Gyno Girl Presents: Sex, Drugs & Hormones

Most people think sex therapy means Masters and Johnson-style homework or uncomfortable demonstrations. Dr. Shannon Chavez explains what it actually is—and why sexual concerns are rarely about sex at all. They're about intimacy, attachment, and learning to feel safe in your own body.Dr. Chavez has spent her career helping individuals and couples navigate sexual shame, intimacy disorders, and compulsive behaviors through a trauma informed, non-pathologizing framework. We discuss how shame is learned, not inherent, and why the opposite of shame is acceptance. We talk about how she approaches vaginismus and pelvic pain patients in therapy, why pain can live in the body even after the physical issue is resolved, and how mental rehearsal and visualization help people reclaim pleasure.We also discuss compulsive sexual behaviors not as addiction in the traditional sense, but as intimacy disorders rooted in early trauma and attachment. Dr. Chavez explains why the sex negative addiction model has done more harm than good, how porn is designed to overconsume just like doom scrolling, and why education around healthy sexuality is more effective than abstinence only approaches. We cover pleasure literacy, the difference between healthy desire and compulsive use, and why sex should feel like play, not another item on your to-do list.HighlightsThe body keeps score even after physical pain is resolved, which is why sex therapy is essential for sexual dysfunction issues.Compulsive sexual behaviors are often rooted in early trauma, attachment issues, and lack of self-soothing skills rather than traditional addiction.The sex-negative addiction model has created more stigma and hasn't been effective healing intimacy disorders is more successful.Pleasure literacy means understanding what pleasure means to you personally, not fitting into a prescribed definition.AI companions and technology are creating more isolation, which amplifies sexual and intimacy issues.If you've been struggling with sexual shame, pain, or compulsive behaviors, know that you're not broken. These are things many people navigate at different points in our lives, and reaching out for help doesn't mean years of therapy sometimes it's just getting permission or validation from someone who understands.Get in Touch with Dr. Chavez:WebsiteInstagramTikTokYoutubeGet in Touch with Me: WebsiteInstagramYoutubeSubstack

Dr. Sadia Malick has practiced medicine across four countries. She's delivered babies in the UK's best hospitals and in the mountains of Pakistan where women have nothing. She's founded a charity that's saved 8,000 mothers' lives. And she's spent her career caring for women who are told their suffering is just "the age of despair."Dr. Malick has spent her life caring for women across the UK, Pakistan, UAE, and Saudi Arabia. She founded a charity that trains midwives on clean, sanitary practices and provides lifesaving interventions to pregnant women in rural Pakistan. We discuss why 50% of global maternal deaths happen in just four countries, and how evidence based measures can save lives.We also talk about how menopause presents differently across cultures and populations, the cultural barriers women face when seeking care, and why conversations about hormones and aging remain deeply stigmatized in many regions. While symptoms may vary, what's universal is how much work we still have to do whether it's PCOS and insulin resistance, young cancer survivors entering menopause without follow up care, or ensuring every woman understands why vaginal estrogen matters.This conversation is about cultural humility, global health disparities, and why education about perimenopause needs to start in schools, not at age 40.Highlights:Maternal mortality is concentrated in just four countries, but simple interventions like clean supplies and IV iron can save lives.Menopause symptoms present differently across populations South Asian women experience more joint pain and mood issues than hot flashes.Cultural expectations around fertility and aging create additional barriers for women seeking menopause care.Young cancer survivors are sent home at 23 in menopause with no follow-up care or education about long-term health risks.Vaginal estrogen reduces death risk by 70% and should be part of routine care for women over 40.The average age of suicide for women in the UK is 51, and 70% of divorces happen after menopause.Get in Touch with Dr. Malick:SubstackInstagramLinkedInGet 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

Your dizziness when you stand up is real. Your pelvic pain is real. Your fatigue is real. And there's actually a connection between all of it that most doctors were never taught to look for.If you've ever been told your dizziness, palpitations, or pelvic pain is "just anxiety," this episode is for you. Dr.Dr. Alexis Cutchins is a cardiologist treating POTS and MCAS—she's willing to say 'I don't know, let's figure it out' instead of dismissing patients.We discuss what POTS actually is, how to diagnose it why 80% of her POTS patients have venous insufficiency, and how treating the veins can sometimes cure the POTS. We also talk about the connection between POTS, mast cell activation syndrome, hypermobility, and pelvic venous disease conditions that often travel together and are frequently dismissed.Dr. Alexis Cutchins explains why the venous system is a "lost organ system" that no one really learns about in med school,how left iliac vein compression (May-Thurner syndrome) can cause everything from pelvic pain to back pain and headachesPlus, we discuss women's cardiovascular health, microvascular disease, coronary vasospasm, and why women's heart attack symptoms can look completely different including neck tightness from allergies that's actually cardiac ischemia.Highlights:You don't need a tilt table test to diagnose POTS simple office based or at home tests can help identify it.First-line POTS treatment: volume expansion (drink water, eat salt), compression stockings, treating comorbid MCAS.About 80% of POTS patients have venous insufficiency treating it can dramatically improve or even cure symptoms.Pelvic venous disease is diagnosed with MRV (not CT) and treated with stenting by interventional radiologists.Women's heart attacks can present as abdominal pain, neck tightness, or jaw pain—not just chest pain.These conditions run in families mothers and daughters often share the same constellation of symptoms.If you've been dismissed for POTS, MCAS, pelvic pain, or any constellation of symptoms that don't fit into a neat diagnostic box, this episode validates what you've been experiencing. These conditions are real. They're treatable. And more doctors are finally starting to listen.Make sure to subscribe to the podcast so you don't miss upcoming episodes on related topics, and share this with anyone who needs to hear that their symptoms matter.Get in Touch with Dr. Cutchins:WebsiteInstagramYoutubeGet in Touch with Me: WebsiteInstagramYoutubeSubstack

Can you really "have it all"? Dr. Sharon Malone OB-GYN, New York Times bestselling author of Grown Woman Talk, and Chief Medical Advisor at Alloy Health joins me for an honest conversation about what it really takes to balance medicine, motherhood, and everything in between. Dr. Malone and I talk about the things we don't usually say out loud. How do you balance being a great doctor, a present parent, and a supportive partner when society tells you to excel at all three simultaneously? Dr. Malone practiced medicine before and after the Women's Health Initiative, so she has a unique perspective on how hormone therapy went from being standard care to being feared and how that fear disproportionately affected women of color. We discuss why only 1% of Black women who are eligible for hormone therapy are actually on it, despite suffering the longest and most severe menopausal symptoms.We also talk about her work with Alloy Health, her new podcast The Second Opinion, and why she believes menopause is inevitable but suffering is not. Plus, we get into the uncomfortable truth about medical racism, implicit bias, and why your gut feeling matters more than your doctor's ego.HighlightsGive yourself grace in midlife perimenopause decreases your coping threshold for everything you're already juggling.Women of color carry the weight of representing their entire group, not just themselves, which adds invisible pressure.Diversity in healthcare leadership literally changes what research gets funded and what treatments get offered.Only 1% of Black women eligible for hormone therapy are actually on it, despite having more severe and longer-lasting symptoms.The "adipose tissue theory" that Black women don't need hormones because they make more estrogen on their own is completely false.Racialized medicine affects everything from endometriosis diagnosis (only thin white women?) to pain management assumptions.If your doctor gets mad that you asked for a second opinion, you need a different doctor.Guidelines are guardrails, not laws medicine requires both confidence and humility.Dr. Malone's book Grown Woman Talk is everything you need to know about navigating midlife with confidence and information. And remember: trust your gut. If something feels off, keep advocating until someone listens.I have an incredible lineup of guests coming up, so make sure you subscribe and leave a review so you never miss episodes like this one!Links:Get in touch with Dr. Malone:WebsiteBookInstagramPodcastGet 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...

Hysterectomy is one of the most common surgeries for women 600,000 are performed every year in the United States. But are women truly getting all their options? Board certified OBGYN Dr. Kameelah Phillips joins me to discuss her groundbreaking book The Empowered Hysterectomy and why understanding the full history and context of this surgery is essential for every woman.In this powerful conversation, I sit down with Dr. Kameelah Phillips to discuss hysterectomies from every angle the good, the bad, and the historically traumatic. Dr. Phillips, author of The Empowered Hysterectomy, shares why she wrote a book that isn't anti-hysterectomy, but rather pro-information and pro-choice.From her origin story working at Planned Parenthood at age 15, to understanding the disturbing history of gynecology built on the experimentation of enslaved women, to counseling patients through one of the most significant decisions of their lives this episode covers it all. We also discuss the importance of true informed consent, the impact on sexual function, and why women of color are disproportionately offered hysterectomies over other treatment options.HighlightsThe birth control pill has such a bad reputation that patients reject it even though it could be the thing that helps their symptoms.The racist history behind hysterectomies continues today Black women are still being steered toward them at a much higher rate than their white counterpartsYou may not realize that your orgasm is actually coming from your cervix, which is why a conversation about sexual function should happen before surgery.Education and income doesn't protect Black women from maternal mortality.Explaining medical concepts in everyday language isn't "dumbing it down" it's ensuring patients actually understand what's happening to their bodies.Properly counseled patients who freely choose hysterectomy often experience profound liberation not just physically but sexually too.If you're considering a hysterectomy or have been told you need one, get Dr. Kameelah Phillips' book The Empowered Hysterectomy to ensure you have all the information you need to make the best decision for YOUR body. And remember you deserve time, information, and advocacy. Don't settle for less.I have an incredible lineup of guests coming up, so make sure you subscribe and leave a review so you never miss episodes like this one!Get in Touch with Dr. Phillips:WebsiteInstagramLinkedInBook Get in Touch with Me: WebsiteInstagramYoutubeSubstack

The FDA told him no in 1992. They said giving estrogen to breast cancer survivors would put women at "unacceptable risk." He did the study anyway.Dr. Avrum Bluming is a medical oncologist, emeritus clinical professor of medicine at USC, former senior investigator for the National Cancer Institute, and co-author of Estrogen Matters. He's been fighting estrogen fear for over 30 years long before it was safe or popular to do so.His origin story starts with his wife. At 45, she developed breast cancer. The chemotherapy he gave her threw her into premature menopause. She couldn't sleep. She had hot flashes, night sweats, painful urination, palpitations. She couldn't remember what she'd read two pages back. And he an oncologist who had induced menopause in countless breast cancer patients—had been sympathetic but didn't know how to help them until he saw what was happening with his wife.So he started a study in 1992 to give estrogen to breast cancer survivors. The FDA denied him twice. He did it anyway. By 1997, he presented his data to 8,500 oncologists from around the world. The National Cancer Institute said it was "irresponsible" to study this. The audience challenged them. Dr. Bluming's data showed no increased risk of recurrence.We talk about the Women's Health Initiative, how the media misinterpreted the data, why the estrogen alone actually decreased breast cancer by 23% and breast cancer death by 40%, and why the box warning that just came off in November 2025 never should have been there in the first place. There are now 26 studies in the English literature on giving estrogen to breast cancer survivors. Only one showed increased risk. Four showed decreased risk. Twenty-five showed no difference.Highlights:The FDA denial story: "Don't shoot me, I'm just the messenger".Why tamoxifen works better in premenopausal women (even though it raises estrogen 4-5x).The DCIS patient whose oncologist changed their tune after the box warning came off.The FDA committee member who asked "most of your patients are going to die anyway, aren't they?"showing how little some understood about breast cancer survival.When he asked if the FDA actually read his research before denying it: "Don't shoot me, I'm just the messenger"—a quote that reveals everything.What actually causes breast cancer (spoiler: nobody knows).If you've been denied estrogen or hormone therapy, share this episode with your provider. Share Estrogen Matters with its 555 references. Share the data. At this point, there's overwhelming evidence showing HRT is safe and beneficial for most women. But some clinicians are still using outdated information from 2002. You deserve care based on current science, not decades-old fear.Get in Touch with Dr. Bluming:WebsiteInstagramStudyGet 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...

There are 80 million women over 40 in America. Only 4,100 menopause certified clinicians. The gap is real. And my guest is working on changing that. Dr. Kelly Casperson is a urologist, sexual medicine physician, and bestselling author of The Menopause Moment and You Are Not Broken. She's been leading the charge on women's health advocacy from serving on the FDA panel that removed the box warning on estrogen to pushing for testosterone deregulation. She has a large following, but as Kelly says: it's just a drop in the bucket. HThere are 80 million women over 40 in America. Only 4,100 menopause certified clinicians. The gap is real. And my guest is working on changing that.Dr. Kelly Casperson is a urologist, sexual medicine physician, and bestselling author of The Menopause Moment and You Are Not Broken. She's been leading the charge on women's health advocacy from serving on the FDA panel that removed the box warning on estrogen to pushing for testosterone deregulation. She has a large following, but as Kelly says: it's just a drop in the bucket.We talk about the women who aren't on social media, who aren't listening to podcasts, who don't know their options exist. How we need to reach people in the community churches, community centers, libraries. We discuss why grassroots education matters, why testosterone is locked behind 1980s doping laws. We discuss why grassroots education matters, why testosterone is locked behind 1980s doping laws, and Kelly shares the real reason for menopause.This is a conversation about what's changing in women's health and what still needs to change.Highlights:Why grassroots advocacy in the community matters as much as social media.Why 30% of women prescribed vaginal estrogen won't use it (the box warning effect).Frailty isn't inevitable it's what happens when you don't maintain your health.The biopsychosocial model: how culture shapes your menopause experience.Kelly's philosophy: you have to advocate for yourself, but you're not alone.Don't be afraid to start conversations with friends and loved ones about menopause, hormones, and the options available. You might be the only person in their life talking about this and that conversation could change be life changing.Get in Touch with Dr. Casperson:WebsiteInstagramPodcastGet in Touch with Me: WebsiteInstagramYoutubeSubstack

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