Episode 22 | Holistic Women's Health and Sexual Health and Wellness for Women
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Holistic Women's Health and Sexual Health and Wellness for Women
[00:00:00] Welcome to the Holistic Health Show, where the worlds of science and spirituality converge to illuminate a path towards total well being. Join us as we embark on a journey to bridge the gap between Western medicine and complementary therapies, offering you a roadmap to embrace a proactive, holistic approach to your health.
[00:00:21] It's time to empower yourself with choices that nurture your body, mind, and soul. Welcome to a world of infinite possibilities for your optimal health.
[00:00:31] Amy Squires: Hello, everyone. Welcome back to the show today. We have Amanda Lewis joining us from the States. I'm very excited to have you on the show today. Now, Amanda, you are from Vivacious Women's Wellness. It's your own business, which is very exciting. And you're a nurse practitioner. And today we're actually going to discuss something we've not discussed on the show before, and that's women's health and [00:01:00] sexual wellness.
[00:01:01] Amy Squires: Yes,
[00:01:02] Amanda Lewis: I'm very excited. So thank you for inviting me on the show. As you can hear, I am from the southern part of the States. So I'm from the deep South. That's Louisiana, Mississippi area. So, most people, if you don't know the States, you at least know New Orleans. Okay. So I'm about 45 minutes north of New Orleans between Baton Rouge and New Orleans, but my business is in Baton Rouge.
[00:01:28] Amanda Lewis: So I like to kind of explain what I have done in the past and kind of what led me here. I started off as a nurse and I've always loved labor and delivery, but it was hard to get into eventually got into labor and delivery had a bunch of crazy stories before that. But that's another day. So finally got into labor and delivery and the place that I was working here did not have midwives.
[00:01:56] Amanda Lewis: So I was working with OBGYNs and I [00:02:00] realized that, ooh, I don't like this. It can be so much better. So then I found another place in Baton Rouge that did have midwives and I moved over there as a labor and delivery nurse. Worked there for a little while and then decided I have to be a midwife, a certified nurse midwife, which is a nurse practitioner.
[00:02:19] Amanda Lewis: So here in Louisiana and in the States, it's a difference in midwifery than it is in other places. So we have two different types of midwives here, certified professional midwives, which basically do home birth. And birth center birth. And then we have certified nurse midwives So that's going to be from, you know, abnormal periods from as a teenager all the way through pregnancy, childbirth, menopause and beyond.
[00:02:48] Amanda Lewis: So my scope as a certified nurse midwife is very different. It's a lot more things that I do than a certified professional midwife. And so I, Started off [00:03:00] my career as a traditional certified nurse midwife in a hospital setting. It was a wonderful experience. I got to experience low risk and high risk birth.
[00:03:12] Amanda Lewis: We did water birth. We did twins and I mean it was just beautiful, but we also did a lot of high risk stuff and my skills were really good, but My heart just wasn't in it. So I moved over to the birth center of Baton Rouge and that is an out of hospital birth center and I worked there for several years.
[00:03:32] Amanda Lewis: I was the clinical director but I really had, as I started to age and I heard so many women coming in for their annual exams kind of complaining about the same things, I started to become more interested in sexual health. Because when you go to your traditional annual exam, Do you have anybody ask you, hey, are you having painful sex?
[00:03:56] Amanda Lewis: Are you having good sex? Most people don't ask about that, [00:04:00] but it's a very important part of a woman's life, especially in a long term relationship. So I wanted to make sure that that we talked about it. So I started training myself in it, and I looked for all the resources around here and realized there really aren't many resources.
[00:04:19] Amanda Lewis: I learned to do the O SHOT, which is another name for the orgasm shot, that is PRP, platelet rich plasma, that we inject into the clitoris and the g spot, and it's a non hormonal alternative to help with lubrication and help with increased sensitivity of the clitoris. And I can talk more about that later, but that's where I kind of started.
[00:04:41] Amanda Lewis: Of course, I had been talking to women about this for a long time, but as far as procedures and learning different things that you can do, I became friends with pelvic floor physical therapist here in town and Went to them and have them teach me. How do y'all do your exams so you can figure out [00:05:00] is this a muscle thing?
[00:05:01] Amanda Lewis: Is this a nerve issue? So I trained myself that way and then I became a member of Several organizations. I have a lot of Organizations that I'm a member of but one of my favorites is is switch. So it's the International Society for the Study of women's sexual health, and it is a wonderful resource. The only thing that they're worried about is women's sexual health.
[00:05:27] Amanda Lewis: So there's just a wealth of information. Now, of course, we've been doing male sexual health forever. I mean, how long has Viagra been around, right? But it, of course, we're behind the ball for women. So I'm very excited. I was very excited that women are, you know, finally getting research done and medications approved and techniques that are approved just for them.
[00:05:50] Amanda Lewis: So what with all of this knowledge that I started gaining, I decided to open up my own place. And I did not just want to do sexual health. I wanted to help women through [00:06:00] the middle part of their life. So I call myself the midwife for midlife. And that is during that really difficult time when you're hitting perimenopause, or you're going through menopause your, your parents are aging, your children are teenagers, you're at a higher level in your job, and you just have so much stress.
[00:06:21] Amanda Lewis: It is one of the most difficult times in our life, that fourth and fifth decade of our life. So I love to help women through that. The place that I opened is Vivacious Women's Wellness and it's holistic health care for women. And I focus on hormones, sexual health, and weight loss, and I do that for all the clients that walk in my door.
[00:06:44] Amanda Lewis: Some women just come to me for initially for sexual health, but then once they're there, they realize, oh, you can help with that, and that, and that. So it is a wonderful process to get to women, get to see women go from when they come in, they're stressed out. They can't even [00:07:00] remember the last time they had good sex.
[00:07:02] Amanda Lewis: They are exhausted. They can't get rid of this belly fat. And then at the end of the 16 weeks that I'm working with them, or, you know, some people end up doing two sessions. They're They're eating better. They're sleeping better. They're having good sex again. It's just wonderful to see these women blossom.
[00:07:19] Amy Squires: That must be incredibly rewarding. It is. I mean, yeah. And I mean, as I sit here, and anybody who watches the show regularly will know that I might just... I get thinking, you know, because some of these topics are so new to me and saying that with the topic being women's health and women's, you know, sexual health, you know, I have an awareness of my own health and general health, but when you mentioned you know, Viagra has been around for a long time, we've been talking about men's health for a long time.
[00:07:54] Amy Squires: It's, you know, kind of been shoved in our faces. I
[00:07:58] Amanda Lewis: mean, you see the [00:08:00] commercials all the time. They're even on when my children's stuff is on, and I'm like, Oh, I don't want you to see, you know, the man getting excited about Viagra. Like, I'm, you know, it's unnecessary. And,
[00:08:11] Amy Squires: and, you know, and Viagra's great, right? I mean, I, it's fun. But, it's not to tout Viagra itself, it's just the fact that it's there and women's, you know, sexual health isn't. And so that brings me back to, I don't think I've ever, as a 37 year old woman, been asked by any health professional what my sex life is like.
[00:08:32] Amanda Lewis: Really? Yeah. I'm so sorry.
[00:08:34] Amy Squires: I think when you think sex, you think, well, why would they be asking you what your sex life is like? Well, it's like, cause it's not just the, the act of sex, is it?
[00:08:43] Amanda Lewis: Well, specifically for me, so for my intake form, when you see me as a client I screen you for hormone deficiencies. I have like, This symptom tracker also screen you for anxiety, screen you for depression, and then screen you for sexual distress.
[00:08:59] Amanda Lewis: So there's [00:09:00] something called the female sexual distress survey. So some women don't have good sex, but it doesn't matter to them. Like, sex is not important to them. It's not important to their partner. Like, it's a functional thing. So on this little thing it says, like, in the past, I think it's in the past month it's. 16 questions, and if you score more than 11, it indicates that your, your sexual like, like your sexual experience, it does distress you. Not as in it's painful, although that's part of it but, It's something that I want to improve. Yeah, it matters. So, for my annual exams, I started asking women about their sexual health years and years ago and when I started asking them, people were like, no one's ever asked me that and it just felt like it opened the floodgates.
[00:09:50] Amy Squires: Yeah.
[00:09:50] Amanda Lewis: =And they started telling me, and I cannot explain to you, Amy, how many times I am the first person they've told that they were assaulted. You know as, or they were [00:10:00] molested as a child or, you know, I've been having sex with my husband forever, but it's always hurt.
[00:10:06] Amanda Lewis: So the thing is, it doesn't have to hurt. The holistic part of what I do is I'm not trying to say that I can fix everything, but I have a lot of connections in this town because I worked here for a long time. So if I have, if I do a pelvic exam and I find that these women have very tender areas that they need a pelvic floor therapist. I can refer you to them if you need help with some sexual trauma, I have therapists for that. If you need a sex therapist for you and your husband, because of some things going on, I have people for that.
[00:10:38] Amanda Lewis: I was telling you about so I have a woman who has, a Grade one uterine prolapse.
[00:10:43] Amanda Lewis: So she told me that sometimes she has pain with sex. Well, as soon as I did her exam, I said, well, I know why you have pain with sex. And she said, well, what do you mean? I said, well, your uterus is sitting a little bit lower. So that's causing your cervix to sit lower in your vagina. So direct Like direct[00:11:00] thrusting is gonna hurt your cervix, I said, so you're gonna have to get, so we looked up different positions that she could get in, but the best thing for her is called the O nut, and it's, it's O H N U T, and it's like a little donut vibratey thing that he puts on his penis, so he can go ahead and thrust and thrust and thrust, but it gives him a spacer, so he's not going as deep.
[00:11:23] Amanda Lewis: So she can enjoy it more because he's not just beating the hell out of her cervix every time, you know. So there are things that we can do to help improve your sex life. Many women really don't have much of a libido, like they have a very low desire for sex during that perimenopause and menopausal period because their hormones are really low.
[00:11:47] Amanda Lewis: And perimenopause, It tends to be a time of estrogen dominance. So your estrogen, it goes a little wacky, kind of like it does when you first start your period. You have like these irregular cycles, they're a little heavy, [00:12:00] and you can have these mood swings. So, we usually try to balance that by adding progesterone and then looking at the other things in your environment that can be increasing your or affecting your estrogen.
[00:12:11] Amanda Lewis: And that's part of that holistic thing. If you're not sleeping well, and you're not eating well, it doesn't matter how much estrogen I give you, or I'm sorry, progesterone that I give you. So, the holistic part of what I do is I look at your entire life. Hey, what's your husband's name? How long y'all been together?
[00:12:31] Amanda Lewis: How'd y'all meet? How's your relationship? How many kids do you have? Are they driving you crazy? Is your mother in law driving you crazy? Or your mom? And what about work? Are you happy at work? And we talk about this every single week. And I help walk them through life and making decisions and how to Give themselves more bandwidth by sleeping better, by eating healthier, by eventually starting to get, to add exercise to that for stress relief and for their bone health.
[00:12:58] Amanda Lewis: So, I don't have [00:13:00] been exercising to lose weight. I have been exercising for stress relief or, you know, doing weights to help them not have osteoporosis and be that little cow, you know, the little old lady that gets all bent over. So that's kind of. What I do and what I talk about. It
[00:13:16] Amy Squires: almost sounds like a girl's best friend, you know, it's just
[00:13:21] Amanda Lewis: It really feels like we're friends by the end of it because again, we're seeing each other every single week it, it almost feels like at the end of the 16 weeks, if we don't do the maintenance where I see them once a month at that point, I feel like I'm kind of missing a friend.
[00:13:35] Amanda Lewis: But it's really just nice to have someone to walk through it with you that doesn't know you, that doesn't know your family, that you can just be honest with about anything.
[00:13:46] Amy Squires: Yeah. And I mean, just having that conversation, like you said about. Opening the doors to hey, you know what? I'm here to talk to you about sexual health and to help you learn What's normal and what's not because yes, [00:14:00] you know if you don't have a close relationship With with anyone that you're comfortable having private and intimate conversations with yes, then when do you learn, you know?
[00:14:10] Amy Squires: Like I know myself. I don't know anything about menopause Nothing, and I don't know anything about IVF Like, I'm completely, you know, I don't know anything about pregnancy, really, because I don't, I don't have children, you know, it's not, I haven't lived it. And when I talk to my friends you know, who have been pregnant, they, and I, and I don't think it's intentional, but I feel like nobody ever tells me how it actually is. Because I don't think it's as great as some people say.
[00:14:40] Amanda Lewis: I will be honest with you about it. Sometimes it's good and sometimes it's not, you know.
[00:14:45] Amy Squires: And I've, as a paramedic in a past life, I've delivered children and I've attended to women who have been pregnant and had complications. So I've seen that side of it and that side of it, from my, Point of view, particularly because it was usually, it's an [00:15:00] emergency setting in most cases.
[00:15:01] Amanda Lewis: It's terrifying. Yeah, it's scary. Yes.
[00:15:04] Amy Squires: So I'm like, you guys keep saying this is friggin fantastic.
[00:15:07] Amanda Lewis: Well, you know, Amy, I will tell you I've had so many people, so I still deliver babies as well. I just do it PRM, which means as needed. So I just do maybe From one to three shifts a month, just because I love delivering babies well, I call it catching babies because you deliver a pizza, you know, you don't deliver a baby. That's just a little technicality, but the mamas do all the work. I'm just the one that catches. Okay. Absolutely. When there's complications, I know how to get in there and do what I got to do to get out. However, when you only see the bad, I will never forget, I had one mom one, it was a young couple and her mom was the she was like a nurse manager or D. O. N. director of nursing at one of the hospitals here, but it was a children's hospital. So the only thing she [00:16:00] saw was the bad babies that came in, like, with. Infections or payment with severe jaundice. So her whole perspective was skewed. You know, she didn't think that she wasn't in that normal birth space and that normal, like, when everything goes right, which most of the time it does and if you don't see the normal, and all you see is the abnormal, of course, you're going to have a very skewed perspective of what birth is and, it, it can be terrifying. So, birth is one of those things pregnancy, childbirth, postpartum, all of that is really good when it works, but when it doesn't, it can get bad really quickly and that's why you want to make sure that you have someone that is skilled.
[00:16:40] Amy Squires: So I'll just kind of just pop back and bring us back to how I was saying how uneducated I am about women's health, despite being a 37 year old woman and about, you know, my friends kind of, and just people talking about pregnancy. And I think part of it is, and maybe, maybe I'm wrong, but I think part of it is you just forget or you want to forget so that you'll kind of do it [00:17:00] again or don't live through that maybe traumatic time or something. But even like, you know, menopause, People kind of say, Oh, I wish I had a known and it's like, well, why don't we start talking about it? So everybody does know and and then I'm seeing so I recently started IVF and egg harvesting and I've we've just completed an embryo transfer And I know a lot of people who do it, but no one in my real or have done it But no one in my really close circle has So I've never had the opportunity to talk to somebody about what it looks like what it feels like, you know I knew there were needles. I knew there were hormones, but outside of that I really I didn't know. And I asked the nurses, and they were lovely, and I, you know, you think you're getting great care, and I, I did. I felt very safe through the whole process. And I remember saying to the nurse, so how am I going to feel taking these injections? And the needle thing didn't bother me, you know. Yeah. I got over that. That's fine. I didn't know that there would be things [00:18:00] that I would have to insert vaginally. I had no idea about that, medications that would have to, and for weeks, I'd have to do this. And, which again, it doesn't bother me, but I just had, you know, I, they sent me to the pharmacy and I came home with this huge bag and I sent a picture to my husband.
[00:18:16] Amy Squires: I was like, this is everything that I have to take for the next almost months.
[00:18:20] Amanda Lewis: I don't know if my body will take all of this.
[00:18:22] Amy Squires: Yeah, you know, and and then I felt horrible and the nurse said to me, no, you'll, you won't really, you'll, you'll be fine. So, oh, well, this is news to me because I know that just when I have my period, my hormones go crazy.
[00:18:35] Amy Squires: I feel like a mess. So, okay, but I'm not, I'm okay. If you say I'm gonna be fine. This is your, your, your thing. I did not feel fine. Emotionally. I was fine. Physically, I felt horrible. Yeah. I felt horrible. I hurt. I had a headache that didn't go away for almost two weeks. The whole time I was taking the injections, I ached.
[00:18:57] Amy Squires: I was exhausted. I slept. And I'm a bit of a, [00:19:00] I like sleep anyway. I'm, I'm like an eight or nine hours a night kind of person, like that's my optimal, but I couldn't get up in the morning and not because I felt sad or depressed. No. I was exhausted.
[00:19:11] Amanda Lewis: Yeah. And I'm very lucky. Yeah. Your body was. Yeah. Your, your body was doing a lot of stuff, but if you
[00:19:18] Amy Squires: And here this nurse just said, no, you should feel fine and I'm thinking, why wasn't I better prepared, you know? And what if I didn't have the flexible working space that I have? Because I was napping every afternoon. There was a couple of days when I think I was awake for all of three hours. And I'm not saying, and this is not to, you know, to intimidate anybody who hasn't done IVF and is planning to, this was my experience and I'm sure there are women who have worse or better experiences than me, but I guess the reason why I'm sharing my personal experience it is because Nobody told me and I don't understand why we don't talk about it. Why? Why do [00:20:00] people always wish they knew why don't so I don't share
[00:20:04] Amanda Lewis: well I don't really know and I it's really sad that We don't talk about these things.
[00:20:11] Amanda Lewis: So to me, perimenopause and menopause, they are these huge life changes that women go through. And I know that my mom didn't tell me about it. Her mother didn't tell her about it. If I'm lucky because I have some friends that are older than me. So they had kind of, said, Oh, wait, just wait. You'll know, you'll know and I am only 40, but I started having those night sweats this year. And I'm waking up thinking, do I have a fever? What is wrong with me? And then the mood swings and some of these other things. And then my mother had a hysterectomy. So, I don't know when she would have gone through natural menopause, right?
[00:20:53] Amanda Lewis: Right. So, with I was kind of talking about it a little bit earlier, but in perimenopause, [00:21:00] your estrogen becomes very dominant. You just don't have enough progesterone to balance out when you sometimes your estrogen levels are really high. Sometimes they're low. It's kind of like a roller coaster ride.
[00:21:12] Amanda Lewis: But they tend to be the much head much more dominant heart. hormone. Progesterone, we call nature's valium, usually helps to balance that part of it out, but when you have the levels going really high, sometimes it can't balance that out. And then often our testosterone just drops. So women always have testosterone.
[00:21:34] Amanda Lewis: So I know a lot of people don't know that we and men have estrogen. Okay. So it is a balance in our bodies that we need to maintain. So estrogen, when you finally run out of it completely. That's when you're going through menopause, once your periods stop, you start to have those mood swings, you will have hot flashes that you just cannot [00:22:00] stand like the whole room is cold and you feel like you're in the pits of hell, and you cannot calm down the nights.
[00:22:07] Amanda Lewis: sweats. Then you also have there's something called genital urinary symptoms of menopause. So that's when your vulva um, the labia and the vulva right there, that will start to atrophy or shrink. The clitoris will start to shrink and shrivel up. Your tissue becomes very friable, which means that it's very easy to tear or bleed or become irritated.
[00:22:28] Amanda Lewis: Vaginal lubrication is a thing of the past. You feel like it's the Sahara Desert down there. And all of this can be fixed with hormones. Now, I do have some things that are not hormones that you can use to fix it, but so many people are scared of hormones because of cancer risk. But when you're looking at estrogen in the vagina and like an estrous cream just on that vulva area, those are not getting in your bloodstream to the point where it's going to affect you for breast cancer.
[00:22:57] Amanda Lewis: Now I check every single person for their [00:23:00] history of breast cancer in their family. If they have a significant breast cancer history, there's some amazing genes, genetic testing that we can do to find out about your specific risk. So a lot of what I do is personalized medicine. So if you have this family history, I'm not just going to try to give you estrogen.
[00:23:17] Amanda Lewis: We're going to go through and look at your risk and benefits. And then we make sure we do shared decision making. But almost every single woman can use that vaginal. Or vulvar estrogen without having an increased risk of breast cancer. And that is a wonderful thing to use and it will help your sex life so much because sometimes no, no, it doesn't matter how much lube, if you get all this friction over and over again, it's gonna tear and there's bleeding and there's pain. You're crying. He's feeling like he just like, Cut you to pieces, you know and then your testosterone, the reason that you want to help replace that it's, it's your libido, but not just your libido. It also is your [00:24:00] muscle mass. It helps with depression and energy levels. So. Men tend to have this drop in their late 30s or to mid 40s, and you will see men, they really can use testosterone therapy as well to help them not just with their libido, but also with that muscle mass, depression, and energy level, okay?
[00:24:25] Amanda Lewis: So all of these hormones when you have a practitioner who you know you can trust, who will do the appropriate blood work and make sure that it's safe for you to take hormones, it can help make this transition period so much easier. It just, it's not even fair that women should have to go through this without hormones you know, if they are a safe candidate for them.
[00:24:48] Amy Squires: And some of those symptoms that you mentioned, like I feel like these are the things that we should know about, we should be prepared for. Yeah. And Again, going back to kind of, you [00:25:00] know, because as I'm aging and I'm noticing my body's changing and you look stuff up and It just becomes overwhelming, you know?
[00:25:08] Amy Squires: It does. Okay, and there's so much contradictory information. Yes. On even like how much of what you should have and at what age you should have it. And again, the age is, you know, it's kind of, it's a bit of a spectrum, isn't it? Because everyone's so different. Yes, I mean...
[00:25:22] Amanda Lewis: We have women having children in their 40s now all the time.
[00:25:25] Amanda Lewis: I mean, I think that Janet Jackson had one at 50. So I actually had a woman in my practice who was 50 years old and pregnant and she was mad about it. So, those change of life babies are a real thing, you know, yeah, I think especially as as you know our generation A lot of them put off having children and for, you know, different reasons.
[00:25:51] Amanda Lewis: So it's not unusual to have babies in your 30s and 40s now. It's actually pretty annoying.
[00:25:57] Amy Squires: Yeah, absolutely. I think we are definitely getting [00:26:00] older and you know, in doing the, hitting these kind of milestones, I suppose. And, and, you know, I often wonder too, is that why there's such, and I mean, maybe there's not an increase in it.
[00:26:12] Amy Squires: Maybe it's because it's more available. I'm not sure. But a lot of people I know. And like I said, I don't have intimate conversations with them about this, but I know plenty of women around my age who've, who've had all of their children through IVF. And I can't help but wonder if that's because like we're 40 now, you know?
[00:26:30] Amanda Lewis: So I will tell you with IVF. Once you are over 35, your increase, you have increased risk of certain chromosomal conditions, but also you want to make sure, I think that a lot of women do IVF because they want to make sure that the quality of eggs that they use, like, Is good, you know, because you only when you're born, so I have an interesting thing when I was pregnant with my daughter.
[00:26:58] Amanda Lewis: The eggs for my grandchildren [00:27:00] were already inside of her. Isn't that an interesting concept to think that while she was inside of me, my grandchildren were also inside of me. You know, I think it's just I've heard that before.
[00:27:12] Amy Squires: It's it's beautiful. Really?
[00:27:13] Amanda Lewis: It's a beautiful thing. Like, you have. All the eggs you're going to have, you know, when you're born and we, we, I mean, we don't need them for a long time.
[00:27:23] Amanda Lewis: So we don't use them. And then, you know, but once we get in our late thirties or early forties, you do have less eggs and then you, and not all the eggs are good quality either, you know? So that's why some of them will have miscarriages and they're like, I just don't know why when you have a miscarriage early in the first trimester.
[00:27:43] Amanda Lewis: I think. Okay. I can't remember which the source, but 80 percent of those or something genetic just didn't mix right. Like something just was not right, and it was, it never would have, you know, created life. So I think of sometimes those early miscarriages as [00:28:00] a, as almost like a blessing, because the child never would have been formed properly.
[00:28:04] Amanda Lewis: But. So even though we have all the eggs we're going to have when we're born, not all of those eggs are really great. So I think that some women just want to make sure that the quality of egg that they're using is good. And it's and it's not always the women that have difficulty. Sometimes, you know, you have to do IVF because the men didn't have like his sperm or wonky or, you know, you have to or they, they're not mobile or something.
[00:28:27] Amanda Lewis: They have, when you look at sperm analysis the terminology is pretty funny. Sometimes.
[00:28:31] Amy Squires: Yeah, they were, because I ask a lot of questions and as in the example of not having, not being told I wasn't going to have any symptoms, I don't always maybe get all the answers, but you know, they were, they had tested my husband as well when we were going through this process and it was, you know, sperm count and are they too big or are they too small and are they too fast or are they too slow?
[00:28:52] Amy Squires: And then you're googling, what does this mean? I had to get off the computer because it just was a rabbit hole. You [00:29:00]
[00:29:00] Amanda Lewis: can definitely go down. That's why I like to find good support groups in the area. So we have we've been very blessed. We have a support group in our area for infertility for women who've lost babies, for women who are pregnant and different places.
[00:29:16] Amanda Lewis: So it's really good to kind of connect with those other women who have. Gone through it already, or they're going through it with you so they can understand, like, the nurse told me that too, but look, this is how I feel.
[00:29:27] Amy Squires: Yeah. And it could
[00:29:28] Amanda Lewis: have just been if the nurse was trying to be kind and just, or she could have just been ignorant, you know, she might not really know if she's never gone through it herself.
[00:29:36] Amy Squires: Yeah, absolutely. You don't have everyone's experience, so. Yeah. Yeah. Hmm. I'd love to hear a little bit more so about, you know, the hormones that you, you offer to help women who are going through these stages of life. And I'd also like to know, I mean, you know, maybe I'm ignorant, maybe there's all sorts of this around me and I've just never, you know, sought it out, but. I, when I see my doctor, I definitely don't [00:30:00] get asked these questions. So, you know, in your area or anywhere else around the world, are you aware of many women doing the same sort of work that you're doing?
[00:30:09] Amanda Lewis: So in my area, we probably have, so as far as hormone clinics, you're, you'll find hormone clinics everywhere, to be honest with you in those big cities.
[00:30:20] Amanda Lewis: Some of them are more you just stop in, get your blood work. They send you your stuff and you'll see them again in three months. And that's the standard. The same thing for, for men's clinics as well. And I will tell you I don't treat many men. The only men that I treat are partners of my current clients.
[00:30:38] Amanda Lewis: Yeah, so if they suspect anything because it doesn't do me any good to get her libido up and stuff if he's Over there. Yeah, so I try to like one of my passions is those long term couples because you know If you've been with somebody for 20 years, and I have been with my husband for 20 years. You're like hey We might want to see if everything's okay.
[00:30:59] Amanda Lewis: [00:31:00] Yeah. Anyway, but what I do is different because I don't see anyone else specializing in the sexual health portion of it or really doing that holistic portion. And I think it's because I'm a midwife. So again, I'm a nurse practitioner, but I'm also a midwife and I've come from that holistic background.
[00:31:18] Amanda Lewis: My whole career, so I always got in trouble for talking with my patients too much. I always got in trouble for taking too long with my patients because I truly care about what they're saying. I care about here, you know and I will say medicine here in the States, and I'm not sure everywhere is not set up for.
[00:31:37] Amanda Lewis: For success for providers to be good clinicians, uh, you can still be a good clinician, but you just can't develop that relationship if you're having to see a patient every 15 minutes to make sure that you meet your quota to get what the insurance will pay you. That's why I don't work with insurance companies.
[00:31:55] Amanda Lewis: When you are coming from a place of wellness, I'm trying to bring them to a place of wellness. [00:32:00] And they're very best version of themselves. Insurance doesn't see value in that. And I honestly believe it's because insurance only is going to make money if you stay sick. So I like to try to heal you from the inside out.
[00:32:15] Amanda Lewis: And so the holistic portion of what I do and the sexual health portion of what I do, I think sets me apart. Now you were asking more specifically about the hormones. So. I do not typically use just oral hormones except for progesterone. The estrogen if you are in menopause and your symptoms and lab work indicate that we need to supplement with estrogen, I usually use a patch.
[00:32:42] Amanda Lewis: And you just change that twice a week, and I have several compounding pharmacies I work with, or I can just send it to your pharmacy if your insurance will cover it. Then for the vaginal estrogen, or estradiol specifically there's three different types of estrogen in your body, and [00:33:00] estradiol is the one that you really want.
[00:33:03] Amanda Lewis: For this type of stuff and it's a cream. So if I have someone who like I gave them the vaginal tablets or the vaginal cream already, the one that they put inside like a suppository, but they're still having itching or burning, like, in that clitoral hood area or like, on the labia, I will just give them a tube of SRA screen and that's what dryness is it?
[00:33:26] Amanda Lewis: Yes, it can be. It's from it's from all that atrophy because they don't have any of that estrogen to help plump up all that tissue so you can just use a like a pea size amount and you apply it to that area and it will improve very quickly and relief.
[00:33:39] Amy Squires: That must be.
[00:33:40] Amanda Lewis: Yeah. I mean, can you imagine you're, you're, you're downstairs? It's always itching. You're like, oh, we're going in the chair.
[00:33:48] Amy Squires: I mean, even when, you know, you get a yeast infection and thank goodness, I don't get them often, I've only had a couple in my life. But that, that, I imagine people get that all the time.
[00:33:57] Amanda Lewis: Yeah. So the vaginal [00:34:00] estradiol is either a tablet or a suppository or some most people don't like the cream because it kind of feels like that yeast medicine, that cream that we used to have to do forever ago. And it's like messy and it goes everywhere and it feels like it's just. So most people just prefer to do the pill. So the first time when you first start taking it, you do it every day for two weeks, then you switch it to just twice a week. So the, the patch is going to be twice a week and that vaginal tablet will be twice a week.
[00:34:28] Amanda Lewis: Now progesterone when you take it orally, It's fine. You take it at night because it does tend to make you a little bit sleepy. The main side effect of progesterone is constipation. So I tend to start on the lower end of the dosing and go up as needed. And then the testosterone, you have several different ways that you can do that.
[00:34:48] Amanda Lewis: I usually just use the cream. There's also injections. Most men tend to use the muscle. It's an IM injection or there's a pellet that you can do. Now, I am not a big fan of [00:35:00] pellets because I am a go low and slow kind of girl to minimize side effects. If you do pellets, you are going to get a good reaction.
[00:35:09] Amanda Lewis: However, it's like you have one really good reaction and it's almost like you can never get back to that same good reaction.
[00:35:16] Amy Squires: So what's a pellet? Is it a tablet?
[00:35:18] Amanda Lewis: It's like a little pellet. It's like a little small pellet and they use a trocar to put it like in your hip and what happens is it slowly or like the bottom part of your back and it will slowly release over three months, three to four months.
[00:35:33] Amanda Lewis: I
[00:35:33] Amy Squires: see. So it's like a slow release implant? It is.
[00:35:36] Amanda Lewis: Yeah, it is. This is very similar, I guess, to I don't know if you'll have the implant on that goes in your arm. It's a birth control. Yeah, I've heard of that. So, but it's a slow release, but if you have a reaction to it, I can't get it out. Right. So, you just have to suffer through it.
[00:35:52] Amanda Lewis: So, I know some people swear by them and love them and that is completely fine. But I, like I said, low and slow, try to [00:36:00] prevent you having a bunch of side effects and Still get the relief and feel good for the rest of your life Not just those first four months when you get your first one. Does that answer your questions?
[00:36:12] Amy Squires: Yeah, absolutely
[00:36:13] Amanda Lewis: Okay, good.
[00:36:14] Amy Squires: Absolutely. And then I mean I'm gonna so I know I'm aware that we're talking in two different very different countries and healthcare systems Yeah, so I am gonna look up later Some of these clinics, you know, in my area and around Australia, I mean, I'm sure they're here and I'm, I'd be keen to know, you know, what the model looks like and how accessible it is.
[00:36:36] Amy Squires: And, you know, cause like you said, you don't work with insurance, so does that make it very expensive for people? And again, I know that the. The insurance and healthcare model in the States is very different to Australia. So I want everyone listening to keep that in mind. And I, I will gather some information on that to make it more relevant to our Australian listeners. But what can you speak of that to anyone listening in, in the States?
[00:36:57] Amanda Lewis: So I have had so many [00:37:00] people come to me because they have already gone to see their OBGYN or try to see their primary care doctor and use their insurance and go through that process. But. It is fighting, you have to fight insurance companies so much to get everything covered and then they won't cover the stuff that you actually need.
[00:37:19] Amanda Lewis: So you end up getting a substitution and it's just not as effective. So seeing me, you do have to be willing to invest your time and your money. So I ask women. When I see them for the first time, are you ready to put you first? Yeah, because it's really a lot of times. It's the first time that women have put themselves first In their whole life.
[00:37:46] Amanda Lewis: So when you first
[00:37:46] Amy Squires: time they're having the conversation.
[00:37:48] Amanda Lewis: Yeah You know, so when you initially come to see me it costs four hundred dollars and that includes all of your lab work It's an hour long visit and it includes your physical exam I'm gonna do [00:38:00] a complete head to toe physical draw all your blood check your vitals And I will do a pelvic exam if you're having sexual health issues And my pelvic exam is going to be different than probably anything you've ever had before I do like explaining and talking about your body and saying, Hey, you see this part here?
[00:38:18] Amanda Lewis: Do you feel this here? And they're like, Oh yeah, I've never had an exam like this. So it's not weird. I promise. It's just very educational. And then that also includes your treatment plan visit. So you come back with me usually within a week and I will explain all the lab work and what I plan to do with you.
[00:38:37] Amanda Lewis: And then you have different levels of packages that you could work with me. So again, you're going to see me once a week for 16 weeks. That's going to include all your lab work, your hormones, your medications. And the, if you're not having to use prescriptions, if we're just going to do supplements and health coaching and life coaching, it starts at 1497.
[00:38:59] Amanda Lewis: And then [00:39:00] if we're going to have to do the script. Oh, wow. And then you can do the if you need to do the prescriptions, then that's going to be, it's more expensive because those medications cost more. So that's going to be 24. 97 and then the, the biggest or the most expensive package is what I call the Lux package.
[00:39:17] Amanda Lewis: It's for people who need me a lot. So you have my boxer so you can contact me multiple times a week if you need to, or if you're struggling with stuff and that's going to be 54. 97 because I can't have too many of those clients and have teenagers and a husband and two dogs, three cats. And for fish.
[00:39:36] Amy Squires: Yeah. That's a lot. That is a lot. Yeah. That, I mean, that sounds like really great value for money and I am conscious that it is an investment, you know, and it is something that you need to sit down and consider. Can I afford this? And is it worth it? You know, am I willing to make, you know, in, in some cases, some cutbacks to it, to put this first, but I can imagine if you're experiencing those symptoms, you're pretty damn likely to cut back in other to [00:40:00] get that money.
[00:40:02] Amanda Lewis: I have not had a single person come back and say it was not worth it. Like, I have helped a woman. She knew that she probably needed to retire. But when we started to identify her stressors, she realized that her work was a big part of her stress. So then, you know, she, she and I talking. Facilitated her talking to her husband and she decided to go ahead and retire and she is the happiest she has been She's lost.
[00:40:32] Amanda Lewis: I think 35 pounds good for her is She's having great sex. She's getting to see her grandkids all the time and She feels like a whole new woman and I can I can just tell you story after story after story of one women who They've basically taken control of their life and changed their life We talked about boundaries and meditation and yoga and I just help empower these women to live their best lives So it's
[00:40:59] Amy Squires: [00:41:00] really a wonderful thing.
[00:41:01] Amy Squires: It really does. It does sound to me like, you know, your best friend, because again, I go back to just seeing the doctor and, you know, cause you can go to the doctor and get you know, hormone replacements and things like this, but that you don't get the, the extra, you don't get the follow up. You don't get the, you know, you just get the blood work and the results sent to you and it's good or it's bad or you need more, you need less.
[00:41:21] Amy Squires: And it's about that connection, I guess. And I really think a lot and it sounds to me. Like a lot of the benefit these women are getting aside from the physical is just that sounding board of having this conversation and the education that I'm sure they're getting on. Yeah, sex doesn't have to hurt, you know,
[00:41:40] Amanda Lewis: and then I have women who don't know if they've ever had an orgasm.
[00:41:44] Amanda Lewis: I said, sister, we're about to figure some stuff out. Okay. I have resources for that. So, I also like I keep sex toys in the office not to use. Okay, please don't think
[00:41:56] Amy Squires: that
[00:41:57] Amanda Lewis: Like I sell them so [00:42:00] people can feel comfortable. They're like, what is that? I'll say Oh, we'll have an example right here. You can feel it.
[00:42:05] Amanda Lewis: You can touch it. And yeah then there's an amazing website It's called OMG. Yes calm. So if you have never if you're not Sure, if you've had an orgasm, you're not sure about what is squirting. What is all this stuff? What is it? Are vaginal orgasms real? Where's the g spot? This website will help you so much, and it is paid.
[00:42:27] Amanda Lewis: Okay, but it is a one time thing. You only have to pay one time. They even have videos that show people techniques for masturbation that are not pornography. It's like funny Educational. Just informative videos that you and your partner can use to explore your sexuality even more. So it's just, and I will tell you, the biggest sex organ right here, the bram, especially for women, we will be having sex in our own head, sometimes making grocery [00:43:00] list if it really isn't good sex, and sometimes thinking, oh, I want to come, oh, I want to come, oh, I want to come, and you're so focused on it, you can't do it.
[00:43:08] Amanda Lewis: So it's about learning to let go and because again, people don't talk about this. People aren't comfortable talking about it. When I finally say, Hey, are you wet? You know, have you done this? And they're like, wait, what? We can talk about this. People just like start talking and talking and talking.
[00:43:26] Amy Squires: Yeah.
[00:43:26] Amy Squires: It's still so taboo in a lot of cultures and just areas of the world and
[00:43:31] Amanda Lewis: especially in the deep South, the religious Christian deep South, and I am a Christian, but God made me. God
[00:43:38] Amy Squires: made sex. Yeah. Mm. You know. Absolutely. It's a very natural, important part of life. Yes. And it makes life, you know. It literally makes life.
[00:43:47] Amy Squires: Yes. Yeah. I think it's really important to get the conversation going and just take the awkwardness out of it, you know? And again, you think back to, I'm very open. We all do it. I don't mind talking about anything. Yeah. But I definitely have [00:44:00] grown up and come across people who won't even talk about it with their partners.
[00:44:05] Amanda Lewis: I know, you know,
[00:44:07] Amy Squires: I just don't have the conversations.
[00:44:11] Amanda Lewis: I feel very sad for those people. I really do. I will tell you, especially here the religion that I grew up in, it was very shame based. We do not have good sex education in our school system here. And I feel like there's so many people that it's just ignorance.
[00:44:32] Amanda Lewis: They just don't know. And if your family is the one that doesn't talk about it, how are you supposed to learn? Well, most people learn from porn. Porn is not real. No, very unrealistic poison to a marriage. So until you become comfortable and can talk about it. And that's what sex therapists do a lot of times, or your regular therapist.
[00:44:56] Amanda Lewis: So I mentioned earlier, I have a lot of resources, marriage therapists, marriage [00:45:00] counselors is another resource that I have because it's. It's something that is hard to talk about if your family of origin didn't talk about it, and it wasn't comfortable for them,
[00:45:10] Amy Squires: so. Yeah, absolutely. I'm just thinking back as well when it comes to sex education.
[00:45:17] Amy Squires: I mean, we were, we were in grade 5 when we had sex education. So, we learned, well, and I mean, and it wasn't.
[00:45:31] Amy Squires: I don't think it taught us a lot. It taught us body parts, you know, and I already was very familiar with my body and what a man's body was. And you know, I thank my parents for that, for being open to conversation. I'm aware that most people, well not most, but many people don't have that.
[00:45:47] Amanda Lewis: Don't have that openness at home.
[00:45:49] Amanda Lewis: But,
[00:45:49] Amy Squires: there, you know, the teacher was awkward teaching it. She didn't it no fault of hers.
[00:45:56] Amanda Lewis: Yeah, it wasn't she had a sign to this. This wasn't a passion [00:46:00] and yeah
[00:46:01] Amy Squires: And and you know what? She was actually I am fairly confident that up until that year. She taught kindergarten So, I mean she was not wanting to talk about penises and vaginas to a bunch of kids Yes, you know and we we were taught how babies were made in not great detail We were never taught about consent, really, and that was it, I think.
[00:46:29] Amy Squires: I mean, that's all, that's all that left a lasting impression on me. And, uh, the girls were taught a little bit about period health. I'm pretty sure the boys, unfortunately, were allowed to skip that lesson, which is appalling to me. Because all these boys are growing up to have, well, most of these boys are growing up to have girlfriends or sisters or mothers or women, right?
[00:46:47] Amy Squires: And
[00:46:47] Amanda Lewis: then they're, they're clueless. I, I have helped my husband become a feminist through all of my education and my poor little boy, he's 10 and October is breast cancer [00:47:00] awareness month. So not this year, but last year I was. doing a talk on breast cancer awareness and I wanted to have a model there. I could not find a breast cancer like model for people to feel on. thAt was not, that was less than 250. I said, well, that is stupid because on Amazon you can get these little stick on breast for like 20.
[00:47:22] Amanda Lewis:
[00:47:22] Amanda Lewis: No.
[00:47:22] Amanda Lewis: So I bought them and I turned them around and I opened the back, like I just cut it open and I would like put a marble in there or put some other stuff so you could feel what a tumor would feel like. So, and then I would sew it back up and I just had them because I was working on it for a few days. I had them on the in the living room and Nicholas said, mama.
[00:47:41] Amanda Lewis: I've got a friend coming over. Can you please put those things up?
[00:47:45] Amy Squires: Put the breasts away.
[00:47:46] Amanda Lewis: Yeah, yeah. So he, he's very aware, but he hates it. He doesn't want to talk about it. If I try to bring anything up, he said no. He just says no and walks
[00:47:55] Amy Squires: away. Nope, he just walks away. How old did you say he is?
[00:47:59] Amanda Lewis: [00:48:00] He's 10, almost 11.
[00:48:01] Amy Squires: That's fair enough, but he'll be very grateful for that openness when he gets older. Yeah. Now,
[00:48:07] Amanda Lewis: my daughter, she said that With her sex education class, they really just taught them about STDs or sexual STIs, sexually transmitted infections, and they tried to basically terrify them. They did teach them about birth control, they, you know, STDs, but not really much else. She said, Mama, I was telling the girls about their hormones and about, like, their periods. Nobody else really. The class wasn't about that. It, it's just sad. Disappointing. Our education is not where it should
[00:48:40] Amy Squires: be. Hmm. And I don't know how it is now. I'm just thinking. About a couple of kids, boys what they've recently learned last year.
[00:48:52] Amy Squires: They were in year seven. And I don't know if that was their entire component on sexual health. It, it really, from what [00:49:00] I saw, it focused a lot on consent. That was huge. It was not just all boys.
[00:49:03] Amanda Lewis: I don't think they did
[00:49:04] Amy Squires: here. Mm. It was a big part of it. And it went into detail about how babies are made. And the body parts and the internal organs and all that.
[00:49:15] Amy Squires: It wasn't just penis, vagina, sperm. It was, cause that's what I learned. Now I can't speak to what the girls were learning. They did, the boys actually did learn about menstruation. Good. And we're, we're required to know the symptoms and how body changes in, in both women and, and men. So I, in comparison to what I learned, I think it's come a long way.
[00:49:36] Amy Squires: Again, I went, I went to school in Canada, so perhaps it's also changed there. I'm not sure. But yeah, as I'm reflecting now on on this particular section of the course, it seems like they did learn a lot more. Then they were even given scenarios and they had to determine if it was a yes, no consent situation and some of them were very gray.
[00:49:57] Amy Squires: They were some very gray areas and [00:50:00] I could, you know um, where it seemed like it was consent, but it, you know, it certainly wasn't, but it was meant to kind of give them these scenarios where you might be in this situation. You think what you're doing is okay, and it's not and I, I really quite pleased to know that they were appreciating that.
[00:50:17] Amy Squires: Yeah. Yeah,
[00:50:18] Amanda Lewis: so my daughter will have friends over and they kind of know at this point that they can ask me anything and one thing that I always let them know is even if you don't have a condom, you said you can get herpes in your throat. Okay, you can get HPV in your throat that can cause throat cancer, so just like y'all, condoms, condoms, condoms.
[00:50:44] Amanda Lewis: Yeah, and I don't want them having sex right now. They're 16, they're too young to me to be having sex and making decisions that can affect the rest of their life, but please don't go in uneducated and ignorant about it.
[00:50:56] Amy Squires: Absolutely. Knowledge is [00:51:00] power.
[00:51:00] Amanda Lewis: Yes, I agree, and that's why I teach all the time. I teach my clients, I teach my poor little boy who's not even wanting to be taught, and I
[00:51:09] Amy Squires: teach whoever will listen.
[00:51:11] Amy Squires: Eventually. As will his future partners, I'm sure. I know, as I hope his
[00:51:15] Amanda Lewis: wife will be in the future. Yeah.
[00:51:18] Amy Squires: Well, Amanda, thank you so much for joining me today. I really appreciate you being open to talking about all things women and sexual health and I'm sure we'll we'll stay in touch. I'd love to have have you on again.
[00:51:28] Amy Squires: I think there's a whole, there's a hell of a lot we can talk about. Yes. And I would love,
[00:51:34] Amanda Lewis: like, if any of your listeners would, like, write in, what do you have questions about? Because I love to teach. And if there's something specifically that you're interested in. Let us know, because I'll come on and talk about it, especially about sexual health.
[00:51:48] Amanda Lewis: I do have a a libido class I'm doing tomorrow because I have so many women that are reaching out saying my libido is low. So I'm trying to kind of educate them. So if there's questions that you have, please [00:52:00] email us. My, my email is Amanda at vivacious dot health care. So that is a V. I. V. A. C. I. O.
[00:52:08] Amanda Lewis: U. S. That is the end of it, and I would be happy to answer any questions you have if y'all are in the states if you're in Louisiana, of course, come see me. If not, I have a wonderful network of like minded professionals all over the states. I have a co op that I'm a part of. Well, it's not a co op, but it's a group that I'm a part of, other providers that are very holistic minded and we can refer out to other people.
[00:52:36] Amanda Lewis: So just let me know.
[00:52:39] Amy Squires: Yeah. And what I'll do as well, I'll, I'll get the email and I'll get Amanda, to share some links with me and I'll pop those into the description so that anyone listening and who would like to know more information or get in touch. Yes.
[00:52:52] Amanda Lewis: Yeah. I'm going to share all
[00:52:53] Amy Squires: that.
[00:52:53] Amy Squires: Yeah. I've written it all down. Yeah. Yeah. Yeah. We're going to share all that with [00:53:00] you. So you'll have all those resources there and get ready get ready to talk about your sexual health and start to make it, you know, something that you can be comfortable with. And yes, as Amanda said, if you have any questions, email her, if you would prefer to just comment on the video, do that and I will make sure the questions get to Amanda and just thanks for joining us today.
[00:53:20] Amy Squires: Thank you, Amanda. Thank you so much. It's been very informative and as always, when I have someone on the show, it's, it's got me excited and I'm going to do a lot more thinking about my own, my own health and I'm very appreciative for that. And so anyone, if you're listening and you like the show, please, I would love it if you'd like and subscribe, leave your comments for, as Amanda said, anything else you'd like to hear about either from Amanda or from me and that's it for, for this episode.
[00:53:48] Amy Squires: So thank you so much and I hope you have a lovely day.
[00:53:51] Amanda Lewis: You too. Bye bye.
[00:53:52] Amy Squires: Thanks for joining me on the Holistic Health Show. If you enjoyed the episode, [00:54:00] subscribe now and get ready to embark on an incredible journey toward holistic wellness. Until next time, be well and stay holistic.
What I used to record this episode