*DISCLAIMER* This episode includes adult content and is not intended for young ears.

Hosea 4:6a (KJV) "My people are destroyed for lack of knowledge: because thou hast rejected knowledge,"

**Transcription Below**

Questions and Topics We Discuss:

What type of sexual dysfunctions are common for your clients to experience?
What all can you teach us about hormones?
Will you educate us on hormone therapy?

Dr. Kris Christiansen is a board-certified family physician who specializes in sexual medicine. She attended medical school and completed her residency in family medicine at the University of Minnesota. She practiced full spectrum family medicine for 10 years and then pursued additional training to specialize in sexual medicine. She works as a sexual medicine specialist at two different clinics in the twin cities. Her clinical interests include both male and female sexual dysfunction, and she loves working with individuals and couples to restore an important part of life.

Dr. Christiansen is involved with teaching medical students and residents at the University of Minnesota Medical School, and she has presented at multiple local, national, and international medical conferences. She is involved with the International Society for the Study of Women’s Sexual Health (ISSWSH) and serves on committees, collaborates with other experts to publish articles for medical journals, and edits informational articles for the society’s new patient facing website. She is passionate about teaching patients, students, and colleagues about the importance of sexual health and well-being.

In her free time, she started her own business called Intimate Focus which provides information and quality products to enhance and restore sexual health and wellness. She also enjoys shopping, hiking, and spending time with her family.

Websites Mentioned:

Dr. Kris Christiansen's Website

North American Menopause Society

Women's Sexual Health Information

Thank You to Our Sponsor: Sam Leman Eureka

Connect with The Savvy Sauce on Facebook or Instagram or Our Website

Gospel Scripture: (all NIV)

Romans 3:23 “for all have sinned and fall short of the glory of God,”

Romans 3:24 “and are justified freely by his grace through the redemption that came by Christ Jesus.”

Romans 3:25 (a) “God presented him as a sacrifice of atonement, through faith in his blood.”

Hebrews 9:22 (b) “without the shedding of blood there is no forgiveness.”

Romans 5:8 “But God demonstrates his own love for us in this: While we were still sinners, Christ died for us.”

Romans 5:11 “Not only is this so, but we also rejoice in God through our Lord Jesus Christ, through whom we have now received reconciliation.”

John 3:16 “For God so loved the world that he gave his one and only Son, that whoever believes in him shall not perish but have eternal life.”

Romans 10:9 “That if you confess with your mouth, “Jesus is Lord,” and believe in your heart that God raised him from the dead, you will be saved.”

Luke 15:10 says “In the same way, I tell you, there is rejoicing in the presence of the angels of God over one sinner who repents.”

Romans 8:1 “Therefore, there is now no condemnation for those who are in Christ Jesus”

Ephesians 1:13–14 “And you also were included in Christ when you heard the word of truth, the gospel of your salvation. Having believed, you were marked in him with a seal, the promised Holy Spirit, who is a deposit guaranteeing our inheritance until the redemption of those who are God’s possession- to the praise of his glory.”

Ephesians 1:15–23 “For this reason, ever since I heard about your faith in the Lord Jesus and your love for all the saints, I have not stopped giving thanks for you, remembering you in my prayers. I keep asking that the God of our Lord Jesus Christ, the glorious Father, may give you the spirit of wisdom and revelation, so that you may know him better. I pray also that the eyes of your heart may be enlightened in order that you may know the hope to which he has called you, the riches of his glorious inheritance in the saints, and his incomparably great power for us who believe. That power is like the working of his mighty strength, which he exerted in Christ when he raised him from the dead and seated him at his right hand in the heavenly realms, far above all rule and authority, power and dominion, and every title that can be given, not only in the present age but also in the one to come. And God placed all things under his feet and appointed him to be head over everything for the church, which is his body, the fullness of him who fills everything in every way.”

Ephesians 2:8–10 “For it is by grace you have been saved, through faith – and this not from yourselves, it is the gift of God – not by works, so that no one can boast. For we are God‘s workmanship, created in Christ Jesus to do good works, which God prepared in advance for us to do.“

Ephesians 2:13 “But now in Christ Jesus you who once were far away have been brought near through the blood of Christ.“

Philippians 1:6 “being confident of this, that he who began a good work in you will carry it on to completion until the day of Christ Jesus.”

**Transcription**

[00:00:00] <music>

Laura Dugger: Welcome to The Savvy Sauce, where we have practical chats for intentional living. I'm your host Laura Dugger, and I'm so glad you're here.

[00:00:17] <music>

Laura Dugger: The principles of honesty and integrity that Sam Leman founded his business on continue today, over 55 years later, at Sam Leman Chevrolet in Eureka. Owned and operated by the Bertschi Family, Sam Leman in Eureka appreciates the support they've received from their customers all over central Illinois and beyond. Visit them today at LemanGM.com.

Today's message is not intended for little ears. We'll be discussing some adult themes, and I want you to be aware before you listen to this message.

Dr. Kris Christiansen is a sexual medicine specialist, and we are fortunate to have her as a guest today to share about sexual intimacy and the role of hormones. She will also offer solutions to common issues that arise in this area of marriage.

Here's our chat. [00:01:18]

Welcome to The Savvy Sauce, Dr. Christiansen.

Dr. Kris Christiansen: Well, thank you so much, Laura, and it is a pleasure to be here. I'm honored to be part of your program.

Laura Dugger: Will you just start by telling us a bit more about yourself and how you ended up in this somewhat unique career?

Dr. Kris Christiansen: It is a unique career. Well, I'm a family physician, and I practiced full-spectrum family medicine for about 10 years before all this happened. Now, I delivered babies and took care of children and adults of all ages, but I always kind of felt unsettled, like there was something else for me and really didn't know what that was.

I prayed to the Lord that he would give me direction where to go, what to do, you know, because after going through medical school and all that time, it's hard to think about change. But what happened was that my husband and I joined a small group on marriage in our church, and we were going through the book, Love & Respect by Emerson Eggerich, which is a great book. [00:02:28] But that first week we met, the leaders asked if anyone wanted to lead a particular chapter. And I'm thinking, "Well, you know, I'm working full-time, I got two small kids, my plate is full, I don't need to add one more thing."

But wouldn't you know that my husband raised his hand and said, "We'll do the one on sex." I thought, "What in the world are we going to talk about?" Because, you know, we could have used a little help in that area too.

So I went to the local Christian bookstore because I had to get books, you know, I always have to rely on something. Our library grew quite a bit after that trip, which was kind of fun. I had prepared this talk knowing that it wasn't going to be much of a discussion in the small group setting because nobody wants to talk about it.

With that opportunity, it was a fun group. And then later, the leaders of our women's ministry asked if I would do that same talk at our women's retreat. [00:03:38] I go to a small church, so here we have, what, 50 women, basically sitting on the edge of their chairs, eyes wide open, taking notes about everything that God had inspired me to talk about.

So through that, he just opened my eyes and what a huge need we have in terms of sex and marriage, because we often don't talk about it. There were several things that happened after that where God just opened key doors. I was able to get training in this area. And then a few years later, this is what I do for my sub-specialty. And it's very rewarding.

Laura Dugger: I love to hear that. Then I'm curious, what type of sexual dysfunctions are most common for your clients to experience?

Dr. Kris Christiansen: Well, I see both men and women, and they have a host of things going on. [00:04:41] As far as female sexual problems go, the most common one is low libido. But sexual dysfunction is usually categorized into four different domains: libido, pain, arousal, and orgasm problems. Women rarely have just one problem. They have two or more of these issues, and each one affecting the other.

A common scenario is for a woman, often in her middle years, but I've seen young women, in their late teens, early 20s. My oldest patient was a man who's 95. Yeah. And I have a handful of 80-year-old women in my practice. It's actually quite fun.

But the common scenario for women, low libido, decreased sexual desire. The root problem is usually not just low libido, it's often associated with other underlying problems, like pain, or decreased arousal, or that difficulty with orgasm. [00:05:47]

So sometimes the low libido is just due to the brain's neurochemicals being a little off-balance, kind of like depression. You know, depression isn't necessarily due to a specific situation, but our brain chemicals are just a little out of whack. In that case, there's no specific external factor contributing to the low desire. It's as if somebody just turned off the switch. And no matter how many date nights, glasses of wine, or vacations she may take, she just doesn't have the desire to engage in sexual intimacy. And it can be really distressing for her, and hard on the relationship. So it's also a matter of trying to figure out what else is contributing to it.

Pain is a very, very common concern. And there are so many things that can cause pain. I see a lot of women who've been to several doctors and other providers who basically just brush them off, say, you know, again, have a glass of wine, relax, use more lubricant, and you'll be fine. [00:06:55] But no matter how much lubricant they use, it's still going to hurt. And then if they have that low desire, along with pain, it's just really not going to help.

One of the common causes of pain in pre-menopausal women is birth control. Hormonal birth control like pills, you know, birth control pills, the patch, or NuvaRing, they can have a significant impact.

Now, most women tolerate those birth control pills just fine and don't have any problems. But there are a few who experience very significant side effects from these medications. We know that birth control can cause low libido and pain, decreased arousal, and problems with orgasm, because the contraception affects their hormones. These pills significantly decrease our own body's estrogen and testosterone, and that has a huge impact. [00:07:53]

I've seen many young women who have so much pain that they are unable to tolerate any kind of vaginal penetration. I mean, not even a tampon, let alone have intercourse. So these women are in loving, stable relationships, and they really want to be intimate with their husband, but they just can't because of the pain. So you can imagine what impact that has on the relationship.

So if we just stop the pills, it helps, but it doesn't necessarily resolve the pain because these vulvar tissues have undergone changes, often like menopause, and usually needs to be treated with a hormone cream to restore these tissues.

These women also have very tight pelvic floor muscles, which contributes to the pain, and then pelvic floor physical therapy can be helpful. So before sending them off to PT, though, we'd like to heal up their vulvar tissues so PT has the best benefit for them. [00:08:52]

As women age, our estrogen levels fall during perimenopause and menopause, and those low estrogen levels contribute to a similar issue with vaginal dryness and painful intercourse. So very similar situation to what women experience with birth control pill problems.

As for men, the most common concern is erectile dysfunction. ED is really common. We know that ED can affect 40% of men in their 40s, 50% of men in their 50s, 60% of men in their 60s, and so on. So by the time he's 95, he probably does need a little extra help.

Our patients have usually tried at least one medication like Viagra or Cialis before they come to see us, but unlike those old commercials used to imply, the oral medications are only effective in about 60% of men, not 100%.

So we offer other treatment options besides just the oral medications, and we also encourage healthy lifestyle habits like adhering to a healthy diet and getting adequate sleep, which is so important, quitting smoking, limiting alcohol, and getting regular exercise because all of these things can be helpful. [00:10:08]

Bottom line, if someone has concerns about their sexual function, they should first talk to their primary care provider. If that doesn't help, then seek out a sexual medicine provider because we are out there, and we're there to offer hope.

Laura Dugger: Wow, I'm just in awe of all of your knowledge and the way you succinctly articulate all of this. Just a follow-up question, is it true that women who are nursing can sometimes experience those same side effects as someone who is in menopause?

Dr. Kris Christiansen: That is absolutely true. We know that during pregnancy, estrogen levels rise, so they're relatively high throughout the pregnancy, which is great. Women often feel much better when they're pregnant. And then as soon as that baby is born and when you're breastfeeding, estrogen levels plummet, and they are really, really low, just like menopause. [00:11:09] And you throw in a few other hormones like prolactin, which also decreases sexual desire, it makes sexual function a little challenging in that postpartum period. Sometimes a little vaginal estrogen can be helpful for pain, but also know that it will get better.

Laura Dugger: And now a brief message from our sponsor.

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Sam and Stephen understand that you have many different choices in where you buy or service your vehicle. This is why they do everything they can to make the car-buying process as easy and hassle-free as possible. [00:12:11] They are thankful for the many lasting friendships that began with a simple “Welcome to Sam Lemans”. Their customers keep coming back because they experience something different.

I've known Sam and Stephen and their wives my entire life, and I can vouch for their character and integrity, which makes it easy to highly recommend you check them out today. Your car buying process doesn't have to be something you dread, so come see for yourself at Sam Leman Chevrolet in Eureka. Sam and Stephen would love to see you, and they appreciate your business.

Learn more at their website, Lemanyureka.com, or visit them on Facebook by searching for “Sam Leman in Eureka”. You can also call them at (309) 467-2351. Thanks for your sponsorship.

Laura Dugger: For the male's side, I'm sure erectile dysfunction, it's too broad to give simplistic reasons, but when you say 60% of men in their 60s and so on, is that often due to the decrease in testosterone that men experience, or is it often related to circulation and their heart health, or are there any other main reasons? [00:13:23]

Dr. Kris Christiansen: Yes, there are a lot of reasons. Men and women, our testosterone levels kind of decrease, maybe 1 to 2% per year, so not huge amounts, so that, you know, the decreased testosterone does impact erections. But even more importantly, it's all these other factors, like age and the wear and tear on the blood vessels, and things that can impact erectile function, high blood pressure, high cholesterol, smoking, diabetes, and being overweight. So the better that we can control all of those factors, the better the blood flow and the better the erections.

Laura Dugger: This is a rather broad question, but hormones clearly affect us in so many ways. So, Dr. Kris, what all can you teach us about hormones?

Dr. Kris Christiansen: Hormones affect absolutely everything. In women, there are three important sex steroids or hormones. I use steroid and hormone interchangeably. But there's estrogen, progesterone, and testosterone. [00:14:33] And we think of estrogen for women and testosterone for men, but both sexes need both hormones.

Women need a little testosterone and men need a little bit of estrogen for their bones. So, for women, we have about 10% of the amount of testosterone that men do, and we need that 10% for sure. It has such an impact on energy and libido and arousal, lubrication, and all those really good things.

Likewise, estrogen has a huge impact on just about every body part. It also impacts sleep, our cognitive abilities, our mood, and definitely the sexual function.

The ovaries start producing estrogen in puberty, and our ovaries continue this production until menopause. There may be some breaks like with breastfeeding, but during our reproductive life, estrogen levels fluctuate throughout the menstrual cycle, and they're highest at the time of ovulation. [00:15:38] And we also know that testosterone levels increase a little bit around that time, which then increases desire. So, you know, it's God's way of helping families to continue to multiply and grow.

So at least around that time of ovulation, libido increases. After ovulation, estrogen levels decrease, and progesterone levels increase. So if conception doesn't occur, then the progesterone levels drop in the experience of period.

When progesterone levels increase, some women may feel a little or a lot more irritable, which is that contributing factor to PMS. For others, progesterone can have a calming effect. Actually taking progesterone as a medication in perimenopause, and menopause can help with sleep, which is kind of nice.

So estrogen affects pretty much every organ in the body. In the brain, it affects our body temperature adjustment. In the perimenopause, menopause years, when our estrogen levels fall, that's when those hot flashes occur. [00:16:42]

It can also affect memory function, learning, language. Sometimes in perimenopause, with those fluctuating estrogen levels, we might have some word-finding problems, trouble making decisions, and just experiencing some brain fog.

Estrogen affects our skin, has to do with elasticity, and has an anti-aging effect. It affects our bones, which has to do with bone strength and bone density. So when estrogen levels fall after menopause, you have an increased risk of thinning bones, osteoporosis, and fractures, unfortunately. So it's important to take that calcium to keep your bones strong.

Estrogen also affects our liver, and that's where the cholesterol production is regulated. So some women experience increasing levels of cholesterol after menopause once those estrogen levels fall.

It also has cardioprotective effects before menopause. [00:17:42] You know, the Women's Health Initiative study, way back, you know, 20 years ago, we used to think that every woman should be on estrogen after menopause because it protects the heart. And that is true when we start estrogen prior to menopause, but after menopause, unfortunately, has the opposite effect and can increase the risk of heart attacks.

Estrogen affects our ovaries, and that's where we get the egg maturation release every month, giving you a period or a pregnancy. And the effect on the uterus, it's monthly preparation for pregnancy in pre- and perimenopausal women. So in perimenopause, if you're still getting a period, even if it's irregular, you could still, fortunately or unfortunately, get pregnant.

Then there's testosterone. Testosterone is really important for both men and women. And like I said, women have about 10% of the amount of testosterone that men do, but we need that because it affects things like libido and lubrication, arousal, and orgasm. [00:18:47] It also helps with energy, mood, and concentration.

Fun fact, women have more testosterone than estradiol or estrogen throughout our lives, and people don't realize that. In our reproductive years, the average level of estradiol is 150 picograms per milliliter. That's just the measurement. During those same reproductive years, we have on average 400 picograms per milliliter of testosterone. 150 versus 400. Who knew?

Laura Dugger: Hmm.

Dr. Kris Christiansen: Yeah. After menopause, estrogen levels fall. So after menopause, estrogen levels are in the 10 to 15 picograms per milliliter range, whereas testosterone is about 290. Again, much, much higher. When women have their ovaries removed with surgical menopause, estrogen levels are quite low, but that also drops our testosterone levels down to 110 instead of 290. [00:19:57] So our ovaries are efficient little hormone factories.

As for men, we know testosterone is really important for them. It affects their mood, concentration, libido, sexual function, muscle mass, strength, endurance, and bone health. If men have low testosterone, they may experience low energy, decreased stamina, decreased libido, trouble with their erections, and trouble with orgasm.

Many of these problems are common and nonspecific. So they might experience these issues and still have normal testosterone levels. So just because they have decreased energy or decreased stamina doesn't automatically mean that their testosterone levels are low. We only want to go about treatment if they have low testosterone levels because there are risks and side effects associated with it.

People often ask how we can maximize our healthy functioning throughout our lives. [00:21:01] Well, it all has to do with just basically taking really good care of ourselves. We should eat a healthy, well-balanced diet with lots of fruits and vegetables, minimize processed foods, and get adequate sleep, which usually means somewhere between seven to nine hours a night.

If we're not getting enough sleep, we're not getting that restoration, and it can definitely impact especially testosterone levels. We also recommend exercising regularly. CDC recommends 150 minutes per week. Maintaining a healthy weight is also really important. We want to drink plenty of water, minimize sugary drinks, and minimize alcohol too.

Other things to avoid: tobacco, vaping, excess alcohol, and drugs. We also want to try to minimize stress and have a healthy way of coping with stress because we know problems occur, stress occurs, but if we have a healthy way of dealing with that, it can have a positive impact. [00:22:04]

As a medical provider, you need to see your medical provider, your family doctor, or internist for routine preventative care. It's really, really important. Much better to prevent problems than to treat them because those problems then lead to effects on our sexual function and our hormone levels.

There are no specific foods, drinks, or supplements that help with hormones. People ask all the time, what if I take this or what can I eat? Again, it just comes down to the bottom line of eating a healthy diet with lots of fruits and vegetables.

I want to caution your listeners about all those supplements that are out there. These supplements, they can make all kinds of claims and promises for miraculous results, but they usually don't have any scientific basis for these claims and they're not regulated by the FDA. So there's no guarantee that what they say on the label is actually in the capsule or pill that they're taking. [00:23:09]

There can be ingredients and even medications that are not reported on the label, and these can interact with current medications. So it can actually be dangerous. So I caution my patients to save their money and try to stay away from those supplements that make all kinds of crazy promises.

Laura Dugger: There is an exciting project taking place behind the scenes right now, and I would love to invite you to participate. I will give you more details as I'm able, but for now, here's my request. Will you email me your personal story of a specific way God has clearly shown up in your life?

Big or small, I want to hear an account of the way he made Himself known to you and maybe received credit for an answered prayer, or a way He worked out a situation in a miraculous way, or how he displayed His power in your life. There's no limit to the type of story to submit, as long as it's true. So please email me your story at this email address, info@thesavvysauce.com. [00:24:15] I can't wait to read your story. Thanks for sharing.

Just as you're sharing these ways to be healthy and how much that affects everything, even our sex lives in marriage, it just makes me think of self-control, which is a fruit of the Spirit. God has laid out these lifestyle rhythms that are healthy and support everything. So from my understanding, testosterone is replenished after sleep. And even when we engage in sex, we then produce more testosterone. Is that correct?

Dr. Kris Christiansen: Yes. Testosterone levels rise during sleep. So they're highest in the morning and lowest in the evening. This is especially true for men, less so for women. And if we don't get that restorative sleep, our body just can't reproduce or replenish that testosterone, which is really important. [00:25:17]

As for increasing levels after sex, maybe a little bit, but not a huge amount. Sex and orgasm definitely increases other hormones like oxytocin and dopamine, norepinephrine, which is all great stuff. But the increase in testosterone after sex, it's probably negligible.

Laura Dugger: Okay, that's helpful clarification. Now that we've kind of discussed this role of hormones, will you also educate us on hormone therapy?

Dr. Kris Christiansen: Hormone therapy is the treatment of menopausal symptoms with estrogen and or progesterone. It can be started during perimenopause when you start having those symptoms. And it can be really helpful during that time. It's also really safe.

It was previously called HRT or hormone replacement therapy. But in the last few years, this terminology has been changed to MHT or menopause hormone therapy. [00:26:24] Because we're not trying to necessarily replace everything. We're just trying to address those symptoms, which can be really bothersome for some women.

In 2002, this study came out, the Women's Health Initiative, which was a huge study, like 60,000 women, average ages of 50 to 79. It was that study that scared all women off their hormones, and it scared doctors from using or prescribing it for the next 20 years, which is where we're at now. The pendulum is starting to swing a little bit and we still have a little ways to go.

This study, unfortunately, did women a huge disservice because they were starting older women, women in their 60s, 70s, and even 80 on estrogen. And we don't do that now because we know that the risk with estrogen does go up when we start those hormones in older women, which is over the age of 60. [00:27:29] And so if we started prior to the age of 60 and within 10 years of menopause, there are a lot of benefits to it and minimal risk.

This study, the Women's Health Initiative, we call it the WHI, you know, it's been analyzed and re-evaluated a number of times. So we've been able to come to terms with some of these issues. The benefits of estrogen, when we start them within 10 years of menopause and before age 60, it's one of the best treatments that we have for hot flashes and night sweats.

It can help with sleep in perimenopause and menopause. It also helps with urinary tract symptoms. It helps with sexual function and improves our skin. Remember, it has that anti-aging effect.

Other benefits. Studies show that there is a decreased risk of developing diabetes, improved blood sugar control if you do have diabetes. [00:28:29] It's great for bone health. It prevents bone loss and reduces fracture risk. There's also like a 30% decreased risk of colorectal cancers.

It's also great for your brain. Women who start estrogen earlier on, again, within 10 years of menopause, before age 60, have a decreased risk of Alzheimer's. It's good for the mood. It may help with depression and perimenopause and improve well-being. There are several studies that show a reduced risk of heart disease when we start it early on, too.

So lots of good things. We do have to be careful because there are potential risks. And the risks increase when we start estrogen in older women, older than 60 or more than 10 years after menopause. With that, it carries the increased risk of gallstones, blood clots, cardiovascular events like heart attacks and strokes, and potentially breast cancer. [00:29:29]

But there was a study published just this past year on looking at whether estrogen really does cause breast cancer. It compared 40,000 women with breast cancer and 400,000 women who did not. And through this study, bottom line was that estrogen did not increase the risk of breast cancer, which is amazing.

Let me say that again. Estrogen did not increase the risk of breast cancer. What they did find increase the risk was synthetic progesterone, which is like Provera. And with that, slight increased risk. However, if we use a so-called bioidentical form of progesterone, which is Prometrium, it's the same structure as our own body's progesterone, there was no increased risk. Again, bottom line, estrogen did not increase breast cancer in that study. [00:30:33]

Other risks with estrogen is that if women still have their uterus, you know, no hysterectomy, they do have to take progesterone. Again, we want to take that bioidentical one because the progesterone protects against uterine cancer. Unopposed estrogen, meaning no progesterone, can thicken the lining of the uterus and that can lead to cancer. But taking the progesterone eliminates that risk. Just like we talked about, the safest type of progesterone is micronized progesterone. Prometrium is the brand name.

As women get older, you know, they have changes such as vaginal dryness and thinning of the tissues and other problems that we call genitourinary syndrome of menopause. And if it's just the vaginal symptoms that we're treating, vaginal estrogen is highly effective and extremely safe.

So vaginal estrogen is a cream and it just acts locally. [00:31:34] It doesn't have the systemic effect like pills and patches do. It most definitely does not cause breast cancer, heart attacks, strokes, or blood clots.

But if you get a prescription for this vaginal estrogen and you read the package insert, unfortunately it lists these risks of breast cancer and heart attacks and dementia and all kinds of crazy things. But the drug companies take the risks associated with systemic estrogen, that's the pills and the patches that increase our blood levels, and they apply that same risk to the vaginal treatments. It's a class effect. This is not the case.

I want to emphasize this is not the case because vaginal estrogen is really, really safe and it can basically be used until you die. There's no reason you have to go off it unless you do get breast cancer, which was not caused by the cream. But for that, you probably have to go off it for at least a period of time. [00:32:34] If you don't want to use that vaginal estrogen, then there are over-the-counter vaginal moisturizers, which if used regularly and consistently every few days, it can be helpful.

Laura Dugger: Wow, Dr. Chris, I have never heard this WHI analyzed so well. I'm just thinking of a few, I'm gonna paraphrase, just a few scriptures off the top of my mind where the Lord talks about my people, I think he says perish for lack of knowledge. That is so unfortunate that women have been given this disservice with this lack of knowledge. And yet in your unique career you are helping set captives free. Because when you're captive to insomnia and hot flashes and all these unpleasant symptoms, that is incredible that we have healthy and safe options available.

Just to clarify, so when women start over the age of 60, that can have adverse effects. [00:33:36] But these same women, if they started prior to that or within 10 years of menopause, then you're saying they even continue after age 60 and it's still safe if they started before that?

Dr. Kris Christiansen: That is true. And that's what the more current research findings are reporting. Unfortunately, if a woman goes to her doctor and having, you know, hot flashes and night sweats and not sleeping, the majority of medical providers aren't always on top of all this more recent information. So doctors are still afraid to prescribe estrogen.

And if you start it early on when it's really helpful and actually protects against all kinds of great things, or protects against bad things actually, it is safe to continue. But the guidelines from years ago say only use the lowest dose for the shortest amount of time needed, you know, try to get off it within five years. [00:34:41] That's still in most providers' minds what they should recommend, but that's not the case.

After age 60 or 65, the North American Menopause Society, they say it's an ongoing conversation between a patient and her provider talking about the risks versus the benefits. And if you continue it, and it's important to get your mammogram every year, it's safe to continue as long as you don't have a heart attack in the meantime or a stroke. That would be reasons to have to stop estrogen.

Laura Dugger: You're also saying estrogen and progesterone, those you would want to start together, is that right, at the same time?

Dr. Kris Christiansen: If you still have your uterus, you have to take progesterone, yes.

Laura Dugger: And at what age approximately would you recommend that?

Dr. Kris Christiansen: Recommend starting it?

Laura Dugger: Yes. [00:35:40]

Dr. Kris Christiansen: When a woman starts having symptoms. I'm a fan of starting it in perimenopause when those hot flashes start, because it can just be so helpful and protective for the heart and the brain and good things. Some doctors, though, may not want to start it until the woman is officially menopausal, which is 12 months after her last period. Bottom line, when a woman is experiencing symptoms, hot flashes, night sweats, brain fog, that would be an ideal time to start hormone therapy.

Laura Dugger: Okay, thank you for that. I'm also curious, because you said a lot of providers are not aware of this, and I would say probably the general population is not aware of this. So where are some trusted places where you do find this information, or how do you stay current with sexual health and medicine? [00:36:43]

Dr. Kris Christiansen: Things are changing all the time. Medicine changes all the time and so staying current is important. I think one of the best places to find information on menopause and hormones is going to the NAMS, North American Menopause Society website, which is menopause.org.

Laura Dugger: Okay, wonderful. We'll put a link to that in our show notes for today's episode.

Dr. Kris Christiansen: Another great website, which is up and coming, is called PROSAYLA.com, P-R-O-S-A-Y-L-A. This is a website that is directed to the patient people, not providers, but providers can learn a lot from that too. It is supported by ISSWSH, the International Society for the Study of Women's Sexual Health. So that's like my AMA, American Medical Association. [00:37:43]

ISSWSH has this new website, just came live last year, that has all kinds of great articles that are based on science. I am on the committee that started this. I wrote a couple of articles that are on the website, and that's where people can go to find absolutely reliable information. I'm passionate about this, as you can tell.

Laura Dugger: Yes, well it's so good. I think clearly you just have an abundance of wisdom to share with us. There's still so much more that I want to hear about low sexual desire and orgasm. And just hear you explain perimenopause and menopause, just so many more topics. But we are out of time for today, so can we pause this conversation here and pick it up next week?

Dr. Kris Christiansen: Absolutely. Yes, no, I would love to chat with you again, Laura. This has been great.

Laura Dugger: Okay, wonderful. We will pause for now, but until we meet again next week, could you provide your website where listeners could go to find out more about you in the meantime? [00:38:52]

Dr. Kris Christiansen: Yes. I actually started a business called Intimate Focus, and the website is Intimate-Focus.com. So with this business, I wanted to provide a place where women and couples can learn more about sexual health, sexual wellness, and purchase quality products to enhance their sex lives. In my medical practice, I often recommend getting a good lubricant or a vibrator, which can help with stimulation. But so many women are often reluctant to go to an adult store, for obvious reasons, or order something from Amazon, because of all the data that gets collected, and it shows up on your previous purchases and such.

So I wanted to provide a safe place to do this, and God has definitely planted this on my heart. My medical specialty and this business are part of my ministry, because I want to help educate and empower women and take away the shame associated with sex.

I believe that sexual health, function, and pleasure are God's given gifts, and we should be able to enjoy sexual intimacy throughout our lives. [00:40:04] However, as we discussed, you know, there are a lot of factors that can impact sexual function, and people need to know that there is help available.

So from the website, Intimate-Focus.com, you can purchase items which will be mailed in a discreet box, and the business name is IGH Focus, not Intimate Focus, so no one's going to suspect anything crazy. I will also be adding a page of resources and information where there are going to be more scientific-based articles and other information.

Again, Intimate-Focus.com, and if you click on the contact button, it gives you a form to fill out for an email, and that just comes right to me. So I would love to hear from you.

Laura Dugger: Wonderful. We will add all of these links to the show notes for today's episode, and I look so forward to continuing this conversation next week. So thank you for being my guest.

Dr. Kris Christiansen: Oh, thank you so much for inviting me, Laura. This has been great. [00:41:05]

Laura Dugger: One more thing before you go. Have you heard the term "gospel" before? It simply means good news. And I want to share the best news with you. But it starts with the bad news. Every single one of us were born sinners and God is perfect and holy, so He cannot be in the presence of sin. Therefore, we're separated from Him.

This means there's absolutely no chance we can make it to heaven on our own. So for you and for me, it means we deserve death and we can never pay back the sacrifice we owe to be saved. We need a savior. But God loved us so much, He made a way for His only Son to willingly die in our place as the perfect substitute.

This gives us hope of life forever in right relationship with Him. That is good news. Jesus lived the perfect life we could never live and died in our place for our sin. [00:42:05] This was God's plan to make a way to reconcile with us so that God can look at us and see Jesus.

We can be covered and justified through the work Jesus finished if we choose to receive what He has done for us. Romans 10:9 says that if you confess with your mouth Jesus is Lord and believe in your heart that God raised Him from the dead, you will be saved.

So would you pray with me now? Heavenly, Father, thank You for sending Jesus to take our place. I pray someone today right now is touched and chooses to turn their life over to You. Will You clearly guide them and help them take their next step in faith to declare You as Lord of their life? We trust You to work and change their lives now for eternity. In Jesus name, we pray, amen.

If you prayed that prayer, you are declaring Him for me, so me for Him, you get the opportunity to live your life for Him. [00:43:04]

At this podcast, we are called Savvy for a reason. We want to give you practical tools to implement the knowledge you have learned. So you're ready to get started?

First, tell someone. Say it out loud. Get a Bible. The first day I made this decision my parents took me to Barnes and Noble to get the Quest NIV Bible and I love it. Start by reading the book of John.

Get connected locally, which basically means just tell someone who is part of the church in your community that you made a decision to follow Christ. I'm assuming they will be thrilled to talk with you about further steps such as going to church and getting connected to other believers to encourage you.

We want to celebrate with you too. So feel free to leave a comment for us if you made a decision for Christ. We also have show notes included where you can read Scripture that describes this process.

Finally, be encouraged. Luke 15:10 says, "In the same way, I tell you, there is rejoicing in the presence of the angels of God over one sinner who repents." [00:44:07] The heavens are praising with you for your decision today.

If you've already received this good news, I pray that you have someone else to share it with today. You are loved and I look forward to meeting you here next time.

Welcome to The Savvy Sauce

Practical chats for intentional living

A faith-based podcast and resources to help you grow closer to Jesus and others. Expect encouragement, surprises, and hope here. Each episode offers lively interviews with fascinating guests such as therapists, authors, non-profit founders, and business leaders.

They share their best practices and savvy tips we can replicate to make our daily life and relationships more enjoyable!