Pam Pagelkopf

After she got married in 2006, one of the wedding announcements Pam Pagelkopf sent was to Jacqueline Thielen, M.D., her physician at the Mayo Women's Health Clinic.

"It was my way of acknowledging that Dr. Thielen and her staff helped me get to that point in my life," Pam says. "With their guidance, I found my way back to being myself again."

The Women's Health Clinic at Mayo Clinic in Rochester is dedicated to providing care for women who have concerns about menopause, hormone therapy or sexual health. Pam's path to the clinic began in 2003 with the unexpected death of her mother. After that, the difficult events piled on top of each other. Over the course of two years, her family experienced the loss of six close family members and friends.

Prior to her mother's death, Pam also had been traveling from Minnesota to Illinois on a regular basis to help her parents prepare to move out of the home they had lived in for more than 50 years. During that time, she was dealing with the demands of a full-time job, while making time for her significant other and her two grown children, as well.

"When it came to grieving these losses and still maintaining my responsibilities, I assumed I could handle it all myself," says Pam. "I had been through a divorce earlier in my life. I thought that gave me the knowledge and skills I needed to deal with change. But, sometimes you don't realize you aren't coping. I had a lot going for me. I still needed some help."

A safe environment
Pam started to worry when she began feeling tired all the time. Usually a well-organized person, she also felt her thinking wasn't as clear and organization skills weren't as sharp as usual. In addition, she was concerned that her sexual drive and desire were at low ebb. When she discussed her unease with her primary care physician at Mayo Clinic, he suggested the Women's Health Clinic. Pam decided to give it a try.

From her first encounter with the clinic, Pam felt she had come to the right place. "The staff was so empathetic," she says. "I felt like it was a safe place for me to open up. When I met with Dr. Thielen, everything came out. I told her all that had happened and all I was feeling and experiencing. The staff made the clinic a comfortable place, so I could acknowledge what was happening and deal with it."

According to Dr. Thielen, Pam's experiences are common, and that was part of what she needed to know.

"Women who have sexual function problems often feel isolated," says Dr. Thielen. "We let them know they aren't alone. Understanding that many other women feel the same way and go through the same things can be therapeutic in itself."

A place for answers
Educating women about how their bodies react to stress and de-bunking myths about aging and sexuality is also part of the process in the Women's Health Clinic.

"People, in general, are not well educated about how stress can affect their overall health. As in Pam's case, difficult life circumstances can have a big physical impact on the way your body works," says Dr. Thielen. "Compounding the problem, many people see their sexuality as separate from the rest of their lives. It's not. It's integrally intertwined with who we are and what we do."

According to Dr. Thielen, many women also believe that after menopause, they just have to accept certain conditions, such as vaginal dryness. In reality, effective treatments are available for many post-menopausal symptoms.

"There isn't much discussion among women about these extremely private issues of sexual function and vaginal health," she says. "We're here for that. I can't tell you how many people have walked out of my office happy and relieved to get answers to questions they haven't felt comfortable talking about with anyone else."

A team approach
Pam's treatment involved medication for her symptoms, as well as follow up visits with Dr. Thielen and her colleagues. Staff in the Women's Health Clinic include specialists in gynecology, general internal medicine, psychology, sex therapy, nutrition and lifestyle counseling. This team works with patients all in one location and puts a premium on privacy and confidentiality.

"Sexual function problems aren't necessarily just physical," says Dr. Thielen. "Psychological, social and cultural issues can all have an impact. To take care of our patients appropriately and get to the root of the problem, we have a team that can offer well-rounded, complete evaluation and treatment."

For Pam, that comprehensive approach made all the difference. "One of the nicest things about the clinic is that they don't treat just the health issue," she says. "They look at you as a whole woman. They take seriously the impact physical problems have on your life and relationships. They treat you with tenderness."