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August 22, 2022

Sexpert Q&A: Dr. Ashley Winter

Dr. Winter is a board-certified urologist specializing in sexual medicine.

We want to provide resources to educate women not only on their anatomy but to understand the safety and mechanism of action of products they are considering using.

Dr. Ashley Winter is the Chief Medical Officer of Odela. She’s a board-certified urologist specializing in sexual medicine. After completing her residency at Weill Cornell Medical Center, Dr. Winter completed her sexual medicine fellowship at San Diego Sexual Medicine. 

What motivated you to go into this particular field?

I’m a board certified urologist, which means I am trained in the management & surgery of conditions involving the urinary tract, as well as male and female genital organs.  While my residency program approached urologic cancers and male sexual function with great complexity and comprehensiveness, I felt that womens gentiourinary symptoms were often compartmentalized or treated superficially.  For instance, there has been excellent data (for over 30 years) showing that post-menopausal women with recurrent urinary tract infections (UTIs) will have a dramatic reduction in UTIs if they use vaginal estrogen.  I don’t recall once in 6 years of residency being told this. Not once. Or that vaginal estrogen can treat symptoms of urinary urgency, frequency, and incontinence in post-menopausal women.  We were taught to treat post-menopausal women with antibiotics and bladder spasm medication, which have a role, but overlooks women's unique physiology and miss the opportunity to address root causes. This realization lead me to do a special fellowship in Women’s and Men’s sexual health, where I learned skills that have been life-changing for my patients.  Now several years into my career, I have literally transformed women's lives- just with a few basic prescriptions! It's incredibly rewarding.  When I was approached by the team at Odela Health, I was thrilled at the opportunity to expand access and education about the world of women's sexual heath beyond my clinic doors.  

What specifically do you hope that Odela can do to address the Orgasm Gap?

Wow.  There are so many places to do this!  First of all is education and empowerment. We want to provide resources to educate women not only on their anatomy but to understand the safety and mechanism of action of products they are considering using.  We are also working on immersive video content —  Leigh Koechner and I made a video all about the G-spot (yes it DOES exist)!  One of our core products is vaginal estrogen —  a product that restores the natural ability to become lubricated during sexual activity, as well reduces pain with intercourse- both of these play a role in facilitating orgasm albeit perhaps indirectly; we know that lubrication and pain-free sex a key to a pleasurable sexual experience.  And then finally, for individuals looking for sex coaching, we offer access to certified sex therapists- who can help women (and their partners) work on closing the orgasm gap.  In the community, many people don’t know how to find sex coaching, and Odela is a tremendous resource for getting women in touch with this individualized care.  

What are your thoughts on testosterone supplementation (goal: better orgasms) for menopausal women? 

This is a phenomenal question and I am so glad you asked it!  Testosterone is a critically important hormone in both men AND women (we just need different amounts).  We know that testosterone affects women at many levels. For example, in post-menopausal women with low sexual desire, low-dose testosterone supplementation can improve libido.  The tissue of the vagina, clitoris, and labia are sensitive to testosterone as well, and there is a role for using testosterone in women with sexual pain and reduced clitoral size/sensitivity.  As Odela expands as a company, we certainly hope to explore opportunities for offering testosterone-based products for women's sexual health. 

Is there any evidence that applying topical estrogen to the vulva and/or labia may help women with improved sexual response?

I don’t recommend applying vaginal estrogen products externally (think labia and skin), but there is a part of the vulva called the vestibule (its a ring of tissue surrounding the opening of the vagina that extends to the labia minora- the opening of the urethra sits there!)- that is very sensitive to estrogen.  The vestibule is really important for sexual activity and has its own separate way of getting lubricated during sex (that is DIFFERENT than the vagina- crazy I know!). Usually if estrogen products are put in the vagina the medication will get to the vestibule, but many women will specifically apply some of the product to the vestibule itself as well. This is one of the many ways that understanding our anatomy helps achieve success with sexual healthcare products.  

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