281: Permanent Sexual Side Effects from Commonly Prescribed Medications with Dr. Irwin Goldstein

In this episode of the Better Sex Podcast, host sex therapist, Jessa Zimmerman, engages in a thought-provoking conversation with Dr. Irwin Goldstein from the San Diego Sexual Medicine Clinic. They discuss the often overlooked and lasting sexual side effects of widely prescribed medications, including birth control pills, SSRIs, and finasteride (Propecia). Dr. Goldstein explains the mechanisms by which these medications impact sexual health and shares research findings and patient experiences. Listeners are informed about the importance of recognizing these side effects and considering alternative treatments where possible.00:00 Introduction to Better Sex Podcast00:46 Welcoming Dr. Irwin Goldstein01:02 The Hidden Dangers of Common Medications02:52 Deep Dive into Birth Control Pills05:01 Exploring Alternatives to Birth Control Pills05:56 Research Findings on Birth Control Pills06:48 Impact of Birth Control Pills on Androgen Receptors09:32 Long-Term Effects of Birth Control Pills12:33 Introduction to Antidepressants and Sexual Side Effects15:37 Impact of SSRIs on Sexual Health15:52 Mechanisms Behind SSRI-Induced Sexual Dysfunction16:37 Animal Studies and Findings17:53 Persistent Erectile Dysfunction in Young Men18:24 Treatment Options for PSSD19:08 Challenges in Treating PSSD19:56 Gender Differences in PSSD21:13 Introduction to Finasteride and Its Side Effects22:42 Mechanism of Finasteride and Its Impact on Hormones24:29 Health Risks of Finasteride27:42 Conclusion and Final ThoughtsWant to work with Jessa? Visit https://www.intimacywithease.comBio:Dr. Goldstein has been involved with sexual dysfunction research since the late 1970's. He has authored more than 350 publications as well as multiple book chapters and edited 6 textbooks in the field. His interests include penile microvascular bypass surgery, surgery for dyspareunia, sexual health management post cancer treatment, genital dysesthesia/persistent genital arousal disorder, physiologic investigation of sexual function in men and women, and diagnosis and treatment of sexual dysfunction in men and women. Dr. Goldstein is Director of Sexual Medicine at Alvarado Hospital, Clinical Professor of Surgery at University of California, San Diego and practices medicine at San Diego Sexual Medicine. He is also Editor-in-Chief of Sexual Medicine Reviews and past Editor of The Journal of Sexual Medicine. He is a Past President of the International Society for the Study of Women’s Sexual Health and of the Sexual Medicine Society of North America. He holds a degree in engineering from Brown University and received his medical degree from McGill University. The World Association for Sexual Health awarded the Gold Medal to Dr. Goldstein in 2009 in recognition of his lifelong contributions to the field, in 2012 he received the International Society for the Study of Women’s Sexual Health Award for Distinguished Service in Women’s Sexual Health, in 2013 he received the Lifetime Achievement Award from the Sexual Medicine Society of North America, and in 2014 he received the ISSM Lifetime Achievement Award from the International Society for Sexual Medicine. He is happily married to his college sweetheart Sue, and together they have three children and five grandchildren.Want to learn more about my sponsored charity? Charity: Water is committed to providing clean water to every human on the planet, 100% of your contribution will be used directly for water projects around the globe. You can learn more at https://www.bettersexpodcast.com/water.More info and resources:Secret Podcast for the Higher Desire Partner: https://www.intimacywithease.com/hdppodcastSecret Podcast for the Lower Desire Partner: https://www.intimacywithease.com/ldppodcastHow Big a Problem is Your Sex Life? Quiz – https://www.sexlifequiz.comThe Course – https://www.intimacywithease.comThe Book – https://www.sexwithoutstress.comPodcast Website – https://www.intimacywithease.comAccess the Free webinar: Intimacy Made Easy: 3 Secrets to Bridging Libido Differences: https://intimacywithease.com/masterclass

In this episode of the Better Sex Podcast, sex therapist Jessa Zimmerman discusses how to use the giver receiver exercise for personal and relational growth. Jessa provides detailed insights on recognizing personal progress, identifying challenges, and reflecting on experiences to foster meaningful breakthroughs in intimate relationships. The episode offers guidance both for the receiver and the giver in the exercise, emphasizing the importance of communication, self-awareness, and practice. Listeners are encouraged to use the exercise repetitively for continuous improvement and transformation.00:00 Introduction to Better Sex00:49 Overview of the Giver Receiver Exercise03:08 Reflecting as the Receiver09:29 Reflecting as the Giver16:28 Conclusion and Final ThoughtsWant to learn more about my sponsored charity? Charity: Water is committed to providing clean water to every human on the planet, 100% of your contribution will be used directly for water projects around the globe. You can learn more at https://www.bettersexpodcast.com/water.More info and resources:Secret Podcast for the Higher Desire Partner: https://www.intimacywithease.com/hdppodcastSecret Podcast for the Lower Desire Partner: https://www.intimacywithease.com/ldppodcastHow Big a Problem is Your Sex Life? Quiz – https://www.sexlifequiz.comThe Course – https://www.intimacywithease.comThe Book – https://www.sexwithoutstress.comPodcast Website – https://www.intimacywithease.comAccess the Free webinar: Intimacy Made Easy: 3 Secrets to Bridging Libido Differences: https://intimacywithease.com/masterclass

In this episode of Better Sex, host Jessa Zimmerman interviews AJ Cheyfitz about kink and BDSM, discussing misconceptions, mental health, and trauma-related aspects. They explore how individuals can safely engage in kink, the importance of negotiation, identifying red flags, and how to find kink-aware therapists. The conversation emphasizes destigmatizing kink and ensuring a supportive environment for those exploring or involved in BDSM.00:00 Introduction to Better Sex Podcast00:59 Exploring Kink and BDSM with AJ Schitz01:56 Mental Health and Kink: Navigating Stigma06:55 Understanding Kink: Myths and Realities09:16 Defining Kink and BDSM16:19 Trauma and Kink: Intersections and Safety29:11 Finding Kink-Aware Practitioners33:29 Conclusion and ResourcesWant Jessa's desire discrepancy resources? Go to https://www.desirediscrepancy.comBio:Amy Julia (AJ) Cheyfitz (she/her) is an AASECT Certified Sex Therapist and a BDSM Educator who has been teaching about kink for well over a decade. In her DC area sex therapy practice (Fox & Owl Psychotherapy) she focuses on kink/BDSM practitioners, ethically non-monogamous and LGBTQ+ clients, as well as supporting clients exploring fat liberation and their relationship with their own bodies.One of AJ’s passions is working to de-stigmatize kink, and she regularly teaches and consults for non-kink professionals, particularly in the mental health and medical fields. Within the kink community she has taught all over the country and for international groups, and focuses on mental health, power exchange relationship dynamics, and self-exploration and advocacy. AJ has been on numerous podcasts discussing kink and mental health, as well as being quoted in many articles about BDSM, sex, and relationships, including in the New York Times. If you want to hear AJ talk about something besides sex, ask about her mischievous cat, Rosalind. Want to learn more about my sponsored charity? Charity: Water is committed to providing clean water to every human on the planet, 100% of your contribution will be used directly for water projects around the globe. You can learn more at https://www.bettersexpodcast.com/water.More info and resources:Secret Podcast for the Higher Desire Partner: https://www.intimacywithease.com/hdppodcastSecret Podcast for the Lower Desire Partner: https://www.intimacywithease.com/ldppodcastHow Big a Problem is Your Sex Life? Quiz – https://www.sexlifequiz.comThe Course – https://www.intimacywithease.comThe Book – https://www.sexwithoutstress.comPodcast Website – https://www.intimacywithease.comAccess the Free webinar: Intimacy Made Easy: 3 Secrets to Bridging Libido Differences: https://intimacywithease.com/masterclass

In this 'soapbox' episode of Better Sex, sex therapist Jessa Zimmerman discusses the concept of transforming sexual encounters into playful, pressure-free experiences akin to visiting a playground. Highlighting the pitfalls of goal-oriented sex, Zimmerman suggests focusing more on pleasure and connection rather than specific outcomes. She provides strategies for reducing pressure and creating a more flexible, enjoyable intimate relationship. Listeners are encouraged to embrace this approach, which can enhance spontaneous and satisfying sexual experiences.00:00 Introduction to Better Sex00:56 The Playground Concept in Sex01:55 Removing Pressure and Embracing Pleasure04:31 Navigating Arousal and Flexibility07:33 Conclusion and Invitation to Explore07:46 Podcast Outro and Listener EngagementWant to learn more about my sponsored charity? Charity: Water is committed to providing clean water to every human on the planet, 100% of your contribution will be used directly for water projects around the globe. You can learn more at https://www.bettersexpodcast.com/water.More info and resources:Secret Podcast for the Higher Desire Partner: https://www.intimacywithease.com/hdppodcastSecret Podcast for the Lower Desire Partner: https://www.intimacywithease.com/ldppodcastHow Big a Problem is Your Sex Life? Quiz – https://www.sexlifequiz.comThe Course – https://www.intimacywithease.comThe Book – https://www.sexwithoutstress.comPodcast Website – https://www.intimacywithease.comAccess the Free webinar: Intimacy Made Easy: 3 Secrets to Bridging Libido Differences: https://intimacywithease.com/masterclass

In this episode of The Better Sex Podcast, host sex therapist Jessa Zimmerman converses with Elle Hamilton Wohl about the multifaceted benefits of pole dancing. Wohl details how this practice serves as a powerful means of embodying sensual movement, aiding in sexuality, trauma recovery, pleasure, awareness, and body acceptance. They explore the therapeutic potential of pole dancing, how it integrates physical fitness with mental health, and its ability to connect individuals to their sensuality. Wohl also shares her personal journey into pole dancing and its transformative impact while offering insights into how listeners can seek suitable classes fitting their needs. This engaging and informative discussion underscores the empowering and healing essence of pole dancing.00:00 Introduction to Better Sex Podcast00:47 Guest Introduction: Elle Hamilton Wohl01:54 The Origins and Evolution of Pole Dancing02:48 Pole Dancing for Empowerment and Healing06:24 Personal Journey: Elle's Path to Pole Dancing08:11 Connecting Pole Dancing to Sexuality and Therapy11:42 Exploring the Therapeutic Potential of Pole Dancing18:13 Finding the Right Pole Dancing Studio19:52 How to Connect with Elle Hamilton Wall21:13 Conclusion and Listener EngagementInterested in the special collections of podcast episodes?https://www.bettersexpodcast.com/collectionsBio:Eleanor Hamilton-Wohl is a therapist and coach who specializes in sex and trauma therapy for people pleasers. She helps people get their needs met- even if they don't know what they are yet! Whether she's helping women heal on the therapy couch or in the pole studio, Eleanor believes in a world that is free from shame, one in which sensuality, creativity, and connection are prioritized.ellehamilton.coembodied_elle [email protected] for couch classWant to learn more about my sponsored charity? Charity: Water is committed to providing clean water to every human on the planet, 100% of your contribution will be used directly for water projects around the globe. You can learn more at https://www.bettersexpodcast.com/water.More info and resources:Secret Podcast for the Higher Desire Partner: https://www.intimacywithease.com/hdppodcastSecret Podcast for the Lower Desire Partner: https://www.intimacywithease.com/ldppodcastHow Big a Problem is Your Sex Life? Quiz – https://www.sexlifequiz.comThe Course – https://www.intimacywithease.comThe Book – https://www.sexwithoutstress.comPodcast Website – https://www.intimacywithease.comAccess the Free webinar: Intimacy Made Easy: 3 Secrets to Bridging Libido Differences: https://intimacywithease.com/masterclass

In this episode of the Better Sex Podcast, host and sex therapist Jessa Zimmerman discusses the importance of experiential practice in improving intimate relationships. She introduces the Giver-Receiver Exercise, a powerful tool from her sex therapy practice and online course, 'Intimacy with Ease.' She explains how this exercise integrates nine essential skills for a thriving sex life, such as prioritizing intimacy, learning to communicate about sex, and practicing mindfulness. Listeners are guided through the instructions of the exercise and its benefits. She also shares the origins of the practice and emphasizes the importance of practicing regularly for long-lasting change. The episode concludes with reminders about the natural challenges that may arise and the significance of personal growth and patience in the process.00:00 Introduction to Better Sex01:21 The Giver Receiver Exercise Explained03:26 Detailed Instructions for the Exercise06:38 Addressing Common Challenges08:08 Integrating the Nine Skills15:20 Final Thoughts and Encouragement17:40 Closing RemarksWant to learn more about my sponsored charity? Charity: Water is committed to providing clean water to every human on the planet, 100% of your contribution will be used directly for water projects around the globe. You can learn more at https://www.bettersexpodcast.com/water.More info and resources:Secret Podcast for the Higher Desire Partner: https://www.intimacywithease.com/hdppodcastSecret Podcast for the Lower Desire Partner: https://www.intimacywithease.com/ldppodcastHow Big a Problem is Your Sex Life? Quiz – https://www.sexlifequiz.comThe Course – https://www.intimacywithease.comThe Book – https://www.sexwithoutstress.comPodcast Website – https://www.intimacywithease.comAccess the Free webinar: Intimacy Made Easy: 3 Secrets to Bridging Libido Differences: https://intimacywithease.com/masterclass

In this episode of the Better Sex Podcast, host Jessa Zimmerman delves deep into the topic of hormonal birth control with nurse practitioner Mia Neustein from San Diego Sexual Medicine. The discussion covers various forms of hormonal and non-hormonal birth control, their side effects, and the specific impact of hormonal birth control on sexual health. Mia explains the vestibule, its role in sexual functioning, and how hormonal birth control can sometimes cause pain, itching, and burning during sex. The episode also explores the importance of testosterone in women's bodies, how hormonal birth control can affect these levels, and the potential benefits and drawbacks of birth control beyond pregnancy prevention.00:00 Introduction to Better Sex Podcast00:49 Guest Introduction: Mia Neustein01:30 Mia's Journey into Sexual Medicine04:14 Overview of Birth Control Methods04:33 Non-Hormonal Birth Control Options07:06 Hormonal Birth Control: Types and Effects09:48 Unexpected Side Effects of Hormonal Birth Control14:00 Impact of Hormonal Birth Control on Testosterone19:46 Understanding Birth Control Side Effects20:16 Personal Insights and Expertise20:44 Impact on Libido and Sexual Health21:17 Jess's Mid-Show Break21:40 Benefits of Birth Control Beyond Pregnancy Prevention22:36 Managing Menstrual and Reproductive Health Issues24:22 Addressing Hormonal Imbalances and Conditions25:23 Effectiveness and Limitations of Birth Control Methods25:48 Investigating and Resolving Birth Control Side Effects27:26 Hormonal Treatments and Their Applications31:25 Growing Awareness and Medical Practices34:53 The Role of Lab Work in Hormonal Treatments38:49 Finding the Right Medical Support41:04 Conclusion and ResourcesWant to work with Jessa? Visit https://www.intimacywithease.comBio:Mia Neustein, MSN, RN, WHNP-BC, NCMP is a board-certified Women’s Health Nurse Practitioner. She obtained her BA in Economic History at Barnard College of Columbia University and her BSN-equivalency and Masters of Science in Nursing from the University of Alabama at Birmingham. (After five years in Alabama, Mia says “y’all” and loves country music.) Mia appreciated her time working at Planned Parenthood, which provided her extensive training in general gynecology. Her interest in sexual medicine peaked when she encountered male and female patients with sexual dysfunction, and she joined the International Society for the Study of Women’s Sexual Health (ISSWSH). Mia’s interest in menopause management led her to become certified by The Menopause Society. Mia prides herself on providing gentle, trauma-informed care that is patient-centered. Mia lived in Lima, Peru and speaks fluent Spanish with what she hopes is a Limenian accent.Want to learn more about my sponsored charity? Charity: Water is committed to providing clean water to every human on the planet, 100% of your contribution will be used directly for water projects around the globe. You can learn more at https://www.bettersexpodcast.com/water.More info and resources:Secret Podcast for the Higher Desire Partner: https://www.intimacywithease.com/hdppodcastSecret Podcast for the Lower Desire Partner: https://www.intimacywithease.com/ldppodcastHow Big a Problem is Your Sex Life? Quiz – https://www.sexlifequiz.comThe Course – https://www.intimacywithease.comThe Book – https://www.sexwithoutstress.comPodcast Website – https://www.intimacywithease.comAccess the Free webinar: Intimacy Made Easy: 3 Secrets to Bridging Libido Differences: https://intimacywithease.com/masterclass

In this episode of The Better Sex Podcast, sex therapist Jessa Zimmerman discusses nine essential competencies for creating and maintaining a great sex life. Jessa emphasizes the importance of prioritizing intimacy, effective communication about sex, accessing desire, enjoying the journey, being present, celebrating 'no,' balancing being selfish and giving, and exploring eroticism. These competencies focus on internal mindsets and skills rather than physical techniques. She also emphasizes the need for practice and understanding one's and their partner's erotic preferences for a fulfilling intimate relationship.00:00 Introduction to Better Sex00:58 The Competencies for a Great Sex Life02:09 Prioritizing Intimacy03:54 Communicating About Sex05:35 Accessing Desire07:01 Enjoying the Journey08:39 Being Present09:57 Celebrating 'No'12:36 Being Selfish and Giving14:27 Exploring Eroticism17:57 Conclusion and Next StepsWant to learn more about my sponsored charity? Charity: Water is committed to providing clean water to every human on the planet, 100% of your contribution will be used directly for water projects around the globe. You can learn more at https://www.bettersexpodcast.com/water.More info and resources:Secret Podcast for the Higher Desire Partner: https://www.intimacywithease.com/hdppodcastSecret Podcast for the Lower Desire Partner: https://www.intimacywithease.com/ldppodcastHow Big a Problem is Your Sex Life? Quiz – https://www.sexlifequiz.comThe Course – https://www.intimacywithease.comThe Book – https://www.sexwithoutstress.comPodcast Website – https://www.intimacywithease.comAccess the Free webinar: Intimacy Made Easy: 3 Secrets to Bridging Libido Differences: https://intimacywithease.com/masterclass

In this episode of Better Sex, host sex therapist Jessa Zimmerman talks with Bea Albina about 'emotional outsourcing' - a concept she coined to describe chronic people-pleasing and codependency. Bea shares her personal journey of detachment from her body and how she transitioned to a more joyful and authentic life. They discuss the overlap between people-pleasing and codependency, how these behaviors manifest, and their impact on intimate relationships and sex. Bea offers practical advice on reconnecting with one’s body, establishing healthy boundaries, and reducing resentment in relationships. She also introduces techniques to calm the nervous system and the importance of self-awareness in fostering deep, meaningful connections.00:00 Introduction to Better Sex Podcast00:46 Guest Introduction: Bea Albina on People Pleasing03:11 Understanding Emotional Outsourcing05:27 Impact of Emotional Outsourcing on Relationships and Sex08:10 Connecting with Your Body and Overcoming Disconnection12:01 Practical Steps to Reconnect with Yourself26:21 Tools to Calm the Nervous System28:29 Conclusion and ResourcesInterested in Jessa's resources for desire discrepancy? Visit https://www.desirediscrepancy.comBeatriz (Béa) Victoria Albina, NP, MPH, SEP (she/her) is a UCSF-trained Family Nurse Practitioner, Somatic Experiencing Practitioner, Master Certified Somatic Life Coach, author of the forthcoming "End Emotional Outsourcing: a Guide to Overcoming Codependent, Perfectionist and People Pleasing Habits" (expected Sept 30, Hachette Balance) and Breathwork Meditation Guide with a passion for helping humans socialized as women to reconnect with their bodies, regulate their nervous systems and rewire their minds, so they can break free from codependency, perfectionism and people pleasing and reclaim their joy.She is the host of the Feminist Wellness Podcast, holds a Masters degree in Public Health from Boston University School of Public Health and a BA in Latin American Studies from Oberlin College. Born in Mar del Plata, Argentina, Béa grew up in the great state of Rhode Island. She has been working in health & wellness for over 20 years and lives with her wife, Billey Albina. You can find her on Instagram @beatrizvictoriaalbinanp and listen to her podcast, Feminist Wellness, here.Want to learn more about my sponsored charity? Charity: Water is committed to providing clean water to every human on the planet, 100% of your contribution will be used directly for water projects around the globe. You can learn more at https://www.bettersexpodcast.com/water.More info and resources:Secret Podcast for the Higher Desire Partner: https://www.intimacywithease.com/hdppodcastSecret Podcast for the Lower Desire Partner: https://www.intimacywithease.com/ldppodcastHow Big a Problem is Your Sex Life? Quiz – https://www.sexlifequiz.comThe Course – https://www.intimacywithease.comThe Book – https://www.sexwithoutstress.comPodcast Website – https://www.intimacywithease.comAccess the Free webinar: Intimacy Made Easy: 3 Secrets to Bridging Libido Differences: https://intimacywithease.com/masterclass

In this episode of the Better Sex Podcast, host and sex therapist Jessa Zimmerman delves into the sexual avoidance cycle, a term she coined to describe a common issue in intimate relationships. She explains how negative experiences and unmet expectations lead to avoidance, creating a cycle of increasing pressure and anxiety around sex. Jessa discusses various factors that contribute to this cycle, such as personal insecurities, relationship conflicts, and external life stressors. She emphasizes the importance of challenging unrealistic expectations, addressing negative feelings, and communicating openly with one's partner to break free from this cycle and enhance intimate relationships.00:00 Welcome to Better Sex00:50 Introduction to the Sexual Avoidance Cycle01:17 Understanding the Cycle05:36 Factors Contributing to the Cycle08:16 Challenging Expectations and Breaking the Cycle09:49 Conclusion and Final ThoughtsWant to learn more about my sponsored charity? Charity: Water is committed to providing clean water to every human on the planet, 100% of your contribution will be used directly for water projects around the globe. You can learn more at https://www.bettersexpodcast.com/water.More info and resources:Secret Podcast for the Higher Desire Partner: https://www.intimacywithease.com/hdppodcastSecret Podcast for the Lower Desire Partner: https://www.intimacywithease.com/ldppodcastHow Big a Problem is Your Sex Life? Quiz – https://www.sexlifequiz.comThe Course – https://www.intimacywithease.comThe Book – https://www.sexwithoutstress.comPodcast Website – https://www.intimacywithease.comAccess the Free webinar: Intimacy Made Easy: 3 Secrets to Bridging Libido Differences: https://intimacywithease.com/masterclass