platelet rich plasma (PRP) from your own blood. Then, using a very tiny needle, the PRP is injected back into the clitoris and upper vagina into the area most important for the sexual response.
The platelet rich plasma is administered by injection into the vagina (after local anesthesia of course). The PRP works by stimulating stem cells, collagen, and blood vessels, effectively rejuvenating the vaginal region and making it feel and respond to stimulation the way it did when a woman was younger.
WHO CAN BENEFIT FROM THIS?
Ideal candidates for The Lady Spot Shot are women who seek:
Stronger Orgasms
Increased Sexual Desire
Increased Natural Lubrication
Decreased Urinary Incontinence
More Orgasms
Post menopausal issues
Vaginal dryness
Urinary urge incontinence
Itching and burning
Vaginal tears
Postpartum loss of elasticity and tone
Painful intercourse
“I heard of the “O Shot” and began online research to find out “O Shot” Is just a trademark name for PRP injections. I spoke with my Gynecologist who then referred me to Dr. Bahnmiller at Columbia Shores. After three vaginal births, and years of taking medication for depression, I suffer from daily urge incontinence, lack of sexual desire and a struggling marriage. During my consult with Dr. Bahnmiller, he recommended the PRP injection to help with incontinence and took a lot of time to help me understand how it can work for increased sensation, but focused more on the importance of connection with my husband giving me a referral to a Sexual Health Counselor. What a relief to talk to a physician who looked at my life as a whole, not only just solving one issue. I confidently recommend Dr. Bahnmiller and his staff to anyone struggling with the same issues. It took about 2 months to notice I NO longer was getting up in the middle of the night to use the bathroom, for the first time since my first child had bladder control and no longer wear pantyliners!! Most important, my husband and I visited the counselor together, reconnecting, and understanding the affects of how busy life, children, medication, lack of sex has strained our trust in each other and relationship. This is not something we should overlook, or be embarrassed of talking about. This is just what Dr. Bahnmiller provided me, confidence in talking about it, addressing the issues, and providing resources to help. ”
TESTOSTERONE AND SEXUAL DESIRE
The hormone testosterone may boost sex drive for some women after menopause.
Menopause happens naturally with age. It also can happen early for medical reasons, such as surgery to remove the ovaries. If you've gone through either type of menopause, testosterone therapy may help for low sex drive that has no clear cause. Limited research has been done on treatment of low testosterone before menopause.
Other treatments may be applied before starting testosterone, since testosterone is supplementation that should be maintained for the rest of your life. These treatments include low doses of the hormone estrogen, scream cream, oral and injectable medications, and a type of counseling called sex therapy.
Testosterone is not for those who've had breast cancer with positive hormone receptors or uterine cancer. Also if you have a history of heart, or liver disease you may not be a candidate for testosterone therapy. If you have a high risk of any of these conditions, talk to us at Columbia Shores Regenerative Health we will help you with your decision about hormones and other options to improve your sex drive.
In the United States and many other countries, government agencies that regulate medicines haven't approved testosterone therapy for women. But it can be prescribed if it might have a health benefit for someone.
Testosterone comes in many forms. These include creams, ointments and gels, injectables and pellet forms. The type and amount you take relate to safety risks, so talk with your health care team about the pros and cons of each.
Side effects of testosterone might include:
Acne
Hair growth on the face and body.
Hair growth after laser hair removal is activation of hair follicles not treated by laser. Doing hormones can bring out those stubborn hairs that will be better treated by laser following testosterone therapy.
Hair thinning and loss
Weight gain from increased muscle mass and/or not balanced with estrogen
Low sex drive and other sexual troubles often have more than one cause. Factors that can play a role include vaginal dryness, medicine side effects, long-term health conditions, lack of emotional closeness, stress and mood concerns. A mix of treatments may work best. Examples include counseling, lifestyle changes, hormones and medicine.
DECREASED DESIRE (HYPOACTIVE SEXUAL DESIRE DISORDER)
Hypoactive sexual desire disorder (HSDD) is a condition in which people lack sexual desire (low libido) or interest, resulting in personal distress or distress in their relationships. It may affect upwards of 50% of women at some point in their lives.
Sexual desire is connected to our self-esteem and the intimacy we have with our partners. Our goal is to provide solutions for women to not only improve sexual desire, but to be able to feel connected to their bodies again.
At Columbia Shores Regenerative Health, we understand the psychological and physical difficulties of HSDD. We are here to support women and are dedicated to creating unique, customized care that helps find solutions that work for you.
Examples of some of our personalized treatments include:
Tailored plasma rejuvenating Sweet Spot Shot
Medications
Sex coaching
Schedule now www.columbiashoresRH.com for a virtual or in person consultation and reignite your sex life.
TREATMENTS
Hormones
Testosterone/bioidentical/estrogen/progesterone
Medications/Compounded Medications
Supplements
Sex Coaching
DECREASED ORGASM/LACK OF ORGASM
Orgasmic dysfunction is when someone has difficulty or the inability to reach an orgasm. For some people, reaching a climax can take longer than normal or be unsatisfying.
The way an orgasm feels or how long it takes to have an orgasm can vary widely. When someone has orgasmic dysfunction, climax can take a long time to reach, be unsatisfying, or be unattainable.
Orgasmic dysfunction affects approximately one-third of women. Factors affecting orgasm are physiologic, situational, life-stressors and primary anorgasmia in which someone has never been able to attain an orgasm. Orgasm is not the only goal of sexual intimacy, but may have a significant impact on one’s relationship with themselves or their partner.
Aside from being a board certified Gynecologist (Women’s health expert physician), Dr. Bahnmiller is the only one in the region with extensive sexual health training, which allows him to uncover and treat what may be limiting your sexual relationship and satisfaction. Schedule a live or virtual consultation at www.columbiashoresRH.com and bring the excitement back.
TREATMENTS
Dream Cream Medication
Medications
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