Vulvar dermatitis can include follicultis, contact dermatitis, vulvar atrophy, lichen sclerosus, Bartholin gland cysts, and more. If you are experiencing persistent redness and itching on or around your vulva, we can help you determine the cause and find a treatment that will work for you. Vulvar atrophy is a condition associated with menopause. As your hormone levels change, so do the cells in your genitals, often resulting in dry or brittle vaginal tissue. We know how to treat this effectively as well, so make an appointment soon!

The use of hormones for menopausal women (hormone therapy) has been a controversial subject for years. As a Past President of the North American Menopause Society, Dr. Simon can be counted upon to be up-to-date on the latest information and advances related to using hormones for menopausal women. New data suggests that beginning hormone therapy close to menopause, using lower dose bioidentical and transdermal options may significantly reduce or eliminate most of the risks. While individualization is critical, and every women deserves her own personal assessment, Dr. Simon is confident that a bioidentical hormonal option can be found for most women if appropriate.

If you would like to schedule an appointment to speak with Dr. Simon about menopausal hormones, including bioidentical hormone therapy, or menopausal symptom relief with or without hormones, please call us at 202-293-1000.

The term “Female Sexual Dysfunction” encompasses a variety of ailments and complaints, from low libido, problems with arousal and orgasm, to pain during sex. If these problems are persistent and distressing to you, call us! We are experts in the realm of sexual dysfunction and we can treat you and your partner to help get your sex life back on track.

Experiencing perimenopausal symptoms brings up many questions and concerns for women. From night sweats, hot flashes, irregular periods, low sex drive, weight gain and more, perimenopause and menopause can be a confusing time for women. Dr. Simon works closely with patients, calling on his extensive experience to help educate women, answer questions and, together, develop a unique, effective plan to manage menopause and perimenopausal symptoms.

The road to reproduction should be fun, enjoyable, and let’s be honest, pleasurable. Unfortunately, for many couples, becoming pregnant is not easy and sometimes even appears impossible. They may face many choices as they try to begin a family: What is causing our infertility? What are our options? Should we consider IVF infertility treatment? How expensive is IVF infertility treatment? And many others. We help patients navigate the emotional rollercoaster of fertility struggles. They help determine what options are most likely to lead to success – from IVF infertility treatment, intrauterine insemination (IUI) or third-party reproduction. We offer expertise in ovulation induction, fertility testing and evaluation, and when necessary, surgical interventions including hysteroscopy, laparoscopy, laparotomy and tubal cannulation.

Dr. Simon provides gynecology treatment for a wide range of women – from those experiencing their first menstrual cycles to couples seeking fertility support and women managing menopause. Working closely with each patient, Dr. Simon seeks to understand her health questions, concerns and goals before putting together a unique gynecology treatment plan to fit her lifestyle.

Sexual dysfunction can be a side effect of several medications. Often, people are unaware of these effects when they begin taking the medications, making them even more troubling.
Post-SSRI Sexual Dysfunction (PSSD).

Selective serotonin reuptake inhibitors (SSRIs) are prescribed for depression, anxiety and other mental health disorders and can have severe sexual side effects, known as post-SSRI sexual dysfunction (PSSD).

Symptoms of PSSD may include:

  • Erectile dysfunction
  • Reduced sensation in genitals
  • Delayed orgasm or inability to orgasm (anorgasmia)
  • Muted orgasms or lack of pleasure with orgasm
  • Decreased libido (sex drive)
  • Decreased or absent nocturnal erections
  • Premature ejaculation

Diagnostic workup may include:

  • Comprehensive medical history including current and previous medications
  • Detailed physical exam
  • Blood tests
  • Penile ultrasound with Doppler technology to look for structural abnormalities, abnormal blood flow, scar tissue, or penile curvature.

Once a diagnosis is established, we created a customize treatment plan with each patient. This may include:

This may include:

  • Behavioral Treatment Strategies / Sex Therapy
  • Specialized physical therapy
  • Medications
  • Additional testing

Post-Finasteride Syndrome (PFS)

Men who have taken finasteride or other 5-alpha reductase inhibitors for enlarged prostate or androgenic alopecia (male pattern baldness) may develop distressing sexual and non-sexual complaints, known as post-finasteride syndrome.

Symptoms of PFS may include:

  • Decreased libido
  • Erectile dysfunction
  • Penile shrinkage
  • Orgasmic anhedonia (loss of pleasure with orgasm)
  • Fatigue
  • Muscle atrophy
  • Depression
  • Brain fog
  • Difficulty sleeping

Sex friendly treatments to maintain your ejaculation

Prostate enlargement can lead to distressing urinary symptoms such as:

  • Urinary frequency
  • Urinary urgency
  • Waking up at night to urinate (nocturia)
  • Difficulty emptying your bladder
  • Weak stream
  • Difficulty initiating urination

BPH is typically treated with lifestyle modifications, medication and surgery. Unfortunately, many traditional treatment options for BPH have devastating sexual side effects causing low libido, erectile dysfunction and potentially irreversible changes to ejaculatory function.
Urologist Dr. Rubin offers minimally invasive treatment options to avoid these unwanted side effects. We can also help you if you’ve had any of these side effects from previous treatments for BPH.

No matter the type, a cancer diagnosis can affect sexual function drastically. Cancer can have significant sexual consequences for you, your partner and your relationship. Various sexual problems can occur with nearly all cancer treatments, including:

  • Chemotherapy
  • Radiation
  • Surgery

Improving quality of life after cancer treatment is one of Dr. Rubin’s main interests. She believes strongly in creating a multi-disciplinary team to properly treat these problems. This includes working closely with your oncologists, specialized physical therapists, and mental health professionals regarding sex after prostate cancer and other challenges.

There are many causes of ejaculatory dysfunction and finding a precise diagnosis allows us to tailor treatment to the individual’s or couple’s specific needs. Types of ejaculatory dysfunction include:

  • Premature ejaculation
  • Delayed ejaculation
  • No ejaculation (anejaculation)

These problems are treatable and require a comprehensive workup to tailor specific treatment plan.

Diagnostic workup may include:

  • Comprehensive medical history including current and previous medications
  • Detailed physical exam
  • Blood tests
  • Penile ultrasound with Doppler technology to look for structural abnormalities, abnormal blood flow, scar tissue, or penile curvature.

Once a diagnosis is established, we created a customize treatment plan with each patient.

This may include:

  • Medications Behavioral and lifestyle changes
  • Couples and sex therapy
  • Specialized physical therapy
  • Medications
  • Additional testing

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