Ob/Gyn Laurie Landeen, MD: Breaking Down Barriers to Intimacy
Aug 21, 2019 07:00AM
By MED Magazine
By Alex Strauss
Menopause, pregnancy, past trauma, depression, cancer, anatomical issues. One thing that all of these disparate situations have in common is that any one of them can stand in the way of physical intimacy for women. It’s an all-too-common problem that has become increasingly apparent to long-time Sanford ObGyn Laurie Landeen, MD.
“Throughout my career, I have worked with a lot of women who have had issues with intimacy,” says Dr. Landeen. “Figuring out ways to help them has become more important to me as I’ve gone through my own life span.”
Landeen was drawn to women’s health issues early in life. She grew up on the East Coast, the little sister of an ObGyn Nurse Practitioner 14 years her senior. After training at Georgetown and the University of Minnesota, Landeen spent five years on active military duty, caring for military women and their dependents, before joining Sanford in 1997.
“I come from a family of nurses and I knew that I really wanted to be in a nurturing environment,” she says. “So I just took off with women’s healthcare.”
Bringing Intimacy Issues Into the Open
For decades, Dr. Landeen has helped her patients deal with various intimacy issues on a “case by case” basis. These might stem from hormonal changes or other problems mentioned above. Often, they surfaced among patients who had had cancer.
“Initially, when they have cancer, all they care about is whether they are going to survive,” says Landeen. “But eventually, months or even years later, they realize that they want to live the life they had before. I wanted to help women restore their full self, regardless of the reason for the problem.”
Although 42 percent of women report having sexual dysfunction at some point in their lives, Landeen says many providers simply do not want to open this “Pandora’s box” and so do not ask the relevant questions.
“It’s not like coming in with a sore throat. It’s not about just one thing. It’s very complex.” says Landeen. After years of facing issues of intimacy and sexual health head-on with her own patients, Landeen has become known as “the person who deals with these kinds of things.”
“I wanted to take away the taboo and the stigma around intimacy issues in women,” she says. “There are now over 20 medications available for men’s sexual health. But what about women’s health? This is about how you feel about yourself. It’s about giving and receiving pleasure and it helps our entire wellness.”
A Multidisciplinary Approach to Sexual Problems
Landeen’s innovative solution has been to establish the area’s first multidisciplinary “intimacy clinic” at the Sanford Women’s Plaza. She plans to devote two full days a month to helping women identify and address their sexual health problems.
“When a patient comes in, I will be giving her a lot of things to fill out so I can get a female sexual distress score and a urogenital distress score,” says Dr. Landeen. “I want to know exactly what is going on and how much distress is this causing. Some people are at peace with where they are. But I need to see where these problems are affecting their life.”
Landeen says doing this initial assessment on paper can make it easier for patients to be honest, open, and thorough.
“Because I need to know...does she need medical treatment, couples therapy, cognitive behavioral therapy, medication? Or maybe something like the Mona Lisa touch laser that addresses problems like vaginal dryness and painful intercourse? We have a lot of tools in our toolbag.”
After the initial assessment, patients will be directed to the appropriate therapy or intimacy clinic team member for their unique situation.
“It’s not about me giving a pill or doing a procedure,” says Landeen. “It’s about involving people with other types of expertise, such as self esteem, weight management, psychology, couples therapy, etc. I have therapists lined up, psychiatrists, family physicians, spiritual health. We even have a life coach here at the Plaza to help patients with defining boundaries.”
Landeen is a passionate advocate for women’s sexual health issues outside of the clinic, too. She and nurse practitioner Molly Kuehl, DNP, work with national organizations to push for recognition of these issues and insurance coverage for things like vaginal treatment after cancer.
“They are still saying that this is cosmetic,” says Landeen. “My goal is for insurance companies to look at this like they look at thyroid disease.”
A Question of Total Wellness
Like the act of sexual intimacy itself, Landeen says she expects the new intimacy clinic to evolve somewhere spontaneously, based on the needs of the community.
“Over time, people will know that this is the go-to place for this kind of thing,” she says. “I am already at the point where I am getting patients referred to me because I saw their friend or their sister, etc.” Landeen emphasizes that the clinic is not exclusively for husband and wife couples. Sexual health, she says, is a matter of total wellness that even impacts longevity.
“There are studies that show that patients who have a healthy intimate life actually live longer,” says Dr. Landeen. “As humans, we all want to love and be loved. It’s who we are. I want people who understand that this is not taboo or dirty. This is about providing a woman with the best way to become her full self.”