Chronic Illness & Libido

madman

Super Moderator

In this episode of the Bendy Bodies Podcast, Dr. Linda Bluestein speaks with sexual health experts Dr. Irwin Goldstein & Sue Goldstein. This amazing husband and wife team share insights on common issues such as vestibulodynia, libido challenges, and treatment options ranging from physical therapy to hormone therapy. They explore the often-overlooked intersection of joint hypermobility conditions like Ehlers-Danlos Syndrome (EDS), Mast Cell Activation Syndrome (MCAS), and Postural Orthostatic Tachycardia Syndrome (POTS) with sexual dysfunction. They discuss how connective tissue disorders impact sexual health, the role of the sacral nerve in arousal and pain, and how patients can advocate for better care. Whether you're struggling with pain during intimacy or looking for solutions, this episode offers practical advice and hope.




Takeaways:

Connective Tissue Impacts Sexual Health:
Conditions like EDS can affect the sacral nerve, leading to pain, discomfort, and sexual dysfunction that many doctors overlook.

Mast Cell Dysfunction Can Trigger Pain: MCAS can cause issues such as vestibulodynia, leading to painful penetration and impacting quality of life beyond intimacy.

Pelvic Floor Therapy is Essential: Specialized pelvic floor physical therapy can significantly improve sexual function and reduce pain for individuals with hypermobility disorders.

Hormone Therapy May Help: Addressing hormonal imbalances, particularly testosterone and estrogen levels, can improve symptoms of vaginal dryness and pain.

Communication is Key: Open conversations with partners and healthcare providers about sexual health concerns are crucial for finding the right treatments and maintaining intimacy.




PS. The vestibule refers to the vulva (female external genitalia) between the labia minora (two inner skin folds that surround the vaginal opening).


PSS. Neuroproliferative vestibulodynia is where there are too many nerve endings in the vestibule tissue.
 

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

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Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

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The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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