Women’s sexual health is an area that needs to get more recognition. Why? Low libido in women impacts relationships, obviously. It also can harm self-image and emotional well-being. With that in mind, I talked with Certified Sexual Health Clinician Rachael Cabreira about intimate well-being. Below is PART ONE of our interview. There was so much to talk about that I divided the interview into two parts!
Disclosure: This sponsored interview focuses on helping women empower themselves to improve their intimate well-being.
Meet Rachael Cabreira, Certified Sexual Health Clinician, RN, BSN, MSN, FNP-C
Rachael Cabreira knows her stuff. Look at all of those credentials after her name. And she has the experience to back it up with 23 years of specializing in pelvic, sexual, and hormone health, infertility, obstetrics, and urogynecology. Her approach is a holistic, non-surgical one that addresses the root causes rather than the symptoms alone.
Rachael is the Founder and CEO of Innovative Wellness Inc., based in Walnut Creek, California. This medical practice provides an integrative and holistic approach to well-being. The team focuses on empowering women to improve the overall quality of life for those who have symptoms of sexual dysfunction, urinary incontinence, or pelvic disorders. Bringing freedom to women is a BIG thing – and Racheal gets that!
At the medical practice, Rachael offers Cliovana treatments for women who suffer from low arousal and sexual response. She can help you determine if the non-invasive treatment is right for you, with the goal being to have a more satisfying sex life.
In the Fem-Tech industry, Rachael Cabreira is a dynamic innovator. She developed Fulfillene, a patent-pending feminine care product designed to protect and restore moisture to intimate skin. This glide product is naturally PH-balanced, free of parabens, and water-based.
Interview with Rachael Cabreira
Thanks for being here, Rachael. Before delving into the stats, symptoms, and risks of low libido in women, let’s talk a bit about your career. It’s impressive!
You have achieved so much in the area of women’s sexual health and well-being. Can you share about this?
First, I have been raised by amazing women in my life, my mom, my great-grandmothers, grandmothers, and aunts. I have a picture of my grandmother with a boa on in her 70s, just loving life and embracing her natural beauty… Feeling sexy and beautiful should be added in some way in your everyday life. It’s connecting the mind, body, and spirit!
I have been in practice for over 23 years, and over the years, I have taken care of women across their lifespan. I started out in OBGYN, and infertility, delivering lots of beautiful babies, and the conversations of starting a family, your relationship, all streamed around sexual health conversations.
As I grew in my career, I started taking care of women that had urinary incontinence, pelvic pain, UTIs, and hormone health. Again, the conversation around sexual health was always a hot topic during the visit. What I then realized is that sexual health is a vital part of every woman’s well-being. “It is the other heartbeat of our body.”
I then fell in love with the field of gynecology pelvic and sexual medicine, and have become a certified sexual health clinician, so I can enrich my practice with the opportunities to offer sexual health coaching, counseling, and clinical solutions to help optimize quality of life. I then completed a fellowship in integrative medicine because a healthy lifestyle is the foundation of intimate, physical, and spiritual well-being. The way we sleep, eat, exercise, our hormones, pelvic and overall physical health is all connected… Which we forget sometimes that we have one body.
What inspired you to form Innovative Wellness Inc.?
There was so much that inspired me about developing and starting my own practice. For years in my early career, I worked in the hospital and ambulatory care, where I not only did patient care, but was on every committee, helped open practices and was a very big part in the community. During that time, I envisioned a business and even wrote a business plan for my very own practice.
As years went by, one day after a long commute from work, I walked in my house, my husband took one look at me and said, “Get your wings on”…. And I never looked back! Inspired by my patient stories and experiences, I knew I needed to make a difference in a different way. I found a gap in the healthcare industry to treat pelvic and sexual health with an integrative approach, which led me to develop a practice that I could build relationships with my patients, create an experience and a destination for patients to tell their stories.
Women’s health is not just a recipe… It’s a lifelong journey, we are like the trunk of a tree with many branches. With that being said, I have continued to grow and develop programs, protocols, and solutions to help women live their best, healthiest life possible. There are days that it’s just holding a hand, letting her cry, letting her vent, laughing, or just sitting together because she needs support in some way. The conversations sometimes have no words to explain, however, every day I wake, there has not been one day that I have not been motivated, dedicated, and passionate about what I do!
Developing and opening this practice has not been easy. It is a true journey, and it’s not just a “practice”; it is a place women come to feel better, with options, choices, and solutions!
Is low libido common in the women you talk with?
WHO IS AT RISK:
If we look at the lifespan of women: It’s like an everlasting gobstopper, from the minute we are born, our hormones and bodies are constantly changing and going through the cycles of life… It’s not over til it’s over!!
When a woman enters menopause, she is now more at risk for cardiovascular disease, osteoporosis, and dementia…. Not only hormone-related, but BLOOD FLOW becomes impacted! Over 60% [some literature states 80%] of women suffer from some level of vaginal atrophy, which leads to decreased libido.
Post postpartum mommies; dry vaginal tissue with breastfeeding: lack of blood flow and decreased libido, fatigues, emotional, body image,
Breast cancer patients; cancer patients, chemo radiation impact [intimacy and disease webinar in itself] however, particularly breast cancer patients, body image, [estrogen blockers] = vaginal dryness [dry, thin tissue], decreased libido, pain with intercourse.
Patients that have dyspareunia, pelvic pain, urinary incontinence, recurrent urinary tract infections, peri-post menopausal. I am treating women in their earlier 40’s with vaginal dryness, lack of orgasm…decreased libido… The very first signs of perimenopause which lands in the vagina-and they are crying because they feel like “this part of their body has left the building”… “outer body experience.” Why am I not feeling connected?
Orgasms have such amazing effects on our overall well-being. Why are we not having them? Let’s touch base on a few: women need lubrication and healthy intimate skin to have optima orgasms.
- 70% of women don’t orgasm during sex/intercourse/penetration
- 50% of the population are women; 30% of them don’t orgasm well
- The clitoris is the only organ in the human body with the sole purpose of pleasure
- 30% of women and men do not know where the clitoris is located
- 53% of women use a vibrator because they want orgasms and that pleasure
- 45% of women in general have some level of sexual dysfunction, but only approximately 15% will actually speak to their provider about it.
- 1 billion women will be menopausal by year 2023; decreased libido, vaginal atrophy [libido is leaving the building, and vaginal atrophy is moving in] Nearly 100% of women experience intimate skin dryness in their life
- 1 in 4 menopausal women will experience some level of vulvar/vaginal symptoms
- Skin noticeably starts to lose its elasticity in your early 30s and particularly the first five years of menopause, when skin loses over 30% of its collagen
- 1 in 3 women has urinary incontinence
- 1 in 5 women has urinary tract infections
Signs and symptoms of GSM [dry vulvar and vaginal tissue (aka genitourinary syndrome of menopause):
- Vaginal burning and itching
- Decreased lubrication during sex, which can lead to painful intercourse
- Bleeding after sex due to dry thin tissue
- More frequent vagina and urinary tract infections
- Frequent urination
All of these changes can affect a woman’s enjoyment of sex and the way she feels about herself and overall well-being [emotionally and physically]. It is estimated that 1 in 4 menopausal women will have at least one of these symptoms.
For a female, her mind and her vagina need to be turned on! Blood flow and oxygenation is the key to rev up, clitoral engorgement, increase lubrication, excitement… That desire!
It is known that women need emotional desire to have sex, while men need sex to have emotional desire.
What are some of the reasons for low libido in women?
“Lovely Libido” is my favorite thing to talk about with my patients. Libido and desire are two different things. Through a person’s lifespan, experience, overall health can impact libido. The daily conversation I have with women daily is, “I don’t feel well, my libido has literally left the building”
The other elephant in the room that can affect one’s sex drive is vaginal dryness or lack of lubrication – There is discomfort now with penetration, or it takes “a lot of revving up to get in the mood,” orgasm have changed… Just having these experiences turns off the engine for sure.
There are many reasons a woman’s sex drive and libido may begin to decline, here are the most common:
Age and other influences on hormones. Estrogen, progesterone, and testosterone all impact your libido, so when hormonal levels change, so can your desire. Perimenopause, menopause, and pregnancy can all lower libido due to hormonal changes. However, it’s important to note that a lower libido is not inevitable. Some women experience a surge in sexual desire after menopause or during pregnancy.
Pain. Declining hormone levels can lead to vaginal dryness and painful sex, which – understandably – weakens sexual desire. The vaginal area is particularly prone to irritated, dry skin, which can lead women to associate sex with pain, and therefore avoid any intimate contact.
Other types of chronic pain can also influence your libido. Who wants to think about sex when their brain is busy focusing on a sore back?
Vaginal dryness is one of my most favorite topics that I discuss with women daily! Due to a gap in the industry, I couldn’t recommend any therapeutic intimate skin moisturizer that restores and protects the most sensitive skin on our bodies…our intimate skin… That’s why I invented and developed Fulfillene Intimate Skin Moisturizer, a patent-pending formulation powered by a peptide complex that women can use as a daily intimate skin moisturizer, pre-during-post intercourse, or any time your skin feels dry or compromised… Why are we not talking about daily intimate skin care? It’s so important to our daily regime.
Nearly 100% of women post-menopausal will experience dry vaginal skin by post-menopausal symptoms we don’t need-so preventable, resolvable… And EFFECT our quality of life in so many ways!
Stress. Chronic stress not only makes it difficult to think about sex because your brain is too busy, it can also lead to higher levels of the stress hormone cortisol. High levels of cortisol can lower your levels of the hormones that influence sexual desire, like testosterone. For women in relationships, relationship stressors can be particularly damaging to sexual desire – it’s hard to think positively about sex if you resent your partner.
Lack of Sleep. Sleep is one of the most valuable and most fascinating functions of the body… Did you know every 90 minutes of your sleep resets a specific function in your body? If we are not sleeping well and we are feeling fatigued all the time, sex isn’t happening!
YES YES YES, we want sleep!
Medications and alcohol use. Many medications can negatively impact libido, including some common blood pressure treatments and antidepressants. One of the first steps in determining a cause of lower libido should be reviewing any medications with your healthcare practitioner.
It may seem counterintuitive, but too much alcohol can also lower your libido. Some studies have found small amounts of red wine can help with libido, but there’s definitely a tipping point at which alcohol is detrimental.
Mental health. Depression is one of the most common contributors to low libido. In fact, one study found that about one-third of premenopausal women experiencing low desire also experience depression.
Anxiety also impacts libido since cortisol levels increase, and anxious thoughts make it difficult to think of other things. Plus, women experiencing anxiety are up to 10 times more likely to experience painful intercourse.
What are common symptoms of this issue?
This is one of the dearest and most passionate conversations I LOVE to talk about!!! I have dedicated most of my career dedicating my practice and expertise to create protocols and resolutions for women’s most intimate well-being.
What causes it?
GSM or GUSm are fancy terms for when your vulva and vagina skin/mucosa are dry due to hormonal changes in the body. Hormonal fluctuations and changes can start as early as late ’30s. I am seeing more and more women in my practice in this age group coming in stating comments like “I feel like it is taking me longer to have an orgasm,” “I don’t feel as much lubrication, and needing to use lots more lube, “libido and/or desire are not there”…
While it may be years for these women to go into menopause, they are experiencing the slow decline of hormonal changes that are starting to take effect. Unfortunately, usually, the vagina is the first place that starts to change.
Moving forward from 40 years on-women will consistently have hormonal declines, and the definition of menopause is no menstrual cycle for one year… “Welcome to the Next Adventure of your Life.”
Menopause is a normal process, but women going through perimenopause into post-menopause can be a very challenging time in their life. Their bodies are changing rapidly, causing a multitude of symptoms. Over the years of being in practice, I have listed over 500 symptoms women have started going through menopause. The most common symptom being vulvo-vaginal dryness.
As estrogen declines, the body does not share the lower quantities in the body, and, unfortunately, our vaginal mucosa becomes dry, irritated, and loses lubrication and elasticity [meaning skin doesn’t stretch as well]. Symptoms of vaginal dryness can include urinary urgency, frequency, leaking, onset of urinary tract infections, yeast or BV infections, and/or painful intercourse.
When there is lack of lubrication, the vulvo-vaginal ecosystem becomes unbalanced and unable to supply oxygenation, blood flow, and overall health to the mucosa = DRY irritated skin.
Think of our natural lubrication as a washer machine… It keeps the mucosa and skin hydrated, plump, healthy, Ph balanced-protecting from infections, and discomfort. Lubrication helps optimize nerve and arterial health-optimizing orgasm strength, sensation, and overall function. Lubrication, ultimately, helps protect and optimize bladder function, pelvic floor function, and sexual function.
Menopausal women are not the only women that can have these symptoms – Women on oral contraceptives, postpartum women who are breastfeeding, breast cancer women, or any woman going through cancer, autoimmune diseases, etc…
“Not to be the bearer of bad news about a dry vagina… the good news is it is Reversible! “ RC
What are the symptoms?
These symptoms affect women not only physically, posing many risk factors as discussed above, but also emotionally. Irritated, painful intimate skin also impacts relationships and overall quality of life in so many ways.
Symptoms can include:
- Vaginal dryness.
- Vaginal burning
- Vaginal discharge
- Genital itching
- Painful intercourse [or dyspareunia]
- Burning with urination
- Urgency with urination
- Frequent urination
- Recurrent urinary tract infections
- Decreased libido and/or desire
- What the heck is going on down there
Stayed tuned! Watch for Part 2 on low libido in women
The second interview with Rachael Cabreira will go live next week. It will discuss ways for women to jumpstart their libido – There is a lot you can do! Rachael offers a great list of suggestions you won’t want to miss.
Plus, she will discuss the need to break the taboo when it comes to talking about sexual health. Let’s keep the conversation going!
Top photo: Meet Rachael Cabreira. Photo courtesy of Rachael.