After the initial month of use, and once you’re experiencing improvements from daily use, you can go into a “maintenance” mode. Maintenance dosing is typically 5 times per week. You should continue at this maintenance dose. Note that if you discontinue use of the product you will return to your baseline.

You may notice a warming and/or tingling sensation at first, which should not last longer than 10 to 20 minutes (It’s a similar sensation to a lip-plumper). 

If the warming and/or tingling sensation lasts for longer than 20 minutes, discontinue use of Julva for 72 hours or until symptoms subside. Restart Julva at ½ the dosage. If symptoms re-occur, discontinue use.

The cream will be well absorbed within 20 minutes.

If you have children in your house that could use your hand towel, please keep one separate for you only so they are not directly exposed to the cream. While Julva is very safe, it does contain DHEA and this is for you and not them! (This is the same advice I give to any man or woman using any hormone creams). It is safe for your partner however!

Before first use, it is advisable to test Julva on your inner arm for 24-48 hrs to make sure you don't have a sensitivity to it. Few people will, but it is always a good idea to test for sensitivities with anything you put on your skin. 

If irritation does occur, discontinue use of Julva for 72 hours or until symptoms subside. Retest at ½ the dosage. If symptoms re-occur, discontinue use.

Note that for a very few women, use of Julva may cause itching due to yeast. The issue is that when you start using Julva you go from an incredibly dry environment in your vulvar area and surrounding tissue, to a very moist one. And moist environments can initially result in increased levels of yeast (as they just love moist environments!). Should this occur, simply start on an anti-yeast protocol: Use an over-the-counter antifungal (such as Monistat), bump up your probiotics (either eating fermented foods and/or using a probiotic supplement), and be sure to avoid sugar (that yeast love).

Keep your Julva cream in a cool, dry place under 40° C (104° F).

It is, however, safe for all of your skin.

DHEA is a natural hormone secreted by your adrenal glands. Normal levels drop with aging (see graphic) starting at around age 30. 

DHEA is important to the integrity of skin, muscle, and bone (in both males and females). It leads to the production of active sex hormones. Healthy levels of DHEA improve mental alertness and energy levels, and it has a role in maintaining libido. It is important in heart health and many other vital health functions. 

For these health benefits, many people supplement with ingested DHEA to increase their serum blood levels. After age 45, we like to see optimal blood levels of DHEA-S in men of 250-450 mcg/dl. In women, we like to see optimal blood levels of DHEA-S of 100-300 mcg/dl.

To increase deficient DHEA levels as they age, men typically are recommended oral DHEA doses of 50 - 100mg daily after age 45. Women may benefit from 5-15mg daily.

The recommended daily dose of Julva is only ⅛ of a teaspoon. This dosage contains approximately 10 mg of DHEA along with the other valuable ingredients of Julva and is locally applied. Based on research we are not expecting a significant transfer of DHEA to blood serum. If you are interested in seeing what your existing levels of DHEA are prior to or while using Julva you can easily be tested. Your doctor simply needs to test your DHEA-Sulfate in your blood or DHEA in your saliva.  

You can also order the blood test yourself for your own reference or to share with a medical professional or other practitioners, at www.ultalabtests.com/drannacabeca

As mentioned above, DHEA levels naturally decline and many people are interested in increasing their blood serum levels. Your DHEA-S level is an interesting reference that you may wish to track over time.

Although, we have not received any feedback relating to shifts in cycles while using Julva, typically when administering any type of hormone therapy (DHEA, testosterone, estrogen, progesterone, etc.) there can be a shift in cycle (timing, duration, or even breakthrough bleeding). Should you have specific concerns, please discuss with your primary care medical doctor.

It has been specifically designed to be gentle to vulvar skin but that does not mean that it can only be used there exclusively. The cream is well absorbed thoroughly and locally into your skin within 20 minutes.

Finally, always remember, that lifestyle can improve most obstacles to optimal health. Follow my online programs for guidance.

In therapy, steroids are often given with mixed results. As a GYN, Lichen Sclerosus is probably one of the most difficult conditions to treat. My Julva feminine cream has had great success with clients who have Lichen Sclerosus. 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 Lichen Sclerosus, you should consider starting at half the dose and on the healthier tissue surrounding the Lichen Sclerosus to allow some gentle nourishing of the delicate vulvar skin to start.

This is conservative as we've had many Julva users with Lichen Sclerosus start out with the full amount directly with benefits, however, I don't know your situation or skin condition. Follow your doctor's advice, and slowly begin with Julva. 

Be patient though! It takes time.

Julva was developed using the highest principles and healthiest natural ingredients. For that reason, as well as testing and feedback from beta users as well as recent clients, we do not anticipate people will experience any problems using the product; but as with any skin-related product, there is always a small percentage of people who may experience a reaction.

Try Julva for 60 days. If you experience any kind of unpleasant reaction, please contact us at team@drannacabeca.com for a return authorization. We will ask you to complete a simple questionnaire about your skin reaction experience, and then we will ask that you return the unused portion to our Georgia address. 

We will not accept returns without the return authorization and the submission of our Julva skin reaction form. 

Once your returned products are received, we will refund your purchase price, minus shipping and handling. Please ship to: Golden Isles Medical, Po Box 30062, Sea Island, GA 31561

My number one intention for all women is to optimize their quality of life and to always do so safely, taking into consideration their unique medical history and current health status. 

Women having had a history of breast cancer need to be particularly diligent about anything – even natural products – that they put in or on their bodies.

I always recommend that women discuss any new prescription, supplement, or over-the-counter product with their primary care doctor. In the case of women having a previous breast cancer diagnosis and/or treatment, I suggest women talk with their oncologists.

Julva is a topical anti-aging cream intended for the vulvar area containing pure, natural ingredients to improve vaginal dryness and reverse the symptoms of aging. 

DHEA is the only ingredient in Julva that may concern women with breast cancer because it is a bio-identical hormone and women may fear using a ‘hormone’. DHEA is naturally secreted by the adrenal gland and ovary and is a very protective hormone with research indicating it is beneficial for brain health, bone health, and breast health.

As a precaution, if you are currently using Tamoxifen I do not recommend using Julva without your oncologist’s approval. 

ORAL DHEA (systemic) converting to estrogen can interfere with Tamoxifen use and can decrease its effectiveness when blood serum levels of DHEAS are > or = 90 microg/dL. +

Once off of Tamoxifen, I have no hesitation in recommending Julva to breast cancer survivors.

Femara/Letrozole (an aromatase inhibitor) does not appear to be affected by DHEA use and may be a better alternative should your oncologist agree. Some studies have in fact shown that breast cancer patients on aromatase inhibitors appear to benefit from higher levels of DHEAS and experience less musculoskeletal pain. ++

If you are concerned about the risk for blood clots: Consult with your primary care physician before trying Julva. We know that oral estrogen can increase blood clots; however trans-dermal estrogen, progesterone, & DHEA have not been shown to increase blood clots at all.

Certainly all women having had or having breast cancer need to be super proactive about their health. I highly recommend these women have a serum Vitamin D (25 OH) test and maintain a level of 80 in the blood. You can get a blood test to check that along with other key markers at: https://www.ultalabtests.com/drannacabeca/Item/Item/Dr-Anna-s-Key-Marker-Panels

Mighty Maca™ Plus and our Keto-Alkaline protein shake are great additions to your nutrition regimen and checking your urine pH to keep it alkaline is also recommended for optimal health. You can use our Keto-pH urine test strips to measure urine pH.

Priority 1-3 Days (Depending on location)

Dr. Cabeca frequently lectures nationally and internationally regarding restorative health and women’s health issues.

She is an Emory University trained, board certified Gynecologist and Obstetrician, as well as board certified in Anti-Aging and Regenerative Medicine, an expert in Functional Medicine and an expert in women’s health. She specializes in bioidentical hormone replacement therapy and natural alternatives, successful menopause and age management medicine. She is a consultant and trainer for other physicians in Bio-Identical Hormone Replacement Therapy and Functional Medicine Principles.

Dr. Cabeca earned her medical degree from Nova-Southeastern University of the Health Sciences in Florida. She completed her residency at Emory University in Atlanta, Georgia, and maintained a highly successful private practice in Southeast Georgia until she retired it in 2013.

Dr. Cabeca now focuses on educating women and men worldwide, including physicians and healthcare providers, on successful age management, hormone balance, and women’s health. She is also the creator of the highly acclaimed virtual transformational programs: WomensRestorativeHealth, SexualCPR, and Magic Menopause™ and hosts the highly regarded educational series, Couch Talk, featuring podcasts on current and cutting-edge health topics.

Dr. Cabeca is also the developer of the alkaline superfoods drink Mighty Maca™, as well as her all-new rejuvenating feminine vulvar cream for women, Julva™. Her website and blog can be found at DrAnnaCabeca.com.

Please send any feedback to team@drannacabeca.com.  Or connect with us on social media!