Talk Pleasure with Irina Abovsky-Akkerman

by Irina Abovsky-Akkerman
Apr 22, 2025

Talk Pleasure to Me

An Honest Intimacy Conversation with Irina Abovsky-Akkerman FNP-C, MSN

Talk Pleasure to Me is our series where we talk to experts on sex, relationships, and caring for your body (& mind) so you can get inspired on your pleasure journey and learn from the best.

Irina Akkerman, FNP-C, MSN, is a board-certified nurse practitioner and the founder and clinical director of Artful Aesthetics. With over 20 years of experience in aesthetic skincare, she’s known for her expertise in facial rejuvenation and her skill as a master injector. Irina holds a Master’s degree in Nursing Science and is passionate about helping people improve sun-damaged and aging skin while offering personalized anti-aging care for both face and body.

She began her nursing journey 27 years ago in women’s health and has since expanded her practice to include weight loss, hormone optimization, and sexual wellness. Today, Irina brings it all together — offering women the tools they need to feel confident and vibrant, inside and out.

Can you tell us a bit about what you do and how you're helping women feel vibrant and connected to their beauty?

I'm a family nurse practitioner and started my career in women's health, which has always been my passion. I spent nearly 10 years in that field before transitioning into aesthetics.

As my patients began to age — and I experienced some hormonal changes myself — I started researching ways to improve overall well-being. That naturally led to offering these solutions to my patients as well.

Now, our practice is not just focused on aesthetics, but also on wellness. I love being able to offer bio-identical hormones and weight loss guidance. These additions have really taken off over the past two years at Artful Aesthetics because so many women feel unheard by conventional medicine.

I love that you're tracking across like the whole female lifespan and that you've gone through some of these changes too. Let’s start with skin. How is the skin on our face different from the skin on our bodies?

Our skin varies in depth, thickness, and the number of nerve endings. For example, the skin on our face is thinner and has more nerve endings than many other parts of the body. Then there's our genital area, which is primarily made up of mucous membranes — very thin, highly permeable, and extremely sensitive.

That’s why anything we apply there needs to be super gentle, pH-balanced, and non-irritating. It’s not a very forgiving area, especially for women.

All of this is further impacted by hormonal changes as we age. With the decline in estrogen, our skin thins and we become drier everywhere. That’s why I love Foria products. They’re 100% non-irritating, and they either restore much-needed moisture or enhance sensation — both of which are so important as we age.

We talk about this all the time with Foria: The sensitivity of your genitals. How do you help customers care for their intimate skin? What are some of the things you offer that people might not know about?

We carry Foria in the office because, in my experience, it's the gentlest and most agreeable product on the market. I’ve tried a lot of things over the years. A friend recommended Foria to me a while back — it completely changed my life.

I love everything from their Intimacy line to the Vibrance line. It really depends on what a woman is looking for. Many women struggle with dryness — not just during sex, but in their everyday lives — and it can be incredibly uncomfortable as they get older. Some women can’t use estrogen, so they need that extra moisture without relying on hormones — and that’s where Foria really shines.

Let’s talk about how to care for different areas of the skin — especially for women who are experiencing hormonal changes and noticing a lack of moisture or resiliency. What would you recommend for them?

Avoid anything that soaps too much. You don’t want to strip away your natural oils. Honestly, for most women, just water is fine for cleansing the genital area. A lot of products out there are actually too harsh — things like douches or heavily fragranced washes can end up causing more irritation and making things worse. Keeping it very simple and basic is usually the best approach. If someone is still feeling dry, oils can be a great option — especially fast-absorbing oils that are gentle on the skin.

The same goes for the genital area. Women can use suppositories, or Foria makes a great Vulva Moisturizer. Who knew you needed a moisturizer for your vagina? But it really makes a difference.

That one sold out like so many times when we first launched it! Do you have some favorite oils?

Anything that is coconut-based is a favorite, it’s super gentle and almost all Foria products have coconut in it. It's moisturizing. It smells amazing. It's got all the things in it.

Women get a lot more pH disruptions — like yeast infections — with these hormonal changes that happen with menopause. I found that Foria’s products are very soothing even when my patients are going through treatments or irritation because it'll calm things down, especially with CBD. Not even for sex, just for irritation. This stuff works really, really well.

That’s such an important point — hormonal shifts like perimenopause, menopause, postpartum, or even hormonal birth control can all affect estrogen levels in the vagina. From what I understand, estrogen plays a big role in moisture retention and the suppleness of vaginal tissue. Can you explain why that is?

Well, it brings blood flow, right? So estrogen brings blood flow to everything. And that's why we call it the beauty hormone. It makes your skin nice and plump. It makes your hair grow. It makes your vagina plump. But it's not just a beauty hormone. It actually also strengthens your urethra so women don't get as many urinary tract infections and yeast infections.

It's more than just for being pretty. It's a very functional, thickening hormone. So as we get older and that decreases, then we get into trouble with urinary tract infections and being more prone to tearing when we have sex and all of those things.

That makes so much sense. What are the basics that someone should know about pH and how to keep theirs balanced?

We want the vaginal pH to stay acidic — that’s really important. But there are a lot of things that can throw it off. For example, bubble baths are a big no — they can be super disruptive. And unfortunately, semen is very basic, so unprotected sex can affect pH too. A lot of those vaginal irrigation products that some companies sell can also mess with your pH, so they’re not a great idea either.

Personally, I really like boric acid for helping maintain an acidic pH. If someone struggles with that, I think it works really well. I use Foria's Vibrance collection along with a boric acid capsule, especially after sex, as a way to help prevent any pH imbalance.

That's a great idea, the combo of the Vibrance Melts and the boric acid.

Boric acid on its own can be quite uncomfortable, so if you combine that with the soothing properties of the Vibrance Melt, then it actually feels pretty great. It can do its job.

A lot of people only think about caring for their intimate skin during showers or baths, but do you ever recommend tending to that area outside of bathing?

I'm a big fan of bidets. If you have access to one, they’re such a gentle way to care for that area. I actually just moved, and installing a bidet was one of the first things I did in my new bathroom. It’s just water, super simple, and honestly, I can’t imagine going without it now.

I’m really not a fan of those scented wipes that are marketed for intimate areas — or even facial wipes, for that matter. Definitely don’t use the same kind of wipe you’d use on your face down there. They often contain a lot of ingredients that can cause irritation or even burning. The vaginal area is an extremely sensitive, permeable membrane, so it’s really important to treat it gently.

How is the skin of the penis different from the skin of the vagina?

Well, men are kind of built differently in that way — they actually have more protection. The penis isn’t made of mucous membrane tissue the way the vagina is. They only have one small area that’s a mucous membrane, while the rest is much more protected. That’s actually one reason why men are statistically less likely to contract an STD during sex compared to women — they just have more physical coverage. So yeah, they’re definitely a bit better off in that regard.

Does that difference in anatomy also mean a difference in sensitivity? We always say to use lube because mucus membranes can tear more easily and need more moisture — but does that also mean we’re more sensitive to pleasure?

Not necessarily. The clitoris is actually just a smaller version of the penis. When we’re in utero, we all start with the same clitoral-like structure, and then depending on how the chromosomes develop, that structure either continues to grow into a penis or stays as a clitoris. So in that way, we're actually really similar — especially in how that part functions.

Shifting to midlife, especially for women — let’s talk about what actually happens to the skin as hormones start to change. We touched a bit on estrogen being the 'beauty hormone,' but what are the real, visible effects people might notice? Not just on the face, but the whole body and the intimate areas too.

On the face, you’ll start to see signs like sagging, more wrinkles, and sunspots becoming more noticeable. That’s because the skin barrier — the epidermis and dermis — becomes thinner and more compromised, so things that have been under the surface start showing up more clearly.

The same thing happens with the skin on the body — it starts to look less smooth, more crepey. And that includes the labia and vulva, too. Everything starts to shrink a bit, lose its color, and become drier over time.

What’s interesting is that these changes can actually start pretty early. I see patients in their 30s — sometimes as young as 36 or 37 — who are already experiencing symptoms. Yes, they still have estrogen, but testosterone, which is often overlooked in women, starts to decline. That drop can lead to a lower sex drive, difficulty having orgasms, trouble building muscle, and challenges with weight management. And all of those hormonal shifts also affect the genitals in a big way.

I heard recently that the inner labia shrink too and get much smaller.

All of it does. And then the vagina itself, if the hormones are not replaced, the vagina itself will shrink and become very brittle. Even if women are not sexually active, I always tell them that estrogen is still a really important hormone to be on for your urethra and bladder because a lot of women will die from kidney infections, and they're preventable.

There’s also a connection between dementia and UTIs and kidney infections, which I had no idea about.

Exactly, that’s such a big deal — and it can be prevented with estrogen therapy. It really blows my mind when I treat women in their early 70s and their doctors tell them they don’t need estrogen anymore, just kind of brushing them off. It’s like they’re being told, 'Okay, you’re done now — go ahead and deal with dementia, broken bones, or end up in a wheelchair.' It’s really frustrating.

At the end of the day, women want to stay active, vibrant, and sexually engaged well into later life. Some of my patients who come in for bio-identical hormones also pick up Foria, which I keep right outside my office. They’ll ask about it, and I tell them it’s something that really complements their hormone therapy. It helps with things like reducing tearing and preventing UTIs, which can make a huge difference. The texts I get a month later are so gratifying — my patients really feel like they’ve gotten their life back.

We talk a lot at Foria about the connection between good sleep and good sex. Can you tell us if there's a connection between good skin and good sleep? Is that something that even touches each other?

Well, getting enough sleep definitely helps you avoid looking haggard when you wake up in the morning. So, does sleep influence your appearance? Absolutely. As for specific vitamins that are great for both your skin and sleep, I’m not sure. Magnesium is a big one — it’s great for your muscles and really helps with sleep. I’m not sure if it directly benefits your skin, but if you're well-rested, you're less likely to wake up feeling puffy and tired, so there’s a clear connection there.

I'm a big fan of magnesium too, especially because I work out a lot. Thankfully, I don’t have trouble sleeping, but I do get sore sometimes, and magnesium is my go-to for that.

We'd also love to talk about the connection between stress and skin, because we talk a lot about stress and we talk about how stress impacts your sexual desire and your availability for intimacy. But how does stress potentially impact your skin?

Stress is a big factor because when we’re stressed, our oil glands get activated, leading to breakouts. And when we’re stressed, we tend to frown more, which can lead to more lines and wrinkles, especially between the eyebrows. Stress also affects the masseters — the muscles we use to chew — and can contribute to TMJ, teeth grinding and headaches. All of that tension can show up in our skin and contribute to more frowning, which makes everything worse. So yeah, stress plays a huge role in skin health.

Foria recently acquired a company called Ned, who makes one of the bestselling magnesium supplements out there, called mellö. Can you talk about how magnesium supports the whole system — hormonal health, mood and overall well-being?

Absolutely. Magnesium plays a huge role in all of that. It helps with mood balance, hormone regulation and even serves as a preventative for dementia, which not many people know. When you’re feeling rested and balanced, you’re naturally more open to human connection.

So, my last question for you: What’s your favorite Foria product and why?

The Melts, for sure. They’ve honestly changed my life. The Intimacy Melts with CBD have been my favorite from day one. They’ve really helped with so many issues I used to experience after sex, and they’re amazing for relaxation, arousal and orgasms. Plus, they help with preventing tearing. I use all the Melts.

More from Irina

To learn more about Irina and Artful Aesthetics, please follow her on Instagram or visit her website.

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