It’s always great to be here and to be at Age Management Medicine Group Conference and to meet all of you and interact because in general in medicine our preventive medicine approach is under prescribed in our standard of care practices and insurance driven practices, so especially in the area of sexual health. So many people ask, ‘Well how did you become interested in sexual health?’ Well let me tell you; who isn’t interested in sexual health right? So but the key thing is when I came out of training at Emory University really the ivory tower of medicine, I had one of my first patients who presented to me was a 63 year old chief executive officer of a biomedical firm who had a previous diagnosis of ductal carcinoma in situ. Her physicians at Emory said, ‘No, you can’t be on hormonal management’, and she said, ‘My sex drive is so low, I can’t orgasm, I’m a woman of the sixties my sexual energy is so important to me I’d rather die, doctor help me!’ Right I’m like, ‘Okay, well I trained at Emory you know let me look in my doctors bag’. What do I have, what do I know that I can do to help this woman? Well I cleared my doctor’s bag, I didn’t have anything. So I started looking online, I did the research, I met with other experts in sexual health and I said, ‘Well why can’t I use vaginal oestrogen for vaginal rejuvenation and dryness? Why can’t I use testosterone, the research seems to support it?’ This was when I graduated Emory 1999, like my first patient in practice and so I started working in this area and working on the importance of addressing these issues and complaints with my patients and giving them viable alternatives and looking at the research that supported my approach and then working on a way to communicate it to my patients. So with today’s lecture we want to talk about and address the issues that keep our sexual health and vitality long long long standing right for many years. So you know, in my family I always say we have a great sense of humour, we have to you know. My dad’s 86 and my dad says his sexual health and vitality is really important to him. I have to watch him when he comes to my office that he’s not getting extra shots of testosterone you know, I mean he is, it’s important to him at 86 and we say we look from the inside out right. There’s no limit on, there’s no age limit on intimacy, sexual health and vitality, and it’s important to reinforce that in our patients. So my objectives with this early morning lecture is not to put you back to sleep but to really discuss the reasons for decreased desire in women and discuss feminine desire and feminine orgasm. And also the seven keys to discovery that are involved in discovering why a patient has decreased desire and decreased orgasm, and give you some of my favourite therapeutic options. So the question is, does desire in women have to come first? And how do we achieve a continuous state of receptivity or turn on? So what I heard time and time again from my patients was, ‘You know hey you know I’m not interested in sex but once I get started I’m good, I’m okay I like to be there.’ Do you hear that? Yeah. So they’re like, ‘Okay well you know well men desire precedes right, with women it’s like okay get me started and I’m good but it’s the getting started part right’. So then I ask how is she fuelled and balanced and positively reinforced so that she is continuously generating the feminine sexual energy of desire, passion, receptivity? So how do we embrace our feminine? How do we embrace our women and fuel them? So fuelled in health, fuelled in mind, body and spirit right so that we’re continuously receptive, open and have that desire and passion for our partner. This is the model that we were taught, the linear stages of sexual response and this is really a linear model and I’ve taught this too but it doesn’t fit the feminine pattern as well and with guys so with this linear model, what is the number one turn on for a guy? Do you agree? Guys are turned on by their partner being turned on. So she’s turned on, he’s turned on. So more than his pleasure is like, ‘Hey I want her to feel pleasure, I want her to be happy, I want to meet her needs’, and women often don’t get that. To purchase the entire DVD lecture series, click here.