The story behind my new Julva feminine cream…

There are many normal physical changes that occur to our beautiful feminine parts over time.  This is just reality.  In general, some of us age better than others. And sometimes there are unnecessary changes and consequences that, up until now, have been ill addressed.

As a gynecologist and obstetrician I have delivered thousands of babies including 4 of my own. Through this experience I became acutely aware of the metamorphic changes that occur to our whole body, especially our breasts and vagina.

If you too have experienced pregnancy, have breast fed, delivered vaginally, or had a perineal tear or episiotomy, you know you become acutely aware of some of the pains and strains.  You also become aware of the amazing and beautiful capability of our feminine body parts.

How amazing that that 9 lb baby came out of there! Wow!  And that it recovers from all that stretching pretty quickly!

Yes, our pregnancy hormones enable these changes.

Other things I witnessed was how some would tear more easily than others during childbirth, or have incontinence and vaginal dryness afterwards.  Some evolved to sexual dysfunction.  I witnessed and cared for those with incontinence and prolapse or pelvic relaxation syndromes, vaginal atrophy, even vaginal stenosis throughout the decades of my medical practice.

As time passed I saw these changes through generations.

Women also came to me to be treated surgically for incontinence doing anterior and posterior repairs, para vaginal repairs, bladder lifts and slings.  I was trained by the best of the best at Emory University and our techniques were really restorative… to a degree.

My studies, interest and expertise developed in functional medicine, sexual health and hormones and I began to notice some things…

I soon recognized that we have to treat the underlying causes before addressing with a non-emergency surgical procedure. 

I recognized that estrogen, what is most commonly prescribed for vaginal dryness, did rarely improve incontinence, nor have any real significant improvements in orgasm or sexual function, although it’s very safe when inserted vaginally.

Based on my research, I recognized that estrogen only effects the mucosal layer of the vagina and does not do very much at all, if anything to improve the muscular layers.

But when I started using androgen therapy such as bio-identical DHEA and Testosterone vaginally or applied topically to the vulvar area, I was getting great results for sexual health and vaginal dryness and my clients loved it!  They also started reporting decreased incontinence symptoms.

Let me illustrate the evolving scenario with an example.

Sue came to me complaining of incontinence when she coughed, sneezed, jumped or tried to exercise. Also, she was very shy to say, she was starting to have some leaking during intercourse with her husband.

After examination, ultrasound and bladder studies, I diagnosed simple stress incontinence. I can fix this with a sling easily – out patient surgery and it will take 30 minutes. I’d done hundreds of incontinence surgeries. Well, up until that point, I’d always prescribed vaginal estrogen in the past for 2-4 weeks pre-operatively to improve the tissue and surgical outcome; but this time, based on my research, I tried something new.  I prescribed vaginal testosterone and DHEA and scheduled her for her pre-op for surgery in 2 weeks.

When she came back she was asymptomatic (she had none of her earlier symptoms)!  What?!

You don’t have anymore symptoms?”  I asked

None!  And my sex life is better than ever.  My husband thanks you too!

Well, I can’t exactly operate now, can I?”  I said, really impressed.

You mean, I don’t need surgery?” she asked, equally bewildered.

Exactly.” I responded.  “No symptoms, no surgery.”

The results confirmed my research!

I had known, based on my research, that I’d get an improvement in the vaginal muscles but really didn’t expect such a significant and quick response! My exam verified, that in just a couple weeks, there was improvement in her vaginal ruggations (the normal folds and elasticity) as well as contractility (the ability to contract the muscles of the pelvic floor).  This meant more strength, more support to the urethra and bladder too.

Interestingly, I was in my eighth month of pregnancy with my son. It was 2004, and I’d had a surgical day in which I did 6 bladder slings in a day.  I made sure to follow up each of those clients with some vaginal androgen therapy too because of the newly evolving risks of mesh erosions and complications.  I attribute my never having any issues or complications to this fact as well as the functional approach I followed my patients with.

Not true for many women however who have suffered devastating complications from vaginal and bladder surgeries.  I’ve treated those, too, with vaginal hormones, probiotics, and believe it or not, my detox which is a gut restoration program.

Well, once my son was born, I stopped OB (intending to go back once he stopped breast feeding) and my practiced evolved more into gynecology and menopausal health.  I found that by using vaginal androgen therapy I rarely needed to operate.  In fact, I never did another sling procedure.

(This is NOT what hospitals want to hear by the way!)

Fascinating, isn’t it!

(While not everyone will be able to avoid surgery for incontinence, prolapse or other situation…the vulvar cream that I developed, Julva, is designed to improve the skin in this area which should improve outcome…more on Julva below).

Vaginal androgen (testosterone and DHEA) therapy resulted in improvements

My love for medicine and healing, and excitement that these very safe and effective methods could restore healthy vaginal function, drove me to lecture about it and to find even more practical solutions to help more women…thereby helping the couple, the relationship, and the family…

Women from far and wide wanted me to help them, but if they were not my patient, and if I wasn’t able to evaluate them in my office, I could not prescribe vaginal hormones for them.

One of the downsides of vaginal hormones is that they are made as suppositories or creams and depending on the compounding pharmacy, they might vary.  Worse than that, is that in Southeast Georgia, they will melt!  In the summer you have to keep them in the fridge.

Then it occurred to me that DHEA is over the counter and I could make a vaginal tablet, like a sublingual tiny lozenge, that dissolves under the tongue, for the vagina.  And it needed to be odorless, tasteless (;-)) be small and effective.

And I did create it.

Within a few months women were ordering from all over the country. But then my manufacturer realized that once we insert something into the vagina, it becomes a drug and we had to STOP offering it. We could no longer produce it without going through all of the expense and requirements of getting it qualified as a prescription drug.

Plus, I really wanted a non-prescription solution. I knew from experience that many women won’t go to their doctor and ask for such a prescription.

We were all devastated.

Physicians could still order the product I designed and make it available to their patients by prescription. Or physicians could have their compounding pharmacy make something similar. But many wouldn’t do so. Why?

At that time, my PTSD from my young son’s accident, was flaring, and I retired my clinical practice.  Women would write and email for the product I created. My office would have to tell them that they would need their physician to prescribe it. But this is not something many physicians would do. I would say even less than 1% are comfortable with or know how to do.  It is really specialized.  I know this because I lecture on Sexual Health all over the country and when I’ve asked the question:  “How many here prescribe vaginal hormones other than estrogen?”  less than a fraction of a percentage of the room will raise their hands and often none, even in a room of Ob/Gyns and urologists.

It’s part of my passion to continue to teach this.

I needed to develop the perfect OTC topical that could help women as much as the vaginal tablet

Once we found out the vaginal solution had to be by prescription I began trying to develop a topical that would be as wonderfully effective and even more so.julva

I wanted this topical solution to be:

  • Restorative to the skin and function of the vulva, urethra, and vagina
  • Healing of vaginal dryness
  • Increase lubrication and healthy glandular function
  • Improve sexual function and satisfaction and pleasure
  • Improve the symptoms of incontinence
  • And yes… be tasteless and smell good!

I’ve perfected this cream with love and prayers that it helps women around the world feel good about our feminine bits, especially as we deal with the normal changes of age. I’ve focused on making it really safe, and along with addressing all of the above…it is designed to effectively improve the divinely designed function of our beautiful, feminine, pelvic floor.

Try it and let me know how you love it!

There is a lot of great research supporting the effectiveness of the natural hormone, DHEA, that I’ve used in my formulation. Many other wonderful, nourishing ingredients as well, including Alpine Rose Stem Cells. Here is just some of the research listed below if you are interested in learning more…or ask me a question! I’d love to hear from you. Email me at

LOVE Julva, or know a friend who might benefit?

Share the great news. Julva is here!


Tweet: Perfect OTC cream for delicate feminine parts #vaginaldryness #incontinence


Did you take my Eve Quiz? Your very own “snapshot” of your current sexual and pelvic health!

In 2 minutes flat, you’ll get a score (from 0 to 70 – where lower is better) that represents an assessment of your sexual and pelvic health. Once you know your starting number, it’s much easier to improve!

QUIZ TIME! Take my Eve Questionnaire to understand your bodies changes better.



References on DHEA as effective treatment for vulvar and vaginal atrophy and related symptoms:

F Labrie, MD, PhD, ‘Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness, symptoms of vulvovaginal atrophy, and of the genitourinary syndrome of menopause’, The Journal of The North American Menopause Society Vol. 23, No. 3, 2016, pp. 243-256

F Labrie, MD, PhD, ‘Intravaginal dehydroepiandrosterone (Prasterone), a physiological and highly efficient treatment of vaginal atrophy’ , The Journal of North American Menopause Society, Vol. 16, No. 5, 2009, pp. 907/922

F Labrie, MD, PhD, ‘Effect of intravaginal dehydroepiandrosterone (Prasterone) on libido and sexual dysfunction in postmenopausal women’, The Journal of the North American Menopause Society, Vol.16, No. 5, 2009, pp.923/931

F Labrie, P Diamond, L Cusan, JL Gomez, A Be’langer, B Candas. “Effect of 12-month dehydroepiandrosterone replacement therapy on bone, vagina, and endometrium in postmenopausal women.’, J Clin Endocrinol Metab 1997;82:3498-3505.

F Labrie, DF Archer, W Koltun, A Vachon, D Young, L Frenette, D Portman, M Montesino, I Cote, et all. “Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness, symptoms of vulvovaginal atrophy, and of the genitourinary syndrome of menopause’, Menopause, 2016 Mar: 23(3):243-56

F Labrie. “Treatment of pain at sexual activity (dyspareunia) with intravaginal dehydroepiandrosterone (Prasterone)’, The Journal of The North American Menopause Society. Vol 22, No.9. 2015. pp 950-963

Related Blogs:

    None Found

32 thoughts on “The story behind my new Julva feminine cream…

  1. I see original tablet also had testosterone as well as DHEA. The Julva has only DHEA. Speak to the difference & how would I get the one with both – what do I ask my doctor to prescribe?

    1. Currently there is prescription Intrarosa which is vaginal DHEA suppository that your Doctor can prescribe. These are FDA approved for vaginal use. Other wise your doctor can prescribe a combination of testosterone with DHEA either in a cream or in a suppository but that depends on your doctors prescribing preferences and experiences with vaginal prescriptions.

  2. I was recently diagnosed with Lichen Sclerosis. I need to be very careful to not apply any topical s that could trigger a flair up. Can you speak to this issue with respect to your cream? Thank you!

    1. Lichen sclerosis can leave the vulvar tissue sensitive, tender and easily irritated. In therapy, steroids are often given with mixed results. As a Gyn, LS is probably one of the most difficult conditions to treat. My Julva feminine cream has had great success with clients who have LS. They report increased comfort quickly and are thrilled with the results. Julva is a nourishing formula and I recommend you try it. I give you a 60day money back guarantee. With LS you should consider starting at half the dose and on the healthier tissue surrounding the LS to allow some gentle nourishing of the delicate vulvar skin to start. This is conservative as we’ve had many Julva users with LS start out with the full amount directly with benefits, however I don’t know your situation or skin condition. Follow your doctors advice, and slowly begin with Julva. Be patient though! It takes time.

  3. Hi,
    I have been diagnosed be a dermatologist that I have severe contract dermatitis. My gynecologist said it’s lichen sclerosis. It affects my vulva area and clitoris. Sex is not happening as I don’t have any desire. The steriod for lichen burns and is very irritating. The other products I’ve used hasn’t helped at all. Please let me know if you think this can help me before I invest in another product.


    1. Lichen sclerosis can leave the vulvar tissue sensitive, tender and easily irritated. In therapy, steroids are often given with mixed results. As a Gyn, LS is probably one of the most difficult conditions to treat. My Julva feminine cream has had great success with clients who have LS. They report increased comfort quickly and are thrilled with the results. Julva is a nourishing formula and I recommend you try it. I give you a 60 day money back guarantee. With LS you should consider starting at half the dose and on the healthier tissue surrounding the LS to allow some gentle nourishing of the delicate vulvar skin to start. This is conservative as we’ve had many Julva users with LS start out with the full amount directly with benefits, however I don’t know your situation or skin condition. Follow your doctors advice, and slowly begin with Julva. Be patient though! It takes time.

  4. Hi Anna, The studies that talk about DHEA for vaginal atrophy are using it intravaginally, does Julva cream give similar results given that it’s applied externally to the vulva? Or can you use Julva internally also?

    1. We are getting great results with my topical Julva feminine cream formula. It is the combination of ingredients that make it so effective and nourishing to use. It is formulated for the vulvar area and can be used prior to intercourse safely as well. Vaginal preparations are by prescription only.

      Please let us know how you do, I expect great results and with that offer our 60 day money back guarantee.

  5. I have just ordered some of your cream and I’m hoping to have great success. I along with thousands of women in a FB group have Lichen Sclerosus. It’s a horrible condition that robs us of our sex like and much more. I wish more Drs were educated in this disease.

    1. Thank you for giving it a try! I truly am encouraged by the results we are seeing and the improvement in the vulvar tissue and comfort level that so many women are reporting. Please be patient, it takes time but I expect you will note improvement within 3 months. Please let us know how you do!

  6. Hi,
    I have been dealing with dysuria and pain in the urethra for over 8 months. I finally got into a urologist.. actually I saw his nurse practitioner. She did an internal exam and said that the little glands on the inside of my vagina were atrophied, and that I should use estrace creme. she said that the lack of hormones created a thinness of the tissue and that the creme would help. Initially I was excited. I had gone from having an ongoing bladder infection, to just a few 1-2, red blood cells in the urine . Then when I got home I looked up the side effects and realized that I couldn’t use it because of my history with blood clots after using birth control pills in my 20’s. I take a natural supplement, called Boluoke to deal with this. If I stop taking it, I get pain in my left calf, so I know it is important to keep taking. My question your creme safe for someone like me? Do I have to worry about blood clots if I use it? I am not sexually active right now, but would really like to be able to live without the daily pain in my urethra.
    I really hope for a response, since I know of no one else who can help me. Thank you for all you do.

    1. You should definitely confirm with your doctor but there is no significant clinical data suggesting my cream would increase thrombosis, nor does transdermal estrogen cream in clinical studies… oral estrogen can definitely however. You may want to begin at half the dose of Julva however to get started slowly as an added precaution. I also recommend in clients with a history of DVT to supplement with Nattokinase and Omega Pure – which are from Xymogen – here’s a link to find out more about those as well: and

  7. Hi Dr. Anna- I have been prescribed dhea vaginal suppositories, 6.5 mg, daily to treat vaginal atrophy. I was recently discontinued from transdermal estrogen related to uterine hyperplasia. Although dhea was helpful in this area, i started to experience the adverse side effect of anxiety. I switched it to every other day and I still had this issue. It appears I may be getting systemic effects of dhea vs local. Would use if your cream vs suppositories address this issue?

    Thank you,

    1. Considering that side effect, the benefit of trying Julva is that you can reduce the dose to a fourth of what I recommend to start. If you decide to try this, please work with your doctor…as only your doctor fully knows what you’ve been experiencing…
      You might also try adding zinc 50mg per day and omega supplementation (like Xymogen’s Omega Mono Pure -email my office
      for ordering info) and also have your doctor test you to make sure your vitamin D level is above 50. Anxiety may be do to the metabolism of the DHEA and these supplements can often help.

  8. I filled out the quiz when you and Dr Ritamarie did the recent fantastic program. The results are no longer in my email box. I filled it out several more times and no email has been received. How can I receive the report?


    My Julva is coming soon!

    1. Hi Sandi, I’m sorry I must have missed seeing this earlier…are you still having an issue getting your results? Please let me know. So glad you are using Julva now…tell me how it is working for you.

  9. Originally you used DHEA and testosterone. Your current product does not contain the testosterone. What benefits does the testosterone provide?

  10. I take 7-Keto DHEA (25mg) and DHEA 5mg daily (test results are low,) – Can I also use this cream on my labia? I ask because Im on HRT (estrogel & prometrium 100mg, due to bone concerns) and my labia has definitely atrophied – will this cream rejuvenate the labia? HRT for 10 years, under the age of 60. I’m not expecting miracles but would like an improved view! I don’t have a sexual partner so I can’t comment on painful intercourse, thinness and tearing.

    1. Sorry for the delay in responding, Tammara, but I was outside the country for a bit… It is definitely worth a try to use Julva feminine cream daily. Since there is significant atrophy it may take time, but direct use of Julva to the vulvar area can help.

  11. I am a Pelvic therapist and misplaced the email where Dr Cabeca said she would give me samples to try with my patients. Could she please send me the Julva samples for my patients?
    Thank you
    Lori LeBarnes
    2110 Southers Circle Suwanee, Ga 30024

  12. Hello, Dr Anna. I have been diagnosed with vulvodynia and have excruciating pain in my clitoris. I have tried an amytriptaline topical cream, amytriptaline oral tablets, biofeedback and pelvic physical therapy, and a low oxalate diet to no avail. I really need help. Is the Julva cream suitable for clitoral pain?

  13. Hi Dr. Anna,

    I was recently diagnosed with a uterine prolapse in January when I had use the bathroom in alarmingly found something sticking out of me and went to the ER and they were pretty sure that’s what it was I went to my OB and she confirmed it. And now I have been going to physical therapy just once so far and they gave me a couple exercises and kegels. I have also had really bad lower back pain. With a grade 1 or grade 2 uterine prolapse I don’t know what I have because my OB didn’t actually say and I don’t know if I have any other type of prolapses other than the one that she did confirm would juvula cream also help me? I have always been quite dry vaginally no matter if I was breastfeeding or not. I have ordered the cream and I do have it currently and I’ve used it twice yesterday and today but I don’t know if it’s making a difference or not it does kind of have a somewhat burning sensation I don’t know if it’s supposed to or maybe it that’s just the tingling that you’re talking about. Because I just applied it topically and externally like in the description the directions that you sent with it. And it’s not as bad of a burning sensation as it was yesterday. Is it just something to get used to? I have had 4 babies vaginally and I have had three vaginal tears after each one were born except one and I was stitched up immediately after they were born. Would the cream also help strengthen the vulvular tissue?

    1. Hi Alecia and thanks for writing. Julva may help you feel better but it will take time. Typically, as a gyn, for severe uterine prolapse we recommend surgical repairs but you are right to spend time with kegel exercises (make sure you are doing them correctly, there is a video on my blogs site here ) in advance to improve surrounding musculature.
      With the irritation/tingling with Julva, use half the dose, it just may be too strong for you, although I understand wanting to get faster results. It will have a rejuvenating effect and will help sensation and discomfort but will take time. Please let me know how you do.

Leave a Reply

Your email address will not be published. Required fields are marked *