Let’s Talk Menopause: Sexual Function & Desire

menopause-loss-sex-driveAs a woman ages, there will come a point in their life where reproduction is no longer possible because menstruation periods come to a halt. For many women, this is both a blessing and a curse. A blessing because menstruation stops and you no longer have to bear through the inevitable pains that occur or worry about becoming pregnant. A curse because there are often many undesired effects or symptoms as a result of menopause.

Loss of Sex Drive from Menopause

First off, let’s establish exactly what symptoms women experience during menopause:

• Night sweats
• Hot flashes
• Unexplained weight gain
• Moodiness
• Fatigue

Just those symptoms alone may result in a decreased drive to have sex. Now, what if the vagina wasn’t being properly lubricated, or suffers atrophy, or the vaginal wall thins or becomes inflamed? These symptoms occur is up to 45% of women post menopause, or after menopause.

You guessed it; the desire for sex will now be even lower. This is because libido is all about energy. The symptoms above all lead to one thing: less energy. This physical and emotional toll that occurs depletes a woman of her energy and inevitably sex will be the last thing on her mind.

Lower Estrogen Levels Are to Blame

What happens during menopause is the estrogen that is naturally produced in the body is no longer being produced as much. This hormone change results in all the symptoms listed above. The symptoms above unfortunately lead to a huge decrease in sex drive. A decreased sex drive could result in tension between you and your spouse or partner.

Managing Your Decreased Sex Drive

Focus on Intimacy

Spend more time cuddling with each other or enjoying each other’s company without engaging in sexual activity. You will appreciate each other more and this could boost your sex drive.

Seek Out Professional Help

If you and your partner feels affected by your newly decreased libido, then you should consult your OBGYN who will work with you to resolve the issue. And often times all that is needed is lubrication. But other options such as hormone therapy involving restoring estrogen levels may be the solution.

Dr. Torbati offers treatment for postmenopausal loss of sex drive at his OB-GYN private practice located in Tarzana, CA.

HIV and Pregnancy – Reducing Risk of Transmission to Your Child

hiv pregnancy transmissionPregnancy is a wonderful phenomenon. Those who are suffering from HIV/AIDS may still continue to undergo pregnancy and support offspring. The main issue against this, however, is the possibility of spreading the disease to your child. This possibility may occur during the pregnancy, while in labor, or even through breastfeeding.

You shouldn’t let this information scare you from trying to become pregnant.

Many Mothers have undergone pregnancy with HIV/AIDS, while managing their disease successfully. In fact, it has been reported that this incident occurs fewer than 2% of the time. In other words, it’s extremely rare.

Steps to Lower Your Risk of Transmitting HIV to Your Child During Pregnancy

There are certain steps you may take in an effort to dramatically decrease your chances of spreading the disease to your children:

1. Get tested.

Roughly 18% of all people with HIV do not know they have the disease. Before beginning pregnancy, get tested to make sure you may or may not have HIV.

2. Start HIV treatment either before or during your pregnancy.

If you are diagnosed with HIV, then talk to your doctor about beginning treatment right away in order to become healthy enough to support pregnancy. If you are currently on treatment, then schedule an appointment with your doctor to discuss what you should be doing. If you choose not to undergo HIV treatment through childbirth, then you are putting your baby at more risk of contracting HIV.

3. Make sure your child is tested immediately after delivery.

This will determine whether or not your child should be put on treatment in order to successfully manage and control the disease. Most of the time your child will have to undergo multiple tests and wait until 2-4 months before a diagnosis is made.

How is HIV Treated?

If you are recommended to undergo treatment, you will be given certain medications designed to slow the disease from progression, as there is currently no cure for HIV. The medication is known as antiretroviral (ARV). However, those who undergo medication treatment are able to live very happily with their HIV.

Increased Risk of Metabolic Diseases in Infertile Men

infertility risksA study presented at a conference held in Munich, Germany has revealed the possibility that almost 1/3rd of men who suffer from infertility problems are at an increased risk of developing metabolic diseases as they age.

Infertility is a Common Issue

Before we even get to the study background & results, it’s important to understand that roughly fifteen percent of all couples will experience infertility. Infertility is the inability to become impregnated, which can be the result of a combination if different factors, however in most infertile couples around half of these cases are due to male infertility. Studies have already shown that men with poor semen quality experience a shorter life expectancy.

Study Background

In the study, a group of 192 men with a low sperm count were compared with 199 men with age-matched controls. Variables such as sex hormone levels, bone mineral density, and HbA1c (which is a biomarker for diabetes) were factored in to the comparison.

The study found that in men under 50 with fertility issues, sex hormone levels (i.e. low testosterone) were really low and this was 7 times as common as amongst the men in control groups. The study also noted that in these men with low sex hormone levels, low bone density levels were found, as well as elevated glucose levels and insulin resistance leaving these men susceptible to metabolic diseases such as diabetes and osteoporosis.

Here’s what the study leader had to say in reference to the findings:

“We found that a significant proportion of men from infertile couples show biochemical signs of hypogonadism. This may be affecting their fertility, but they can also serve as early warning signs for metabolic diseases in later life, such as osteoporosis or diabetes. We would recommend that levels of reproductive hormones should be checked in all men seeking advice for fertility problems. Those at risk of serious disease should be followed after the completion of fertility treatment.”


Dr. Torbati obstetrician tarzanaDr. Torbati Addresses Infertility Issues

Dr. Torbati addresses infertility issues in Tarzana and surrounding areas. His consultations are all private and personal for a comfortable experience. You can expect to be treated with care at his office. Both partners are evaluated. Dr. Torbati is board-certified and possesses ample experience as an OB-GYN.

Flu Vaccines Highly Effective for Pregnant Women & Children

flu vaccine for pregnancyFlu is the leading cause of death from a vaccine-preventable disease in the US, responsible for 36,000 deaths and 200,000 hospitalizations. The greatest burden of disease is among expectant mothers, kids, elderly citizens, and people with certain medical conditions. The highest incidence of influenza-related hospitalization among children is for infants below the age of 1 year, especially those aged less than 6 months.

The WHO and CDC Recommend the Flu Shot

Consequently, the World Health Organization and the Centers for Disease Control and Prevention (CDC) recommends influenza vaccination for all pregnant women regardless of the trimester, as well as for children, except for infants aged less than 6 months and individuals with a severe allergy to egg protein. Since the flu vaccine is inactivated, it does not pose any safety concerns to pregnant women.

In addition, the vaccine has been found to be very successful in preventing flu and related complications in expectant women and the baby, for a short time (6 months) after birth. According to a study published in the Journal of General Virology, an infant’s concentration of flu antibodies at birth correlates with that of the mother. Higher concentrations of flu antibodies in the infant resulted in the delayed onset and lower severity of influenza infection.

Risks of Complications from Flu

Influenza is known to cause more severe complications in expectant mothers than in non-expectant women. Changes in their immune system, lungs, and heart during pregnancy make expectant mothers (as well as women up to two weeks post-partum) more susceptible to serious illness from influenza, resulting in hospitalization and even death. Flu-related complication can also cause serious problems before birth, like birth defects and premature labor and delivery.

Administering the influenza vaccine to expectant mothers during their second and third trimesters has been shown to increase seroprotection against all strains of flu for most women, and more than half of their newborns. However, the protective levels against the flu completely disappears within 6 months in the newborn; hence, the requirement by the CDC that all persons above the age of 6 months get an annual influenza vaccination.

Points to note about the flu shot:

  • The influenza shot is one of the most critical things for a pregnant woman during her prenatal care, irrespective of the trimester.
  • The inactivated flu shot, with or without the preservative thimerosal, is safe for pregnant mothers, and the protection extends to the newborn for a period of up to 6 months, protecting the baby against acute respiratory infections and bipolar disorder.
  • The flu shot is claimed to reduce the risk of stillbirths/miscarriages, as well as other birth complications like an underweight baby or preterm birth.

Early treatment for influenza is critical for pregnant women. So, if you notice flu-like symptoms, contact your doctor immediately for the safety of your child.

Recent Phenomenon: Understanding the Zika Virus

understanding zika virus symptomsThe “Zika” virus has been quite the phenomenon lately going around the world. Understanding it can help you stay in the loop and make sure you are out of harm’s way.

Exactly what is the “Zika” virus?

It is a virus that occurs from the result of mosquitoes that carry the virus. This virus has been reported to cause these symptoms:

• Fever
• Rash
• Red eyes (conjunctivitis)
• Joint pain

The symptoms being to appear roughly two weeks after exposure to the virus. However, it is estimated that 80% of those infected do not even experience any symptoms.

Pregnant women that contract this virus are at risk of having children born with a disorder known as microcephaly, as well as other Zika-induced birth defects. Pregnant women are at the most risk, but non-pregnant women may still experience the symptoms above.

Where is the virus currently?

The virus has been spreading across the globe, with a few cases occurring in the United States as a result of those traveling from outside the country. The Centers for Disease Control and Prevention (CDC) has issued a travel warning for pregnant women to the following places:

• South America
• Central America
• Mexico
• Caribbean
• Puerto Rico
• Pacific Islands

The list is updated often so if you are pregnant and plan on traveling soon, view this list first.

How can I prevent this virus?

The best way to prevent this virus at this time is to avoid traveling to the locations that are at risk as specified the CDC. Currently, there is no vaccine or treatment developed for the Zika virus.

Also, if you do decide to travel to an affected area, it is strongly recommended that you invest in insect repellant and follow the manufacturer’s directions.

Best Holiday Maternity Clothing Styles

Holiday Maternity Clothing
Are you expecting? Congratulations. The holiday season is a great time to celebrate new life with style, and unlike the past when you were expected to conceal your pregnancy with shapeless fashion, many fashion outlets today feature maternity clothing sections that address all basic apparel needs.

What are you waiting for? Dive in to Dr. Torbati’s personal maternity clothing tips that he has gathered over the years practicing as a OBGYN in Tarzana.

Best Holiday Maternity Clothing Tips

1. Wear what you like.
Just because your tummy is expanding does not mean that you should transform your wardrobe. In the second trimester, when the bump is still not that visible yet, you can pair a loose blouse with a pair of skinny jeans. As the bump grows, you can easily accommodate the changes with skirts or pants with flexible waistbands designed to expand as you grow with your baby.

2. Wow them with your glowing self.
You will be the center of attraction during the holidays. So, you can impress the crowds by looking radiant in a one-shoulder dress or simple shirt paired with magnificent jewelry and a cute blazer or cardigan to portray that smart mommy-to-be look. For much cooler weather, consider a long-sleeve or sweater dress, accessorized with a scarf.

3. Embrace Lycra or wrap it up.
In your third trimester, your bump will be very noticeable. If you don’t want to look bigger, you can accentuate your sexy tummy with stretchy lycra dresses that show off your shape in a fantastic way. Alternatively, you flaunt your bump with a wrap dress. The cut is comfy, there are no annoying buttons, and the plunging necklines are incredibly sexy.

4. Look amazing in graphic prints.
Although graphic prints seem like a scary choice for a growing belly, you can look amazing by making the right selection. Choose items with straight lines that contour your body. For a laid-back vacation vibe, get a pretty tunic or one piece for a full body cover.

5. Keep it simple.
There are quite a few clothing options that don’t cost a lot, like pretty maternity dresses and comfy women’s jeans. You may want to avoid bright colors, like satin and loud prints. Consider dark, solid-color tops and dresses or neutral-colored stripe clothing. Also, get some staple maxi dresses. Other options include a swing dress, socialite dress, one-shoulder dress, sweatshirt dress, floral pencil dress, and body-conscious dress.

Final Note
When you’re still in the holiday shopping mood, you may want to get some items to make your life easier, like maternity belly supports that help to reduce back pain and lighten the stretch marks, and nursing bras to make breastfeeding a breeze. You also need to change your intimates as every part of your body will be expanding, in order to accommodate your new figure.

Stay away from your hubby’s closet! Instead of stealing your daddy-to-be sweats and shirts, stay fashionable with the options mentioned above. Having a baby is an amazing thing that you can only do once or a couple of times, so flaunt it this holiday.

New Report Finds Eating Light Meal During Labor is Beneficial

eating light meal during laborIt had traditionally been believed that fasting was necessary while a woman was in labor. The reason being to avoid aspiration that could lead to pneumonia. However, a new report has found that this actually may not be the case. The report, presented during the Anesthesiology 2015 annual meeting found that eating a light meal is beneficial for the labor process.

What The Researchers Found…

Researchers visited hundreds of cases on women who have had birth in a hospital. They found that the energy demands of a woman undergoing labor is similar to a marathon runner, whose body will use fat as an energy source if it cannot be found elsewhere (i.e. through adequate nutrition).

For laboring women, this phenomenon would lead to reduced uterine contractions, leading to longer, more strenuous labor and lower health scores for newborns.

Aspiration is a Very Rare Phenomenon

To re-emphasize, the main concern eating during labor was because of aspiration troubles.

Advancements in anesthesia have made the pain involved during labor a lot more manageable and safer, which reduces risks related to eating. Aside from this, the researchers also noted that aspiration is very rare citing only one case that had occurred between 2005 and 2013 of a woman suffering from obesity and pre-clampsia.

Benefits of a Light Meal During Labor

Provided you are in good health standing, which is to be determined by your doctor, a light meal during labor could provide benefits. Researchers note that light meals would “give expectant mothers more choices in their birthing experience and prevent them from being calorie deficient, helping to provide energy during labor”.

Always Follow Your Doctor’s Advice

Regardless of the findings, you should always follow the advice of your obstetrician or doctor. They will direct any laboring women as to whether a light meal would benefit them or not.

Dr. Torbati is a board-certified OB/GYN in Tarzana. He specializes in obstetrics, family planning, and other related services. He has been practicing for over 20 years, having delivered several newborns to happy Mothers. For more information, please contact our office @ (818) 575-6021.

When Does Pregnancy Brain Start?

Is “Pregnancy Brain” Real?

When does pregnancy brain startSome may argue that “Pregnancy Brain” is real and that it’s only normal to develop it during a pregnancy. Conveniently speaking, this would be a great deal for all women and moms-to-be, imagine for a moment you have an excuse to be ‘forgetful and unaware’, which honestly isn’t the case. There’s no doubt there may be many changes that happen to women’s bodies during pregnancy, but your ability to process and analyze ideas isn’t one of them.

Pregnancy Brain – Myth or Reality?

It is believed that “Pregnancy Brain” develops during pregnancy and women reach a state of incomprehensiveness. A number of women across the globe have actually bought into this idea, they genuinely believe that they are in fact expected to go through this haze during pregnancy.

Any research on the topic that tries to support this idea has been close to compromised since there’s just a lot to be discovered when it comes to pregnancies. Dr. Louanne Brizendine, a neuropsychiatrist at the University of California, San Francisco, and author of The Female Brain, informs her readers that women’s behavior is in fact affected by changes in their brain during pregnancy. But it isn’t unawareness or incomprehension but rather women become exhausted and fatigued by all the hormonal changes throughout their body.

Tips on Preventing Pregnancy Brain

In order to prevent exhibiting signs and quickly diagnosing yourself with “Pregnancy Brain” practice the following tips to help ease the stress and tiredness all of these changes in your body during pregnancy. Pregnancy tiredness is only normal during the first trimester and reappears again in the third trimester, luckily for you, there are natural ways for you to help lessen the intensity of these moments.

  • Start by food swapping cravings for anti-inflammatory yet satisfying foods.(Try more organic fruits and vegetables and less processed foods.)
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  • It is highly recommended to stay hydrated during pregnancies, fluids are extremely precious at this point. Try natural fruit juices, milk, and tea (decaf only) if the idea of only water saturates your taste.
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  • Commit to daily exercise and light stretching. Aerobic exercising would be a great style of exercise to practice during pregnancies, such as brisk walking outdoors will help blood flow and leave you feeling refreshed.
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  • Avoid skipping opportunities to nap. Give into your need to sleep, taking 15 to 20-minute naps can help you feel rejuvenated and diminish any stress you might’ve developed during your day.
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There’s going to be a lot of changes in your life and your body during this new experience. It might feel overwhelming at times, but there’s no need to doubt or question your thinking. You are designing a life within you and you need the rest and tranquility, don’t fall into the whole pregnancy brain syndrome or ‘momnesia’ and its sociopolitical theories. They’re nothing but a whisper in the wind.

Incorporating Omega-3 Fatty Acids Into Your Diet

omega 3 fatty acids benefitsPeople have known about the benefits of eating fish for ages. Scientists have also known for decades about the positive health effects of fish oils. Studies conducted in the 1970s revealed that the Inuit, as well as people who maintained a Mediterranean diet, had significantly lower incidence of cardiovascular disease compared to most Europeans. Studies have also shown that the Japanese have one of the highest life expectations.

One thing that the diets of these regions have in common (with the exception of Europe) is their considerably high omega-3 fatty acids content – abundant in most fish. Numerous scientific studies have shown that a diet rich in Omega-3s impact reduces the risk of heart attacks, and also helps to counter depression, diabetes, cancer, Alzheimer’s disease, and attention-deficit hyperactivity disorder (ADHD). Also, there is strong evidence showing that omega-3s reduces Crohn’s disease, rheumatoid arthritis, and other inflammations.

So, What are Omegas?

The Omegas are a group of polyunsaturated fatty acids that are regarded as “essential” to the human body because you need them, but the body cannot manufacture them. So, you can only get them from your diet.

The omegas include omega-3s, -6s, and -9s. Studies show that the modern Western diet is largely unbalanced because it mostly comprises the omega-6 fatty acids found in grains, but not enough omega-3s. The omega-9s are found in fats like olive oil, and are considered to be neutral. This means that they are neither good nor bad, but are better compared to unhealthy saturated fats.

Sources of Omega-3

The term omega-3 refers to a range of fatty acids, three of which are very important for your health: docosahexaenoic acid (DHA), elcosapentaenoic acid (EPA) – only found in oily fish – and alpha-linolenic-acid (ALA) – obtained from plants (nuts and vegetable oils).

Animal-based sources of omega-3 fats include:

  • Salmon – the American Heart Association recommends 2 servings of wild salmon per week.
  • Fish oil – a great source of omega-3 fats, though it is weak in antioxidants
  • Krill oil – a fantastic source of omega-3s and antioxidants.


Vegetable-based sources of omega-3 fats include:

  • Walnuts – major source of ALA
  • Organic flaxseed oil – rich in omega-3s, protein, and fiber
  • Kidney beans and legumes
  • Seaweed – plant sources for DHA and EPA
  • Berries – great source for vitamins, minerals, antioxidants, and omega-3s

How Much Omega-3 Do You Need?

Omega-3s constitute part of the membrane around every cell in your body, and help to control what substances pass in/out the cells, as well as how the cells communicate with each other. Nutritionists and scientists recommend that you consume at least two 75-gram servings of fish every week, which translates to about 500mg of EPA and DHA per day. That said, studies suggest that you cannot possibly get too much omega-3 fatty acids in your diet.

Omega-3 fatty acids are critical for fetal neurodevelopment and may be important for the timing of gestation and birth weight as well. This is why Dr. Torbati recommends all pregnant women incorporate omega-3 into their diets.

In The News: “Female Viagra” for Women

addyi female viagra for women 2015Viagra is a little blue pill that quickly became popular as the ideal treatment for erectile dysfunction in men. Now, there is a little pink pill – dubbed the “female Viagra” – that is believed to have a positive effect on sexual dysfunction in premenopausal women.

It is estimated that 10 percent of the female population develops hypo active sexual desire disorder (HSDD) – a condition whose primary sign is low sexual drive – and up to 40 percent experience this condition at some point. There are a number of psychological factors that contribute to the low sexual desire, including stress, low self-esteem, and mental health problems, as well as hormonal changes and physical factors, such as lifestyle habits and fatigue.

How the “Female Viagra” Corrects HSDD

Flibanserin, also known by its brand name Addyi, was recently tested and approved by the FDA for the treatment of HSDD. The drug, which is manufactured by Sprout Pharmaceuticals, is believed to correct an imbalance of brain chemicals involved in stimulating sexual desire, though the actual mode of action is unclear.

According to the FDA, a 100-mg dose of Flibanserin should be taken once a day, just before going to bed. If there are improvements in sexual desire after taking the drug for 8 weeks, it is recommended that you discontinue.

Studies Leading to Approval of Viagra for Women

The FDA found the drug safe for use after conducting 3 randomized, double-blind placebo-controlled tests with a sample population of around 2,400 women of a mean age of 36 years and with HSDD.

For the duration of 24 weeks, the women were administered with a placebo or 100-mg dose of flibanserin every day before bedtime. The women who took the flibarensin dose reported a modest increase in both sexual desire and number of sexual events during the period of study, as well as a reduction in anguish resulting from low sexual desire.

Risks of Addyi – Women’s Sex Pill

With regard to the safety of the drug, the FDA reported that the most common adverse reactions noted were fatigue, dizziness, nausea, dry mouth, insomnia, and sleepiness.

addyi female viagra risksBefore the approval, the FDA has rejected the drug twice before, in 2010 and 2014, because it was associated with hypertension – extremely low blood pressure, as well as loss of consciousness especially when taken with alcohol.

Consequently, flibanserin was approved based on a risk evaluation and mitigation strategy (REMS) that requires prescribers to attend a training program before administering the drug to patients.

Additionally, the drug comes with a boxed warning alerting patients of the risk of concussion and hypertension if taken with alcohol. There is also a warning for women with liver impairment and those taking CYP3A4 inhibitors to stay away from the drug.