Labia Logic

Perimenopause can feel like your body suddenly changed the rules without sending you the updated handbook. Mood swings, brain fog, sleep problems, weird bleeding, libido changes. And yes, you can still be having perfectly regular periods while all of this is happening.  So… WTF is actually going on? In this episode of Labia Logic, Dr. Ashley Fuller and Dr. Meredith McClure are joined by Women's Health Nurse Practitioner Dr. Jaclyn Piasta to talk all about the hormonal chaos of perimenopause. They talk about why perimenopause cannot always be confirmed with a single hormone test but is still a clinical diagnosis. They also cover why symptoms can change from month to month, and how treatment may include birth control pills, IUDs, menopausal hormone therapy, vaginal estrogen, or a mix-and-match approach depending on what your body is doing. The topics of painful sex, vaginal and urinary symptoms, libido, testosterone, mood changes, bleeding, and the very real mental load of midlife all come up too.  Here's the hot take: perimenopause is not one-size-fits-all, treatment may need to evolve as your hormones do, and "normal labs" or regular periods do not automatically mean your symptoms should be dismissed.  Consider this your permission slip to ask better questions, explore your options, and expect care that actually listens to what your body is telling you. Links: mymonarchhealthco.com @jackiep_gynnp on IG https://ww@monarchhealthclinicianacademy on IG   About Our Guest: Dr. Jackie Piasta is a Doctor of Nursing Practice, Women's Health Nurse Practitioner and a nationally recognized expert in perimenopause and menopause care, with a career spanning 16 years in women's health. She is the founder of Monarch Health, a specialty midlife women's health practice, and Monarch Health Clinician Academy, a CME-accredited training program that has educated hundreds of clinicians in evidence-based midlife and menopause care. She serves on the Medical Advisory Committee for the National Menopause Foundation and contributes to national professional organizations, including The Menopause Society, the National Association of Nurse Practitioners in Women's Health, and the International Society for the Study of Women's Sexual Health. She speaks nationally on women's health topics and most recently chaired NPWH's annual Virtual Menopause Summit. She is also adjunct faculty at Vanderbilt University School of Nursing, where she lectures on menopause care for women's health nurse practitioner students. Dr. Piasta was awarded the Excellence in Leadership and Innovation Award from Frontier Nursing University in recognition of her contributions to menopause education and clinical leadership. In 2025, she was inducted into the inaugural Fellow class of the National Association of Nurse Practitioners in Women's Health. Her work bridges advanced clinical practice, clinician education, and national advocacy. More about the hosts of Labia Logic: Dr. Ashley Fuller is a Sexual Medicine Gynecologist and Vulvar Specialist in Seattle, WA.  www.ashleyfullermd.com https://www.ashleyfullermd.com/labia-logic-podcast Dr. Meredith McClure is a Menopause Specialist, Sexual Medicine Gynecologist, and Vulvar Specialist in Dallas, TX. www.meredithmccluremd.com Follow the show on Instagram @labia_logic    This episode was produced by Audiotocracy Podcast Production.  

Water? Green light. Vaginal steaming? Hard red. Boric acid? Well… that depends. The internet has no shortage of products promising to clean, balance, freshen, moisturize, tighten, detox, or otherwise "fix" your vulva and vagina.  But which ones are actually helpful? And which ones would your vulva very much like to be excluded from? In this episode of Labia Logic, Dr. Ashley Fuller and Dr. Meredith McClure play a round of Red Light, Green Light: Vulvar Edition, sorting common vulvar and vaginal products and habits into the good, the questionable, and the please-don't. They cover everything from gentle cleansing, lube, moisturizers, vaginal estrogen, and bidets to boric acid, probiotics, period products, wipes, shaving, tight workout clothes, douching, fragranced products, vaginal steaming, Vagisil, and the dreaded one-day Monistat. These docs want you to remember: your vagina is self-cleaning, your vulva doesn't need to smell like a spa, and more products definitely doesn't mean better care. No matter what TikTok tells you. Labia Logic – The Clinical Course – Meredith McClure MD   More about the hosts of Labia Logic: Dr. Ashley Fuller is a Sexual Medicine Gynecologist and Vulvar Specialist in Seattle, WA.  www.ashleyfullermd.com  Dr. Meredith McClure is a Menopause Specialist, Sexual Medicine Gynecologist, and Vulvar Specialist in Dallas, TX. www.meredithmccluremd.com   Follow the show on Instagram @labia_logic    This episode was produced by Audiotocracy Podcast Production.  

What actually happens to the vulva and vagina after giving birth? How long does it take for swelling, bleeding, dryness, and soreness to improve? And when are postpartum symptoms a normal part of healing versus a reason to call your doctor? In Labia Logic Gets Knocked Up: Postpartum Edition, Dr. Ashley Fuller and Dr. Meredith McClure get candid about what recovery really looks like after a vaginal delivery or C-section. They explain postpartum hormone changes, vaginal tearing and stitches, urinary leakage, pelvic floor trauma, painful sex, breastfeeding-related vaginal dryness, and the many pads, ice packs, and sitz baths involved in welcoming both a baby and a temporarily unfamiliar vulva. Listeners will learn what to expect during the first six weeks postpartum, why vaginal estrogen may help with dryness and discomfort, and how pelvic floor physical therapy can support healing from incontinence, pelvic pain, prolapse, and pubic bone separation.  The doctors also discuss granulation tissue, resuming sex, postpartum contraception, mood changes, anxiety, depression, and why asking for help is an essential part of recovery—not a sign that your body has failed. Labia Logic – The Clinical Course – Meredith McClure MD More about the hosts of Labia Logic: Dr. Ashley Fuller is a Sexual Medicine Gynecologist and Vulvar Specialist in Seattle, WA.  www.ashleyfullermd.com   Dr. Meredith McClure is a Menopause Specialist, Sexual Medicine Gynecologist, and Vulvar Specialist in Dallas, TX. www.meredithmccluremd.com   Follow the show on Instagram @labia_logic    This episode was produced by Audiotocracy Podcast Production.  

swelling, discharge, pressure, and occasional "lightning crotch"? Is all that extra sensitivity normal? And when should a change actually earn a call to your OB? In the Pregnancy Edition of Labia Logic Gets Knocked Up, Dr. Ashley Fuller and Dr. Meredith McClure explain how pregnancy hormones, increased blood flow, pelvic pressure, and a rapidly changing body can affect the vulva and vagina. From darker or swollen labia and vulvar varicose veins to yeast infections, hemorrhoids, pelvic floor changes, and pregnancy discharge, the hosts share candid answers with their usual mix of medical expertise, reassurance, and zero shame. Ashley and Meredith cover which vulvar and vaginal changes are common during pregnancy, why estrogen and progesterone deserve some of the blame, and what can help ease throbbing, pressure, constipation, and discomfort.  They also cover sex during pregnancy, safe treatment options for vaginal infections, herpes management before delivery, and warning signs that should be evaluated by a medical provider.   Labia Logic – The Clinical Course – Meredith McClure MD More about the hosts of Labia Logic: Dr. Ashley Fuller is a Sexual Medicine Gynecologist and Vulvar Specialist in Seattle, WA.  www.ashleyfullermd.com Dr. Meredith McClure is a Menopause Specialist, Sexual Medicine Gynecologist, and Vulvar Specialist in Dallas, TX. www.meredithmccluremd.com Follow the show on Instagram @labia_logic  This episode was produced by Audiotocracy Podcast Production.  

Why do men get decades of sexual-health innovation while women are still told to wait, cope, or buy something vaguely "wellness-adjacent" from their social media feed? And why are conditions that affect quality of life, relationships, pleasure, and reproductive health still treated like optional extras instead of actual healthcare? Sabrina Martucci Johnson, founder and CEO of Daré Bioscience, joins this episode of Labia Logic to talk about the costly, complicated, and long-overdue work of developing better treatments for women. Sabrina explains why she founded Daré, how women's health receives only a fraction of private healthcare investment, and why existing science can often be reformulated into solutions designed specifically for female bodies. Sabrina also shares what Daré is developing next, including a monthly vaginal ring for menopause hormone therapy, a hormone-free contraceptive, and a vaginal antiviral treatment for high-risk HPV. Because women's health is not niche. It is essential, overdue, and worth doing right. Links: darebioscience.com Instagram @darebioscience TikTok @sabrinadareceo LinkedIn @sabrina-martucci-johnson   About Our Guest: Sabrina Martucci Johnson doesn't just talk about the gap in women's health – she's working to close it. In 2015 she founded Daré Bioscience on a straightforward thesis: the science exists, the need is real, and the market is massive. What's been missing is execution. Under her leadership, Daré has built a pipeline of first-in-category product candidates spanning contraception, sexual health, menopause, vaginal health, and infectious disease, and is now bringing them to market. Sabrina's edge is the combination of scientific credibility and commercial discipline. She started as a research scientist at Baxter Healthcare, moved through commercial and financial leadership at Cypress Bioscience (NASDAQ:CYPB) and WomanCare Global (as both CFO and COO), and built Daré from the ground up. She understands the biology, controls the financials, and knows how to launch. That trifecta is uncommon in any CEO. In women's health, it's nearly singular. She holds degrees in Biomedical Engineering (Tulane), Biochemical Engineering (University College London), and International Management (Thunderbird). She serves on the boards of AtaiBeckley, Biocom California (as chair), and BIO. Her work has been recognized by Ernst & Young Entrepreneur of the Year (Pacific Southwest), Fierce Pharma's Most Influential People in Biopharma, the Medicine Maker Power List, and Endpoints Women in Biopharma. Women's health has been underfunded, understudied, and underestimated for decades. Sabrina Martucci Johnson is doing something about it. More about the hosts of Labia Logic:Dr. Ashley Fuller is a Sexual Medicine Gynecologist and Vulvar Specialist in Seattle, WA. www.ashleyfullermd.com Dr. Meredith McClure is a Menopause Specialist, Sexual Medicine Gynecologist, and Vulvar Specialist in Dallas, TX. www.meredithmccluremd.com Follow the show on Instagram @labia_logic This episode was produced by Audiotocracy Podcast Production.