Dr. Streicher’s Inside Information: Menopause, Midlife, and More

Dr. Jen Ashton- you know her as the chief medical correspondent for ABC News and Good Morning America, who appeared in your home every morning, explaining the hot topics in health.  

Today, we talk about her pivot into her passion- fitness and wellness- and how to incorporate into the second half of your life..and love your age. 

How Dr. Ashton ended up as an anchor on Good Morning America How she has reinvented herself as a wellness and obesity expert We revisit “The Reinvention Convention we participated in years ago The key traits of wome...

Come Again: Sexuality and Orgasm, my solution-driven audio Series, for both non-healthcare professionals and healthcare professionals is now  available on demand on drstreicher.com. Subscribers get loads of supplementary guides and resources. Health care professionals have an option to purchase additional material on incorporating sexual medicine into their practice. 

For a 25% discount to the COME AGAIN Series, use code PODCAST25. This discount code expires December 21.

This episode is a free preview from COME AGAIN Episode 19

When it comes to testosterone, hairy guys with round the clock virility come to mind, thanks to those non-stop ads...

At my monthly Ask Me Anything Webinars,  I always get questions about hormone therapy- when to start, when to stop, if the dose should be changed as women get older, and what to do if someone continues to have symptoms or continues to bleed… 

In this episode, Dr. Risa Kagan and I answer submitted questions. 
We start by briefly running through the established indications for starting menopausal hormone therapy (MHT), and then Dr. Kagan and I discuss the “what ifs” of hormone therapy.  

Do you have to wait for 12 months without a period before starting M...

In case you missed it, last week was quite the week in the menopause world. The FDA made a landmark decision to remove all black box warnings from estrogen products and to update the labels of individual products. I was in the room where it all happened and in this episode, I’m going to break it all down for you. But here’s the headline- this label change is overall, a good thing, a very good thing.

A transcript of this podcast, along with photos and graphics, can be found on DrStreicher.Substack.com

In this...

Human Papillomavirus, or HPV, is responsible for 6 different kinds of cancers…Cervical, anal, oral pharyngeal, vaginal,  vulvar,  and penile. So, it was a big deal when the HPV vaccine was approved in 2006 females between the ages of 9 and 26.   In 2018, the age range was expanded to include adults up to the age of 45. But, what about women over 45? Shouldn’t they have the option of getting a vaccine that prevents 90% of HPV related cancers? 

My guest is Dr. Vivien Brown, an Assistant Professor at the University of Toronto with a special interest in Adult Immunization and Vaccine Preventable Illness...

Selene Yeager is not a doctor; she is a health reporter with an enormous following of women who count on her to provide evidence-based medical information.  

Recently, we sat down to discuss challenges in prescribing hormone therapy for her podcast, "Hit Play, Not Pause." We had such a good conversation that I asked her if I could share her episode with my audience.  

👉Hormone therapy research
👉The cardiovascular implications of hot flashes
👉Why formulations matter 
👉Why the route of delivery (transdermal vs oral) matters
👉Why bio-identical is not always best (link to my article belo...

"The psychological aspects of having obesity are rarely recognized. The psychological burden that people carry outweighs the adipose tissue.”
                                                                                             Robyn Pashby PhD

This episode is a must-listen for anyone struggling with obesity, or who knows someone with obesity, or a healthcare clinician who has patients with obesity. 

The complex biology of why some folks have excess weight is just beginning to be fully understood. Having obesity is a complex interplay of biology and psychology, and it is time to stop framing obesity as a personal failure. The solution is not as simple as “Eat less, move more”. 

Dr. Robyn Pashby is a he...

Emotional lability, anxiety, crying jags. Welcome to perimenopause.

70% of women experience depressive symptoms and alterations in mood when estrogen levels plunge or start to fluctuate.  While many factors increase the risk, there is no denying that changes in hormone levels have something to do with anxiety, mood, and depression, even in people who never had issues before perimenopause.   

 Dr. Pauline Maki is a world-renowned expert in menopause, mood, cognition, and the impact of menopause on the brain. She has authored hundreds of scientific articles and leads a National Institutes of Health (NIH) funded research prog...

Hot flashes, vaginal dryness, and sleep disturbance are the three most common symptoms of menopause. Currently, there are over 20 FDA-approved products to treat hot flashes. There are roughly 10 FDA-approved products to treat vaginal dryness. There are zero FDA-approved products to treat insomnia due to menopause. Zero. 

My guest is Dr. James Simon, a clinical professor of Ob-Gyn at George Washington University and an expert on all things menopause.   

In this episode: How common it is for women to have new-onset sleep disturbances due to hormonal changes? Are Insomnia and sleep disturbance the same thing What hap...

 If you are a menopausal woman and spend any time on social media, you are familiar with Dr. Corinne Menn. She is a trustworthy voice of science and evidence-based medicine in a sea of influencers who don’t always stick to the data. 

 Dr. Menn is one of the authors of a recent study titled Women’s Insights on Sexual Health after a Breast Cancer Diagnosis. This study, published in the Journal of Clinical Oncology, asked 1,463 women with a breast cancer diagnosis about their sexual experience, including how the health care system either helped or, in most cases...

I have written many times about how in the 1800s, vibrators were not sexual items that women bought for themselves, but medical devices used by doctors to treat a medical condition then known as hysteria. 
The problem is- that’s not true.
And be sure to check out my photo gallery of devices discussed in this episode!

The popularly accepted history of the vibrator Hysteria, and how it was treated in the early 1900s Dr. Lieberman’s research  What medical conditions electric vibrators were used for The story continues..the mid-1900s The re-launch of the...

I was invited to participate in the FDA roundtable on menopausal hormone therapy. 

I declined. 

In this episode, I’m going to tell you why. 

A brief history of the FDA Why there is a black box warning on all estrogen products Why the black box warning should be removed from all local vaginal estrogen products Prior efforts to get the label removed How product labels and warnings  traditionally have been modified or removed at the FDA My concerns and why I did not participate in the roundtable My article on increased sepsis when l...

 
 Dr. Dawn Mussallem, a board-certified lifestyle medicine physician, was diagnosed with Stage 4 cancer at age 26, followed by a heart transplant.  She walks the walk when it comes to healthy lifestyle choices.  At the Mayo Clinic Breast Center, Dr. Mussallem is the go-to expert for how healthy choices not just prolong life, but also make life better.. not just for women living with a cancer diagnosis, but all women. 

 Dr. Mussalem’s personal story- and how lifestyle medicine saved her life What Lifestyle Medicine is The six pillars of lifestyle medicine that impact longevity and quality of life: Stress M...

Any mid-life woman knows that once you hit your 40s, 50s, or 60s, things will not go well if you eat the same way you did when you were 20. But it’s confusing to know what to eat, and how much to eat, without downloading multiple APPs and carrying around a calculator 

My guest, Alexandra Filingeri, holds a doctorate in Clinical Nutrition with a focus on evidence-based nutrition interventions, particularly in mid-life and menopause.  In this episode, we cover practical nutrition tips- what to eat and how much to eat to maximize health aging. Dr. Filingeri also answered ques...

Women are generally told that if they have a breast cancer diagnosis, they should steer clear of estrogen. In this episode, I have a conversation with Dr. Swati Kulkarni, the lead investigator of a new study in which women with a newly diagnosed breast ductal carcinoma in situ, DCIS, were given a month’s worth of hormone therapy before standard treatment to see the impact it would have on developing cancer cells.  What DCIS is and how it is typically diagnosed. If DCIS is considered to be a pre-cancer or a cancer If DCIS is untreated, how often it will pro...

Do cell phones cause brain cancer?  Does using an antiperspirant increase the risk of breast cancer? Does fluoride in the water increase the risk of bone cancer? Is the HPV vaccine lifesaving or dangerous? 

In this episode, I am joined by Dr. Shikha Jain, an academic hematologist and oncologist. We start by busting cancer myths and then move on to discuss the impact of the “Make America Healthy Again Movement” (MAHA)on cancer care and cancer research, and why the rationale behind the MAHA movement is FLAWED and DANGEROUS. 


Which of the following is associated with ge...

When it comes to the risk of developing dementia, family history is a factor, but it is far from the only factor. It is well known that physical activity, social isolation, smoking, alcohol, medical conditions like diabetes, heart disease, or being hard of hearing, all impact the risk of developing dementia down the road.
In this episode, I explore the relationship between what you eat and brain health with Dr. Annie Fenn, the author of The Brain Health KITCHEN, Preventing Alzheimer’s through Food.  WHY food impacts the brain  What foods should be avoided What foods are neuroprotective                                                        Annie Fenn, MD Dr. Fenn’s Subst...

When women think about the benefits of menopausal hormone therapy, things like hot flashes, insomnia and vaginal dryness come to mind. 
But for many women, bone health is, or should be, at the top of the list.  
In this episode, I speak with Dr. Risa Kagan about the role of estrogen, progesterone, and testosterone in bone health.
Definition of Low Bone Mass (Osteopenia) and Osteoporosis The Difference Between a T score and a Z score  FRAX- Fracture Risk Assessment Tool When Bone Mass Peaks How to Maximize Bone Health Before Menopause Hits Role of Estrogen in You...

Transdermal estrogen in the form of a patch, gel, or cream is often the preferred delivery method for menopausal hormone therapy. Unlike oral estrogen, in addition to other advantages, transdermal estrogen does not increase the risk of blood clots.  But a new study, published in the journal Menopause, indicates that your transdermal estrogen… may not be doing what you think it’s doing. Today, I am speaking with one of the authors of that study, Dr. Louise Newson. 

My Substack post summarizing the study: 
https://drstreicher.substack.com/p/is-your-estrogen-patch-gel-or-spray?r=740mq

Link to article...

I get lots of questions on various platforms. But I never get to all of them. So, today is Q and A day. 
I asked my friend and colleague, Dr. Heidi Flagg to join me because it’s always good to get another point of view. Dr. Flagg is, above all, a clinician. She is in her office in NY city, day in and day out, helping women navigate peri menopause and menopause. And unlike many people out there who are new to the scene, Dr. Flagg brings decades of real-world experience to the table.  

QUESTIONS Do you...

Welcome to COME AGAIN:  Sexuality and Orgasm Podcast

What if suddenly your tried-and-true maneuvers that consistently ended in orgasm no longer worked? Or it took so long and the climax so pathetic it was hardly worth the effort? Along with hot flashes, sandpaper sex, and a loss of libido, add the inability to have an orgasm to the list of post-menopause surprises your mom "forgot" to warn you about.

In this episode you will hear the first two episodes of COME AGAIN-a new podcast series  with science-based information to get your libido to kick in and yo...

As our bodies age, so do our teeth. And, no surprise, menopause also has an impact on dental health. My guest, Whitney Difoggio, AKA Teeth Talk Girl ,knows it all when it comes to dental hygiene ,anti-aging tips and post menopause teeth, gums, and tongues.
Whitney DiFoggio, founder of teethtalkgirl.com, is a passionate dental health communicator and registered dental hygienist, recognized as "Teeth Talk Girl" on social media (@teethtalkgirl). With a bachelor’s degree in biology from the University of Illinois Chicago and a master’s degree in health communication from Arizona State University, she is currently purs...

The vagina is a dark and mysterious place. It is the passage by which most of us enter the world. As an adult, it is the place where our sexuality is housed, hopefully, associated with pleasure, but it can also be a place associated with pain, and sometimes trauma. 
It is impossible to see the vagina without a speculum since the vagina is completely internal. And it was the invention of the speculum that allowed physicians to help women suffering from gynecologic conditions.  But, there is a dark history to the origins of the speculum exam, and ev...

Menopause experts rarely see patients with no medical issues. We see the patient with multiple medical problems and concerns.  In this episode, I bring in menopause expert Dr. Risa Kagan to collaborate on options for the following complex patient.
(Be sure and check out my Substack article that gets into the nuances of bazodoxifene)

Beth is 51 years old.  I’ve been flashing for 2 years with no end in sight.  I really want to try estrogen not just to help my hot flashes, but also because my mom had osteoporosis. I don’t have osteoporosis yet, but I’m worried...

GLP-1 drugs like Ozempic™ and Wegovy™ do a great job at helping folks lose large amounts of weight, but there is emerging evidence that the benefits go well beyond achieving a healthy weight. And then there is the dark side…can they also harm? 
In this episode, Dr. Alexandra Sowa, an internist who is certified in obesity medicine, and the author of the just published book The Ozempic Revolution: A Doctor's Proven Plan for Success to Help You Reverse Obesity, End Yo-Yo Dieting, and Protect Yourself from Disease discusses the impact of the GLP-1 drugs throughout the body. 

...

Hot flashes, the hallmark of menopause are experienced by up to 80% of women. And if you are in your late 40s or early 50s and dressing in layers, carrying a fan, and sweating through your pajamas, chances are, it’s menopause. But maybe it’s not. 
In this episode I run through the list of conditions that have nothing to do with menopause, that can cause women to sweat through the day and night.


Dr. Streicher is on SUBSTACK
• Articles
• Monthly newsletter
• Monthly News Flash Reports on recent research
• Monthly Zoom Q and A Webinar...

The 1950s and 60s were a time of medical paternalism in America. The doctor, who was male in 98 percent of cases, decided what was best for his patient and unilaterally made decisions that were rarely, if ever questioned. In 1969 Dr. Marcus Welby was the TV prototype of this godlike paragon, and he spoke decisively and with authority in countless American households, including my own, on a weekly basis. This paternalistic approach to medical care affected both male and female patients but had a more profound impact on women since they regularly required medical intervention due to childbirth and...

Sexual fantasy is at the top of the list when it comes to taboo topics. My guest, Dr. Justin Lehmiller is a social psychologist, an award-winning educator, a prolific researcher, and is the host of The Sex and Psychology podcast. He is also the author of The popular book, Tell Me What You Want_ The Science of Sexual Desire and How it Can Help You Improve Your Sex Life based on his survey of sexual desire in America, including how fantasies change as women age. 

The most common sexual fantasy  If people intend or desire to act out th...

Many, if not most women and clinicians believe that bioidentical estrogen is always best when it comes to post menopause hormone therapy. This comes from the premise that bio-identical estrogen is completely natural and therefore safer and more effective than other forms of estrogen.  Except that is not necessarily true.
  
In this myth-busting episode, I discuss: Why words and terms need to have precise meanings The difference between HT, HRT and MHT The three general categories of estrogen     Synthesized      Conjugated     Bioidentical How the term bioidentical came to be Four myths about bioidentical estrogen              Bioidentical estrogen is completely natural 
   ...

Less than 3% of post-menopause women use commercially produced hormone therapy. However, increasing numbers of women dealing with hot flashes, insomnia, painful sex, and loss of libido are using non-FDA-approved hormone pellets. Millions of women have no idea that they are using a form of hormone therapy that is unregulated and associated with side effects such as an enlarged clitoris, and male pattern baldness, as well as an increased risk of hysterectomy.

How pellets are different than FDA-approved commercial hormone therapy Why pellets are so popular The problem with pellets Side effects from pellets Irreversible side effects Typical...

Most women don’t even think about their urethras, but an estrogen-starved urinary tract can be the culprit when it comes to recurrent urinary tract infections and that persistent “gotta go” feeling. 

In this episode I sit down with Dr. Kelly Casperson, a board-certified urologist, a certified Menopause Practitioner of the North American Menopause Society, and the host of the hit podcast You Are Not Broken to discuss the role of estrogen in urinary health including: 

·      How to get rid of URINARY URGENCY
·      How to use a local vaginal estrogen to alleviate many BLADDER SYMPTOMS
·      Why s...

30% of women over the age of 50 are single. 50% of women over age 65 are single.  Too often the whole dating process is overwhelming, frustrating, and unsuccessful. Enter Bela Gandhi- the nationally known dating coach who regularly appears on Good Morning America and hosts a hit podcast, “The Smart Dating Academy.” So whether you need to fix your picker, find the whole idea of dating daunting or are not finding success when it comes to companionship and love, Bela’s got your back. And if you are not on the hunt, you know someone who is! 
After you listen to this epi...

As 2024 ends, I decided to revisit the top episodes from last year. If I were to go by my favorites, choosing would be impossible. According to the number of downloads,  the two top contenders are Top Tips for Skin and Hair with Dr. Ellen Gendler and Musculoskeletal Syndrome of Menopause with Dr. Vonda Wright.  I am going to update Dr. Gendler's episode in a few weeks. 

In this episode I am going to revisit Musculoskeletal Syndrome of Menopause with Dr. Vonda Wright. Dr. Vonda Wright, an orthopedic surgeon has made it her mission to raise awareness about the...

If you haven't finished your holiday shopping yet, I've got you covered.  In this episode, I have great gift ideas that also happen to be healthy.
There were two criteria to make it to this list. One, it had to be something I already own or would like to own. Second, there had to be a scientifically proven health benefit to using these items.
And if you have already finished your shopping, these are great gifts to buy for yourself. 

For a transcript of this episode, including video demonstrations, go to Substack.com/@DrStreicher
Duration: 00:19:07

An “MD” after the name is no assurance that the person to whom you are about to bare your soul—and your vagina—is an expert when it comes to menopause. 
In this episode, I am going to walk you through the steps to find someone you can trust to fix your flashes, foggy brain, and failing sex life.

Head over to Substack.com/@DrStreicher for a transcript of the episode, and bonus!  I posted an article with specific questions to ask during a menopause consultation (and answers you might get) that will let you know if you can tr...

If you would like to read a transcript of this episode along with some additional information, head on over to my substack- substack.com/@DrStreicher

Chances are you have heard at least one expert say that systemic hormone therapy will prevent heart disease. But you also may have heard other experts say, No- if you don’t have hot flashes or low bone mass, it is not recommended to take hormone therapy to prevent heart disease down the road. So, who is right? Why is this controversial?  Isn’t the data, the data?  In this episode, I explain why ex...

The only thing predictable about perimenopause is that it is …unpredictable. My guest today is Dr. Steven Goldstein, a tenured professor at NYU's Grossman School of Medicine, the past President of the International Menopause Society, Past President of The Menopause Society, and one of the WORLD’S  top experts on the science of perimenopause.  


The problem with the standard definition of menopause.  Why bleeding and having a period is not the same thing Why perimenopausal women bleed erratically Why anxiety and other symptoms occur during  How to interrupt FSH and estradiol blood levels The best treatment for perimeno...

Men have always had the clear advantage of being able to inspect their genitals with very little effort on their part. Women’s genitals are not quite as accessible, resulting in a lot more uncertainty about what’s normal and what’s not. No wonder women are frequently blindsided by not only the physical changes that occur with the onset of menopause but also symptoms like dryness, painful sex, itching, recurrent urinary tract infections, and that constant “gotta go” feeling! 

Why the term VAGINAL ATROPHY is problematic GENITOURINARY SYNDROME OF MENOPAUSE- What it is and what it means The PHYSICA...

Studies reveal that 70% of women experience a sense of being overlooked socially and professionally once they hit 50. The term for this phenomenon is Invisible Woman Syndrome. In this episode, I am joined by Christine Morrison, who writes about the social constructs in the fashion, beauty and wellness industry that inform the way society views women, and the way women often feel about themselves as they get older. Christine Morrison’s writing has appeared in print and online vehicles such as The Washington Post, The Boston Globe, The Quality Edit and Margot Magazine, among others, and in advertising campaigns for Alastin Sk...

I give two to three lectures a week. No matter who I am talking to or what the topic is, the part I like the best is the Q and A. It’s always different and I never know what I am going to get. In this episode I answer 37 questions in  a 45 minute webinar I did on behalf of Midi Health where I am the Medical Director of Community Education and Outreach. If you are looking for in-depth explanations like I often give, you won’t get that in this episode. But, if you would like more detailed infor...

You grab a product off the shelf—maybe it promises to help with bladder control, take off ten pounds, erase wrinkles, or boost orgasms. You assume it will do what it claims to do because it has the FDA seal on the package. Most consumers have no idea that most over-the-counter products have not been tested to ensure product claims are legitimate. The history of the FDA Why estrogen disappeared from face cream in 1962 The different FDA categories and what they mean FDA Approved  FDA Cleared FDA Listed FDA Registered  What it takes to be FDA-approved  Why testosterone was never FDA-a...

Managing menopause in the face of cancer can be complicated. Many women are made to think that they should just be grateful to be alive and not complain about their all day all night hot flashes, brain fog and sex that is excruciatingly painful. Many oncologists are not experts when it comes to menopause or sexual function and don’t bring it up or give information that isn’t accurate. Many women aren’t aware that hormone therapy may be safe, and if it’s not, that there are non-hormonal options to solve virtually every problem. 
In this Q and A epi...

                                                                   Episode149
                                            The Menopause Society Meeting
                                                      Insights from an Insider

Once a year, the Menopause Society holds an annual meeting where thousands of experts gather to present their research and learn from each other. In this episode, I will discuss some of the most interesting research presented at the meeting…and explain why I didn’t attend the meeting. 

·      VOICE as a Predictor of HEALTH
·      The impact of TESTOSTERONE on the VOICE
·      How to find out if you have a GENETIC MUTATION       
·      How ARTIFICIAL INTELLIGENCE is being used to read MAMMOGRAMS
·      How a MAMMOGRAM can predict HEART DISEASE
·      How WORK can make your MENOPAUSE SYMPTOMS worse
·     ...

You know what a Hack is…something that solves a problem, simplifies a task or reduces frustration.  Who doesn’t love a good hack? This episode is loaded with  GYNECOLOGIC HACKS ...your gyne never told you. Useful tips, tricks and solutions for frustrating gyne problems. Alternative uses for products that are intended to be used on your vulva or in your vagina.   And if this does well, I’ve got plenty more. 

·      How to Easily Remove Your Estring™ Hack
·      Hands-Free Vulvar View Hack
·      Expired Birth Control Pill Hack
·      Ditch Your Vaginal Estrogen Applicator Hack
·      Silicone Lubricant Hacks
· ...

There is a long history of women not only not knowing nothing about sexual pleasure but being made to feel as if there is something dangerous and wrong with them if they seek it. My guest for this episode is Dr. Laurie Mintz a professor, a therapist, and the author of “Becoming Cliterate: Why Orgasm Equality Matters- and how to get it”, the groundbreaking book that changed not only how millions of women, and men, think about female sexual pleasure, but how women can OWN sexual pleasure.

Why, HISTORICALLY, women have not been educated about the clitoris and its...

Put a group of menopause experts in a room, and there are certain things everyone will agree on. But there are other topics, that do not result in universal agreement. And, usually, when that happens, it’s the battle of the academic purists vs …everyone else. And in the menopause world right now, there is  no more controversial topic than the use of testosterone as part of the standard hormone therapy cocktail.  

So today, Dr. Kelly Casperson, the host of the You Are Not Broken podcast, and I will discuss WHY there is controversy and where that leaves us in...

Something happens to skin after your 40th birthday, and that something isn’t good. So is it just a coincidence that wrinkles and sags show up at the same time your periods disappear, or is it just one of those mid-life things? The answer is both.  Post menopause skin without estrogen is dryer, thinner, blotchier, hairier, and wrinklier.  So, is TOPICAL ESTROGEN the answer? And is it safe? 

The specific impact of loss of estrogen on skin  Why bone loss impacts the way your face looks Why you get increased facial hair post menopause When estrogen was in over-t...

In a world where women are barraged with information when it comes to how best to manage menopause, it can be overwhelming and confusing. Between having their symptoms dismissed by their regular physician, and then being overwhelmed with information on social media, it’s hard to know what’s fact and hype.  And what do you do when the doctor you trust, tells you that the social media expert you also trust is wrong?
In this episode, I chat with Tamsen Fadal, a menopause advocate who has made it her mission to help perimenopausal and menopausal women navigate through the i...

It can be terrifying to have bleeding when you are post-menopause. It’s not just about making the midnight run for tampons, it’s that stomach-dropping fear that “blood equals cancer” that causes women to spend hours consulting Dr. Google for some reassurance. But, although most women imagine the worst, in most cases, postmenopausal spotting or bleeding is not, is not, an indication of anything serious. How to know WHERE the blood is coming from The 3 causes of Post Menopause VAGINAL WALL BLEEDING What causes Post Menopause CERVICAL BLEEDING Causes of UTERINE BLEEDING post menopause Uterine POLYPS Uterine FIBROIDS  Uterine ATROPHY ...

In Part 1 on Mid-Life Hair Loss,  I covered hair care strategies, vitamins, and supplements. And pretty much every section ended with the equivalent of “Don’t waste your money.” This episode has useful advice to get those follicles to kick in and significantly increase the hair on your head. 

TOPICAL minoxidil  ORAL minoxidil FINASTERIDE Dutasteride Platelet-rich plasma  (PRP Injections)  Low Light LASER HORMONE THERAPY Testosterone Estrogen Also of interest: 
Episode 139  Hair When Your Hair Today is Gone Tomorrow
Episode 117 Top Tips for Terrific Skin & Hair with Dr. Ellen Gendler
Episode 122  Navigating Menopause Celebrity Style- Here We Go Again! Duration: 00:20:50

The market for adult diapers in the US is almost as large as the market for baby diapers. Part of this trend is because birth rates have slowed and longevity continues to lengthen. Still, the other reason why almost 50% of adults experience some form of urinary incontinence is due to an increase in risk factors. Today, with my guest, urologist Dr. Rachel Rubin, I am taking on the taboo topic of urinary incontinence- why it happens and how to make it go away.
This episode originally aired during Season 1

We discuss: The difference between urge, stress, and...

For guys, middle-aged hair loss is upsetting, but not something that generally prompts a doctor’s appointment. But that is not the case for women that are suddenly seeing a lot more scalp. While not exactly a medical emergency, it qualifies as an emotional emergency. 

This is PART 1 of 2 parts on post-menopause hair loss. This episode covers  hair care strategies, vitamins, and supplements. PART 2 will include pharmaceuticals such as topical minoxidil, oral minoxidil, finasteride, platelet rich plasma injections, estrogen and testosterone therapy. 

Part 1: WHY women lose hair mid-life NON-HORMONAL  causes of hair loss What androgenic alopecia looks...

A recent New York Times article was titled “The Troubling Trend in Teenage Sex”. Before I even clicked, I knew what that troubling trend was since I had recently attended a medical conference where I heard a lecture from Dr. Debbie Herbenick about the increasing numbers of young adults who were including CHOKING as part of their sexual repertoire. Today I am having a conversation with Dr. Herbenick about how common this practice has become, why it is problematic, along with other current trends in sexual practices across America, and in all age groups.
What SEXUAL PLEASURE looks like and...

“The physician who puts a woman on ‘Premarin’ makes her pleasant to live with once again- something for which husbands are grateful"    1960 Premarin ad

The history of hormone therapy goes back over 100 years.  And it didn’t start with horses; it started with cows.  If there is a theme, it is that history continues to repeat itself, and following the money is as important as following the science. 

For more information on this topic: 

Episode 21:  Say Yes! to Testosterone for Women

Episode 122  Navigating Menopause Celebrity Style- Here We Go Again! 

Episode 66 Don’t...

Vaginas are not the only part of the body that change mid-life. With age, muscles start to naturally atrophy- a condition called sarcopenia. Women can lose up to 10% of their muscles mass every decade.  In this episode, my guest is fitness expert Amanda Thebe, who addresses the value and importance of exercise, diet, and lifestyle choices to keep your muscles from getting mushy! 

Amanda’s PERSONAL JOURNEY as a fitness expert who struggled when she entered menopause The CHANGES that occur in our muscles after menopause Why PROTEIN is so important when it comes to maintaining muscle mass.  Why i...

When there is a lack of lust decades into an otherwise loving marriage or relationship, many, if not most, women assume their indifference to sex is a result of declining hormone levels and that a prescription for estrogen, testosterone or a libido enhancing drug will re-light the flame. A plunge in hormones can be part of the problem, and sometimes a trip to the pharmacy will help, but there are a lot of other reasons that have nothing to do with hormones or menopause that impact on keeping that sexual spark alive. 
In this episode, I am joined Dr. A...

Women who have a history of a blood clot, or a risk factor that makes them at high risk for developing a blood clot are generally told that hormone therapy is not an option. And then there is that terrifying black box warning on every single estrogen product, including local vaginal estrogens, that states, “Using estrogen alone may increase your chances of getting strokes or blood clots”
Except nothing in that statement is true when it comes to transdermal or local vaginal estrogens. So, why is it even there? And what is the risk? 

In this episode: Why g...

There continues to be great confusion regarding the impact of hormone therapy on the breast. And despite the known benefits of hormone therapy, and reassuring data regarding the impact of hormone therapy on breast cancer, most clinicians are still reluctant to prescribe it, and most women are reluctant to take it. Even more so if a woman is high risk for breast cancer or has a breast cancer diagnosis. 

In this episode, I am joined by Dr. Corinne Menn, a board-certified Ob GYN and menopause expert who herself had a breast cancer diagnosis when she was in her 20s...

Men have always had the obvious advantage of inspecting their genitalia with essentially no effort on their part. For women, it’s a little more challenging. Combine that with the recommendation that there is no need for women to have a gynecologic exam as they get older, most doctors are also not looking. Today I am joined by Dr.Jill Krapf, a gynecologist whose area of expertise is …the vulva. We will be discussing one of the most maddening, frustrating symptoms in all of gynecology- THE ITCHY VULVA , but just as important, why even if your vulva isn’t itching, why it...

More likely than not, if you are over 65, your internist has declared everything between your belly button and your thighs to be the “NO NEED” zone. “NO NEED”  for a pap, “NO NEED”  need for a speculum, “NO NEED”  to remove your underpants, and definitely “NO NEED”  to see a gynecologist unless you have a specific problem. But in today’s episode, I am joined by Dr. Shieva Ghofrany to explain the flaw in this reasoning and why “no complaint” is not the same as “No problem”.

We discuss specific issues that are addressed post menopause: 

Pap tests and other screening tests...

… and how to increase longevity with and without hormone therapy

The idea that menopause only lasts for a few years is a common misconception. You may have even been told by a  medical professional that when you no longer have hot flashes, you are done with menopause!  

But menopause means you’re no longer producing estrogen. There are hormone receptors throughout the body and there are lifelong consequences of being without estrogen even if perimenopausal symptoms are in the rear-view mirror.

In this episode:  Why not every woman has long-term health issues post menopause The lon...

When I first learned about PCOS during my training, I was told that once a woman with PCOS hit menopause, irregular periods, excess hair growth dealing with fertility problems and other manifestations of PCOS were in the rear-view mirror. And that’s true, but we now know that women who had PCOS during the reproductive years, are not entirely off the hook down the road and that PCOS early in life is associated with several health issues later in life.  Today I am having a conversation with reproductive endocrinologist Dr. Alison Rogers, about the impact of PCOS later in life. 
...

While not everyone is necessarily good about regular physical activity, no one questions that it’s good for you. Cardiovascular health, weight management, cognitive function, mood, better sleep and even reducing the risk of many kinds of cancer are all established benefits to moving as opposed to sitting on your butt all day. But, when it comes to the impact of exercise when it comes to reducing hot flashes, the jury is still out. 

Dr. Maria Sophocles is the Medical Director of Women’s Healthcare of Princeton. She is a certified menopause practitioner and has a particular interest in no...

The only thing more miserable than a urinary tract infection (UTI) is when it happens again, and again, and again. But, good news, there are ways to prevent post menopause RECURRENT URINARY TRACT INFECTIONS.  But sometimes urinary urgency, burning and that “gotta go” feeling is NOT FROM an INFECTION, and need a completely different kind of treatment.  You need to know the difference. 

In this episode, Dr. Streicher covers: WHY post menopause women have so many UTIs The typical symptoms of a UTI  What BLOOD in the urine means Why symptoms that MIMIC a UTI but are not caused b...

Every available type of hormone therapy will effectively eliminate hot flashes and other menopause symptoms.   However, all hormone therapy is not the same.  Individual formulations impact bone health, breast health, and cardiovascular health differently.   In episode 123, Dr. James Simon and I discussed starting hormone therapy after the age of 60. In this episode, we discuss the nuances between different hormones and their impact on breast cancer and bone health. 

Why it is important to individualize hormone therapy Why there is the perception that estrogen causes breast cancer There is a difference between causing breast cancer and making breast cancer grow...

While it has been established that the most optimal time to start hormone therapy is within ten years of the menopause transition or before age 60, one of the most common questions that pops up is, “Is it safe to start hormone therapy after age 60?” In this episode I have a conversation with Dr. James Simon to determine WHO is a candidate for a “late start” and HOW to evaluate if it is safe. 
 I also included (at the end!) breaking news on a new study that gives reassuring data about continuing hormone therapy well  the age of 60.

How it was...

In 2009 I was invited to appear on The Oprah Winfrey Show as a menopause expert to counter the other menopause “expert”, actress turned author Suzanne Somers.  
“Dr” Somers is not the only celebrity to help women navigate menopause.  Today, Gwyneth Paltrow, Selma Hayek, Naomi Watts, and others are also doling out advice, and in some cases selling products, to manage menopause symptoms. And now, Drew Barrymore has joined the ever-growing list of actresses who have jumped on the menopause money making bandwagon. But far more women are taking their advice than the advice of medical professionals. 
In this episode, I’...

                                Don't Mess with These Menopause Experts!
When The Lancet, one of the oldest, most respected medical journals, published a series of articles saying that “menopause had been over-medicalized”, that many symptoms were “just in her head” and that overall, women should navigate menopause “without the need for medical treatments” a group of furious menopause experts went ballistic.  In this episode, Dr. Mary Claire Haver and I tell you why there was such a huge backlash from hundreds of menopause experts, and how we took action. 

Dr. Haver and I address 4 specific statements from the Lancet article:  “Most women navigate menopause without...

Dr. Kathleen Jordon and I sat down to discuss the two most commonly prescribed GLP- 1 Inhibitors:  Semaglutide (Ozempic™) and Terzepatide (Mounjaro™) 

What are GLP1 Inhibitors? How GLP-1 Inhibitors  Who is a GOOD CANDIDATE to take a GLP-1 Inhibitor Who is NOT a GOOD CANDIDATE based on medical conditions Other HEALTH BENEFITS from taking a GLP1 Inhibitor besides weight loss The COST of the drugs?  INSURANCE coverage? When it is OK to get a GLP 1 inhibitor from a COMPOUNDING pharmacy What are the problems with some compounding pharmacy How well these drugs work Potential side effects What happens with the medi...

It was news to me that estrogen levels can impact on the likelihood of reflux, your gut microbiome, and even the frequency and consistency of your poop. It’s complicated, and I had a hard time interpreting the data, so I invited gastroenterologist Dr. Michael Ruchim to help me out. 

In this episode: How and why GERD is impacted by menopause  If  Hormone Therapy Make GERD worse or better? The impact of hormones on the gut microbiome How frequency of bowel movements correlates with menopause symptoms If an alteration in diet will change the microbiome and influence hot flash...

In this episode I am talking to a dermatologist that has over 100 thousand followers on Instagram. And with good reason. She is funny, she tells it like it is, she is a rock star in the world of dermatology and is my go-to when it comes to mid-life skin care, fillers, Botox, not to mention how to have more hair on your head and less hair on your face.

Dr. Ellen Gendler is a Clinical Associate Professor of Dermatology at NYU Langone Medical Center, where she was a co-director of the Contact Dermatitis Division for many years. Dr...

Estrogen is not only good for your brain, your bladder, and your bones, estrogen is also good for your blood vessels. And a lack of estrogen is one of the reasons, that heart disease spikes in women post menopause. Hormone therapy, if started within ten years of the menopause transition, appears to be heart protective. Today I am joined by Dr. Marla Mendelson, a cardiologist and associate professor of Medicine at the Feinberg School of Medicine, Northwestern University.   She is also the former co-director of the Women’s Health research Institute. Dr. Mendelsohn has devoted her career to the evaluation and...

In the 1960s, under the leadership of Helen Gurley Brown, Cosmo morphed from a “proper ladies' magazine” to a much racier version that was thought of as being a sex manual disguised as a woman’s magazine. The target audience was the young working woman. Women in their 60s were not reading it and were certainly not buying subscriptions for their daughters or granddaughters. 
And here we are, Cosmo has just published a groundbreaking, article titled Sex after 60 based on research done in collaboration with the renowned Kinsey Institute of Sexual Research. The Kinsey research team, which I was part of...

While many women are aware that hormone therapy is good for the bones, it is usually thought of as a side benefit. You know, women take hormone therapy because they are flashing or can’t sleep and then are told, are told, by the way ..estrogen will also help prevent bone loss. 

In the United States, there are 10 million women with OSTEOPOROSIS and 43 million women with OSTEOPENIA. Most of these women have no idea that they are at risk for a potentially life-changing or even fatal fracture and also have no idea that hormone therapy is a proven str...

Pregnancy tests, ovulation tests…and now the latest in tests you can do in your bathroom laboratory- Menopause Tests! Clear Blue™, who sell ovulation predictor kits and home pregnancy tests, has come out with an over-the-counter kit to help women who are “confused and wondering if what you’re feeling is the start of the menopause journey, or perhaps something else.” All you need to do is pee on a stick, and you will know if you are pre-menopause, perimenopause or post-menopause.
So, what’s the deal with these kits? 
How these tests work Accuracy of home FSH tests Why the...

Jill Wine-Banks may be known to you as the Watergate Special Prosecutor who famously cross-examined Rose Mary Woods, President Nixon’s secretary, about the 18-minute gap in the Watergate tapes.  In addition to multiple other high-profile jobs (scroll down for the list!) decades later, she is now an MSNBC Legal Analyst. In addition, she is the author of The Watergate Girl: My Fight for Truth and Justice Against a Criminal President.  Jill is also one of the hosts of two hit podcasts- Sisters in Law, and iGen Politics. But, this is not a political podcast. I usually talk about hot flash...

 A recurrent theme in my podcasts is that most medical students and residents do not get training in sexual medicine and menopause, which is why most doctors are not experts. And why so many women get frustrated that finding solutions for their menopause symptoms is too often a do-it-yourself research project. But today, I am joined by someone who is passionate and dedicated to educating the doctors of tomorrow.  
 This episode was initially aired on Sex Med for Sex Ed, hosted by Dr. Terry Gibbs, an OB-GYN and the founder of The Ohio Sexual Health Collaborative, a multi-disciplinarian organization of...

In a perfect world, an alert would pop up on your phone announcing, “You are now in perimenopause,” followed at the appropriate time by “You are now leaving perimenopause and entering post menopause.” But it’s not a perfect world, and unless you are thrust into menopause because of ovary removal or chemotherapy, in many, if not most cases, it’s hard to know what your ovaries are doing. Menopause is defined as starting when you haven't had a period in 12 months. And while that’s a very specific definition, that definition is only useful in retrospect. And the 12 months without a peri...

 If you think you’re having a hard time navigating vaginal dryness, painful sex, insomnia, and hot flashes, I can guarantee that if there is a man in your life, he is also having a hard time. More likely than not, he is completely in the dark about why you are having these symptoms and what he can do to help. In this episode, I sit down with Rachel Hughes, the host of Perimenopause WTF to discuss five things guys need to know about menopause. This segment was originally aired during a live webinar on The Perry Channel. 
Rachel and...

I spend a lot of time talking about dry vaginas and the impact that genitourinary syndrome of menopause has on your sex life, your day-to-day comfort, and bladder function. But vaginas are not the only thing that gets dry during menopause. This episode is all about another area of the body that biologically has a lot in common with a dry vagina…and that’s your post-menopause mouth. 

What mouths and vaginas have in common. How common dry mouth is in post-menopause women  Other things that cause dry mouth Why low estrogen causes dry mouth Symptoms of dry mouth ...

The number one complaint during perimenopause and menopause is insomnia. When a woman goes to her doctor and asks for help, she is rarely if ever, told that cannabis may be the answer. But at least one of four women walk out of the office and march right over to a local cannabis dispensary to get some help.  Today’s guest, Ellen Scanlon, is the host of the hit podcast, How to Do the Pot, and she is going to help you figure out, How to Do the Pot ...and get some sleep. 

How many women are consuming cann...

When someone is diagnosed with uterine cancer, in most cases, their uterus announces there is a problem by bleeding when it is not supposed to, or bleeding too heavily. Breast cancer, in most cases makes itself known by a lump, a nipple discharge or an abnormality on a mammogram. But ovarian cancer is not so accommodating and, in many cases, does not make its presence known until it has already moved well beyond the ovaries. My guest today is Dr. Shieva Ghofrany a practicing Ob-Gyn who was diagnosed with stage 2 ovarian cancer at age 46. She is going to share her...

You are never going to get your 20-year-old body back any more than you are going to return to a wrinkle-free face. In Episode 100,  I went through all of the reasons why on average, women put on 5-7 pounds during perimenopause, and are twice as likely as mid-life men to have obesity. So now that you understand why you woke up one day and your scale registered your mother’s weight, there are strategies to prevent the weight gain in the first place, keep it from continuing to climb and take it off.

Medical reasons WHY it is imp...

On average, women put on 5-7 pounds during perimenopause, and then 1 to 5 pounds every year after. While lifestyle and age are partially responsible, men have the same genetics, lifestyle changes and less than perfect diets as women do. But it is twice as likely- for a midlife woman to have obesity compared to men.  So, what’s the difference? The difference is men don’t have hot flashes, insomnia, and a sudden drop in their hormones. And that’s where the menopause factor comes in. 

This episode is in 2 parts. 
Episode 100: WHY women Put on Weight in Menopause...

Years before estrogen production completely shuts down, hormone levels start to fluctuate wildly during that special time of life known as perimenopause. Perimenopausal hormonal fluctuations result in the same symptoms that many women experience when they are in full menopause, hot flashes, vaginal dryness, and insomnia. But there is a bonus symptom that post-menopausal women don’t experience - irregular and unpredictable bleeding. 
In this episode, I discuss: WHY perimenopause women have irregular bleeding How your clinician should evaluate abnormal bleeding Strategies to manage perimenopausal bleeding
 Progestogen  Birth Control Pills  Progestogen IUD  Endometrial Ablation  Hysterectomy  Do nothing! 
What to do...

The Menopause Society, formerly known as the North American Menopause Society, or NAMS, is the professional society to which pretty much every menopause expert and researcher belongs. Every year menopause experts from all over the world gather for five days of lectures, symposiums, panel discussions, and presentation of new research at the menopause society annual meeting. 

In this episode, I will give you my top 5 takeaways from the meeting, followed by interviews with many of the experts about their presentations and what they learned from other experts including Lisa Larkin MD the current President of The Menopause society a...

If you laugh, weep, or have foot pain when have an orgasm, you are not the only one. But, since it’s not a topic that generally comes up in casual conversation, you may think you are the only one, and end up spending a lot of time explaining to your partner that you are not laughing at them, and if you burst into tears post orgasm, you are not necessarily unhappy.  What you may be experiencing is peri-orgasmic phenomenon. 

In this episode, I discuss: The difference between a normal orgasmic response and peri orgasmic phenomenon PHYSICAL manifestations of p...

It is estimated that between 50% and 75% of postmenopausal women use complementary and alternative therapies for management of menopausal symptoms. The options are as endless, as are the ads. In today’s episode I’m going to fill you in on which of the over-the-counter botanicals might fix your broken thermostat. 
This episode is the last segment of a three-part series covering all of the NON-HORMONAL options currently available to help with hot flashes. Episode 85 was an update of non-hormonal MEDICATIONS THAT REQUIRE A PRESCRIPTION. Episode 87 covered LIFESTYLE; things like yoga, mind-body techniques; acupuncture and cooling devices. 
This episode covers...

Have you ever wondered why so many women professional singers retire in their prime, but the guys keep on going?  I googled “musicians over the age of 70 who are still performing” and Paul McCartney, Elton John, Marvin Gaye,  Mick Jagger, and dozens of others popped up. The list was really long for guys, and really short for women. 
One reason is that when estrogen levels take a plunge, the change in hormones has a significant impact on vocal frequency and range. In this episode, my guest is Dr. Cheryl Kinney, an expert on the impact of hormones on the voice...

                          Uterine? Ovarian? Cervical? Lung? Breast? Colon?
Hormone therapy really needs a PR firm. Most people think it is right up there with cigarettes and asbestos as something that will more likely than not, give you not only breast cancer, but also other life-threatening cancers. In this episode, I am going to set the record straight and tell you the facts when it comes to using systemic estrogen (both birth control pills and menopause hormone therapy) and your risk of getting ovarian cancer, uterine cancer, cervical cancer and the three most common non-gynecologic cancers. If you already have one of those kinds o...

It’s no secret that there is a connection between menopause and hot flashes, but there are many other symptoms that are consequences of a lack of estrogen beyond night sweats, vaginal dryness, and bone loss. And joint pain is definitely on that list. So, what is the impact of menopause on arthritis and joint pain? Is estrogen therapy the answer? 

In this episode I am joined by Dr. Stephanie Faubion, the Director of Mayo Clinic’s Center for Women’s Health, chair of the Department of Medicine at Mayo Clinic in Jacksonville, Florida, the medical director for The Men...

While not every woman fakes orgasm, and most don’t do it routinely, it’s the rare woman who hasn’t done it at least once. Early research indicated that roughly 55% of women have faked orgasm at least once in their lifetime. This general pattern has since been confirmed in more recent studies, some reporting rates as high as 74%. In this episode I am joined by certified sex therapist Rachel Zar, LMFT. 
We discuss:  WHY women fake orgasm What factors predict the likelihood of faking orgasm If it’s ever OK to fake orgasm What a woman should say to her par...

Not only can you laser your face smooth, laser your pubic hair away, and laser off regrettable tattoos—you can also laser your vagina. But should you? Vaginal laser is highly controversial in medical circles. Here’s why it gets mixed reviews, along with need-to-know info if you do choose to sign up. 

This episode will include:  The science behind the CO2 laser and how it works Why many doctors and medical organizations do not recommend laser Why the term “vaginal rejuvenation” should never be used Why it is critically important to only have a laser procedure  from an expert W...

Many women are highly motivated to manage their hot flashes without hormones, drugs or sketchy herbs and spices.  But before investing in a pricey cooling device or signing up for a year’s worth of unlimited yoga, it helps to know what works—and what doesn’t. This is part two of a three-parter on non-hormonal strategies to treat vasomotor symptoms. Part one, Episode 84, included non-hormonal prescription options. Part 3 will consist of herbal and botanical preparations. 

This episode includes a discussion of the following interventions when it comes to helping hot flashes:  Cooling devices Wardrobe adjustment  Cooling sprays Avoidance...

It is beyond unfair that when someone with menstrual migraines is finally heading into menopause and no longer must worry about monthly migraines, those same women often experience an uptick in frequency of headaches due to the peri menopausal hormone roller coaster. 
In this episode, Dr. Streicher discusses:  The relationship between hormones and migraine headaches Why birth control pills are often not prescribed to women with migraines with aura If it is safe for women with migraines to take hormone therapy If hormone therapy will decrease the frequency of migraine headaches What kind of hormone therapy is best for wo...

The 2023 Menopause Society  (NAMS) position statement regarding the non-hormonal treatment of Vasomotor Symptoms- hot flashes and night sweats- was just released. Position statements are expert analyses of current studies in order to determine recommendations based on science, as opposed to what the latest Tik Tok star or celebrity is promoting. Because new studies are constantly being published, there is always new information to inform those recommendations, which is why position statements need to periodically get updated. 

Because the position statement is very extensive and long, I have divided it into 3 episodes. 

Part 1- Non-hormonal prescription options
...

An estimated 6.7 million Americans are living with Alzheimer’s dementia and woman are twice as likely to develop Alzheimer’s Disease as men.   So does hormone therapy increase the risk of Alzheimers, decrease the risk or have no effect? That question has been in the news this last week because of a new study that suggests that hormone therapy increases the risk..a finding that is exactly opposite to other studies. But is this new study valid? 

In this episode, I break down:

The difference between perimenopause brain fog and dementia What happens in the brain with Al...

In this episode, I sit down with menopause maven Dr. Mary Jane Minkin, a clinical professor of Ob-Gyn at Yale University, to discuss articles published in the most recent edition of Menopause: The Journal of the North American Menopause Society.

We discuss the following 5 articles*: 

Treating where it hurts—a randomized comparative trial of vestibule estradiol for postmenopausal dyspareunia

Goetsch MF, Garg B, Lillemon J, Clark AL. Treating where it hurts-a randomized comparative trial of vestibule estradiol for postmenopausal dyspareunia. Menopause. 2023 May 1;30(5):467-475. doi: 10.1097/GME.0000000000002162. Epub 2023 Feb 14. PMID: 36787525.

The association between hormone the...

It is no longer unusual for a woman to live well into her 80s or 90s, allowing for multiple career chapters.  Today, my guest is 80-year-old former Playboy Bunny, actor, and author Kathryn Leigh Scott. 
Kathryn Leigh Scott is best known as the actor who was the leading lady of NBCs Dark Shadow, the gothic vampire drama that is now a cult classic. 

In this episode, we discuss what keeps someone youthful and productive from decade to decade. : Why being in her 80s is an exciting time of life Kathryn Leigh Scott’s experience as a Playboy Bunny...