Dr. Streicher’s Inside Information: Menopause, Midlife, and More

Women who are in the throes of menopause are never thrilled about having hot flashes, but they aren’t particularly surprised by them.  It’s other symptoms that often blindside women, including symptoms that are not often associated with menopause.
Esoteric symptoms are different than unusual symptoms. 
An unusual symptom is something that rarely occurs. An esoteric symptom, on the other hand, is one that occurs commonly, but is rarely discussed and often not well understood. 
My guest is Makeba Williams, MD, FACOG, MSCP a Professor of OB-GYN and the Director of the Center for Health Awareness and Research on Menopause at the University of Illinois
We discuss:

Tingling Skin

Other Skin Changes

Ringing in the Ears

Hearing Loss

Dry, Burning Eyes

Dry Mouth 

Facial Changes

Sleep Apnea

Voice Changes

Palpitations

Reflux, Bloating, Frequency of Bowel Movements

Arthritis/Joint Pain

Bladder Symptoms

For more information on post menopause hearing loss: Estrogen and Your Ears

For more information on post menopause dry mouth: Dry Mouth? I’m Doing Some Research

For more information on post menopause palpitations: Palpitations in Mid-life Women

For more information on post menopause gastrointestinal changes: Menopause and the Gut

COME AGAIN is a 30-part audio series to address the biological, hormonal, and medical issues that can sabotage your sex life. This solution-driven, science-based guide will help get your libido to kick in and your clitoral nerve endings to wake up.
For more information, go to DrStreicher.com/COMEAGAIN

Dr. Streicher is on SUBSTACK      DrStreicher.Substack.com

Articles

Monthly News Flash Reports on recent research 

Monthly Zoom Ask Me Anything Webinar

Lauren Streicher MD, is a clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine, the founding medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause, and a Senior Research Fellow of The Kinsey Institute, Indiana University. She is a certified menopause practitioner of The Menopause Society. 
Dr. Streicher is the medical correspondent for Chicago’s top-rated news program, the WGN Morning News, and has been seen on The Today Show, Good Morning America, The Oprah Winfrey Show, CNN, NPR, Dr. Radio, Nightline, Fox and Friends, The Steve Harvey Show, CBS This Morning, ABC News Now, NBCNightlyNews,20/20, and World News Tonight. She is an expert source for many magazines and serves on the medical advisory board of The Kinsey Institute, Self Magazine, and Prevention Magazine. She writes a regular column for The Ethel by AARP and Prevention Magazine. 
 
LINKS

Subscribe To Dr. Streicher’s Substack

Information About COME AGAIN

Dr. Streicher’s CV and additional bio information

To Find a Menopause Clinician and Other Resources

 Glossary Of Medical Terminology

Books by Lauren Streicher, MD
 

 Slip Sliding Away: Turning Back the Clock on Your Vagina-A gynecologist’s guide to eliminating post-menopause dryness and pain

Hot Flash Hell: A Gynecologist's Guide to Turning Down the Heat

Sex Rx- Hormones, Health, and Your Best Sex Ever

The Essential Guide to Hysterectomy

                                  
  Dr. Streicher’s Inside Information podcast is for education and information and is not intended to replace medical advice from your personal healthcare clinician. Dr. Streicher disclaims liability for any medical outcomes that may occur because of applying methods suggested or discussed in this podcast.
 
 
 

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Dr. Jen Ashton- you know her as the chief medical correspondent for ABC News and Good Morning America, who appeared in your home every morning, explaining the hot topics in health.  

Today, we talk about her pivot into her passion- fitness and wellness- and how to incorporate into the second half of your life..and love your age. 

How Dr. Ashton ended up as an anchor on Good Morning America

How she has reinvented herself as a wellness and obesity expert

We revisit “The Reinvention Convention we participated in years ago

The key traits of women who “Love their Age.”

Why Dr. Ashton is learning to play Mah Jong

How to plan for the second half of life

For women who don’t love their age, what should they accept and… not accept

Dr. Ashton’s Wellness Experiment

The difference between wellness and longevity

What most doctors get wrong about nutrition

The concept of “nutritional gynecology”

 “Super foods”

Menopause nutrition

Exercise after age 55- for the avid exerciser and the never excerciser

Why BAREFOOT Training is important

Dr. Jennifer Ashton is board-certified in OB-GYN and Obesity Medicine with a Master’s degree in Nutrition from Columbia University. She is the Founder and President of Ajenda, a multimedia health platform focused on science-driven metabolic and hormonal health for women. For 12 years, Dr. Ashton was seen by millions of people daily on national television as the  Chief Medical Correspondent for ABC News and co-host of  GMA3: What You Need to Know.  She was the first woman and only the third physician to hold that role in network history. 

https://www.instagram.com/drjashton/?hl=en
https://www.instagram.com/joinajenda/?hl=en
https://www.joinajenda.com/experiment

COME AGAIN is a 30-part audio series to address the biological, hormonal, and medical issues that can sabotage your sex life. This solution-driven, science-based guide will help get your libido to kick in and your clitoral nerve endings to wake up.

For more information, go to DrStreicher.com/COMEAGAIN

Dr. Streicher is on SUBSTACK      DrStreicher.Substack.com

Articles

Monthly News Flash Reports on recent research 

Monthly Zoom Ask Me Anything Webinar

Lauren Streicher MD, is a clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine, the founding medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause, and a Senior Research Fellow of The Kinsey Institute, Indiana University. She is a certified menopause practitioner of The Menopause Society. 

Dr. Streicher is the medical correspondent for Chicago’s top-rated news program, the WGN Morning News, and has been seen on The Today Show, Good Morning America, The Oprah Winfrey Show, CNN, NPR, Dr. Radio, Nightline, Fox and Friends, The Steve Harvey Show, CBS This Morning, ABC News Now, NBCNightlyNews,20/20, and World News Tonight. She is an expert source for many magazines and serves on the medical advisory board of The Kinsey Institute, Self Magazine, and Prevention Magazine. She writes a regular column for The Ethel by AARP and Prevention Magazine. 
 

LINKS

Subscribe To Dr. Streicher’s Substack

Information About COME AGAIN

Dr. Streicher’s CV and additional bio information

To Find a Menopause Clinician and Other Resources

 Glossary Of Medical Terminology

Books by Lauren Streicher, MD

 Slip Sliding Away: Turning Back the Clock on Your Vagina-A gynecologist’s guide to eliminating post-menopause dryness and pain

Hot Flash Hell: A Gynecologist's Guide to Turning Down the Heat

Sex Rx- Hormones, Health, and Your Best Sex Ever

The Essential Guide to Hysterectomy

                                  

  Dr. Streicher’s Inside Information podcast is for education and information and is not intended to replace medical advice from your personal healthcare clinician. Dr. Streicher disclaims liability for any medical outcomes that may occur because of applying methods suggested or discussed in this podcast.

Come Again: Sexuality and Orgasm, my solution-driven audio Series, for both non-healthcare professionals and healthcare professionals is now  available on demand on drstreicher.com. Subscribers get loads of supplementary guides and resources. Health care professionals have an option to purchase additional material on incorporating sexual medicine into their practice. 

For a 25% discount to the COME AGAIN Series, use code PODCAST25. This discount code expires December 21.

This episode is a free preview from COME AGAIN Episode 19

When it comes to testosterone, hairy guys with round the clock virility come to mind, thanks to those non-stop ads warning men of the dire consequences of "Low T". Not as well known is that TESTOSTERONE is not just a male hormone but is a HUMAN hormone that is just as important for women. 

In this episode:

·      The ROLE of testosterone in women

·      WHERE testosterone is normally produced 

·      The potential BENEFITS of taking testosterone 

·      How well testosterone therapy WORKS and why it doesn’t work in everyone

·      How to PREDICT if you will respond to testosterone therapy

·      What TESTS you should have prior to starting testosterone therapy

·      Why is SEX HORMONE BINDING GLOBULIN important? 

·      Why someone would have a HIGH SEX HORMONE BINDING GLOBULIN

·      Why the FDA has never approved testosterone for women

·      Why PELLETS are a PROBLEM

·      Why gels are the SAFEST and MOST EFFECTIVE form of testosterone for women 

·      The potential SIDE EFFECTS of testosterone therapy

At my monthly Ask Me Anything Webinars,  I always get questions about hormone therapy- when to start, when to stop, if the dose should be changed as women get older, and what to do if someone continues to have symptoms or continues to bleed… 

In this episode, Dr. Risa Kagan and I answer submitted questions. 
We start by briefly running through the established indications for starting menopausal hormone therapy (MHT), and then Dr. Kagan and I discuss the “what ifs” of hormone therapy.  

Do you have to wait for 12 months without a period before starting MHT?

If someone is taking birth control pills for control of perimenopause symptoms, at what point should they go off? And can they immediately transition to MHT or do they need to take a break and make sure they are no longer making estrogen?

A  woman with severe hot flashes is having all day, all night hot flashes- how long is it going to take to get some relief? 

Does it matter if it is oral or transdermal as far as the onset of action? 

What are the chances of getting 100% relief?  

If someone has started MHT but is still having flashes, how long should they wait before adjusting it? 

What is the best starting dose if someone has severe flashes? High or low?

A woman wrote in that she has been using a 0.75 patch, but continues to have severe flashes.  She got a serum level, and it is 10. Her doctor is reluctant to increase her dose. What would you tell her?

A woman has tried four different protocols and has nuisance bleeding with all.  She had an ultrasound and biopsy, and it was all normal. She wants to continue MHT, but is tired of the bleeding. She wants to know which protocol is the least likely to cause bleeding

An internist told a woman that after 5 years, it is time to go off her MHT. 

What about if she is primarily taking it for hot flashes- how likely is it that her hot flashes will return? 

What about if she is primarily on it for bone health (known osteopenia) and joint pain-?

What about if she is primarily taking it for sexual benefits? (Libido, lubrication, orgasm) ?

What about if she is primarily taking it because she is worried about dementia

A woman decided to go off HT since she was only taking it for hot flashes and is now 10 years out. Her manicurist told her that she should taper; otherwise, her flashes will come back. Her gyne says, stop. What does Dr. Kagan say?

A 60 year old woman started estrogen when she had a hysterectomy and ovary removal. She was told by her internist that there is no way she will still be having hot flashes in her 60s, and therefore no reason to continue her estrogen. Is that correct? What is the likelihood that she will still be having hot flashes in her 60s or 70s? 

The next question is from a woman who increased her oral estradiol to 2 mg to get rid of her flashes,  but is still taking her original Prometrium dose 100 mg. Is that enough to protect the lining of her uterus? When do you increase it?

A question from a Substack reader- “I used estradiol gel for 8 years at the start of menopause. I decided to stop it and did so for 3 years; however, my hot flashes (sleep, mood, etc) were relentless and violent. I decided to start again after a 3-years hiatus and at the age of 65. I feel so much better. Is this a problem having stopped and then started again a few years later?” 

How can you tell the effectiveness of the HRT you're taking (other than no more hot flashes?) I still feel lack of motivation, low libido, joint aches and I'm so much slower running (1 min+/mile).  (What this really comes down to, is what are realistic expectations for what HT will do?) 

How long can a postmenopausal woman stay on testosterone, estrogen and Progesterone? 

Let’s say a woman has been using a .05 estradiol patch but her skin is really irritated and has decided to try the spray instead.  What is the equivalent dose?

A woman with a hysterectomy who is taking estrogen alone has been taking a 1 mg estradiol pill. She has decided to switch to conjugated equine estrogen since she would like breast protection.  Is that correct thinking? If she is going to make the switch, what is the equivalent dose? 

A 51 year old is no longer having hot flashes but wants to continue her transdermal estrogen since she has low bone mass and is worried about progression to osteoporosis. What is the minimum dose of estradiol to ensure that she is getting maximum bone protection? 

Many questions came in about initiating hormone therapy after age 65...

Dr. Risa Kagan is a Clinical Professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the University of California, San Francisco, and a consulting gynecologist with Sutter Health. 

Other episodes with Dr. Kagan

Episode 114- Is Duovee the Ideal Hormone Therapy?
Episode 175 Your Bones On and Off Estrogen

When an IUD is Your Post Menopause Plan

In case you missed it, last week was quite the week in the menopause world. The FDA made a landmark decision to remove all black box warnings from estrogen products and to update the labels of individual products. I was in the room where it all happened and in this episode, I’m going to break it all down for you. But here’s the headline- this label change is overall, a good thing, a very good thing.

A transcript of this podcast, along with photos and graphics, can be found on DrStreicher.Substack.com

In this episode: 

A historical perspective of how the Black Box label came to be on all estrogen products

A review of the Women’s Health Initiative Study  (WHI) that lead to the specific warnings on the label. 

The fall out from the release of the WHI

The Problems with the Black Box label on estrogen products

Class Labeling

The difference between oral, transdermal and local vaginal estrogen. 

How the required black box label influenced the likelihood of physicians writing a prescription for estrogen, and the likelihood that women would use hormone therapy. 

Why I never stopped prescribing estrogen

Last week’s announcement from the FDA

If it is medically appropriate to remove the black box warning from local vaginal estrogen

If it is medically appropriate to remove the black box warning from systemic estrogen

The inaccurate messaging during the FDA press conference

The POLITICS  of WHY the FDA removed the Black Box warnings

Related Podcasts: 

Episode 124 All Hormones Are Not Created Equal with Dr. James Simon

Episode 164 Is Bioidentical Always Best?

Episode 181 The FDA Roundtable on Menopausal Hormone Therapy

Related Substack Articles

Top 20 Questions about Local Vaginal Estrogen

Is Bioidentical Always Best?

BLOOD CLOTS and ESTROGEN: The Facts

Crises at the FDA

Why RFK is a Scary Choice for HHS

Dr. Streicher is on SUBSTACK      DrStreicher.Substack.com

Articles

Monthly newsletter

All COME AGAIN podcast episodes

Monthly News Flash Reports on recent research 

Monthly Zoom Ask Me Anything Webinar

 
 Information on Dr. Streicher's COME AGAIN Podcast- Sexuality and Orgasm
 
 

Lauren Streicher MD, is a clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine, the founding medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause, and a Senior Research Fellow of The Kinsey Institute, Indiana University. She is a certified menopause practitioner of The Menopause Society. S
 

Dr. Streicher is the medical correspondent for Chicago’s top-rated news program, the WGN Morning News, and has been seen on The Today Show, Good Morning America, The Oprah Winfrey Show, CNN, NPR, Dr. Radio, Nightline, Fox and Friends, The Steve Harvey Show, CBS This Morning, ABC News Now, NBCNightlyNews,20/20, and World News Tonight. She is an expert source for many magazines and serves on the medical advisory board of The Kinsey Institute, Self Magazine, and Prevention Magazine. She writes a regular column for The Ethel by AARP and Prevention Magazine. 
 

LINKS

Subscribe To Dr. Streicher’s Substack

Information About the COME AGAIN Podcast

Dr. Streicher’s CV and additional bio information

To Find a Menopause Clinician and Other Resources

 Glossary Of Medical Terminology

Books by Lauren Streicher, MD
 

 Slip Sliding Away: Turning Back the Clock on Your Vagina-A gynecologist’s guide to eliminating post-menopause dryness and pain

Hot Flash Hell: A Gynecologist's Guide to Turning Down the Heat

Sex Rx- Hormones, Health, and Your Best Sex Ever

The Essential Guide to Hysterectomy

                                  

 
  Dr. Streicher’s Inside Information podcast is for education and information and is not intended to replace medical advice from your personal healthcare clinician. Dr. Streicher disclaims liability for any medical outcomes that may occur because of applying methods suggested or discussed in this podcast.