Does your sex life need a tune-up?
~ Debra Wickman, MD

Approximately 44% of women have some degree of distress about their sexual function. The most common reason for dissatisfaction is lack of sexual interest, or desire. Other problems include difficulty with arousal, orgasm, or sexual pain. There may be an underlying medical condition that is contributing to this, or there may be a combination of several factors.

These problems seem to increase as a woman ages, though they can occur at any time of life. After while, distress about one's sexual function can result in relationship conflict, depression, anxiety, and poor self-image.

The encouraging news is that there may be a medical treatment that can help. Dr. Debra Wickman has had extensive training in sexual medicine, having completed a year-long fellowship at the UCLA Female Sexual Medicine Center. She is a member of the International Society for the Study of Women's Sexual Health (ISSWSH) and is committed to keeping up with the latest thoughts and treatment ideas in this field.

If you have concerns about any aspect of your sexual function, please do not hesitate to make an appointment to discuss your situation.

A recent article in the Arizona Republic titled "Hormone therapy loses more ground" attracted much interest from women in our practice. The article begins this way: "Hormone-replacement therapy, already linked to increases in breast cancer, heart disease and stroke, nearly doubles a woman's risk of dying from lung cancer".

In my opinion, this is simply irresponsible reporting. Here's why:

1. These numbers were taken from the Women's Health Initiative study, or WHI. The hormones used in that study were Premarin and Provera. Premarin is an antiquated estrogen replacement therapy made from pregnant mare's urine. It is not bioidentical. It was the first estrogen replacement therapy available to women, but has been almost completely replaced by newer, safer bioidentical estrogen products from plants.
2. The progesterone used in this study is medroxyprogesterone acetate, a synthetic progestational agent that is, again, rarely used anymore. It has been replaced by bioidentical progesterones such as Prometrium or compounded progesterone creams.
3. There is no mention of whether these women smoked cigarettes, which is the leading cause of lung cancer.

At this office, we use bioidentical hormone replacement options almost exclusively. There is no evidence that bioidentical hormones increase the risk of any cancer.

In short, we would need to see a study looking at bioidentical hormones and their effect on lung cancer incidence before we became concerned about a relationship between hormones and lung cancer.

We are happy to announce that we are having great success with our in-office minor procedures! We offer Essure sterilization, Thermachoice endometrial ablation, labial reduction and D&C's to our patients at a fraction of the cost of the outpatient surgery center. A qualified anesthesiologist is in attendance along with a nurse trained in anesthesia. These procedures are painless and quick. Our patients have been thrilled and we are too!

Our new suite is located at 9180 East Desert Cove, Suite 106, Scottsdale, Arizona.

Please schedule a consult with one our physicians by calling 480-860-4791 to explore these options.

Procedures offered:

• Thermachoice Endometrial Ablation
  Endometrial Ablation is an uncomplicated solution for heavy periods. We use the Thermachoice system, which involves placing a balloon filled with hot saline inside the uterus and allowing the heat to burn the uterine lining down to its base. The uterine lining is what sloughs off once a month to cause a "period", and by reducing or eliminating this lining, the period is either greatly reduced or eliminated.
   
  Endometrial Ablation takes about 20 minutes. Upon waking up from your light anesthetic, you will experience some cramping that is normally controlled with Ibuprofen. Over the next few weeks, you will experience a watery bloody discharge. Most women are able to return to their normal activities in a few days.
   
  Women who bleed heavily despite a relatively normal uterus are the best candidates for this procedure. Women with adenomyosis or large fibroids are better served by a laparoscopic hysterectomy.
   
  Visit www.gynecare.com/thermachoice for more information.

• Essure Permanent Contraception
  The Essure procedure does not require any cutting into the body. Instead, an Essure trained doctor inserts small flexible micro-inserts™ through the body’s natural pathways (vagina, cervix and uterus) and into your fallopian tubes.
  
  During the 3 months following the procedure, your body and the micro-inserts work together to form a natural barrier that prevents sperm from reaching the egg. During this period, you must continue using another form of birth control (other than an IUD or IUS).
  
  Unlike birth control pills, patches, rings, and some forms of IUDs, Essure does not contain hormones to interfere with your natural menstrual cycle. Your periods should more or less continue in their natural state. Visit Essure.com for more information.

• Labial Reduction
  The inner lips of the vulva are called the labia minora. Most women are not bothered by this tissue, but some women have large labia that catch on clothing, pull during sports activities, and are inconvenient or painful during sexual intercourse. Some women simply do not like the "look" of large labia minora, and some simply want their labia to be more symmetrical.
  
  Reduction of the labia involves trimming excess tissue from the labia so that the labia are smaller and less bothersome. Women who undergo labial reduction are able to choose how much tissue is removed. Some women simply want asymmetric labia to be more closely matched.
  
  Recovery after a labial reduction is approximately one week. This does not mean that activities are to be completely curtailed, but sitting for long periods of time or exercise would not be recommended due to potential discomfort.
  
  This type of skin generally heals without visible scarring and the results are great. Talk to your provider next time you come into the office if this is an issue for you.
  
  For more information, google "labial reduction" or click here for one of the best informational web sites.

Here are some of the reasons that patients think they are not candidates for minimally invasive hysterectomy:

1. I have had cesarean sections in the past
2. I have a large uterus and I have been told that it is too large to get out except through an incision in my abdomen
3. I might have abnormal cells in the uterus
4. I have never had a baby
5. It is hard to see everything laparoscopically, so I need to be opened
6. I might have adhesions
7. Laparoscopic hysterectomy is a longer procedure and there is more blood loss

All of these statements are wrong. Don't let misconceptions like this prevent you from exploring minimally invasive options!

Dr. Wilson and Dr. Spieldoch are experienced laparoscopic surgeons and offer minimally invasive hysterectomy to almost any candidate.

Adhesions can be handled through the laparoscope, even if they are extensive. Cesarean section adhesions included. Visualization through the laparoscope is actually better than during an "open" surgery. The possibility of abnormal cells in the uterus is not a reason to make a large incision. Even the gynecologic-cancer surgeons use laparoscopic techniques. In our hands, a laparoscopic hysterectomy is actually a shorter, simpler procedure with less blood loss.

Visit the surgery section at DrWilsonOBGYN.com for more information on laparoscopic hysterectomy. If you need a hysterectomy, please explore all options before making a choice. There are many myths out there that may not be true. You can potentially save yourself weeks of healing by investigating your options before you decide.

Visit us on-line at www.skintiquemd.com or call 480.860.9383 for a free consultation!

Hi! This is Lori from Skintique! I just want to let everyone know that we have moved into our new office location. We are now located at 9180 East Desert Cove, Suite 105. We are just past Dr. Wilson's main office towards 92nd street. We are planning an open house and lots of other fun events — more information on these will be in the upcoming newsletters.

For our facial and dermaplaning clients, we now have a separate facial room! It is designed to be like a tropical island getaway, so come on in and relax your stresses away! We are also continuing our special IPL/Photo-Facial price of $150 through the month of November! Please come on in and treat yourself!

I want to welcome our newly hired nurse practitioner — Deirdre Mountjoy. She will be doing our Restylane and Dysport injections.

Stay beautiful inside and out!

Deirdre has been a registered nurse for 28 years, 18 of which have been spent in advanced practice as a family nurse practitioner. She has worked in a variety of settings, to include internal medicine, urgent care and geriatrics. With a zest for creativity and a love for science, Deirdre has a special interest in aesthetic medicine. With Dysport and a variety of dermal fillers, she is able to help patients enhance and rejuvenate their image.

Deirdre finds Arizona an ideal place to live. She enjoys knitting, needlepoint and collecting antiques. Near and dear to her heart are her rescue animals. Currently, her furry family includes two small poodles — Frosty and Lambchop.