Gyno Girl Presents: Sex, Drugs & Hormones

What happens when your family stages an intervention because they've been avoiding you 10 days every month?I'm sharing the story of a patient who had a complete breakdown at Christmas dinner. She snapped at her husband, her kids, her mom, her in-laws—everyone. A few hours later, her family told her: "We love you, but for 10 days every month, we actively avoid you."She came to me asking: Am I bipolar? Am I manic? What's happening to me?This is PMDD premenstrual dysphoric disorder. And when it collides with perimenopause, it becomes a perfect storm. This is not just PMS. This isn't you being dramatic. It's a real biochemical thing happening in your brain an abnormal response to normal hormonal changes.I discuss the science of PMDD: how GABA receptors respond to progesterone metabolites, why some brains are change sensitive, and why the hormonal volatility of perimenopause (erratic estrogen, declining progesterone, unpredictable timing) makes everything exponentially worse. I explain treatment options from luteal-phase SSRIs to Yaz to Duavee for refractory cases, and why tracking your symptoms for at least two cycles is critical for diagnosis.Highlights:Why "I feel like I'm watching myself burn down my life and can't stop it" is the hallmark of PMDD.The DRSP tracking tool: why you need 2 cycles to diagnose PMDD properly.Why Vitex (chasteberry) might help mood swings and breast pain.What Duavee is and why it works for women who can't tolerate progestins.Why Dr. Tammy Rowan calls PMDD a progesterone sensitivity issue.Ulipristal: the emergency contraception drug being studied for PMDD.If you've ever felt like your brain gets hijacked on a schedule, if you've felt completely out of control, this episode is for you. Track your symptoms. Find a clinician who takes cyclic mood symptoms seriously. You don't have to live like this. Please share this episode with someone you know might be experiencing this or a clinician you think would benefit from it.Resource:DRSPDr. Tami RowenGet in Touch with Me:WebsiteInstagramYoutubeSubstackMentioned in this episode:GSM CollectiveThe GSM Collective - Chicago Boutique concierge gynecology practice Led by Dr. Sameena Rahman, specialist in sexual medicine & menopause Unrushed appointments in a beautiful, private setting Personalized care for women's health, hormones, and pelvic floor issues Multiple membership options available Ready for personalized women's healthcare? Visit our Chicago office today. GSM Collective

What does it mean when 6,000 women a day enter menopause but there are only 4,100 certified clinicians to treat them?In this year end solo episode, I'm reflecting on 2025 in women's health. It was a year that felt heavy at the start personally for me after losing my mother, and globally with so much suffering and injustice. But even in all of that, women's health moved forward in meaningful ways. Not perfectly. Not fast enough. But enough that it deserves reflection.I'm covering the moments that shifted conversations this year from the FDA removing the black box warning on estrogen to new cervical cancer screening guidelines allowing self-collection HPV tests. From Addyi finally being approved for women under 65 to the release of comprehensive GSM guidelines that make genitourinary syndrome everyone's business, not just gynecologists'.And I'm getting personal about why I launched a concierge practice this year, what it taught me about the broken healthcare system, and why sexual health cannot be practiced in 10-minute appointments.Highlights:Why you're not too old for screening and what "safe exit criteria" really means.Menopause certification jumped from under 1,000 to over 4,100 practitioners in 2025.Menopause divorce vs. midlife clarity: Why hormonal chaos shouldn't decide your marriage.DARE to PLAY is a new, topical sildenafil launching in 2026 for female arousal disorder.Treating male partners reduces recurrent BV by 50% (New England Journal of Medicine).Hormone therapy for prevention: The nuanced conversation about bone health and cardiovascular risk.Why I launched a concierge practice and what it revealed about what women actually need.Thank you for being here for another year of Gyno Girl Presents: Sex, Drugs & Hormones. Your support, your messages, and your stories are what keep me going you are my why. If this year-in-review resonated with you, please share it with someone who needs to hear that they're not broken, not dramatic, and not asking for too much. And keep following the show in 2026 we've got incredible conversations lined up.Get in Touch with Me: WebsiteInstagramYoutubeSubstack

What happens when a medication designed to help you lose weight also changes what brings you pleasure?In this solo episode, I'm doing a deep dive into what nobody's discussing about GLP-1 medications (Ozempic, Wegovy, Mounjaro, Zepbound) and what they do to your sex life.These medications have been absolutely transformational for metabolic disease, obesity, and cardiovascular health. But they don't just work on your gut and pancreas they work centrally in your brain, in your reward pathways, in your pleasure centers.I'm sharing stories from my practice: the glamorous patient who suddenly didn't want to shop anymore. The wine connoisseur who lost interest in drinking. The foodies who can't stand restaurants. And yes, the patients whose sexual desire completely disappeared because their brain stopped experiencing reward the same way.Highlights:Why GLP-1 medications are actually anti-inflammatory powerhouses (and what that means for PCOS, endometriosis, even PGAD).How these drugs modulate dopamine and serotonin the same pathways that control sexual desire.Why improving body image doesn't always improve sexual function (the biopsychosocial model).The emerging science on GLP-1s reducing alcohol cravings, substance use, and compulsive behaviors.What SHBG changes mean for your free testosterone and libido.Why your brain doesn't compartmentalize pleasure food, shopping, alcohol, and sex all use the same reward circuits.The informed consent conversation every doctor should be having (but isn't).If you're on a GLP-1 medication or considering starting one, ask your doctor about how it might affect what brings you pleasure including sex. With great power comes great responsibility, and sexual health is health. Period.Get in Touch with Me:WebsiteInstagramYoutubeSubstackMentioned in this episode:GSM CollectiveThe GSM Collective - Chicago Boutique concierge gynecology practice Led by Dr. Sameena Rahman, specialist in sexual medicine & menopause Unrushed appointments in a beautiful, private setting Personalized care for women's health, hormones, and pelvic floor issues Multiple membership options available Ready for personalized women's healthcare? Visit our Chicago office today. GSM Collective

One of my brave patients shares her story with lichen sclerosis from being dismissed and told it was "all in her head" to finding proper treatment and relief.I'll never forget the day Jess walked into my office. By the time she found me, she'd already been dismissed by multiple doctors including specialists at what was supposed to be one of Chicago's premier women's health centers. They told her the severe pain and skin changes she was experiencing were "all in her head." Two different physicians suggested she needed a therapist, not medical treatment. Her depression history was weaponized against her, used as proof that she was just being hysterical.But Jess wasn't hysterical. She had advanced lichen sclerosis, and her vulvar skin was literally fusing together. Had she not found proper treatment, she would never have been able to have penetrative sex again. Even worse, without treatment, her risk of vulvar cancer would have climbed from 1% to 3-5%. Yet nobody had explained any of this to her. She'd been handed a tube of clobetasol and essentially told to figure it out herself which she did, on YouTube, learning the proper application technique that her doctors never bothered to teach her.In this episode, Jess bravely shares her journey living with lichen sclerosis—from the devastating experience of being gaslit by female physicians to finding relief through injectable steroids and surgical lysis of adhesions. We talk about how her symptoms worsened when she entered menopause in her mid-40s (common with autoimmune conditions), the complete loss of libido that left her sobbing when a doctor said "it's never coming back," and the body changes that made her feel like a "potato."But this conversation is about more than just lichen sclerosis. It's about the failures of our healthcare system, the importance of advocating for yourself even when you're furious and exhausted, and learning to accept yourself exactly where you're at. Jess's story will resonate with anyone who's ever been dismissed, anyone struggling with vulvar health issues, and anyone navigating the chaos of menopause while trying to hold onto their sense of self-worth.Highlights:Why most gynecologists miss lichen sclerosis (hint: they're not actually looking at your vulva).The proper way to apply clobetasol that doctors don't teach.How vaginismus became a catch-all diagnosis for any woman with painful sex.The We Do Not Care Club movement and redefining your value at midlife.What it means when influencers are the face of menopause marketing.If you've been dismissed or told your vulvar symptoms are "all in your head," this episode validates your experience and shows you're not alone. And if you're a clinician, this is your wake-up call we can no longer dismiss women's symptoms as psychological when real physical disease is staring us in the face. Please share this with someone who needs to hear that their symptoms are real and treatment is available.Get in Touch with Me: WebsiteInstagramYoutubeSubstack

Have you ever wondered why trauma seems to "live" in the body? Or why so many women struggle with sexual dysfunction after difficult childbirth experiences that they're told they should just be "grateful" for?Join me as we explore the profound connection between trauma and sexual health with Erika Kelley, an award-winning clinical psychologist who specializes in women's sexual medicine and trauma treatment.Erika Kelley is revolutionizing how we understand and treat the intersection of PTSD and sexual dysfunction. Winner of the prestigious Irwin Goldstein Award at ISSWSH for her groundbreaking research on childbirth-related PTSD, Erika shares insights from her years of experience helping women reclaim their bodies and sexuality after trauma.Together, we discuss the often overlooked reality of "smiling PTSD" the postpartum trauma that women hide behind societal pressure to appear only joyful after childbirth. Erika explains how trauma becomes physically embedded in the body through the fight-flight-freeze response, creating real physiological changes that impact everything from pelvic floor function to sexual desire.She also shares the evidence based psychotherapies that are proven to help, including Prolonged Exposure Therapy and Cognitive Processing Therapy, and how these treatments can be integrated with pelvic floor physical therapy and sexual medicine approaches for comprehensive care.Erika's commitment to building trust with marginalized communities through community-based participatory research demonstrates how we can address healthcare disparities while advancing trauma care. Her work with Black women and perinatal mental health is paving the way for more inclusive and effective treatment.This episode is essential listening for anyone who has experienced trauma, healthcare providers who work with trauma survivors, and anyone interested in understanding how our bodies truly do "keep the score." By listening, you'll gain crucial knowledge about recognizing trauma symptoms, accessing appropriate treatment, and advocating for yourself or your patients.TRIGGER WARNING: This episode contains discussions of sexual assault, traumatic childbirth experiences, medical trauma, PTSD symptoms, and obstetric complications. Please listen with care and reach out for support if needed.HighlightsHow PTSD manifests physically in the body and affects sexual health.Dr. Kelley's award-winning research on childbirth trauma and sexual dysfunction.Why "smiling PTSD" prevents women from getting help after traumatic births.Evidence-based treatments that work: Prolonged Exposure Therapy, CPT, and EMDR.How to prepare for subsequent pregnancies after traumatic childbirth.Trauma-informed care and why communication during emergencies is critical.Healthcare disparities affecting BIPOC women and community-based solutionsIf this episode resonated with you, please rate and review the show on Apple Podcasts or Spotify it helps other women find this life changing information. Share this episode with someone who needs to hear that their trauma is real and treatment is available.Get in touch with Erika:WebsiteInstagramGet in Touch with Me: WebsiteInstagramYoutubeSubstack

It's our 100th episode! I celebrate this milestone with Karen Bradley, NP, discussing the biggest wins, most common questions, and key themes from nearly two years of podcasting about women's sexual health and menopause.We dive into the FDA's recent decision to remove the boxed warning from vaginal estrogen a huge victory for women's health advocacy. This warning has prevented countless women from getting treatment for painful sex, recurrent UTIs, and other symptoms of genitourinary syndrome of menopause. I share a powerful story of a patient with breast cancer history who was denied hormone therapy by her oncology team, only to have them completely reverse course once the boxed warning was removed.The conversation covers the most frequently asked questions from listeners: Is it perimenopause or just stress? (It's both.) Why is my libido gone? (Biology, psychology, and life circumstances all play a role.) Why do I keep getting UTIs after sex? (Often it's vestibulodynia or changes in the vaginal microbiome from estrogen deficiency.) How do I talk to my partner about sex? (Communication is key, and sometimes you need a sex therapist to help.)We also discuss the reality of midlife weight gain, the role of GLP-1 medications like Wegovy and Zepbound, and why building muscle matters more than endless cardio. This episode is a celebration of how far we've come and a reminder that you don't have to suffer through menopause.Highlights:The FDA removed the boxed warning from vaginal estrogen—what this means for access to careThe biology behind midlife low libido and why it's not "all in your head"Why recurrent UTIs after sex might actually be vestibulodynia or vaginal microbiome changes.How to talk to your partner about sex when you've never had those conversationsThe truth about midlife weight gain and what hormones can and can't doGLP-1 medications: FDA approvals for weight loss, cardiovascular protection, MASH, and sleep apneaThank you for being here for 100 episodes. Honestly, there have been times I've wanted to stop, but then I get a DM from someone saying they heard something on the podcast that changed their care, or a patient tells me they finally found answers here. That's what keeps me going.The biggest way you can help me keep doing this work is simple: share this show with someone who needs it and hit subscribe. When you share an episode with a friend who's struggling, a family member who's been dismissed by doctors, or post about it on social media, you're helping me reach more women who deserve better care.Thank you for listening, for learning, and for advocating alongside me. Here's to the next 100.Get in Touch with Me: WebsiteInstagramYoutubeSubstack

Dr. Noor Al-Humaidhi is a general practitioner from New Hampshire who discovered a massive gap in midlife women's healthcare. After experiencing perimenopausal symptoms herself and realizing how little she understood about the connection between hormones and chronic disease, she started Lifestyles by Dr. Noor a multidisciplinary practice focused on prevention, metabolic health, and helping women stop suffering through menopause.We discuss why stress management isn't just "woo woo" but creates measurable biological changes in blood sugar and cardiovascular health, how continuous glucose monitors reveal the real-time impact of stress on your body, and why women in the Middle East face unique barriers to hormone therapy access. Dr. Noor shares her approach to building a practice with dietitians, mind-body therapists, and weightlifting programs because hormones alone aren't the answer it's about addressing sleep, muscle, nutrition, and stress together.The conversation covers why sleep is so under treated in perimenopausal women, the cultural differences in how menopause is experienced across the world, and why there's such a high tolerance for women's suffering. Dr. Noor explains why she refuses to give up on helping women access care, even when hormone therapy isn't available in their countries.Highlights:Why stress creates measurable biological changes in blood sugar and blood pressure.How continuous glucose monitors show real-time impact of stress on your health.The importance of CBTI (cognitive behavioral therapy for insomnia) over sleeping pills.Why weightlifting with proper form matters more than endless cardio.Cultural differences in menopause experience between the Middle East and the US.Why suffering through menopause isn't noble you deserve to feel better.You're part of a growing community of women who refuse to accept suffering as inevitable. If you found value in this conversation, subscribe and help us spread the message that midlife women deserve comprehensive, compassionate care.Get in Touch with Dr. Noor:WebsiteInstagramLinkedInGet in Touch with Me: WebsiteInstagramYoutubeSubstackMentioned in this episode:GSM CollectiveThe GSM Collective - Chicago Boutique concierge gynecology practice Led by Dr. Sameena Rahman, specialist in sexual medicine & menopause Unrushed appointments in a beautiful, private setting Personalized care for women's health, hormones, and pelvic floor issues Multiple membership options available Ready for personalized women's healthcare? Visit our Chicago office today. GSM Collective

Dr. Jila Senemar is a board-certified OB-GYN in Miami who's integrating longevity medicine with menopause care. After nearly two decades in traditional practice, part of her work is catching women in their 30s and 40s before chronic disease develops.We discuss why your standard annual labs are missing the markers that actually predict heart disease and diabetes, how to finally break free from the cardio-only mentality that's keeping you from building muscle, and why eating more protein feels impossible when you've been trained to restrict food your entire life. Dr. Senemar reveals the advanced testing she runs on every patient and explains why most women are being managed reactively instead of proactively.We cover transitioning out of insurance medicine to actually spend time with patients, why strength training won't make you bulky, and when peptides and longevity treatments fit into your health plan. Plus, we talk about what it means to optimize your health span, not just your lifespan.Highlights:The critical biomarkers your doctor isn't checking (ApoB, Lp(a), fasting insulin, inflammatory markers).Why perimenopause accelerates your risk for heart disease and metabolic problems.How to shift from endless cardio to building muscle that protects your bones and metabolism.The real reason getting enough protein feels so hard and why it matters.When peptides, NAD, and supplements belong in your health plan.Starting health optimization in your 30s instead of waiting for disease in your 50s.This show has grown over nearly two years thanks to viewers and listeners like you. While menopause and sexual health have become more mainstream, too many women still aren't getting the help or education they need. I'm working to change that. If you found this episode helpful, please subscribe to the show and leave a review on Apple Podcasts. Get in Touch with Dr. Senemar:WebsiteInstagramPodcastGet in Touch with Me: WebsiteInstagramYoutubeSubstack

Dr. Arthur "Bud" Burnett is a legend in urology whose pioneering work on nitric oxide helped make Viagra possible. As a Professor at Johns Hopkins and author of "The Manhood Prescription," he brings nearly 40 years of research to understanding how men's sexual health impacts their partners.We discuss why erectile dysfunction in male partners directly affects female sexual dysfunction, the treatments for Peyronie's disease that most couples don't know exist, and why testosterone replacement is straightforward for men but controversial for women. Dr. Burnett explains his holistic approach beyond just prescribing pills and shares insights on helping prostate cancer survivors recover sexual function.The conversation covers healthcare disparities in men's sexual health and how implicit bias affects treatment outcomes. Dr. Burnett emphasizes that sexual health is a right and encourages advocating for comprehensive care.Highlights:How nitric oxide research led to Viagra and revolutionized treatment.Why one in 10 men develop Peyronie's disease and available treatments.Nerve-sparing surgery techniques that preserve function after prostate cancer.Healthcare disparities that affect men of color in sexual medicine.Why advocating for yourself matters when providers dismiss concerns.Get in Touch with Dr. Burnett: WebsiteFacebookInstagramLinkedInGet in Touch with Me: WebsiteInstagramYoutubeSubstackMentioned in this episode:GSM CollectiveThe GSM Collective - Chicago Boutique concierge gynecology practice Led by Dr. Sameena Rahman, specialist in sexual medicine & menopause Unrushed appointments in a beautiful, private setting Personalized care for women's health, hormones, and pelvic floor issues Multiple membership options available Ready for personalized women's healthcare? Visit our Chicago office today. GSM Collective

Last week was the Menopause Society meeting in Orlando, and while I couldn't attend in person due to getting sick, I spent the weekend watching all the sessions remotely from bed. What struck me most were the cardiovascular sessions. Recording this on the eve of my mother's one-year death anniversary from a massive heart attack, I want to talk about the real changes that happen when estrogen leaves the chat and why cardiovascular disease awareness among women has actually dropped from 65% to 44% in recent years.I talk through the key cardiovascular takeaways including why white coat hypertension isn't benign, how the 2025 American Heart Association guidelines changed what's considered normal blood pressure, and why perimenopause is a time of accelerated cardiovascular risk when cholesterol and blood pressure can spike suddenly. The most fascinating session covered invisible heart disease: INOCA (ischemia with no obstructive coronary arteries) and microvascular dysfunction. This is when women have chest pain, get full cardiac workups showing wide-open arteries, yet still have reduced blood flow to the heart through tiny vessels that don't show up on standard angiograms.I discuss mental stress ischemia, a hidden killer where emotional stress causes measurable damage and reduced perfusion to the heart even when exercise stress tests are normal. How many women were told they had panic attacks when they actually had coronary microvascular dysfunction? The mind-heart connection is real, and the sympathetic nervous system surge during high stress can constrict small vessels cutting off microcirculation. I share practical steps including finding preventative cardiologists, getting CT angiograms if you have family history, understanding your blood pressure parameters, and why stress reduction isn't just self-care, it's cardiovascular medicine.Highlights:Why awareness that heart disease is the #1 killer in women dropped from 65% to 44%.How white coat hypertension is NOT benign and leads to cardiovascular events.New 2025 blood pressure guidelines: normal is now less than 120/80.Why perimenopause causes accelerated cardiovascular risk with sudden cholesterol spikes.What INOCA and microvascular dysfunction mean for women with chest pain and normal angiograms.How mental stress ischemia causes measurable heart damage even with normal stress tests.If this episode helped you understand cardiovascular risks in menopause and why symptoms like chest pain deserve thorough evaluation beyond standard testing, please share it with women who need this information. Subscribe and leave a review to help more people discover these critical discussions about heart health in midlife.Resources: Microvascular NetworkINOCA Get in Touch with Me: WebsiteInstagramYoutubeSubstack

Have you ever felt stuck, ashamed, or just plain confused about your sexual wellness? I am so excited about today’s conversation. I am diving deep with Dr. Jennifer Litner, a brilliant sex therapist and founder of Embrace Sexual Wellness, to talk about how we can unlearn sexual shame, communicate better in relationships, and teach the next generation about healthy sexuality.I love exploring the how sexual wellness, shame, and communication, all need to work together. Jennifer shares her journey into the world of sex therapy, why she believes naming what we do is so powerful, and how shame around sex can impact us even if we are educated or in committed relationships. We also explore practical strategies for improving communication with your partner, overcoming desire mismatches, and creating a culture of openness in your relationship.We also discuss how early sex education or the lack of it affects adults, how parents can start conversations with their kids without shame, and why understanding pornography and modern sexual culture is crucial for young people today. Plus, we touch on how sexual identity, including asexuality, is being more openly discussed and accepted in today’s world.Whether you are a clinician, a parent, or just someone curious about your own sexual wellness, this conversation is packed with insights, practical advice, and validation that yes, you deserve pleasure and connection.Highlights:How sexual shame develops and shows up in relationships.The power of naming what we do and embracing sexual wellness without fear.Tools and exercises for improving communication and connection in intimate relationships.Why early, open, and shame free conversations about sex matter for the next generation.Insights into modern sexual identity, desire discrepancies, and responsive desire.If you are ready to explore your own sexual wellness, improve communication with your partner, or learn how to have these conversations with your kids, this episode is for you. Don’t forget to subscribe, leave a review, and share this episode with anyone who could benefit from a little sexual empowerment in their life.Get in touch with Dr. Litner:WebsiteInstagramFacebookLinkedInGet in touch with me:WebsiteInstagramYoutubeSubstack

You've probably heard of cancer survivors, but have you heard of previvors? These are women with genetic mutations like BRCA1, BRCA2, or CHECK2 who are at higher risk for cancer but don't have it yet. October is both Breast Cancer Awareness Month and Menopause Awareness Month, making it the perfect time to discuss genetic testing, cancer risk assessment, and what previvors need to know about their options.Using a 28-year-old patient with CHECK2 mutation as an example, I walk through when genetic testing makes sense, how to calculate your lifetime risk, and what screening protocols change when your risk is elevated. I cover modifiable lifestyle factors that account for 30% of breast cancer cases, including alcohol intake, diet, exercise, and optimal body weight. The key message: genetic testing is about empowerment and prevention, not fear.I also address surgical menopause after risk-reducing procedures. When you remove ovaries in your 30s or 40s to prevent cancer, you fall off a hormonal cliff with immediate consequences. The critical issue: estrogen therapy is NOT contraindicated for previvors without personal cancer history, yet surgical patients are rarely given a menopause plan before going under anesthesia. Early estrogen loss increases cardiovascular disease, dementia, osteoporosis, and all-cause mortality risks.Highlights:What CHECK2, BRCA1/2, and other mutations mean for lifetime cancer risk.How removing ovaries before age 45 without HRT increases all-cause mortality risk.Why previvors without cancer CAN and SHOULD take estrogen after preventative surgery.Why you should demand a menopause plan BEFORE risk-reducing surgery, not after.If this episode empowered you to have conversations about family history and genetic testing, or helped you understand why hormone replacement matters after preventative surgery, please share it with women who need this information. Subscribe and leave a review to help more people discover these critical discussions about cancer prevention and quality of life.Get in Touch with me: WebsiteInstagramYoutubeSubstackMentioned in this episode:GSM CollectiveThe GSM Collective - Chicago Boutique concierge gynecology practice Led by Dr. Sameena Rahman, specialist in sexual medicine & menopause Unrushed appointments in a beautiful, private setting Personalized care for women's health, hormones, and pelvic floor issues Multiple membership options available Ready for personalized women's healthcare? Visit our Chicago office today. GSM CollectiveGSM CollectiveThe GSM Collective - Chicago Boutique concierge gynecology practice Led by Dr. Sameena Rahman, specialist in sexual medicine & menopause Unrushed appointments in a beautiful, private setting Personalized care for women's health, hormones, and pelvic floor issues Multiple membership options available Ready for personalized women's healthcare? Visit our Chicago office today. GSM Collective

If you've been following along, you may have noticed things look a bit different around my practice. In this episode, I'm sitting down with my amazing team—Karen Bradley (NP) and Grace Prete (pelvic floor PT)—to talk about why we transitioned to concierge medicine, changed our name to the GSM Collective, and what this all means for the care we provide. We discuss how insurance restrictions meant that even when we spent 30 minutes with patients more than most providers could offer it still wasn't enough time for patients with complex conditions like PGAD, vaginismus, and chronic pelvic pain who needed proper evaluation and treatment. Under our new concierge model with Ms. Medicine, we can now offer 90-minute first visits for pelvic floor patients, co-treat in the same appointment, and collaborate seamlessly to address the full spectrum of each patient's needs.Grace walks through what actually happens in pelvic floor PT, dispelling the anxiety many patients feel about internal exams. She explains her three-year journey from orthopedics to discovering her passion for treating chronic pain with emotional and physical components. The conversation covers why "just do kegels" is often wrong advice, how tension creates weakness, and why a tight pelvic floor causes urinary incontinence despite conventional wisdom.We also emphasize that pelvic floor dysfunction isn't just about postpartum issues it affects children with constipation, teenagers on hormonal birth control, athletes overworking their cores, and menopausal women with GSM. Highlights:Why we left insurance-based model. How concierge medicine allows 90-minute first visits and same-day co-treatment between providers.Why pelvic floor PT should be preventative, not just reactive to pain and dysfunction.How nitrous oxide helps those who are anxious progress through dilators in single sessions.How TMJ, back pain, and anxiety all connect to pelvic floor tension and clenching.Why pregnancy itself damages the pelvic floor regardless of delivery method.If this episode helped you understand the importance of pelvic floor therapy and comprehensive sexual medicine care, help other women discover this information by subscribing and leaving a review. Your reviews help more people find these discussions about different approaches to sexual health.Get in touch with me and my team:WebsiteInstagramYoutubeSubstackKaren's InstagramMentioned in this episode:GSM CollectiveThe GSM Collective - Chicago Boutique concierge gynecology practice Led by Dr. Sameena Rahman, specialist in sexual medicine & menopause Unrushed appointments in a beautiful, private setting Personalized care for women's health, hormones, and pelvic floor issues Multiple membership options available Ready for personalized women's healthcare? Visit our Chicago office today. GSM Collective

Dr. Rachel Pope explains how her sister's cancer diagnosis and a patient in Malawi asking "can you fix my vagina" opened her eyes to the massive gap in sexual health education within gynecology. As a fistula repair surgeon working in Sub-Saharan Africa for four years, Dr. Pope realized that even after successfully repairing bladder leaks, many patients couldn't have intercourse due to vaginal scar tissue yet providers never asked about sexual function. Meanwhile, her sister battling cancer was asking basic questions about intimacy that Dr. Pope, despite all her training and a fellowship, couldn't answer.These twin revelations led Dr. Pope to pursue sexual medicine education and eventually building Cleveland's first female sexual health division that spans multiple departments. Her unique background in global women's health, fistula repair, and reconstructive gynecology informs her holistic approach to sexual medicine and menopause care.The conversation also explores Dr. Pope's current research focus on perimenopause and cardiovascular health, believing this critical 10-year window before menopause holds the key to prevention rather than just treatment. She shares her proactive approach to her own perimenopause, including checking baseline testosterone levels at peak ovulation to guide future hormone therapy decisions.Highlights:Sexual function should be assessed after every pelvic surgery, not just assumedObstetric fistulas are still happening globally but were eliminated in the US once C-sections became accessible.Building a sexual medicine division works best when spanning multiple departments for true biopsychosocial care.The fellowship program accepts both urology and OBGYN applicants, with only two OBGYN programs in the country.Her work continues in Africa doing shorter trips and training local surgeons.If this episode inspired you to think differently about international women's health and sexual medicine education, help others discover this conversation by subscribing and leaving a review. Your reviews help more clinicians and patients find these discussions about comprehensive sexual health care.Connect with Dr. Pope:WebsiteInstagram LinkedInTikTokXConnect with me:WebsiteInstagramYoutubeSubstack

This conversation with Lauren Tetenbaum revealed how her journey from reproductive rights lawyer to therapist led her to write "Millennial Menopause" after realizing she had no idea what was coming next in her late 30s. Her unique perspective combines legal advocacy, mental health expertise, and millennial pop culture references to make perimenopause education accessible and relatable.Lauren emphasized that millennials are still being dismissed by providers with harmful phrases like "you're too young" and "your labs are normal so you're fine." She stressed that perimenopause can start in the late 30s and that normal lab results don't rule out hormonal changes. The shadow of the Women's Health Initiative continues to create unnecessary fear about hormone therapy, with breast cancer concerns being the most common question she receives.The discussion highlighted how perimenopause intersects with major life transitions that define the millennial experience - career changes, relationship evaluations, and identity shifts. Lauren and I discussed while men experience "midlife crisis," women going through perimenopause often experience "midlife clarity" once they understand and treat their hormonal changes. This clarity sometimes leads to relationship changes as women reevaluate what they want and deserve.A significant focus was placed on the mental health impact of perimenopause, particularly for women with previous anxiety or depression. Lauren explained that old coping mechanisms often stop working, and symptoms like rage, brain fog, and irritability can feel overwhelming. She advocates for psychoeducation as the first step, helping women understand that these changes are hormonally driven and treatable, not character flaws.Lauren shared practical coping strategies including mindfulness techniques like box breathing, cold water on wrists or neck, and "putting the pause back in menopause." She emphasized the importance of partners getting educated and helping with the mental load rather than just witnessing the struggle. Her approach combines cognitive behavioral therapy with self-compassion work and acceptance.Highlights:Why millennials need to start preparing for perimenopause now, even in their 30s.Debunking the "too young" myth and normal lab fallacy.How perimenopause creates "midlife clarity" vs traditional midlife crisis.Practical mindfulness techniques: box breathing, cold water therapy, five senses grounding.The connection between postpartum mental health and perimenopause preparation.Why partners need education and how to support without judgment.If this episode helped you understand millennial perimenopause preparation and mental health support, help other women find this conversation by subscribing to the channel and leaving a review on Apple Podcasts. Your reviews help more women discover these important discussions about preparing for life's next phase.Connect with Lauren:WebsiteBookInstagramLinkedInConnect with me:WebsiteInstagramYoutube

This conversation with Dr. Carolyn Moyers revealed how personal experience with perimenopause transformed her from a general OBGYN into a Menopause specialist. Her journey began when her youngest son pointed out she was getting "mean as she got older," leading her to recognize her own perimenopause symptoms and start estrogen therapy.Dr. Moyers emphasized the critical importance of debunking perimenopause myths that continue to harm women. The most damaging myths include "it's all in your head," "your labs are normal so you're fine," "you're too young for perimenopause," and "hormone therapy just delays the inevitable." She stressed that perimenopause is a clinical diagnosis that can start in the early 30s and last 7-10 years before the final menstrual period.The discussion highlighted the complexity of managing perimenopause versus menopause, with Dr. Moyers noting that perimenopause is actually more difficult to treat because of the "pesky period running around." She advocates strongly for the Mirena IUD, which reduces bleeding by 90% in the first six months, making hormone management much more straightforward.A significant focus was placed on metabolic changes during the menopause transition, including the natural 0.6% annual decline in muscle mass. Dr. Moyers outlined a comprehensive approach including strength training, protein-rich diets, sleep prioritization, and stress management. She introduced the concept of "thought dumping" - an unedited journaling practice combined with identifying three daily wins and three goals for tomorrow.Dr. Moyers shared her unique integration of osteopathic manipulation into menopause care, offering quarterly OMT sessions as part of her membership model. This hands-on approach helps balance the autonomic nervous system and addresses the physical manifestations of hormonal changes, particularly beneficial for pelvic pain and pregnancy-related discomfort.Highlights:Debunking harmful myths: "you're too young" and "labs are normal".Why perimenopause is harder to manage than menopause.Osteopathic manipulation for hormonal balance and pelvic pain relief."Thought dumping" stress management technique with daily wins tracking.Comprehensive metabolic support including strength training and nutrition.Strategic use of GLP-1 medications as jumpstart tools for sustainable change.If this episode helped you understand perimenopause management and holistic care options, help other women find this conversation by subscribing to the channel and leaving a review on Apple Podcasts. Your reviews help more women discover these important discussions about comprehensive midlife health care.Connect with Dr. Moyers:WebsiteInstagramPodcastConnect with me:WebsiteInstagramYoutubeSubstackMentioned in this episode:GSM CollectiveThe GSM Collective - Chicago Boutique concierge gynecology practice Led by Dr. Sameena Rahman, specialist in sexual medicine & menopause Unrushed appointments in a beautiful, private...

If you've always managed just fine but suddenly feel like everything is falling apart in your 40s, the problem might not be perimenopause alone it could be revealing ADHD that's been masked your entire life.This conversation with therapist Mandi Dixon revealed a critical connection between ADHD and perimenopause that's leaving countless women struggling without answers. Dixon's work focuses on the intersection of neurodivergence and hormonal changes, addressing why so many women receive their first ADHD diagnosis during midlife transitions.The discussion explored how ADHD in girls and women presents differently than in boys - with internal hyperactivity like daydreaming and anxiety rather than external disruption. This leads to years of successful masking, where women learn to follow rules and appear organized while struggling internally. The hormonal support of estrogen helps maintain these coping mechanisms until perimenopause strips away that scaffolding.Dixon introduced the concept of "ugly perimenopause" - the severe mental health struggles that go beyond typical mood changes and require immediate attention. She emphasized that the highest suicide rates in women occur between ages 46-54, making this a critical period for intervention and support.The conversation highlighted how neurodivergent women experience more intense perimenopause symptoms due to nervous system sensitivity. Sensory overload becomes overwhelming - from cooking exhaust fans to children's noise levels. Rejection sensitive dysphoria, already challenging for ADHD individuals, intensifies with hormonal fluctuations, making criticism feel devastating.Dixon's therapeutic approach combines traditional counseling with EMDR (Eye Movement Desensitization and Reprocessing) therapy, which uses bilateral stimulation to help reprocess trauma. This technique proves particularly effective for both mental health recovery and physical conditions like pelvic pain where trauma responses interfere with healing.The discussion addressed the "menno divorce" phenomenon, with Dixon explaining that divorce often results from pre-existing relationship issues becoming intolerable once women stop accommodating poor treatment. Perimenopause doesn't cause problems but reveals them, giving women clarity about what they will and won't accept.Dixon stressed that neurodivergent women require specialized menopause care, describing them as "orchids" who need delicate handling during hormone therapy. The combination of hormonal treatment with mental health support often provides the best outcomes, with some women needing long-term antidepressant therapy as a "safety net" alongside hormone replacement.Highlights:Why ADHD gets missed in girls due to internal vs. external symptoms.The "ugly perimenopause" requiring immediate mental health intervention.Sensory overload and rejection sensitivity intensifying with hormone changes.EMDR therapy for trauma processing and pelvic pain recovery.How menopause empowerment reveals relationship problems rather than causing them.Neurodivergent women needing specialist hormone care and patience with treatment.The importance of combining hormone therapy with mental health support.Suicide risk peaks between ages 46-54 in women.If this episode helped you understand the ADHD-perimenopause connection, help other women find this conversation by subscribing to the channel and leaving a review on Apple Podcasts. Your reviews help more women discover these important discussions about neurodivergence and hormonal health.Connect with Mandi: WebsiteInstagrama...

Dating after divorce, widowhood, or decades of marriage feels impossible - but what if the problem isn't that love is scarce, but that nobody ever taught you how to find the right person?This conversation with dating expert Bella Gandhi revealed why traditional approaches to finding love fail and how midlife presents unique opportunities for rewriting your romantic story. Gandhi's philosophy centers on "fixing your picker" learning to identify and choose partners based on compatibility rather than superficial chemistry or outdated checklists.The discussion explored the cultural challenges faced by South Asian women and others from conservative backgrounds who were discouraged from dating during their formative years, then suddenly expected to find life partners without any relationship skills. This creates a particularly challenging dynamic for professionals who focused on career development while neglecting romantic education.Gandhi addressed the "gray divorce" phenomenon, noting how hormonal clarity during perimenopause and menopause often coincides with women recognizing they've been settling for relationships that don't serve them. Economic independence allows women to leave situations their mothers and grandmothers couldn't escape, leading to increased midlife divorces and subsequent re-entry into dating.A major myth-busting focus emerged around modern dating being "harder than ever." Gandhi argues that technology simply provides more options than the historical six-block radius of potential partners. The real challenge isn't the dating landscape but the lack of education around relationship skills - something we'd never expect someone to master without training in any other life area.If this episode gave you hope about finding love at any age, help other women discover this conversation by subscribing to the channel and leaving a review on Apple Podcasts. Your reviews help more women find the support they need for all aspects of midlife transitions.Highlights:Why "fixing your picker" matters more than finding matches.The cultural challenges of South Asian dating expectations.How perimenopause clarity contributes to "gray divorce".Debunking the myth that modern dating is impossible.Red flags: inconsistency, not respecting boundaries, too much too soon.Success stories from clients in their 70s finding love.Teaching relationship skills to teenagers and young adults.Connect with Bela: WebsiteInstagram Facebook YoutubeConnect with me:Website InstagramYoutubeSubstackMentioned in this episode:GSM CollectiveThe GSM Collective - Chicago Boutique concierge gynecology practice Led by Dr. Sameena Rahman, specialist in sexual medicine & menopause Unrushed appointments in a beautiful, private setting Personalized care for women's health, hormones, and pelvic floor issues Multiple membership options available Ready for personalized women's healthcare? Visit our...

Perimenopause isn't just a buzzword it's the missing vocabulary that finally explains why your body feels like it's betraying you in your late 30s and 40s.This conversation with Dr. Jackie Piasta explored why perimenopause has become such a powerful word for women finally finding answers to years of unexplained symptoms. We discussed the complex hormonal orchestra that begins breaking down in the late 30s and early 40s, creating a cascade of physical and emotional changes that often leave women feeling like they're "not themselves."The physiology behind perimenopause involves the ovaries becoming less responsive to brain signals, leading to missed ovulations and progesterone deficiency. This creates what's often called "estrogen dominance" though we prefer the term "progesterone deficiency" to avoid vilifying estrogen. The result is unpredictable cycles, mood changes, brain fog, sleep disruption, and metabolic shifts.A major revelation emerged around hormone testing it's largely unhelpful during active perimenopause with regular cycles, since hormones fluctuate daily. However, testing can provide validation for women experiencing significant cycle disruptions, even if it doesn't change treatment plans. The key is understanding when testing makes sense versus when it's a waste of money.The conversation highlighted how perimenopause accelerates metabolic dysfunction, with cholesterol, blood sugar, and liver enzymes often rising for the first time. Dr. Piasta introduced the "red wine sign" when alcohol tolerance suddenly disappears as an early warning that metabolic changes are happening throughout the body.Treatment approaches vary based on individual needs, considering contraception requirements, cycle regulation, and symptom management. Both birth control pills and menopausal hormone therapy have roles in perimenopause care, often used together with IUDs providing contraception while hormones address symptoms. The goal is having more tools in the toolbox, not fewer.Highlights:Why perimenopause is a "power word," not just medical jargon.When to test hormones (and when not to waste your money).Metabolic changes that accelerate during perimenopause.Birth control pills vs. menopausal hormone therapy approaches.When your body stops processing alcohol.Weight gain and metabolic dysfunction solutions.Treatment strategies for the "sandwich generation".If this episode gave you new perspective on perimenopause and metabolic health, help other women find this conversation by subscribing to the channel and leaving a review on Apple Podcasts. Your reviews help more women discover these important discussions about taking control of their healthcare choices.Connect with Dr. Piasta:WebsiteInstagram Connect with me:Website InstagramYoutubeSubstackMentioned in this episode:GSM CollectiveThe GSM Collective - Chicago Boutique concierge gynecology practice Led by Dr. Sameena Rahman, specialist in sexual medicine & menopause Unrushed appointments in a beautiful, private setting Personalized care for women's health, hormones, and pelvic floor issues Multiple membership options available Ready for...

I sat down with plastic surgeon Dr. Dahlia Rice to uncover why the beauty industry's biggest lies are keeping you from aging on your own terms.This conversation explored the evolution of plastic surgery from dramatic transformations to natural, undetectable enhancements. The discussion covered how celebrity influence, particularly Kris Jenner's recent facelift, has normalized conversations about aesthetic procedures while highlighting the shift toward subtlety over obvious results.A major focus was the reality of dermal fillers contrary to marketing claims about 12-16 month dissolution, many patients retain fillers for years due to individual metabolism differences. This has led to overfilled appearances and the need for ultrasound guided dissolution techniques.The conversation highlighted practical anti-aging strategies, particularly upper eyelid surgery as a high impact, low downtime procedure that can dramatically improve appearance without looking artificial. Fat transfer emerged as a game changing technique that provides natural volume while improving skin quality through growth factors.The discussion addressed modern challenges like "Ozempic face" from rapid weight loss and the limitations of non-surgical skin tightening. We also discussed the importance of rejecting societal pressure around aging and aesthetic choices, framing these decisions as personal autonomy rather than vanity.Throughout, the conversation challenged stigmas in both plastic surgery and women's health, advocating for patients to address what bothers them rather than suffering in silence. The overarching message was about empowering women to make choices that improve their quality of life without shame or judgment.Highlights:Celebrity influence on plastic surgery trends (Kris Jenner's facelift analysis).The shift from "overfilled" to natural aesthetics in modern plastic surgery.Breast reconstruction for cancer survivors and body image.Filler dissolution and the truth about how long they really last.AI filters vs. realistic surgical expectations.Ozempic face/body and massive weight loss surgery.Small procedures with big impact (upper eyelids, lip lifts).If this episode gave you new perspective on aging and body autonomy, help other women find this conversation by subscribing to the channel and leaving a review on Apple Podcasts. Your reviews help more women discover these important discussions about taking control of their healthcare choices.Connect with Dr. Rice:WebsiteInstagramTikTokConnect with me:Website InstagramYoutubeSubstackMentioned in this episode:GSM CollectiveThe GSM Collective - Chicago Boutique concierge gynecology practice Led by Dr. Sameena Rahman, specialist in sexual medicine & menopause Unrushed appointments in a beautiful, private setting Personalized care for women's health, hormones, and pelvic floor issues Multiple membership options available Ready for personalized women's healthcare? Visit our Chicago office today. a...