By Dr. Michael S. Mall

Michael S. Mall, M.D. is the medical director of Michael S. Mall, MD | Medical Concierge and New Image Advanced Laser Skin Center. Dr. Mall answers some common questions about health, but encourages those with concerns to seek professional help.

Q: When should a woman get her hormone levels checked?
A: For many women, their hormone levels begin declining in their mid-30s. The symptoms can be subtle, such as fatigued more easily than before, difficulty maintaining muscle mass and strength, gaining excess body fat, decreased libido, anxiety, decreased ability for a restful sleep, and vaginal dryness. Getting the appropriate lab test done with an even more appropriate interpretation of what they really mean can be a challenge. It is best to have them ordered by a physician who deals in bioidentical hormone replacement daily, otherwise the physician just looks at whether or not your results fall within the reference range as opposed to where they should be.

Q: What can I do about a low libido?
A: Low libido can be the result of many things. Assuming a supportive, loving partner and minimal stress, hormone levels should be checked as answered above. Laser vaginal rejuvenation improves the biological age and function of the vagina, increasing elasticity, tightness and lubrication. That itself may improve libido, as there is positive feedback from improved sexual function and pleasure, especially if intercourse was painful prior to vaginal rejuvenation. The O shot improves the ability to orgasm as well as the quality of the orgasm. So, although not designed to treat low libido directly, the O shot can increase libido with the positive feedback of more easily achieving an orgasm with sexual activity. Although both the O shot and vaginal rejuvenation certainly improve sexual function, neither balances or treats hormone levels. Hormone replacement therapy, including testosterone, can improve vaginal dryness, low energy levels and low libido. Vaginal rejuvenation improves sexual function and pleasure, which certainly compliments hormone replacement therapy, but either one alone can certainly help.

Michael S. Mall, MD | Medical Concierge and New Image Advanced Laser Skin Center offers a new approach to health care, especially for women and their unique needs. Dr. Mall and his team adhere to the highest medical standards and utilize the most advanced technology. For more information, visit and