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Dr. Renee in the news! The Detroit Free Press and USA Today go to the experts and tackle women’s sexual health.

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Infertility, Intimacy and “Homework Fatigue”

The inability to conceive can take a couple on an emotional roller-coaster ride. In addition, infertility has also been shown to be a risk factor for female sexual dysfunction.

A case-control study was conducted with 119 infertile woman and 99 healthy female controls without infertility between the ages of 18 and 45.  It was found that the group of infertile women had a lower score in desire, arousal and a lower frequency of sexual encounters. It followed that their satisfaction was also lower. Why does this happen?

When the goal is pregnancy, there is only a 24 hour window of opportunity each cycle.  That is, the egg is viable for 24 hours while the sperm is viable for 72 hours.  Sex on demand eliminates any spontaneity.  The focus of sex becomes conception, rather than pleasure. All this can lead to pressure to perform and conceive which may lead to less satisfaction.

Infertility can also affect a woman’s sense of herself and her sexual identity.  Males accordingly may be affected and become depressed, experience performance anxiety, premature ejaculation and erectile dysfunction.

Now add in the effects of certain fertility medications. Although the effects are short lived, these drugs may have to be used repeatedly. They suppress ovulation for IVF cycles and can cause decreased libido along with vaginal dryness and pain.  Drugs like Clomiphene (Clomid) are used to induce ovulation but can cause nausea, breast tenderness, hot flashes and mood swings.  This is certainly not a great way to “bring sexy back!”

What to do?  Talk with your doctor.  There may be alternatives to certain medications. Talk with your partner. Just being aware of possible concerns may help.  If necessary, seek the counsel of a therapist who is knowledgeable about sexual issues.  When lovemaking has to be an assignment, remember how pleasurable impromptu sex can be, that it isn’t always going to be about procreation.

Keep your eyes on the prize and realize that you can turn that roller coaster ride into the tunnel of love!

Menopause, Painful Sex and a New Solution

Menopause.  What is the first thing that comes to mind when you hear that word?  Chances are good you think of hot flashes.  Certainly, hot flashes are part of the mid-life change and for some women, they can be quite bothersome.  However, there is another condition associated with menopause that can be even more bothersome and quite painful.  It is vulvovaginal atrophy, which causes burning, itching and at times, bleeding.  Unfortunately, many women are too embarrassed to discuss this matter with their health care providers.  Ladies, let’s turn this around. There is no need to suffer!

Painful sex in and around the time of menopause is often due to the natural decline of estrogen, which makes vaginal tissue thinner, drier and less elastic.  The result?  For many women, sex becomes uncomfortable and sometimes impossible.  Insufficient lubrication can cause tearing of vaginal tissues during intercourse.  Anxiety and frustration may also take its toll and cause future arousal difficulties or a halt to sex altogether. It is estimated that 20%-45% of middle-aged and older women are affected by these symptoms.

Prescription remedies are available in the form of vaginal estrogen rings, tablets and topical creams.  The estrogen used in these products is low dosage and a much lower risk than estrogen pills used in hormonal replacement therapy. There is a low rate of absorption into the bloodstream. For those who prefer a nonhormonal alternative, an over the counter lubricant like K-Y Jelly, or moisturizer such as Replens, can be helpful.

Recently, the FDA approved Osphena, the first nonhormonal pill, taken once a day to treat moderate to severe sexual pain.  This drug mimics estrogen on some tissues and is in a class of medications called selective estrogen receptor modulators, or SERMS.  In the vagina and uterus, it acts like estrogen and can relieve sexual discomfort

Yes, there are side effects with Osphena as with all medications.  They include vaginal discharge, blood clots and stroke.  It is always important to check with your doctor, be honest, ask questions and weigh the risks.  For those who want a non-estrogen alternative and prefer swallowing a pill over the messiness of applying a cream, Osphena may the right answer for you.

It is always important to talk with your doctor and get regular checkups. Remember, good health starts with you.  A comfortable and happy sexual relationship is part of the total package!

Ready for a Close-up!

Dr. Horowitz is at it again! The spotlight is shining bright on the founder of the Center for Sexual Wellness and this time, she made an appearance in HOUR Detroit’s Top Docs Issue. They called on Dr. Horowitz for her expertise on intimacy in relationships and sexual dysfunction. One thing’s for sure: Dr. Horowitz isn’t afraid to talk sex and it’s because of her willingness to listen that she has helped so many. To read the informative article about this “top doc”, click here.



Vulvar Afflictions and Skin Conditions

Quick quiz:  What is the largest organ of the human body? Hint: freckles, sunburn, pimples, eczema.  If you said skin, you win!  Not only is our skin the largest organ; it is the fastest growing.  Very simply, this marvel of our anatomy keeps good things in (like internal organs, bodily fluids) and bad things out (like harmful bacteria, environmental elements).

Because skin covers our entire body, it is part of the vulva, or external female genitilia. The word vulva is derived from the Latin volvere, or “wrapper”– to roll over. So any skin afflictions or diseases that occur anywhere on the body can also affect us “down there.”

Dermatitis, tattoos, piercings, vajazzling – the vulva has been subjected to it all. Most of the time, this “forgotten area” is taken for granted.  However, when pain occurs anywhere around the vulva, we call it vulvodynia. It can become overwhelming and mentally exhausting.

Vestibulodynia is one such condition.  The pain around the entrance to the vagina is described as being “cutting or searing.” It can be so severe that intercourse and even inserting a tampon are impossible.  Why does this happen?  It can be hormonally triggered via birth control pills or menopause. It can also be caused by an allergic reaction, a previous injury or childbirth.  Another possibility is congenital neuroproliferative vestibulodynia (pardon another medical term), when a female is born with more nerve endings in the vaginal vestibule.

Treatment can vary from oral medications like antidepressants, to seizure medications which can help to desensitize the pain. Other approaches include nerve block injections, biofeedback or surgery.  A vestibulectomy will remove the affected tissue and can be very successful in providing relief.

Correct diagnosis is important and can take time.  The pain that accompanies vulvodynia is real. If your current physician is not providing you with adequate options, please know that specialists are available to help.

The Surprises of Sex!

As it turns out, some research suggests that having sex may not only be purely for pleasure. In fact, some studies are suggesting that having sex is actually beneficial to your health. Sex is not a magic remedy to all health issues, but if one is having safe sex, they may begin to see the benefits psychologically, emotionally and physically. Feeling stressed? Sex can help. Having trouble sleeping? Grab your partner and do some research.  Dr. Renee Horowitz weighs in on this stimulating research during a conversation on HuffPost Live. Click here to learn more!


Don’t get steamed over this new trend!

Stressed?  Have any female issues bothering you lately like infertility, reoccurring bladder infections or menstrual cramps?

The latest and trendiest solution sweeping the country among alternative medical practices and spas is the vaginal steam bath.

Although new to the U.S., this natural “treatment” is actually centuries old.  Called “chai-yok” in Korea and “bajos” in Central and South America, the patient sits on an open-seated stool above a pot of herb-filled steamy water.  The bath lasts about 30-40 minutes and is believed to help release toxins within the female anatomy.  It is said that the steaming will reduce stress, increase circulation and regulate menstrual cycles.  Some believe it will even increase your chances of becoming pregnant. Not to discriminate, this steam treatment is also available for men and is used to cleanse the perianal area.

The steaming “brew” is a combination of many herbs but predominantly mugwort and wormwood. Both are considered to be antifungal antimicrobial agents and have been used by herbalists and alternative medicine advocates to balance female hormones. Vaginal steaming has not undergone any clinical analysis in the U.S.

Bottom line, the human body is a wonderfully crafted machine.  Nature provides effective means to cleanse the female reproductive anatomy. If you become hot and bothered by any female disorders, please see your doctor.

Snow, Fire and STDs?

You might have heard the expression – “Just because there’s snow on the roof doesn’t mean there’s no fire in the furnace!”  Advanced medical techniques and new drugs have made it possible for us to live longer and it’s no doubt that most of us would love to stay healthy into our golden years. That includes keeping those embers burning brightly in the intimacy department.

The creation of drugs for erectile dysfunction have helped to keep those “home fires” stoked. However, along with the increased chances of sexual activity there is an alarming uptick in sexually transmitted diseases within a demographic not usually associated with such behavior.

For more information, click here.

An Evening of Sexual Innuendo, Art and Song 2/21/13 at the Lido Gallery in Birmingham

 Please join us!

 Whether you have been the seducer, the seducee or a participant on both sides of this subject, you are invited to a stimulating evening exploring science and the arts on Thursday, February 21 at 7 p.m. at The Lido Gallery, (33535 Woodward Ave., Birmingham, MI 48009, between 14 Mile Rd. and Maple Rd).

This entertaining event will weave together the alluring elements of music, art, literature and medicine, and Dr. Renee Horowitz, founder of the Center for Sexual Wellness in Farmington Hills will be the featured speaker. “An evening talking about sex and seduction in the engaging atmosphere of the Lido Gallery promises to be not only a lot of fun, but thought provoking as well,”  said Dr. Renee Horowitz, who has been a respected obstetrician and gynecologist in metro Detroit for over 25 years. She is a frequent contributor to television and radio programs and has been quoted in Good Housekeeping, Esquire and Metro You magazines.

The Lido Gallery exhibits art and sells a wide variety of unique gift items, from household accessories to jewelry and specialty foods. The gallery also hosts lectures as well as a Poetry and Music Series highlighting local talent as well as notable artists.  Detroit music icon Mitch Ryder, songstress Jill Jack and celebrity performer/author Angela Bowie have all appeared at the Lido Gallery.

Owner Diane DeCillis is a well-known supporter of the arts as well as a poet.  “We are so fortunate to be a meeting place within such an active and talented arts community. It is a pleasure using the Lido Gallery as a showcase for the meeting of artistic minds,” she said.

Light refreshments will be served.  This event is free and suggested for adults only.

Medical Tests for Twentysomethings

Whether you call yourself a millennial, or part of Generation X, young women in their 20s-30s have a lot on their plates.  Chances are, as a twentysomething, you are still in school, have started a job or career and in addition, may also be juggling family obligations and responsibilities.

So, how does health care fit in at this age and what does it mean?  Staying healthy means everything!  In addition to visiting your internist for a physical exam, it is imperative that all women get a yearly gynecological exam whether you are sexually active or not.  Your visit will include a pelvic exam, pap test, breast exam and tests for sexually transmitted diseases.

The specifics

A Papanicolaou (Pap) test or smear – involves a gentle scraping of cells from the cervical canal, which is the lower part of the uterus.  The testing of these cells will detect infection and the presence of abnormal cells which could turn pre-cancerous.  Early discovery can prevent cancerous development.

Breast Exams – Starting at the age of 20, all women should be performing monthly breast self-examinations, the best time being after your period.  Become familiar with how your breasts look and feel, what is normal for you.  This way, should any changes occur, your observations will be of great value to your doctor.  Although breast cancer occurs in 5% of women under 40, you should be aware of your risk factors and discuss them with your doctor.

Tests for Sexually Transmitted Diseases (STDs) – HIV, Chlamydia and Gonorrhea.  Close to 20 million STD cases are reported each year.  The good news is that they are treatable.  However, if not treated, these diseases can lead to cancer and infertility.

Being twentysomething is a great time of life!  Stay on top of your healthcare to ensure a happy and healthy future!