Areas of expertise
Sexual Health
Most women have a version of this they have never said out loud to a provider, usually because they expect to be moved along. There is enough time here to say it, and it will be taken seriously.
What is happening
Common, treatable, andleft alone for years.
A great many women experience changes in desire, comfort or response at some point, and far more of it happens during hormonal transitions than most women are ever told. These concerns are common and they are treatable. What makes them different from other symptoms is how long they go unmentioned, often for years, and usually because there was never quite the right moment to raise them.
Desire, arousal, comfort and pain each have their own possible causes, and they frequently overlap with hormones, medications, sleep, stress and the rest of your health. So this is not a conversation held in the last two minutes of a visit. It starts with your symptoms, your history, what you are taking, what has changed and when, and where relevant, your relationship context.
What is commonly treated
The concerns women bring here most.
- Menopause-related changes in desire, arousal and comfort
- Low libido, including Hypoactive Sexual Desire Disorder
- Painful intercourse, or dyspareunia
- Chronic vulvar and vaginal pain, including vulvodynia
- Arousal and orgasm concerns affecting intimacy
- Pelvic floor dysfunction contributing to discomfort
- Recurrent urinary tract infections and ongoing irritation
- Vaginal dryness, and changes in tissue over time
You do not have to keep guessing, and you do not have to push through discomfort.
How this is approached
What your care can include.
- 01
A focused evaluation of what may actually be contributing, across hormones, medications, tissue health, pelvic floor function and stress.
- 02
Hormone evaluation and laboratory work where the result will meaningfully change what we do.
- 03
Treatment options to support comfort, desire and sexual response, chosen against your history and explained before anything is decided.
- 04
Guidance for vulvar and vaginal health, reducing pain, and preventing the problems that keep returning.
- 05
Ongoing clinical adjustment, because comfort and desire respond gradually rather than all at once.
You are part of every decision, and you will not be rushed through any of it.
← All areas of expertiseQuestions
The three I am asked most.
How does this work if care is virtual?
It starts with a detailed conversation about your symptoms, when they began, your health history, your medications, your hormones and what you want to change. That conversation is where most of the answer comes from. If an examination or testing is needed, I help you arrange it locally and bring the findings back into your plan.
What treatment options might be discussed?
It depends entirely on the cause. It may include vaginal and vulvar health strategies, hormone evaluation or support, medication where it is appropriate, targeted approaches for desire or discomfort, and practical guidance alongside them. You are part of the decision in every case.
Is this private?
Yes. Your care is secure and confidential, and many women find it easier to raise these things from their own home than across a desk.