Sexual Medicine: What’s HOT and What’s NOT?

Sexual Medicine: What’s HOT and What’s  NOT?

By: Michael Krychman, MD • Posted on December 12, 2017 • Updated April 28, 2023

Sexual Activity Linked to Overall Health & Well-Being

Many of us don’t recognize that sex is surprisingly healthy. There is an emerging body of scientific literature that links sexual health and wellness to overall general health and well-being.

Sexual connectedness not only nurtures our bodies and bathes our brain in the love and feel-good hormones, but the trends in medical thinking are that a satisfying sexual life may lead to:

The science of sex and sexual satisfaction is evolving and consequently the big of business of sexuality has been thrust upon us. How is the average consumer able to separate fact versus fiction?

Here is a short list of what’s hot and what’s not when it comes to emerging trends in sexual function and pleasure.

What’s Hot?


Sexual technology is all the rage! Sexual accessories is a new concept coined “Teleo-dildonics” which means using sexual accessories with a distant partner. For instance, you may be in NYC and your lover is programming your latest sex toy in California - sex-skyping has been brought to a new all-time high.


Lioness, a new pleasure device, can even help provide sexuality feedback to help enhance the sexual journey.

Formal Medical Sexuality

The field of formal medical sexuality is exploding. The Food and Drug Agency (FDA) now regulates sexual lubricants and has regulations to monitor what’s on both vaginas and penises and now advocate that products be 510K cleared.

Natural, water-based personal lubricants, like SYLK®, have been researched and have regulated pH balanced ingredients, which may be healthier for the vaginal flora and designed concentrations that are monitored to ensure high quality.

Other favorites include:

Be aware that funky new additives like caragold (THC derivatives) and THC (marijuana oil) itself have also found their way into the bottles of sexual lubes. Some over-the-counter sexual arousal oils, that can be rubbed into the clitoris, like Zestra, may help with climax.


Milli, a novel self directed expanding dilator, hit the market in late 2017 and is getting favorable reviews. Milli is a techy dilator that opens one millimeter at a time to help women who may suffer from sexual pain syndromes.

Women with cancers, particularly breast cancer, gynecological cancers and colorectal cancers requiring radiation should see a physician well-versed in sexual medicine SOONER rather than later.

Cosmetic Aesthetic Surgery

Cosmetic aesthetic surgery that impacts sexuality is on the rise. And the number of people actively seeking out these procedures is growing. Those cosmetic aesthetic surgeries include:

  1. Vaginal rejuvenation with lasers for vaginal dryness
  2. Geneveve® treatment, which is radiofrequency and surface cooling for vaginal laxity and loss of sexual sensation - Viveve
  3. Anal and vaginal botox for vaginismus

There continues to be hormonal and non-hormonal options for post-menopausal women with painful intercourse:

  1. Osphena (Ospemiphene) - a non-estrogen oral daily medicine and is an option to treat vaginal atrophy/genital syndrome of menopause.
  2. Intrarosa (Prasterone/vaginal DHEA) - the new kid on the block and shows excellent promise.

It's exciting that women have so many choices!

Focusing on sexual pleasure, without distraction, is now in vogue. Although mindfulness, has been around for many years, it is important for couples to refocus and re-prioritize their sexual escapades into busy lifestyles.

It’s easy to forget about intimacy and sexual connectiveness and put it on the back burner as we focus on family, finances, the children and aging parents and in-laws. In our chaotic world, there seems to be a growing awareness that we need to stay grounded and focused on health, wellness and sexual fulfillment. We are focusing more on the journey of sexual pleasure and connectedness rather than a quick orgasm.

What’s Not?

Rejecting That Sexual Dysfunctions Are Real

Rejecting that sexual dysfunctions may not be severe and impactful has completely fallen out of favor, especially when it comes to women. We now accept that Hypoactive Sexual Desire Disorder (HSDD) is a real, medical and impactful condition that warrants either psychological and/or medical intervention.

We have finally seen the approval of Flibanserin/Addyi®, the first and only medication for women with distressful lowered libido. Addyi is also reported to be associated with weight loss.

Celebrity Sexual Product Endoresements

Celebrity sexual product endorsements are definitely out! From Gwenth Paltrow’s GOOP, to the Vagical (a so-called facial treatment for your vagina where you sit on a steamed bath of exotic herbs to purify and cleanse the vagina) or the Jif tip (adhesive tip to the penis), these new products are rightly being challenged by sexual medicine professionals. Vulvar care and hygiene are key!

Unregulated Procedures

Plastic surgery procedures by non-experts and unregulated, unapproved procedures like silicone injections into penises and buttocks have led to serious medical complications or even deaths.

Gimmicky Fads With No Scientific Evidence

Empowered women are smarter than ever, and doing their sexuality homework and thus need access to accurate information. They should not be fooled by gimmicky fads that make outlandish claims that have no scientific evidence. Certain procedures like Scrotox (Botox to the scrotum of males) and G-shot (O-shot-injection into the G-spot of the vagina) are receiving more and more criticism in the scientific world, so please talk with your healthcare provider before doing any procedures.

    Be Empowered

    Smart consumers, are seeking sexual pleasure and want education, safety and evidence. You and your partner need to investigate before purchasing devices, lubes, or undergoing any genital aesthetic procedure. Sometimes just having a frank discussion about your concerns and questions will put you at ease and reassure you that you are normal.

    Be empowered to find a women’s health care clinician that you are comfortable asking about any concerns you have from:

    You are never too old to enjoy sexual intimacy and adding to your sexual repertoire may bring you health and satisfaction.

    Be Strong. Be Healthy. Be in Charge!

    -Michael Krychman, MD

    Check out Dr. Krychman and Dr. Dweck’s book: The Sexual Spark: 20 Essential Exercises to Reignite the Passion.

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