Adv. Workshop: Sexual Dysf. On-Demand Agenda

Thursday, November 4th

Advanced Workshop: Sexual Dysfunction in Men and Women

Sexual dysfunction is a common problem among both men and women, particularly in the aging patient. It can be caused by physical problems and medical conditions, such as heart disease and hormone imbalances, or by psychological problems, like anxiety, depression and the effects of past trauma. Age Management Physicians will be confronted with these issues; in fact sexual dysfunction may be a primary motivator for patients to seek out treatment. This workshop will focus on sexual dysfunction, diagnosis and treatment modalities that can be used in an Age Management Practice.

Time
Presentation
45 minutes Love and Libido: Gender Differences in Sex
Angela DeRosa, D.O., MBA, CPE
Founder & President, Hormonal Health Institute, Scottsdale, AZ
Men and women are very different species when it comes to many things, but none more relevant than the differences in not only how one thinks about sex, but also the physiologic response to sex. Women are held to a different standard and have many more biases that need to be addressed and overcome in order to have a healthy intimate relationship. Men have been given a larger freedom to “spread their seed” without remorse. The 21st century with various heralding events, drove a social acceptance regarding women and their sexual needs, but it also created an opportunity to understand the differences between the two sexes. As providers it is important to understand these differences as we address the needs of our patients when it comes to not only safe sexual practices, but also how to properly treat sexual dysfunctions and the drivers in each sex of these concerns.
45 minutes Medical and Psychological Causes of Sexual Dysfunction in Men & Women
Angela DeRosa, D.O., MBA, CPE
Founder & President, Hormonal Health Institute, Scottsdale, AZ
Men and women are very different species when it comes to many things, but none more relevant than the differences in not only how one thinks about sex, but also the distinct causes of sexual dysfunction and how to properly evaluate and address.As providers it is important to understand these differences as we formulate a proper work up and treatment protocol so that we can assist our patients in having happier, healthier sexual intimacy
45 minutes Patient Assessment and Diagnosis of Sexual Dysfunction in Men: Beyond Prescribing 5-alpha-Reducatase-Inhibitors
Kathy Maupin, M.D.
Founder and Medical Director, BioBalance Health
Male sexual dysfunction is much more than ED and must be approached diagnostically by evaluating multiple physiologic systems, ruling out lifestyle and medication etiologies, anatomic abnormalities, and in some cases relationship counseling. The initial evaluation is complex and doesn’t begin with a prescription of a 5-alpha-reductase inhibitor but by diagnosing the physiologic dysfunction. Proper evaluation includes blood laboratory analysis of hormonal adequacy, diagnosis of contributing vascular and other medical diseases, which often requires radiologic tests, and relationship counseling. The optimal treatment plan is prioritized by normalizing all hormonal deficiencies, primarily by treating men with bioidentical testosterone, then treating medical diseases concomitantly, then adjusting medications that may worsen sexual performance and libido, defining and improving contributing lifestyle choices, and finally adding 5-alpha-reductase inhibitors, prostaglandin injections or referral for penile implantation if the result is not as robust as the patient desires. Patients appreciate the complete evaluation and treatment plan that this approach offers.
45 minutes Nutrition Plan to Reduce Incidence of ED and Increase Heart Health
Paul Thompson, M.D.
Medical Director, Thompson Clinic
Chief Medical Officer, Launch Medical
Advisory Board, Organicell
Vascular disease is epidemic in size, Metabolic syndrome has become a way of life and everyone is looking for the MAGIC pill to fix their problems. The leading cause of death in the US is far and away cardiovascular in nature and sexual dysfunction is rampant. The common numbers are 50% of 50-year-olds, 60% of 60-year-olds, etc., suffer from sexual dysfunction. The answer today, pop a pill and fix your problem. The fallacy is that by doing so you are correcting the problem freeing you up to continue your habits that led to the problem. The worst part is, as you go along your merry way you are still highly likely to become a victim of a lethal cardiac event.
While being a vegetarian seems like a drastic step there are many benefits including decrease in vascular inflammation, reversal of plaque, improved sexual function and a decrease in hypertension and many of the things that are associated with the metabolic syndrome. This lecture will point out the benefits of reducing animal protein and sticking with a plant-based diet.
45 minutes Evidence Based Treatment for Sexual Dysfunction in Men Using Hormones, FDA Approved Peptides and Other Common Modalities
John C. Carrozzella, M.D., MSMS
Director & Founding Physician, CEO, Florida Center for Hormones and Wellness
Sexual Dysfunction in men is far more common than conventionally thought. Several studies suggest that almost every man will experience some degree of sexual dysfunction in his lifetime. From lack of desire, to poor physical performance, to a complete inability to have a sexual encounter, the extent of sexual dysfunction in men is wide. Since the introduction of Testosterone Therapy in the 1950’s and Sildenafil in 1998, the number and variety of remedies for sexual dysfunction have expanded dramatically. In this presentation, the attendee will learn about the root causes of sexual dysfunction in men.  Then the presenter will discuss a number of Evidence Based treatments that have been well studied and shown to be medically effective.
45 minutes Use of Non-Hormone Clinical Interventions for Sexual Dysfunction: Shockwave Therapy, P-Shot
Michale Barber, M.D.
CEO & CMO, Better Life Carolinas, Charleston, SC & Charlotte, NC
Over the past decade the use of unique therapies for erectile dysfunction have emerged. This lecture will explore the science and effectiveness of Low intensity extracorporeal shock wave therapy for treatment of ED. A review of the literature will be presented to assess the physiology of shock wave therapy, suggested protocols for treatment and effectiveness and possible adverse effects. The use of platelet-rich plasma (PRP) for treating ED will also be discussed with a focus on up to date literature for use in erectile dysfunction. The literature will be reviewed for results including improvement in subjective patient scores, intracavernous pressure, analysis of penile tissue and other pertinent clinical data. Possible risks and contraindications will also be discussed.
45 minutes Patient Assessment and Diagnosis of Sexual Dysfunction in Women: Unravelling the Mystery and Treating the Problem
Kathy Maupin, M.D.
Founder and Medical Director, BioBalance Health
Secondary sexual dysfunction in women over 40 has a history of being misdiagnosed, ignored, treated with the wrong hormone, obstructed from treatment through governmental agencies and generally categorized as a psychiatric condition. Sexual function is a real physiologic, hormonal, psychological condition that affects many women after age 40. Sexual function and dysfunction involve many components of what we consider sexual function: libido, arousal, engorgement, comfort, orgasm, and emotional engagement. This complexity makes it more important to delineate what component is involved as each may require various treatments. Because sexual function is very complex in nature, the diagnosis and treatment of sexual complaints should be approached in an organized and complete fashion. Gynecologists generally rule out anatomic abnormalities which are rare in the mature patient but should not be overlooked. Hormonal deficiencies, medical illnesses and poor lifestyle choices are the most common causes of female sexual dysfunction. The fact that testosterone is necessary for female sexual function and the FDA has not approved a testosterone replacement for women, offers us an opportunity to use non oral bioidentical testosterone to treat the most common cause of female sexual dysfunction in mature women. I will offer case studies from my practice to illustrate the multifaceted problem of poor sexual function in mature women, and offer treatment protocols that work well.
45 minutes The Use of Hormones & FDA Approved Peptides as an Evidence Based Treatment for Sexual Dysfunction in Women
Carolyn DeLucia, M.D., FACOG
Womens Intimate Health Clinic, NYC, NY
Member and Instructor, American Aesthetic Association & American Cosmetic Cellular Medicine Association
Fellow, American College of Obstetrics and Gynecology
We will explore the literature on use of hormones both bioidentical and pharmaceutical grade products for sexual wellness. We will analyze the use of Peptides that are still FDA approved and available. The pertinent literature will be reviewed. The FDA’s impact on bioidentical hormones will be discussed and scrutinized. 
45 minutes The Use of Vylessi and HIFEM Technology in the Treatment of Pelvic Floor Muscles as a Cause of Female Sexual Dysfunction (Men & Women)
Carolyn DeLucia, M.D., FACOG
Womens Intimate Health Clinic, NYC, NY
Member and Instructor, American Aesthetic Association & American Cosmetic Cellular Medicine Association
Fellow, American College of Obstetrics and Gynecology
HIFEM technology is the first to market of its kind to treat sexual medicine.  Its value as opposed to traditional physical therapy and biofeedback techniques will be analyzed. The resent literature published and studies underway exploring HIFEM in the treatment of sexual dysfunction will be reviewed. The value of a noninvasive, operator independent, painless simple procedure will be appreciated.
75 minutes Sexual Dysfunction Complex Case Discussion (Men & Women)
Neal Rouzier, M.D.
Director, The Preventive Medicine Clinics of the Desert, Palm Springs, CA
A 60 y/o male presents for evaluation of hormone replacement that he has been receiving from a physician colleague. His chief complaint is loss of libido, erectile dysfunction, and weight gain. He also notes worsening of weight and body fat after being placed on anastrozole (Arimidex) for high estrogen levels that resulted from testosterone injections. Since then, he c/o increased fat and sexual dysfunction that he did not have before. Although he is on HRT, he wonders if you can offer something else as his friend who you treat does not complain of any of the side effects or problems that he is experiencing.Carolyn DeLucia, M.D., FACOG
Womens Intimate Health Clinic, NYC, NY
Member and Instructor, American Aesthetic Association & American Cosmetic Cellular Medicine Association
Fellow, American College of Obstetrics and Gynecology
A case of a woman with anorgasmia will be reviewed. What approach was taken and what else should be explored will be debated. Can every aspect of the orgasmic system be evaluated and treated?