Gyno Girl Presents: Sex, Drugs & Hormones

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...

I'm thrilled to have Dr. Justin Lehmiller, renowned psychologist, sex researcher and author of "Tell Me What You Want," join me to uncover what people really fantasize about based on his groundbreaking survey of over 10,000 adults.In this fascinating episode, I dive into the hidden world of sexual fantasies with Justin a psychologist who has conducted the largest study on what people actually fantasize about. As someone who works daily with patients struggling with sexual health concerns, I found this conversation incredibly revealing about what's happening in people's minds behind closed doors.Justin reveals the seven universal fantasy themes that emerge across all demographics, from threesomes and kink to romance and taboo scenarios helping me understand what my patients are likely thinking about but afraid to discuss. We explore the surprising finding that religiously and politically conservative people often fantasize about the very things they're "not supposed to" do, and how taboos actually amplify excitement through what he calls the "forbidden fruit effect."One of the most valuable insights I gained was learning that 80% of people report positive experiences when sharing fantasies with partners, and how women who act on fantasies have higher orgasm rates. We also discussed surprising findings about who people fantasize about most (hint: it's usually people they know, not celebrities), and how factors like age, gender, and culture shape our secret desires. Perhaps most importantly, we addressed how most people think their fantasies are much rarer than they actually are, creating unnecessary shame that impacts sexual wellbeing.This conversation opened my eyes to just how normal and diverse human sexual fantasies really are. For anyone wondering if their thoughts are "weird" or struggling with shame around their desires, this episode offers both validation and practical insights.Highlights:Justin surveyed over 10,000 people to uncover the seven most common sexual fantasy categories.Conservative people often fantasize about breaking the very taboos they publicly support.80% of people have positive experiences when sharing fantasies with their partners.Most people fantasize about people they know rather than celebrities.Women who act on their fantasies report higher rates of orgasm.Curious about more honest conversations around sexual health? I encourage you to subscribe to my podcast, for more candid discussions that help you advocate for your sexual wellness. Do you have questions about sexual health? I always tell my listeners -don't hesitate to discuss your concerns with a qualified healthcare provider who specializes in sexual medicine. Remember: I'm here to educate so you can advocate for yourself.Connect with Justin:WebsitePodcastInstagramLinkedInConnect with me:Website InstagramYoutube

Dr. Tiffany Moon, anesthesiologist, entrepreneur, and author of "Joy Prescriptions," joins me for a candid conversation about the hidden struggles behind external success. After years of following the traditional achievement pathway elite schools, medical training, career advancement Dr. Moon found herself asking "is this it?" despite checking all the boxes society told her would lead to fulfillment.In this deeply personal episode, Dr. Moon shares her transformation from a people pleasing perfectionist to someone who prioritizes authentic joy and connection. She opens up about her challenging fertility journey with twins, the systemic barriers she faced as a part-time physician (including being denied promotion solely for working three days a week), and her controversial experience on Real Housewives of Dallas, where she faced racist harassment that ultimately led her to leave the show. Our conversation explores the unique pressures facing women in medicine, from cultural conditioning around achievement to the impossible myth of "having it all." Dr. Moon discusses her mid-career burnout, how she found creative outlets through entrepreneurship, and why she believes joy must be cultivated from within rather than sought externally. She also addresses the double edged sword of social media how it can build businesses and connections while also fueling dangerous comparisons and shares practical strategies for maintaining authentic relationships in an increasingly digital world. Highlights:The Achievement Paradox: Why following traditional success markers often leaves high achievers feeling empty and unfulfilled.Systemic Bias in Medicine: Research showing 75% of women physicians delay childbearing, with career penalties for part-time work.Cultural Conditioning: How Asian American upbringing around being "smart and obedient" creates lifelong people-pleasing patterns.Reality TV Racism: Dr. Moon's experience with harassment on Real Housewives of Dallas and learning when to walk away.Mental Health Stigma: The importance of seeking treatment for anxiety and depression, especially in medical culture.Social Media Strategy: Using platforms for business growth while avoiding the "comparison trap".Redefining Success: The difference between conditional happiness and sustainable inner Boundary Setting: Practical advice for saying no and valuing your worth as a professional.Get in Touch with Dr. Moon:WebsiteBook linkLeadHer Summit InstagramTikTokLinkedInGet in Touch with me:Website InstagramYoutube

I’m joined by Amy Ege, professional organizer and founder of Amy Louise Organizing, to explore how physical clutter can intensify hormonal upheaval and why bringing order to your environment may be the most overlooked step toward emotional clarity during perimenopause.Many women in midlife find themselves overwhelmed by clutter but don’t connect it to their irritability, fatigue, or mental fog. In this episode, we explore how disorganization can worsen the emotional toll of perimenopause, and why seeking support without shame is both practical and therapeutic.Amy shares how hormone shifts intersect with household stress, why “just buying bins” won’t solve the problem, and how a well organized space can actually help regulate mood, sleep, and decision making. We also dig into the emotional weight of stuff, the cultural shame around mess, and how to build systems that support not sabotage your daily life.Highlights:Why perimenopause amplifies stress from household clutter.The emotional payoff of donating with purpose and clearing space.Why traditional storage solutions often fail, and what works instead.How shame and societal roles keep women stuck in disorganization.How to build resilience and reclaim peace at home through simple systems.If your home feels like one more thing you can’t manage, this conversation will offer both empathy and a path forward. Subscribe, leave a review, and share with someone who needs it.Get in Touch with Amy:WebsiteInstagramGet in Touch with me:Website InstagramYoutube

Dr. Lyndsey Harper built Rosy to fill the void medicine left behind this episode dives into how she's reshaping sexual health for women through tech, data, and desire.Rosy isn’t a one size fits all app. It’s a platform built by a variety of clinicians and trained experts in their fields to support women with low libido, arousal issues, and the systemic failures around both. Through erotica, CBT based coaching, education, and clinical trials, Rosy is setting a new standard for how sexual health care can actually work.In this episode, Dr. Harper shares how the platform continues to evolve and what the data is showing us. We talk about desire, responsive arousal, cultural context, and the new tools changing how we treat sexual dysfunction. If you’ve ever wondered what expert driven, patient-centered care really looks like, this is it.Highlights:How a platform built by clinicians, therapists, and researchers is changing care for low libido and arousal.Why erotica is an evidence based intervention and how Rosy makes it accessible without shame.What Rosy’s data reveals about responsive desire, cultural identity, and unmet sexual health needs.Behind the scenes: Rosy's upcoming arousal treatment, coaching expansion, and Quickies feature.Get in Touch with Dr. Harper:WebsiteInstagramGet in Touch with me:Website InstagramYoutube

In this candid conversation, Dr. Fenwa Milhouse board-certified urologist and fellowship-trained specialist in female pelvic medicine joins me to talk about conditions that affect so many of our patients but are often dismissed or misunderstood. She also happens to be my urologist, so I know firsthand the impact of her work.We discuss her journey into urology, the importance of representation in medicine, and her focus on female pelvic health from prolapse and incontinence to the surgical and non-surgical treatments that can dramatically improve quality of life.From mid urethral slings to bulking agents like Bulkamid, Dr. Milhouse breaks down the options for restoring bladder control and day to day comfort. We also explore how pelvic floor dysfunction can affect self-image and sexual wellbeing and why informed consent must include conversations about pleasure, not just pathology.Highlights:Representation in Urology: Dr. Milhouse shares how meeting a Black woman urologist shaped her path into a field traditionally dominated by older white men and how that representation continues to matter.Prolapse Realities: From “it felt like I had a scrotum” to “an egg between my legs,” Dr. Milhouse describes how patients experience pelvic organ prolapse and what options exist to restore both anatomy and confidence.Incontinence Treatments Explained: A breakdown of surgical and non-surgical options—like mid urethral slings and Bulkamid and how patient goals and downtime factor into decision making.Preserving Sexual Function: Why asking about cervical orgasms matters, and how uterine sparing procedures can protect sexual wellbeing during prolapse repair.Medical Bias and Advocacy: A frank discussion about racism, bias, and the emotional toll that clinicians of color face—both from patients and within the healthcare system.If you found this episode helpful, please subscribe, rate, and leave a comment. Your support helps us reach more people who deserve real, respectful conversations about their health.Connect with Dr. MilhouseWebsiteInstagramYoutubeConnect with Dr. Rahman:Website Instagram Youtube

Could vaginal estrogen be the missing piece for some of your menopause symptoms? Many women find it has been a game-changer for their relief.I often talk about the lack of current information many doctors have about hormones. This is a global issue, which is precisely why I wanted to have a leading UK menopause expert on the show.Have you ever felt like your own body was working against you? Like your mood, memory, or even sexual health just aren't what they used to be, and no one's really listening? In this episode, I sit down with Dr. Louise Newson to dig into why so many women first experience these frustrations and why they feel such immense relief after speaking with a menopause specialist, especially after constantly being dismissed by other clinicians.Dr. Newson, a relentless advocate for women's health, challenges why hormones like estrogen, progesterone, and testosterone are often denied to women, highlighting a pervasive medical bias against female physiology. She shares crucial insights on testosterone deficiency and its effects on the brain, the revolutionary benefits of vaginal DHEA (Prasterone) for recurrent UTIs, painful sex, and vaginal atrophy, and the potential for deprescribing opioids and antidepressants through hormone optimization. Tune in for a frank, evidence-based discussion that empowers you to advocate for personalized hormonal care at every stage of life.Episode Highlights:Challenging Medical Bias: We confront the historical medical bias denying women crucial hormone therapy (HT) and discuss its impact on overall health.Hormones, Mood & Brain Health: Discover how estrogen, progesterone, and testosterone function as neurotransmitters, profoundly impacting mood, memory, and sleep. Learn how hormone optimization can even reduce the need for opioids and antidepressants.The Power of Testosterone: Beyond libido, we discussl how testosterone replacement can boost brain function, energy, and combat chronic joint pain.Vaginal DHEA: A Game-Changer: Hear about the revolutionary benefits of vaginal DHEA (Prasterone) for recurrent UTIs, painful sex, and vaginal atrophy.Advocating for Long-Term Health: Understand why hormone deficiency raises risks for major conditions like dementia and heart disease, emphasizing the need for personalized hormonal care for healthy aging.If this conversation has sparked questions or empowered you, don't keep it to yourself. Share this episode with a woman in your life who needs to hear it, and remember to visit my Youtube Channel for more resources. Until next time, stay informed and advocate for your health!Guest Bio:​​Dr. Louise Newson is a world-renowned physician, women's hormone specialist, and member of the UK Government’s Menopause Taskforce, widely known as the "medic who kickstarted the menopause revolution." An award-winning doctor, educator, and Sunday Times bestselling author, she founded the free balance menopause support app (over 1M downloads) and hosts the No.1 UK medical podcast. Through her Newson Health clinic and extensive research, Dr. Newson is committed to improving access to individualized menopause and hormone treatment, while tirelessly working to educate healthcare professionals and challenge medical bias without pharmaceutical funding.Get in Touch with Dr. Newson:WebsiteInstagramLinkedinGet in Touch with Dr....

Midlife isn’t just about hot flashes or forgetting names it’s a time when many women start noticing subtle (and sometimes not-so-subtle) shifts in how they feel, think, and relate to the world around them. For some, it’s frustration they can’t quite name. For others, it’s sleep disruptions, mood changes, or a fading sex drive. These changes aren’t imagined and they’re not always easy to talk about.In this episode, I talk with Dr. Kate White about what really happens to the body and mind during midlife and why so many women feel unsupported during this transition. We explore how hormonal shifts can affect mood, memory, desire, and relationships not for everyone, but for more women than we acknowledge. Dr. White brings both her clinical experience and personal insight, shedding light on why these experiences are real, valid, and deserving of better care.We also dig into the emotional weight that comes with midlife the shifting roles as parents, professionals, and partners and how this period can lead to questioning everything from career goals to long-term relationships. It’s not about assigning blame to hormones, but about recognizing them as one piece of a complex puzzle.This conversation is about validation, education, and hope. Whether you’re in the thick of midlife changes or just starting to feel things shift, this episode is an invitation to listen without shame and to speak up without apology.Highlights:Why midlife can feel like an emotional landmineHow hormone changes impact libido, focus, and memoryWhat no one tells you about perimenopausal rageThe link between invisible labor and sexual disconnectionTips for recalibrating long-term relationships without blowing them upWhy naming the problem isn’t blaming—it’s empoweringDid you enjoy this episode? Make to follow the show, leave a rating or review, and share this episode with someone who needs to hear it. Your support helps more women find real answers and better care.Guest Bio:Dr. Kate and Jay White are the married duo behind Heads and Tails, a podcast about recalibrating life, love, and identity in midlife. With over 50 years of combined experience Kate as a nationally recognized gynecologist and menopause/sexual medicine specialist, and Jay as a seasoned therapist, musician, and magician they bring both clinical expertise and real-life perspective to the mic.Married for 26 years, they’ve weathered their own relationship evolutions while raising kids, building careers, and navigating the many curveballs of midlife. Together, they speak candidly (and often hilariously) about everything from hormones and hot flashes to emotional intimacy and second chances.Their chemistry is real, their advice is grounded, and their mission is clear: to help listeners turn the so-called “midlife crisis” into a powerful recalibration body, brain, and relationship.Get in Touch with Dr. White:WebsiteInstagram Get in Touch with Dr. Rahman:WebsiteInstagramYoutube