Understanding Thyroid Disease

This week, our focus turned to the intricate world of thyroid disease, a topic that impacts millions worldwide yet remains largely misunderstood by many. Delving into the complexities of this glandular dysfunction, we aim to shed light on its various manifestations, diagnostic measures, and treatment modalities.

The thyroid, a butterfly-shaped gland nestled in the neck, orchestrates a symphony of metabolic processes vital for cellular growth and activity. Its importance cannot be overstated, as it governs everything from metabolism to mood regulation. Despite its small size, the thyroid wields considerable influence over our overall well-being.

Thyroid disease encompasses a spectrum of conditions, with hypothyroidism (low thyroid functioning) and Hashimoto’s thyroiditis taking center stage in our discussion. The signs and symptoms of thyroid dysfunction are diverse, ranging from weight fluctuations to mood disturbances. Whether it’s the lethargy of hypothyroidism or the restlessness of hyperthyroidism, the impact on one’s quality of life can be profound.

Diagnosing thyroid disease involves a multifaceted approach, with thyroid hormone levels serving as key indicators. Thyroid-stimulating hormone (TSH), produced by the pituitary gland, acts as a barometer of thyroid activity. Elevated TSH levels often signify hypothyroidism, whereas decreased levels suggest hyperthyroidism. Additionally, assessing thyroid antibodies like thyroid peroxidase (TPO) aids in identifying autoimmune thyroid conditions such as Hashimoto’s disease.

Treatment strategies for thyroid disorders vary depending on the underlying cause and severity of symptoms. Thyroid hormone replacement therapy, utilizing medications like levothyroxine or a combination of T3 and T4 hormones, remains the cornerstone of management. Beyond conventional medications, emerging research underscores the role of adjunctive therapies such as selenium, vitamin D, and certain dietary modifications in optimizing thyroid function.

Moreover, thyroid disease intersects with various aspects of reproductive health, underscoring its relevance in gynecological and fertility contexts. Conditions like polycystic ovarian syndrome (PCOS) and primary ovarian insufficiency often coexist with thyroid dysfunction, highlighting the intricate interplay between endocrine systems.

For individuals grappling with thyroid nodules or concerns about thyroid cancer, vigilance is paramount. While thyroid cancer typically progresses slowly and responds well to treatment, early detection through regular screenings and prompt medical evaluation is essential.

In conclusion, navigating the landscape of thyroid disease requires a nuanced understanding of its complexities. As healthcare providers, we must remain vigilant in recognizing its myriad presentations and empowering patients with the knowledge to advocate for their thyroid health. By fostering collaboration between patients, clinicians, and specialists, we can strive towards improved outcomes and enhanced quality of life for all affected by thyroid disorders.

Understanding Arousal Disorders: Exploring the Complexities Beyond Desire

In our modern world, conversations about sexual health and wellness are increasingly prevalent, yet some aspects remain shrouded in misunderstanding or silence. One such topic is arousal disorders, a complex array of conditions that can profoundly impact an individual’s sexual experiences and relationships.

In a recent YouTube video, Dr. [Name], a renowned expert in sexual medicine, delved into the nuances of arousal disorders, focusing particularly on the physiological and psychological aspects that contribute to these conditions. Throughout the discussion, Dr. [Name] emphasized the importance of distinguishing arousal from desire, highlighting how they are distinct yet interconnected components of human sexuality.

Desire, as Dr. [Name] explained, stems from the mind—a complex interplay of neurotransmitters and psychological factors that drive one’s interest in sexual activity. Arousal, on the other hand, is the physiological response to that desire, involving changes in heart rate, breathing, blood flow, and genital response. These two components must align for optimal sexual functioning, but when they diverge, individuals may experience frustration, confusion, or distress.

One notable condition discussed by Dr. [Name] is Persistent Genital Arousal Disorder (PGAD), now known as Genitopelvic Dysesthesia. While not the focus of the video, PGAD warrants its own in-depth exploration due to its unique challenges and complexities.

From a physiological standpoint, arousal is mediated by the parasympathetic nervous system, signaling safety and relaxation. Conversely, orgasm is mediated by the sympathetic nervous system, often associated with the fight-or-flight response. Achieving full arousal requires a sense of comfort and safety, factors that can be disrupted by various medical conditions, medications, or psychological issues.

Dr. [Name] elaborated on the myriad factors that can interfere with arousal, including hypertension, diabetes, nerve damage, and trauma. Addressing these underlying causes may involve medication, therapy, or lifestyle modifications tailored to each individual’s needs. For example, medications like sildenafil can enhance blood flow to genital tissues, while therapies such as pelvic floor exercises or guided masturbation may help address psychological barriers to arousal.

Moreover, Dr. [Name] underscored the importance of considering neurodivergent conditions like ADHD, which can affect attention and focus during sexual experiences. By recognizing and addressing these factors, individuals and healthcare providers can work collaboratively to develop holistic treatment plans that address both physical and psychological aspects of arousal disorders.

In conclusion, Dr. [Name] emphasized the prevalence of arousal disorders and the need for compassionate, comprehensive care for affected individuals. By fostering open dialogue, raising awareness, and providing accessible resources, we can support those navigating the complex landscape of sexual health and wellness.

As we continue to expand our understanding of arousal disorders, may we approach these discussions with empathy, respect, and a commitment to promoting sexual well-being for all.

Postpartum Particularities – Hormones, Pelvic Floor & Sexual Health

Bringing a new life into the world is an extraordinary journey, but it’s also one that comes with a myriad of physical and emotional changes for the mother. As we delve into the intricacies of postpartum life, it becomes evident that understanding and addressing these changes is crucial for a smooth transition into motherhood.

This week, our discussions revolved around postpartum particularities, covering a spectrum of topics from hormonal fluctuations to pelvic health and sexual wellness. It’s imperative to recognize that the postpartum period extends far beyond the immediate weeks following childbirth, encompassing a significant portion of the first year post-delivery.

Let’s begin by exploring the hormonal changes that accompany pregnancy and childbirth. During pregnancy, there’s a surge in sex hormones, including estrogen, progesterone, and testosterone. However, after delivery, especially for breastfeeding mothers, these hormone levels plummet, often leading to postpartum depression, anxiety, and physiological changes such as vaginal dryness.

Thyroid function is another aspect to consider, as pregnancy can alter thyroid hormone levels, potentially leading to postpartum thyroiditis or even thyroid disorders. Additionally, gestational diabetes can progress to type 2 diabetes post-delivery, highlighting the importance of postpartum health monitoring.

Pelvic health emerges as a focal point in postpartum care, with the pelvic floor bearing significant strain during pregnancy and childbirth. Issues like pelvic organ prolapse, urinary incontinence, and bowel dysfunction can arise, necessitating specialized attention and treatment.

Pelvic floor physical therapy stands out as a gold standard treatment, offering targeted interventions to address pelvic floor dysfunction comprehensively. For those experiencing painful intercourse, whether due to hormonal changes or pelvic floor issues, it’s essential to prioritize comfort and communication with your partner, emphasizing consent and mutual understanding.

Navigating postpartum challenges requires a multidimensional approach, encompassing physical therapy, medical intervention, and open communication with healthcare providers and partners. It’s crucial for new mothers to prioritize self-care and seek support when needed, whether it’s addressing postpartum mood disorders or managing pelvic health concerns.

As we continue to explore the intricacies of postpartum care, let’s foster a culture of understanding and support for mothers navigating this transformative journey. Remember, every postpartum experience is unique, and there’s no one-size-fits-all solution. By advocating for comprehensive postpartum care and fostering open dialogue, we can empower mothers to embrace their postpartum journey with confidence and resilience.

Hormone Therapy & Cancer


In a world where misinformation often spreads faster than truth, it’s refreshing to delve into the depths of scientific data to uncover the realities of hormone therapy and its relationship with cancer. In a recent video transcript, Dr. Babb embarks on a journey through the complexities of hormone therapy, debunking myths and shedding light on the nuanced realities that underpin this crucial aspect of medical treatment.

Diverse Linguistic Exploration

Before delving into the medical intricacies, Dr. Babb sets the stage by highlighting the linguistic diversity of our world. From Lingala in the Congo to Esperanto, the first constructed international language, and Quiche, a native Incan language found in Peru, the global tapestry of languages mirrors the multifaceted nature of medical science itself.

Navigating Hormone Therapy

Central to Dr. Babb ‘s discourse is the exploration of hormone therapy, particularly its association with cancer treatment. With a focus on gynecologic hormonal symptoms like those associated with menopause, Dr. [Name] emphasizes the importance of education and empowerment in making informed medical decisions.

Drawing from the North American Menopause Society’s consensus statement on hormone therapy, Dr. Babb elucidates the wealth of data available to guide practitioners and patients alike. By dispelling the myth that hormone therapy universally leads to adverse outcomes, Dr. Babb highlights the nuanced considerations that inform treatment decisions.

Unveiling the Breast Cancer Conundrum

A pivotal moment in Dr. Babb’s discourse is the exploration of the Women’s Health Initiative study and its implications for breast cancer treatment. By dissecting the study’s findings, Dr. [Name] elucidates the subtle nuances often overlooked in media narratives. While the study initially sparked fears surrounding hormone therapy and breast cancer, deeper analysis reveals a more nuanced reality.

Embracing Individualized Care

Throughout the discussion, Dr. Babb underscores the importance of individualized care. From considerations of receptor positivity in breast cancer to the nuanced approach required for different cancer types, Dr. Babb advocates for a personalized approach that balances symptom relief with risk mitigation.

Empowering Patients

Perhaps the most poignant message echoed throughout Dr. Babb ‘s discourse is one of empowerment. By encouraging patients to engage in open dialogue with knowledgeable providers, Dr. [Name] empowers individuals to take control of their health journey. Through education and advocacy, patients can navigate the complexities of hormone therapy with confidence, dispelling fears and embracing the potential for improved quality of life.

In conclusion, Dr. Babb’s exploration of hormone therapy serves as a beacon of clarity in a landscape often clouded by misinformation. By embracing science over fear, patients and practitioners alike can forge a path towards informed decision-making and empowered health outcomes.

Pudendal Neuralgia

Last week, we delved into the intricate topic of pudendal neuralgia and potential neuropathy, aiming to unravel the complexities surrounding these conditions. Let’s consolidate our knowledge and explore this subject further.

Firstly, let’s clarify some terminology. Throughout this discussion, I may use the terms “neuralgia” and “neuropathy” interchangeably. Essentially, both refer to either pain with or a disorder of the nerve. “Neuralgia” denotes pain, while “neuropathy” is derived from “pathos,” indicating a disease or condition affecting the nerve.

So, what exactly is potential neuropathy? It involves inflammation or irritation of the pudendal nerve. Originating from the sacrum, specifically the second, third, and fourth sacral nerves, the pudendal nerve travels through the pelvis and branches into three divisions: one leading to the labia and clitoris, another to the perineum, and the third to the anus.

Symptoms of potential neuropathy can range from mild itching to sharp, electric shock-like pain along the course of the nerve. Activities such as prolonged sitting or sexual activity may exacerbate these symptoms. Notably, chronic vulvar itching, especially in the absence of visible skin changes or infections, could indicate potential neuropathy and warrants further investigation.

Various factors can contribute to nerve irritation, including pelvic floor dysfunction, pregnancy, childbirth, pelvic surgeries, and chronic pelvic pain conditions. Additionally, activities like cycling or spinal trauma can also play a role.

Diagnosis involves identifying the location of nerve dysfunction to tailor treatment effectively. Pelvic floor physical therapy is often recommended, focusing on muscle relaxation and strengthening. Intravaginal muscle relaxants or nerve blocks may provide relief, particularly for muscle-related pain.

For patients with spinal issues, consultation with a physical therapist or spine surgeon may be beneficial. Medications such as gabapentin, pregabalin, or amitriptyline can help alleviate nerve pain, alongside adjunctive therapies like low-dose naltrexone.

In certain cases, patients with connective tissue disorders like Ehlers-Danlos syndrome may be predisposed to potential neuropathy, warranting specialized care.

Treatment approaches may vary, ranging from conservative measures to invasive procedures, depending on individual circumstances. If you’re experiencing symptoms of potential neuropathy, don’t hesitate to seek professional assistance and embark on a healthcare journey towards optimal well-being.

Remember, understanding the intricacies of potential neuropathy empowers you to make informed decisions about your health. Together, let’s navigate this journey and strive for a better quality of life.

Hormonal Vestibulitis: Causes, Symptoms, and Treatment Options


This week, our discussions have delved into the intricacies of hormonal vestibulitis, exploring various aspects such as diagnosis, treatment, and its correlation with other medical conditions. Before we proceed, let’s take care of some housekeeping matters. Throughout the week, we’ve explored the languages of Banks, Korean, and Georgian, which have sparked some interesting conversations. If you enjoy these diversions, let me know your thoughts. On another note, I appreciate the responses to our query about what “Haven” means to you; your input will shape our upcoming reveal on Monday.

Now, let’s dive into the anatomy and physiology of the vestibule. Anatomically, the vestibule represents a specific area of the external genitalia, situated between the labia majora and the hymenal remnant or ring. This region, rich in estrogen and androgen receptors, can manifest symptoms such as irritation, redness, and discomfort when hormone levels are imbalanced.

One of the primary causes of hormonal vestibulitis, particularly in reproductive-age individuals, is the use of oral contraceptive pills (OCPs). Estrogen-containing OCPs, combined with certain progestins, can disrupt hormone levels, leading to vestibular symptoms. Switching to transdermal applications may mitigate these effects to some extent.

Additionally, periods of low estrogen, such as menopause or postpartum stages, can contribute to hormonal vestibulitis. In postmenopausal patients, the decline in ovarian hormone production underscores the importance of considering testosterone supplementation alongside estrogen therapy for optimal symptom management.

Moreover, individuals undergoing treatment for breast cancer, particularly those on aromatase inhibitors, may experience hormonal vestibulitis due to reduced estrogen levels. Collaborating with an oncologist to explore hormone replacement options, such as intravaginal DHEA, can alleviate symptoms while minimizing risks.

Furthermore, autoimmune conditions like lichen sclerosus (LS) can intersect with hormonal vestibulitis. Although LS primarily affects the vulva, individuals with low estrogen levels are at higher risk. While hormonal medications may alleviate vestibular symptoms, steroid therapy remains essential for managing LS and reducing the risk of squamous cell carcinoma.

In conclusion, hormonal vestibulitis underscores the intricate interplay between hormones and vulvar health. Whether caused by medication, physiological changes, or autoimmune conditions, addressing hormonal imbalances is paramount for symptom relief. By understanding these connections, healthcare providers can navigate treatment options effectively, enhancing patient care and quality of life.

Tubal Sterilization: Understanding the Procedure and Its Implications

In the latest installment of our medical discussion series, we delve into the intricate world of tubal sterilization. Amidst my scratchy voice this week, we’ve explored the nuances of tubal ligations, post tubal ligation syndrome, and the broader landscape surrounding tubal procedures.

This week’s linguistic journey took us through Dutch from the Netherlands, Wattle from a native Aztec language, and Yoruba from Nigeria. But let’s refocus on the medical intricacies of tubal sterilization and how it intersects with recent changes in reproductive rights.

Tubal sterilization, fundamentally, is a form of surgery aimed at preventing pregnancy. Typically performed laparoscopically or through incisions during C-sections or postpartum deliveries, it involves disrupting the fallopian tubes’ function to impede the egg’s journey to meet sperm, thereby averting fertilization.

The surgical techniques vary, from traditional ligation to newer methods like salpingectomy, where the entire tube is removed. However, reversibility and insurance coverage pose significant considerations. Reversal surgeries, though available, are complex and often out-of-pocket expenses, contrasting with the increasing accessibility of in vitro fertilization (IVF).

While tubal sterilization boasts high success rates in preventing unintended pregnancies, it’s not foolproof. Ectopic pregnancies, occurring outside the uterus, remain a potential complication. Moreover, the decision to undergo sterilization should be weighed against the possibility of future reversals and associated challenges.

Enter the enigmatic post tubal ligation syndrome (PTLS), characterized by a constellation of symptoms akin to menopause. Despite lacking definitive medical explanations, theories abound, implicating disruptions in ovarian circulation or hormonal shifts post-surgery.

The landscape surrounding PTLS is contentious, with limited empirical evidence in medical literature. Yet, patient experiences underscore its significance, prompting deeper exploration into its mechanisms and management.

As medical practitioners, our understanding of tubal sterilization’s implications extends beyond surgical techniques. It encompasses nuanced discussions on patient autonomy, reproductive rights, and informed decision-making, especially amidst evolving legal and social landscapes.

In conclusion, tubal sterilization transcends mere surgical interventions; it embodies broader narratives of reproductive health, choice, and empowerment. As we navigate these discussions, let’s ensure inclusivity, empathy, and evidence-based practices, shaping a more informed and compassionate healthcare landscape for all.

Gynecology for ADHD, Autism Spectrum Disorders, and other Neurodivergent Conditions

We have been discussing neurodivergence and Gynecology- specifically looking at ADHD as well as the autism spectrum disorders in terms of hormonal functioning sexual functioning basic Gynecology things kind of everything that’s in there now obviously the preamble to this video is that there is not a lot of data out there about these conditions and the specific topic you know in terms of sexual medicine for example I mean the you know the whole specialty is honestly kind of new-ish and you know these things represent the the there be dragons kind of you know aspect of the map of what’s going on with with sexual medicine so there’s lots of stuff coming down the pike there’s but there’s not a lot of of information to to pull data statistics from.

The idea of neurodivergency or neurodifferential processes comes from the thought that patients who have these types of conditions are interpreting data in a different way than the averagel person and whether that means that the neurons in the brain are firing differently whether it means that they are kind of interpreting you know the input of of stimulation differently whatever it may be it’s considered kind of a Divergent way of of dealing with this input of data and so when you look at that there is a huge spectrum of this and and obviously you know we’re just talking about two different things today, but even within those two different areas there’s lots of degrees there too

There’s so muchdata  to be found kind of in this this sub-area of of mental health and medical health that is really unique and interesting.

ADHD or attention deficit hyperactivity disorder has gone through a lot of different names for the condition. For a long time this was just thought to be people that couldn’t sit still – maybe they had a hard time concentrating, maybe they were fidgeters… typically the kids that are ‘bouncing Off the Wall’, and there wasn’t a lot of thought put into it.

Times have changed- we have learned a lot more about the diagnosis… we’ve learned that you know there’s a broad variety of different treatments for patients with these conditions everything from medication, to counseling, dietary control- a whole slew of stuff- so once again times change and so do treatments and diagnoses.

From a gynecologic standpoint or from a hormonal standpoint what goes on is that you have episodes or periods of high amounts of hormonal fluctuations- and this goes back to one of the less understood characteristics of estrogen where it acts almost a neuroprotective type hormone. It’s soothing to the neurons to the activity that’s going on there and so in times when estrogen levels vary wildly you can see manifestations or exacerbations of this condition so during puberty, postpartum and menopause are the three main times in an ovary-owning person’s life when they may notice exacerbations of the symptoms.

With puberty, you have big ups and downs- obviously postpartum with pregnancy you’ve had very high levels of estrogens and the body and then they collapse and then with menopause obviously things are taking a downward term too. Those low levels of estrogen make the neurons act more friable and erratic and so you have more prevalence of the symptoms where patients feel like they can’t concentrate, they can’t remember things, they have brain fog, they feel like they can’t sit still, they don’t rest well at night, etc…


Patients with ADHD in general have intrinsic dopamine which is a neurotransmitter that produces less endogenous dopamine being produced and so what that means is that the patient has to get those dopamine hits from external stimuli, so instead of being able to say, “oh this is really interesting I’m going to keep focused” instead it, “this is now starting to get boring oh look that’s a pretty light oh that’s a squirrel!” whatever it may be.

From a hormonal standpoint testosterone has dopaminergic effects and so testosterone levels go up.  Those intrinsic dopamine levels may be kind of higher or those dopamine receptors are getting plugged more well once again in these periods of hormonal fluctuation or hormonal decline testosterone is going to be going down as well because remember the ovaries are the primary producers of testosterone in the body and so if gonadal function starts to decline then you will see those testosterone levels start to go down too.

So what does this mean in terms of sexual functioning?

Well we know that patients with ADHD a lot of times have a higher rate of sexual issues typically you may see that patients have a harder time with arousal and then with orgasm as well if you have a hard time kind of staying focused while you are doing sexual acts, you may find that you lose a little bit of enjoyment with them that you have a hard time maintaining that aroused state. You may find that you have a hard time achieving orgasm as well. A Common treatment for orgasmic dysfunction in this case is the use of medications for ADHD. Adderall is is documented for that. We also sometimes use Concerta or Ritalin, but basically the thought is that the patient then can focus more on what’s going on at hand and so then they have an easier time achieving that level of sexual satisfaction that they want to see from a hormonal standpoint

If you have a a higher rate of ADHD because of lower testosterone levels replacing testosterone may actually help not only with sexual function there but also the ADHD type symptoms.

I’m not saying that everyone who has ADHD needs to be on testosterone but it’s something to consider if you have both of those issues – your sex drive is lower and you deal with ADHD.

Navigating Ehlers-Danlos Syndrome: Understanding its Impact on Women’s Health

Hey everyone, it’s Friday, which means it’s time for our weekly compilation video. As you can see, my office is getting cleaned out here in Bartlesville as I transition over to The Haven Center for Sexual Medicine and Vulvo Vaginal Disorders. The clinic opens on the 4th of October, so if you have any questions about that, be sure to send them my way.

Next Monday night, Jacqueline from the Lost Labia Chronicles and I are doing an Instagram live discussing lichen sclerosus and autoimmune disease. So, if you’re watching this today and have questions about that, shoot either her or myself a message, and we’ll answer them.

This week, we’ve been talking about Ehlers-Danlos Syndrome (EDS) and how it relates to women’s health. If you’re unfamiliar with EDS, it’s essentially a collection of syndromes or conditions that affect the way connective tissue forms. While many think of collagen in terms of skin, it’s present throughout the body in joints, muscles, and blood vessels. Therefore, any condition affecting collagen can lead to various issues.

Currently, there are 13 described EDS subtypes, but there could be more. Each subtype presents unique challenges, so seeking a healthcare provider knowledgeable in the condition is crucial for proper treatment.

In gynecology, EDS primarily impacts pregnancy, pelvic health, sexual health, menstruation, and menopausal changes. Throughout different life stages, patients may experience specific challenges:

  • Pre-pubertal: Children with EDS, especially hypermobility types, may exhibit flexibility and joint issues. Vigilance is required to identify signs like frequent dislocations or strains.
  • Menstruation: EDS patients often have heavier periods due to impaired uterine cramping and increased vascular fragility.
  • Sexual Activity: Pain with penetration and decreased lubrication are common, stemming from fragile skin, tear-prone tissues, and pelvic floor spasms.
  • Pregnancy: EDS may lead to increased joint pain, preterm labor risk, and complications during childbirth, such as rapid or prolonged labor.
  • Postpartum: Pelvic organ prolapse and delayed wound healing, including after C-sections, are more prevalent.
  • Menopause: Genitourinary symptoms of menopause, such as vaginal dryness and pain with intercourse, are exacerbated in EDS patients due to collagen-related issues.

Despite advancements, diagnosing EDS remains challenging, often requiring genetic testing or skin biopsies. However, awareness and understanding among healthcare providers can aid in timely diagnosis and management.

EDS is not just a medical curiosity but a complex condition that profoundly affects patients’ lives. The key takeaway is self-advocacy; if something feels wrong, seek professional help and find providers who understand EDS. Though rare, EDS may be more common than we think, and as our knowledge expands, so will our ability to support those affected.

In conclusion, navigating EDS requires a multidisciplinary approach and ongoing education. By recognizing its impact on women’s health and empowering patients to advocate for themselves, we can strive for better outcomes and improved quality of life. That’s it for today’s video.