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. Our providers are able to work with you to treat this effectively.

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Experiencing perimenopausal symptoms brings up many questions and concerns for women, or people with vulvas. From night sweats, hot flashes, irregular periods, low sex drive, weight gain and more, perimenopause and menopause can be a confusing or frustrating experience.

At IntimMedicine, we work closely with patients, providing education, answering questions and, together, developing a unique, effective plan to manage menopause and perimenopausal symptoms.

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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 questions as they try to begin a family, including:

  • 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. We offer expertise in ovulation induction, fertility testing and evaluation, and when necessary, surgical interventions including hysteroscopy, laparoscopy, laparotomy, and tubal cannulation.

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IntimMedicine provides gynecology treatment for a wide range of people– from those experiencing their first menstrual cycles to couples seeking fertility support to women managing menopause. Working closely with each patient, our team seeks to understand each person’s health questions, concerns, and goals before putting together a unique gynecology treatment plan to fit your body.

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:

  • 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

Penile curvature (known as Peyronie’s disease) can occur at any age. The curvature is only seen during an erection and happens because a dense collagen plaque builds up around the erectile tissue.

While Peyronie’s disease is not a dangerous condition, it can cause disfigurement of the penis, pain during intercourse, and significant distress for men and their partners. The curvature can be so severe that penetration is painful or impossible.

Diagnostic workup may include:

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

Treatments include:

  • Medications injected directly into the plaque which facilitate dissolving the plaque
  • Surgery to straighten the penis (plication)
  • Surgery to insert a penile implant

Penile Implant:

When conservative Peyronie’s disease treatment strategies fail, a penile prosthetic implant is a successful method of achieving reliable and rigid erections and straightening curvature. Dr. Rubin has advanced training and special expertise in penile prosthetic surgery. She offers a variety of different implant options tailored to each patient’s specific needs. Unfortunately, research shows that oral medications once thought to treat this condition are not effective.

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A normal menstrual cycle occurs every 21 to 35 days and can last from 2 to 7 days, and can sometimes be somewhat irregular without being considered a serious problem. Menstrual irregularities involving the following symptoms:  absent menstrual periods, painful menstruation, or sever premenstrual symptoms can be caused by a number of things including:

  • PCOS
  • Breastfeeding and pregnancy
  • Eating disorders
  • Pelvic inflammatory disease (PID
  • Uterine fibroids
  • Premature ovarian failure.

If you are experiencing any of the symptoms listed, make an appointment so we can diagnose and treat the problem.

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