Dr Rachel Rubin: "I'm Filled With Rage!" Your Doctor Was Never Taught About Women's Bodies!

“That's what we have the most evidence for. And then the fourth thing is vaginal hormones. Now, vaginal hormones are micro doses of estrogen or what we call DHEA vaginally that supports the bladder and the vagina. So it helps with pain with sex, dryness, urinary frequency, urinary urgency, leakage, and it prevents urinary tract infections massively.”

“And this prevents those problems in those people too. And what is this? So vaginal hormones. So this is a really important topic. It's called genitourinary syndrome of menopause or GSM. Say GSM loudly for your listeners. GSM. GSM, genitourinary syndrome of menopause.”

“And so, we know women who are sexually active also have an increased risk of urinary tract infections. So, again, like a plant needing water, vaginal hormones help support the vagina and the bladder to maintain that acidic environment. And research has been clear since the 1990s that using vaginal hormones prevent UTIs, urinary tract infections, by more than half.”

“So, what have we got here in front of me? All right, so there's a bunch of different ways you can give yourself vaginal hormones. The most common way is a cream. Now, this cream is $14 on Mark Cuban's pharmacy, and it lasts about two and a half months.”

“And so, they do make pills, but it's a small, these things are small things that help. Drinking lots of water can help, but vaginal hormones, vaginal estrogen or vaginal DHEA, which we just showed a bunch of, prevent UTIs by more than half. They don't just prevent UTIs, they help with urinary frequency, urgency, leakage, pain with sex.”

“If you've had cancer, blood clot, stroke, any problems at all, vaginal hormones are safe and could save your life. And so, this is such an important topic. My partner's 33 years old now, she's not yet in the perimenopause stage.”

“And so, there's all sorts of hormonal changes that can happen at that time. So, we see a big need for vaginal hormones in this patient population. It's safe for the breast milk, it's safe for the baby, it doesn't cause any problems, but it can really help with all of those symptoms. Now, say she is done having babies, and now she's 38, 39, 40, and she is doing fine and she has regular”

“doesn't feel, it sort of feels like back when it did on birth control pills. That may be an indication where she may benefit from whether it's testosterone or vaginal hormones or some kind of combination. What if she's 43 and her sleep starts to get really bad?”

“I shared data and papers and we did a shared discipline. We just worked with each other. And I wasn't pushing anything on her, but ultimately she started with vaginal hormones. Her orgasms come back. Her arousal gets back and she comes back to see me and says, Ruben, what are you doing here? I'm feeling much better.”

“That's what we have the most evidence for. And then the fourth thing is vaginal hormones. Now, vaginal hormones are micro doses of estrogen or what we call DHEA vaginally that supports the bladder and the vagina. So it helps with pain with sex, dryness, urinary frequency, urinary urgency, leakage, and it prevents urinary tract infections massively.”

“And so, there's just different, it's all the same stuff, it's just in different formulations. Now, the one different one, this is something called DHEA. Now, DHEA is the precursor hormone to estrogen and testosterone. And remember, I said the vulva, the vagina, the bladder need testosterone too.”

“So, this is a chemical that converts into estrogen and testosterone. And so, DHEA is a supplement you can buy, you know, sort of in the supplement aisle. But if you put it locally in the vagina, this is an FDA approved product, it's called intrarosa. And if you just put this in the vagina, it's meant for every night, but you can do it twice a week.”

“a small, these things are small things that help. Drinking lots of water can help, but vaginal hormones, vaginal estrogen or vaginal DHEA, which we just showed a bunch of, prevent UTIs by more than half. They don't just prevent UTIs. They help with urinary frequency, urgency, leakage, pain with sex.”

“women? Pee after sex, wipe from front to back. Like that's not data driven, by the way. That's all a folk tale. Like that's, that's folklore. There is some data that cranberry, pills can help with preventing UTIs, but the amount that you'd have to drink is very sugary and diabetes inducing and wouldn't taste that good.”

“cream called? It's Estradiol cream. Estradiol. Take it on your finger, you rub it inside the walls of the vagina. And just rub it in like you would rub sunscreen on your face. And if you do that twice a week, you can prevent death from urinary tract infections. You can help with urinary frequency, urinary urgency, leakage.”

“now if you really dont want do anything twice a week, this is a ring that goes in the vagina and it can stay in there for three months... and theres a chemical inside this ring that going to diffuse out. Estradiol, that slowly diffuses estrogen.”

“the disastrous side effects. That's why on the commercials, they talk about all the disastrous side effects. But often they don't even research the sexual side effects. So, for example, GLP-1s, OK? What's a GLP-1? Yeah. The GLP-1s are the weight loss drugs that everybody's talking about. Ozempic, Mounjaro, all the celebrities are on these injections that are making them lose tons of weight.”

“But if you put it locally in the vagina, this is an FDA approved product. It's called Intrarosa. And if you just put this in the vagina, it's meant for every night, but you can do it twice a week.”

“OK? What's a GLP-1? Yeah. The GLP-1s are the weight loss drugs that everybody's talking about. Ozempic, Mounjaro, all the celebrities are on these injections that are making them lose tons of weight. We are starting to look at these drugs in women, but they're not, nobody's looking at it for sexual health.”

“OK? What's a GLP-1? Yeah. The GLP-1s are the weight loss drugs that everybody's talking about. Ozempic, Mounjaro, all the celebrities are on these injections that are making them lose tons of weight. We are starting to look at these drugs in women, but they're not, nobody's looking at it for sexual health.”

“Oh, here we go. Okay. So this is vibrating now. So this one, this kind of device is interesting because it is a wand that can help just like with trigger points. So if you have pain in these muscles, this can go inside, vibrate to help with engorgement, also get rid of some of the tension in some of those muscles.”

“a small, these things are small things that help. Drinking lots of water can help, but vaginal hormones, vaginal estrogen or vaginal DHEA, which we just showed a bunch of, prevent UTIs by more than half. They don't just prevent UTIs. They help with urinary frequency, urgency, leakage, pain with sex.”