Femplus

18/07/2025

Great piece on Stress urinary incontinence surgery.
Thanks to Dr O’Sullivan and all the hospital colleagues who are fighting hard to ensure proper medical treatment is available for patients who need it.
Listen back on drivetime playback 17th of july.

29/01/2025

MENOPAUSE MISINFORMATION

Somebody asked me what type of social media information we consider wrong.
The most common I think is related to testosterone.
What you might read out there is:
👉every woman needs testosterone supplementation in menopause
👉testosterone levels plummet in menopause
👉testosterone helps with brain for and energy levels
None of these statements have any scientific evidence behind them and are promoted by private clincis selling testosterone supplementation appointments.
We do prescribe testosterone in specific situations.
For evidence based information follow Prof Davis who has conducted large randomised trails on testosterone.

05/11/2024

Please consider donating
Www.indreni.org

12/08/2024

I suggest listening to this podcast. Good chat on facts on hormones and why not everything that we feel is wrong with us might be hormone related.

31/07/2024

28/07/2024

IF YOU THINK YOU HAVE LOW DESIRE
You should ask yourself these questions:
-do you ever notice your body turning on in response to a s*x scene on tv?
-dose desire kick in once you have started having s*x?
-do you and your partner know what triggers your desire?
-does s*x start the same way, follow the same order each time?
-how pleasurable is your s*x experience?
-how does s*x make you feel in comparison to other things you might think are a better use of your time?

S*x communication is really difficult in a relationship, more difficult in a long term relationship.
Also difficult is to maintain s*xual currency.
Passionate kissing is one of the most natural triggers but is usually only done before or during s*x. It does not have to be just done to initiate s*x but can be used to maintain closeness and desire.
Many women feel the need for closeness but they avoid it because they are afraid it will lead to s*x and they refrain from general physical contact.

What intervention are needed?
-you need a good va**na
-if you experience pain or discomfort during s*x that is not normal and you should seek medical treatment
-most women don’t need testosterone but need to understand how desire works

Useful resources:

TED TALK
Karen Gurney
-The surprising truth about desire and how to future proof your s*x life
-the truth about faking or***ms

Dipsea app
Is an app for audio erotica
Useful to test your response to triggers

28/07/2024

HOW DOES DESIRE WORK?
What actually scientifically happens is that arousal comes first. That is when our body responds to triggers. In s*xual research the vast majority of people who report low desire will have a normal response to specific triggers.
For the response to the trigger to happen we need to listen and if our mind is occupied by other thoughts and worries this will shut down the trigger response. This is a normal biological event. Higher cognitive loads (like the worry of feeling pain during s*x, the worry about how our body looks) will decrease and stop our normal biological s*x response.
In addition to all of this s*x has to have a good currency value. If our s*xual experience has been low in pleasure or or**sm our body and mind will not value it and we will have no motivation to move towards it.

Desire has to have all the following components:
1- The automatic response to a s*xual stimuli
2- The ability to pay attention. If our head is full of other things we will shut down our natural response. Normally women tend to have a higher workload as household managers and that has a huge impact on response to arousal.
3- The experience of learning and memory attribution (women were raised not to approach s*x freely because it can cause unwanted pregnancy, ruin your reputation and it is more for the man pleasure and reward. This is why problems are more common in heteros*xual couples)
4- The incentive because there is a reward

27/07/2024

At last BMS meeting we had a wonderful lecture from Dr Karen Gurney on s*x and libido.
Many women report low libido as a common symptom but it is very important to understand how desire works if you want to improve your s*x life. IF you expect an easy fix you are going to be disappointed.
I will share a summary of the talk and add resources at the end.
It is a bit long wo I will divide it.

WHAT IS LOW DESIRE OR LOW LIBIDO?
S*x is not just a biological event depending only on hormones.
There is a misconception that low desire happens because of menopause and that all women will need testosterone supplementation to fix it.
The reality is far more complicated than that.

Reporting low desire is very common in women at different ages.
Most likely the reality is not that the desire is low but that the expectations of what desire should be are incorrect.
Desire is not an internal drive (like hunger) but it depends on external factors.
Unlike hunger the less s*x we have the less s*x we want to have.
There is no “normal” level of desire so we perceive as abnormal might in fact be completely normal.

Not feeling like having s*x out of the blue is very common and normal.
The most likely reason for this is being in a long term relationship and we do not emphasize enough how normal this is.
We get our ideas of what s*x should be like from television and medias and we think that if we do not feel like what we see there must be something wrong with us.
Most women think that desire should come by itself if we love our partner. They expect it to magically happen. This concept is incorrect because that is not how our bodies work.

10/07/2024

DRY eyes on HRT?
Somebody asked me this week what to do with dry eyes if already on HRT. While this is one of the symptoms on those symptoms checker lists we have to be careful to presume that anything wrong with us is hormone related. That is my main reason no to use those lists!
👉We have seen a number of patients over the years dismissing symptoms just because they thought were menopause related. This can lead to a delay in diagnosing other medical conditions.
👉My general advice is that if a symptom does not go away with hrt you have to think again and arrange proper investigations.

06/07/2024

WEIGHT GAIN ON HRT:
Hrt does not cause weight gain.
Menopause itself and ageing cause weight gain. Unfortunately in menopause we have changes in our metabolism, increased insulin resistance and an increased tendency in putting on weight especially around our waist.
This process is not reversed by using hrt. It is also not reversed by any of those supplements your Instagram and Facebook account is probably plagued with (like mine).
There are some specific approaches that work better and that is the reason why we have a specific diet plan for our menopause patients. It does require hard work, nothing happens by magic.
Check our linktr.ee for more information.
https://femplus.ie/services/diet-plan/

02/07/2024

We were delighted to attend the annual British Menopause meeting last week. Maintaining specialist qualifications takes a bit of work. Doing it with your colleagues makes it a very enjoyable experience. We listened and learned, laughed and met many menopause specialists colleagues from other places.
I will be reporting on all of this in the next few weeks.

25/03/2024

Lichen Sclerosus is a chronic dermatological condition.

Symptoms are:
-chronic itch (often misdiagnosed as recurrent thrush)
-burning
-uncomfortable s*x

The diagnosis is usually done with a clinical exam. Often a biopsy is done to:
-confirm diagnosis
-exclude malignancy
Accurate diagnosis is essential as patients have a small chance to develop skin cancer in the area.
If left untreated can
-progress to malignancy
-cause scarring and alterations in anatomy which make s*x very painful
The main treatment is topical steroids applied with a very specific plan.
Erbium laser can be very helpful to reduce inflammation and improve functionality and elasticity of the skin.