OBGYN Dr. Nicole E. Williams joins us to answer listener questions, discuss sexual wellness and weigh in on how to:
- Have sex on your period (if you want to)
- Manage heavy bleeding due to fibroids
- Get in the mood post-hysterectomy
- Find your clitoral legs!
- Deal with burning post-orgasm
- Consider options other than a hysterectomy
- Explore more frequent and intense orgasms with Cliovana & other approaches
This podcast is brought to you by Cliovana.
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This is a computer-generated rough transcript, so please excuse any typos. This podcast is an informational conversation and is not a substitute for medical, health or other professional advice, diagnosis or treatment. Always seek the services of an appropriate professional should you have individual questions or concerns.
Intensify Pleasure & Orgasms!
00:00:05 – 00:05:02
You’re listening to the sex with dr. Jess podcast sex and relationship advice you can you off tonight? Welcome to the sex with dr. Jess podcast. I’m your co-host Brandon. We’re here with my always lovely other half. Dr. Jess. Hey, hey, how are you? Feeling? Good. Yeah good. Yeah, we had a nice little getaway. We were working but we’ve we’ve been doing some hiking and I don’t know it always feels nice to get out in nature, but also up high we’ve seen some great views. Yeah with the with the colors changing here in Southern Ontario to the Views last weekend on that hike were spectacular. Yeah. So if folks no no the region where we’re in Toronto and we headed out toward toward Niagara and Grimsby has this beautiful hike that’s it’s not particularly hard, but you get a great view of birth. Lake and the Niagara escarpment and it’s all changing colors and I’m super excited for the full because I’m not usually here in the fall. Normally I’m traveling. In fact, I was supposed to be in India right now and save the rest of Southeast Asia, but I’m excited to be here because I never get to see the Fall colors. So I’m hoping that we get out again this coming weekend. It folks know any really fabulous hikes. If you look on my Instagram use like the list of hikes we’ve been doing but if you know anymore, I totally want to hear about them. Yeah, definitely need some more hikes of great views for the Fall colors. Yeah and some real climbs cuz a lot of the hikes in Southern Ontario, like we don’t usually have mountain mountains the last how you could 70 vertical meters. And we’re still laughing. And yeah, every time we go hiking I’m huffing and puffing and I feel like you’re just humming along. That’s just because I’m sucking wind behind the scenes every time you look away. I’m taking a deep breath. That’s the trick. You you breathe through your behind, I guess so sure like that one did yeah. I kind of put me on the spot didn’t know how to respond respond. You know today. We are going to be answering some of your questions with an OBGYN doctor and Nicole Williams and we are excited to introduce a new partner and podcast sponsor Cleo Vanna and Cleveland has developed a non-invasive technology to intensify and increase the frequency of orgasm and what they use is sound waves to stimulate the growth of new blood vessels and nerve endings and this results in increased sensitivity and responsiveness. So I’m looking forward to both having some questions answered and learning a little bit more about this and if you’re interested you can learn more about Teavana.com or you can call +188-580-300-5134 joining us today is dr. Nicole Williamson the founder and CEO of the Gynecology Institute of Chicago. She specializes in minimally invasive gynecological surgery and Women’s Health and she has worked all over a traveling to the Dominican Republic to Haiti Rwanda Cambodia. The Philippines Mexico Ghana. I’m sure I’m missing some cuz she got quite the resume to perform necessary gynecological surgery. Welcome. Welcome. Dr. Williams. Thank you for joining us. It is such a pleasure to be with you. Dr. Jess. Now, you have a long and prestigious resume. It’s a mouthful I had asked did you always know you wanted to grow up to be a doctor? You know, I either was going to do that be an airline pilot or what was that other thing? I’m home. Interested or you know be a Broadway singer and Dancer. So I think I I picked the best of the three and I think we’re lucky to have you I realize you do you do work with heavy menstrual periods with fibroids with sexual dysfunction menopause bioidentical hormone therapy incontinence. And I think many of these experiences or diagnosis have been relegated to the sidelines, you know, many of these issues for folks with with Volvo’s. They have kind of a history of being ignored or discounted. I’m curious how you found yourself studying and working with these types of issues like fibroids and incontinence, you know as a little bit thanks for asking that dr. Steven was a little bit of a roundabout kind of way because I believe that it was a personal experience and I have I do have a fibroid it’s not that bad but for somebody like myself African American woman and being dead Having my symptoms when I was a medical student completely downplayed and especially in the specialty of Obi dine most of the attention. It gets paid toward the O B portion not toward the guide portion because hate to say a baby money is good money.
00:05:04 – 00:10:26
I don’t get any of that and you know, I make significantly less, you know, but that’s that’s not an issue for me. The issue is so many of my patients when they come to me and we’re talking about these things are like, this is the first time that anybody ever actually listened to my concerns because a lot of dots they don’t have as much time and I do have that kind of time because I don’t have to run and go and perform a delivery or a C-section birth in the middle of my day. So I I have the time and I actually take the time because these patients are really their health isn’t very important because when a woman is healthy the computer Unity is healthy that’s such an important piece and you know periods with half of the world getting them at some point and fibroids. I mean High incidents of fibroids it is it’s such a shame. We don’t talk about them and I receive so many questions about these topics. So I’m hopeful that you would be willing to answer a few for our listeners right now. Absolutely. Okay. So the first person wage rates in and says I get really heavy periods, but I also find that my libido spikes when I’m on my period so are there any risks to having sex on my period and how do I get over the idea that it’s great job was to do it during my time of the month. Oh, well, that’s a really wonderful question. First of all understand that the menstrual periods just blood tissue that you do not need. So it’s not that it is gross or anything like that. It’s just not necessary anymore. So your body builds it there’s no baby in there not needed your body’s just kind of releasing and allowing you to continue on your next cycle. That’s how I tell my patients to Envision. What menstruation is secondarily off just put a towel down and have added I believe that if you are feeling your most lascivious during your menstrual cycle, you should harness that and enjoy it. I love it. I love it. I know for example, I’m not necessarily more in the mood while I’m on my period but I I feel more desire to be close close to you Brandon like to just I don’t know feel your touch. I feel a little bit more needy actually, which is a hard word for I think someone like me to say, yeah. I mean, I would agree you generally sometimes you also just want me to take care of things. Yeah or birth. You just want to take care of things yourself, but I’m just saying it kind of depends on the day. So I really appreciate you putting it people at ease that you know, if you’re into it while you’re in there. Go ahead and do it and I’ve mentioned before summer the sex blankets that are on the market that allow nothing to drip through them. They’re made of fleece. So there’s there’s one called the no more wet spot but there are other brands on the market as well that people can check out our website. Awesome. I actually work or used to back in the normal days. Sometimes I’d speak at these trade shows and they would make this blanket into the base of a fountain off and run water like a fountain through it the whole time and not a drop would go through the entire weekend. So you’re yeah, so you’re Peter. Fluids will not go through there. So that’s Thursday. Sure. Now, we have a few other questions from folks. This one’s a bit longer. So this says I have fibroids and my bleeding is so heavy that I’ve leaked through on two chairs in meetings blood on Tuesday. You in church and often stay home because it’s painful. My doctor basically told me it was in my head. It took three other doctors to finally get a diagnosis. I know you’ve heard this so many times with dr. Williams now, sorry to go back to the question. Now, I’m working through my options, but it has really taken a toll on my relationship. Especially our sex life. How can I even begin to get my sexual groove back? Oh, that’s a hard one. So I’m glad that we’re going to address this now if she’s already see if she’s still weighing treatment options. She should know that there are medications out there on the market that her doctor could recommend to her to curtail her heavy periods that that is actually non-hormonal. So it’s called trash, Cassat. She could try that while she’s still kind of figuring out what she wants to do about her fibroids. Now when it comes to options if she hasn’t done anything already, there’s a few I can just kind of run through birth. Briefly please first one is uterine artery embolization. That’s a non-invasive a minimally-invasive procedure where they actually cut off the blood supply to the uterus and that shrinks down the fibroids. The second one is radiofrequency fibroid ablation. That’s an outpatient surgery to where we shrink the fibroids and then more invasive, of course include a myomectomy meaning. It’s a cut on the belly where you changed the fibroid and then of course, the most extreme is a hysterectomy where you actually do remove the uterus entirely now when it comes to the sex life and bleeding if you’re not feeling your best, especially what if you’re anemic you don’t have the energy to have sex, so what I would advise her, and I’m glad that she kept on going to different doctors is find a doctor who’s going to happen or you who’s going to image you who’s going to do something about these fibroids has really if that’s really your hindrance.
00:10:26 – 00:15:08
You really want you to get ahead of that. So then you can get your sex groove back. I’m thank you for that for. Thanks. And down the options. I’m curious about the the medication that reduces the flow of of the menstrual fluid. How does do you know how that works or what that entails? It’s it’s again. It’s called tranexamic thought it was originally given to for haemophilia and a bleeding disorders. So it actually interferes with what is called the clotting Cascade so we know when you’re it comes off the little blood the little blood vessels that are left over have to close themselves off and they literally have to clot off in order for you to stop bleeding. That’s how that medication works. It promotes all these little blood vessels to close. So you stop getting interested in so is that ever indicated for patients with for example, polyps who have heavy bleeding or just fibroids? Yes. In fact, we give it for polyps and just general heavy periods without fibroids. It’s actually over the counter in Europe. Okay. Awesome. Now you you mentioned hysterectomy as kind of a final and most invasive option and you know, we’ve all heard stories from people. His doctors go straight to hysterectomy without considering all these other potential approaches again kind of dismissing woman’s overall quality of life. And so the person actually wrote in about their hysterectomy. So this person says since my hysterectomy, I’ve lost interest in sex. I can get myself in the mood with your arousal first desire approach. That’s you know, I talked about the fact that desire doesn’t always occur spontaneously. It’s not really my Approach but so I can get myself in the mood. But once I’m there I have trouble getting to orgasm since the history up to me and she keeps our pointers. Oh, yes. I have a lot of page not a lot. I got a handful of patients who do suffer from you know lack of proper sexual function after hysterectomy. Now, it could be immediately after the surgery. Like if you’re just trying to get back to sex that might be an issue. I think a lot of times patients after their history. Deniz are afraid like after you’ve had a baby many women are afraid to have sex for those first few times after they’ve had the baby either whether it’s a C-section or a vaginal birth, that could be an issue like, oh is it going to hurt, you know, those kind of things then secondarily if they’ve had a hysterectomy and the ovaries were removed and you’re not then you’re missing some of those vital hormones that are going especially cuz it’s Jordan and testosterone walk hand-in-hand you’re missing that vital testosterone is really going to help with the libido. So those are a couple of the things I’m just trying to think about like right off the top of my head that could be reasons behind that and then also know that once the uterus is gone that is not an even if the ovaries were left the lack of the uterus is not the seat of your actual t Women think that you know, because the uterus has gone, they’re not they’re they don’t feel as sexy they’re not as they don’t feel as feminine. But I want all of my patients to understand the uterus has gone. It’s jesal. The ovaries are where everything is at and the clitoris is where everything is at. So just enjoy not having a uterus cuz then you’re not bleeding. Well, I’ve never even really used my uterus. It uses me a month a month, but I haven’t put it to the use that I think, you know, my parents were hoping but it’s all right. So thank you. Thank you so much for that and another and I’m just powering through because I’m so happy to have you here this person wants to know. Okay, so they’ve been tested for STIs. They have a clean bill of health. No UTIs normal levels of stress Etc, but they have burning after they have an orgasm just for 5 to 10 minutes and they’re asking is this common and can you explain why I have this Burning after orgasm out. So it’s it’s not, New Jersey. Call Des orgasmia it’s not common, but we know it happens and one of the prevailing theories on how that happens. And we do know this happens at orgasm is you release oxytocin oxytocin is released a couple of different ways. It’s released when you breastfeed to promote closeness and so oxytocin at orgasm is to promote closeness between you and your sex partner took it. Also we give oxytocin in your body makes us at oxytocin when you’re going into labor and that can also actually caused some pain and cramping. So that might be the reason now. Generally we just kind of recognize what this is and recognize that it’s short-lived and it goes away and that shouldn’t be a hindrance to your seeking orgasm.
00:15:08 – 00:20:08
Not such an interesting perspective cuz we always talk about oxytocin as like the you know, the pleasure hormone and having this palliative effect. But of course there are all the different shades to any experience. Yeah, it does promote closeness. And bonding but we give it during labor. Do you to we give it to induce labor too? Cuz it causes cramping interesting. Okay now so just the night so that I understand can it also alleviate the pain of cramping or is that not so no that’s that’s it might lessen the sensation because that’s it’s interesting how oxytocin works. So, you know, you want to change your baby and then when you’re breastfeeding you want to remain close to your baby, so there’s cramping that you’ll feel but it wouldn’t it’s not as intense and that’s also a nice side effect of oxytocin. Okay, I love this conversation, and I’m so happy. We’re talking about sexual Wellness because I think that you know oftentimes the sex part is discounted in medical research and practice wage and there’s so many reasons why that I’m sure you know better than I do whether it’s a lack of training for some folks lack of comfort among practitioners, but now, you know more patience and more Health Care practitioners Like You song Ali speaking up and emphasizing that sexual Wellness needs to be a big part of the conversation. And so I just want to ask yeah, so why why does sexual wellness and pleasure matter so much sexual wellness and pleasure are directly tied to overall health and wellness. So we know that people who are having happier sex lives, whether it’s same-sex self sex or heterosexual sex. They have up their load their blood pressure is lower. They don’t get sick as often cardiac which we know is so key when it comes to special even to women’s health is much more improved you sleep better. Your self-esteem is just more elevated. So the second choice help is completely tied to overall health and so many different ways and it needs to be a part of just our everyday conversations. Are you noticing that Physicians are better equipped to discuss said And Sexual Health. Are you seeing that like with you know, younger graduates or with or with more experienced folks seeking out training or is it is it still a divided in the medical community? I think it’s a little bit of both of those things a little bit of a hodgepodge. So the younger residents and new graduate Physicians are understanding the importance of sexual wellness and they’re seeking training on our own because remember our our medical system in the system of training is archaic. It came about in the 1830s when The Residency program originated. So it’s very hierarchical but now it’s becoming a lot more collaborative and the younger doctor saying hey, you know what we want to learn about these things and they’re seeking this out. I mean, I was a younger dog once upon a time and I received very little training about sexual health and sexual Wellness cuz we were so concerned with okay here. Let’s get the baby out then. How did how did the baby get there in the first place dog? Yeah, it wasn’t a stork and you know, when we say sexual Wellness sometimes with left out of that conversation is pleasure itself. And so the good Folks at covanta sent you here to you know, share your knowledge on a range at home. So I definitely want to talk about pleasure and orgasm cuz it’s not just a matter of having sex. It’s ensuring that sex is fulfilling and for so many people part of that fulfillment is having an orgasm but so many folks especially folks with clitoris aren’t having orgasms. I like that. You also looked at looked at me when you said that when you’re talking about having an orgasm you looked over directly at me and my I I was like, I’ll take two. So let’s talk about clay, Ivana. You’ve been working with with cliff on what is clear Vana and how does it work? So I’m clear Vana is a novel way to promote blood flow nerve growth and happier and healthier clitoral orgasms. So first of all, you do want to address one thing all orgasms are clitoral to that so many of my patients who look at the cover of Cosmo and they’re like, oh I need to have this super special vaginal orgasm Lottie. And I thought well guess what? They’re all the same everything comes from the clitoris whether or not it’s the tip of the clitoris or the root of the clitoris. So your vaginal orgasm comes for the root of the clitoris off and you’re screaming high pitch orgasm comes from the tip of the clitoris. But the nice thing about clay Ivana, is it stimulates the entire clitoris through three ways. There’s a little bit of a suction cup was extrapolated from little penises, you know suction cup, of course, then we use non-invasive sound waves to stimulate the entire clitoral complex.
00:20:08 – 00:25:02
Everybody thinks it’s just that little bit at the end but what we now learned and they have just put this into anatomy books in I think it was 2005 or 2015, but it took just that long before we knew about the complete anatomy of the clitoris. And so we put sound waves to the the branches of the clitoris and that is really good. That’s the key to Cle Ivana. And that’s what gives you your deeper thoughts are more pleasurable orgasm does longer deeper guttural orgasms, otherwise known as the quote unquote vaginal orgasm. Yeah. It’s interesting you talk about types of orgasms cuz people always want to know how many are they and how did how does it work? And I mean what I I tell people is like it actually doesn’t matter cuz people can literally have an orgasm from their nipple. They can have some people can like, you know, they need documented folks who can think themselves off I can’t but I mean, thank God because I’d never get any work done if I could just sit here and think myself up you’re talking about clay Ivana stimulating entire clitoral complex. You have a little head that pokes out and I have a big rule that you cannot treat that like a doorbell you don’t just press and release press and release that a man think that I know I know song. And then the shaft and the hood and I don’t know all the terminology but you I think you have the bulbs on the inside and then I call them legs on the side, but I think you call them a different clinical term. Yeah, the anatomical term is called the Packers clitoris Okay. So we’ve got all of that only a small portion externally and much of it. I presume cuevana works. Is it through the labia that you accept the rest of the internal components of the clipboard? Exactly. Dr. Jess. So you actually will find immediately behind where the interface between the labia majora and labia majora are is where the bulb and the crews are and that’s where we use are non-invasive sound waves to stimulate new blood flow to that area, which will also in turn increase intelligence activity interesting. So so what does the treatment or the process look like? It’s pretty simple. So it’s for treatments over the course of two weeks and it’s dead. You step process for each turn. So first as a suction cup applied primarily to the clitoral body and glanced at the top. Then the sound waves go to the bulb and the crowd Boos and then there’s a cool down to help to kind of diffuse all of that other wonderful positive energy and that’s done four times over the course of two weeks. And it’s the nice thing about it is you can actually go and have sex as soon as the treatments done if you so choose wink-wink-nudge-nudge, right? I’d be like doing now just let’s just do it see how it works. So is that that is all access that occurs in in the doctor’s office. Yes, everything occurs in our office. Okay, and then how long does each session take session takes around about seven to ten minutes each so you can get in and out of the office relatively quickly and get on with your day or on with some sex. And so there are other treatments on the market, you know, I’ve seen treatments for example Our internal and treat the walls of the vagina but cleavant is different than that. Yes. Giovanna is actually the only one that focuses entirely on the health of the overall clitoris the laser treatments which we still do offer in our office because we know that these treatments can be additive that focuses primarily on the health of the vaginal mucosa the national tube itself, not the clitoris necessarily, although it does give the like I said, it’s an additive and an adjunct of effect and so in in kind of lay persons terms since I’m not a medical practitioner is this about creating more sensitivity and responsiveness in the clitoral body itself. Exactly. It is just about enhancing what the good Lord already gave you in order to use it to her best potential. So interesting. So alongside clear Varna as an option. I’m curious, you know, what else can we do to improve overall, you know sexual response. Their well-being. Do you also talk about dietary or lifestyle or other medical approaches that you integrate into your practice? I always tell my patient, you know, are you really going to go to a hairdresser whose hair is looking better going to go to a makeup artist who doesn’t know what to do with themselves. So you can’t expect your body to you can’t expect to live a lifestyle where you’re not living as healthy as we really should and we all know that we need to change the time of coal-bed people’s diets have kind of you know, kind of hit a little bit of a backslide but we know like we just talked about sexual health and overall health or walking hand-in-hand. So when you are living a clean lifestyle everything does tend to become to get the kind of fall into place.
00:25:02 – 00:30:00
So your sexual health is going to be directly tied to that in addition some of the other things. I do recommend are good old-fashioned Kegel exercises and I have every single one of my general annual exam patients. Learn how to Kegel because not only does that help to elevate your pelvic floor dead. If you can think about key going during intercourse that actually brings everything up that brings the angle of the penis into a different type of an angle which might actually help to stimulate your G-spot or it’s not it’s not dr. G spot any more. We know that that’s where the bulb of the clitoris and the clitoral body actually meet but we know that by doing those Kegel exercises that’s actually helped to stimulate that two resulting in a more pleasurable experience. So yeah, there are a few things that we can do ourselves that are completely free to help our sexual Wellness. Yeah, and I think in a holistic approach, it’s so important like, you know, certainly, you know procedure like Cleo van is can be a great option for some people and their needs to be an investment in the overall health. And also if you’re if you have a partner in the relationship, that’s right. No procedure know there is just nothing we can do to address, you know resentment relationships cuz you know, I’m so glad you talked about that because the orgasm Gap is real. So if they are looking at heterosexual couples about the orgasm get meaning who’s having orgasm and who isn’t it’s only about 52% of women in a 52 to 60 or so percent of women in heterosexual relationships having orgasms with each sexual encounter. Now when you look at same-sex couples, of course, if you’re looking at lesbian sex that’s going to be a lot higher than if you’re talking about partnered male female sex and that’s about I think it’s around 80% or lesbian partners because they are actually paying more attention to their Partners. I mean, that’s just a theory but you know, this is came out of a couple of Journal articles. I was researching for this podcast. Yeah, and it makes sense to when you think about two Volvos having sex am doing different things than if a penis is in the room, right? We’re doing the things that rub the entire clitoral complex to begin with as opposed to just penetrative sex. And in fact, sometimes we are having penetrative sex and sometimes Not and I think it’s a good reminder for the hetero folks there that you don’t have to just do it one way. We have all of these options and there are so many different ways to play and thought that’s one of the other things that I do talk to my patients about is that with male female partner sex. It doesn’t be often so many of my patients especially, you know, looking at Cosmo looking at looking all these magazines that are promoting. Oh how to make him run go wild like no no. No, you should be talking to there’s there’s nothing on the cover of any man’s magazine that said how to make her go off while often does that happen not very often. So I tell my patients don’t wait for him to give you an orgasm. You take your orgasm. Absolutely. Yeah, that’s actual model. I live button. Hey, whatever works. Listen. I I’m just I’m just here for the ride. I wanted to say I’m just here for the ride, but yep. It’s funny know before I let you go. If you could just wave a wand and change one thing about sexual Wellness or pleasure. What would it be knowledge? I know that’s a big big topic. I have patients who are coming here and their fifties and they’ve yet to have an orgasm and that was just due to lack of knowledge about their sexual selves. And again, the thing I said, they’re waiting on the man to do something amazing to get them off and I say that would be the thing and that’s why I’m here talking to you and this is why I talk about it to every single one of my patients about understanding your clitoral complex and that it’s there’s so much more to it than meets the eye and that your potential for orgasm is almost unlimited. So take it. I love it. I love it. Well, thank you for the work you do. Thank you for answering our questions today and folks will certainly be following along with your birth. So thanks for being here. All right, dr. Jess. It was such a pleasure and hope to be on again soon anytime. Love to have you back and really teach us about about fibroids because I have pages of questions. Excellent. Let’s do it. All right, great. Thank you. Thank you so much to dr. Nicole Lee Williams. I learned a lot. Yeah. I thought that was excellent, but my problem is I have so many more questions. So thanks to you babe. Thanks to you for listening. And of course thanks to Cle Ivana. You can check them out Cleavon a.com or give them a call with any questions 188-583-5134. Wherever you’re at. Have a great one.
00:30:05 – 00:30:12
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