Show notes
*DISCLAIMER* This episode includes adult content and is not intended for young ears. **Transcription Below** 215. Enriching Sexual Function, Part One with Dr. Kris Christiansen Hosea 4:6a (KJV) "My people are destroyed for lack of knowledge: because thou hast rejected knowledge," 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. Sponsor: Sam Leman Chevrolet in Eureka has been owned and operated by the Bertschi Family for over 25 years. A lot has changed in the car business since Sam and Stephen's grandfather, Sam Leman, opened his first Chevrolet dealership over 55 years ago. If you visit their dealership today, though, you'll find that not everything has changed. They still operate their dealership like their grandfather did, with honesty and integrity. 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…
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