Ageless and Outrageous

Today I sit down with Dr. Alicia Robbins to discuss the critical need for better education and support for women in perimenopause and menopause. Dr. Robbins shares how her background as a general OB/GYN led her to realize that many women in their late 30s and 40s were struggling with symptoms like sleep disturbances, mood swings, and weight gain—yet traditional training left her without the right tools to help them. Together, they break down the misinformation surrounding hormone therapy and why menopause care needs to be a recognized specialty.

Tune in as we explore:

• The lack of perimenopause education in traditional medical training
• Why hormone therapy is often misunderstood and underutilized
• How women can advocate for themselves when their doctors dismiss menopause symptoms
• The importance of sleep and how hormones impact mood, weight, and long-term health
• Why today’s women are demanding better menopause care compared to previous generations

This episode is essential listening for women of all ages—whether you’re approaching menopause, in the midst of it, or just want to be better prepared for what’s ahead. 🎧🔥

Dr Alicia Robbins is a board-certified OBGYN, menopause practitioner and lifestyle medicine doctor. Originally from southern Arizona, she completed her undergraduate studies at Vanderbilt University and graduated medical school and residency at Mount Sinai Hospital in New York City.

She then worked at Mount Sinai Hospital in New York City as a full-time faculty member and received several teaching awards during her time there. In addition to teaching residents, she sat on the admission committee at Mount Sinai. 

Once she turned 40, she realized there was not a lot of guidance for women in their 40s and 50s on how to optimize health and feel better.

After more than decade in NYC, she and her husband and moved to Greenwich, CT where she has been working for 5 years performing obstetrics and surgery at Greenwich Hospital. She is a certified Peri/Menopause Practitioner and a Lifestyle Medicine physician. She speaks regularly on women's health and has been featured in Allure Magazine, The New York Times, ABC channel 7, Parents magazine and several podcasts. 

She is married to Dr. Tarek Korban, an oral-maxillofacial surgeon in NY and is the mother of 3 young boys. She is an active member of her community and is passionate about supporting the women in her community and especially hte female-founded local businesses. She cherishes spending time with her family and friends and tries to remember that the simple things in life bring the most pleasure. 

Follow Dr Robbins on social:

Intstagram: https://www.instagram.com/aliciarobbinsmd/

Facebook: https://www.facebook.com/people/The-Elm-Greenwich/61552052893831/

Visit Dr Robbins at her practice, The Elm, in Greenwich, CT: https://theelmgreenwich.com/

Thank you Dr Robbins for your amazing information!

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Listen in as Dr. Jackson and Dr. Krapf discuss:

• The lack of education around vulvar and vaginal disorders in traditional OB/GYN training
• What genitourinary syndrome of menopause (GSM) is and why it’s more than just vaginal dryness
• The autoimmune nature of lichen sclerosis and how to manage it properly
• The role of testosterone in female sexual health and how it impacts the vulva
• How to advocate for better vulvar care and find a specialist for chronic pain conditions

This episode is a must-listen for anyone experiencing vaginal discomfort, pain, or hormonal changes—or for those looking to better understand how to optimize their sexual health at any age. 🎧✨

Dr. Jill Krapf is a board-certified Obstetrician Gynecologist specializing in female sexual pain disorders and Director of the Center for Vulvovaginal Disorders Florida in Tampa, Florida, USA.  She is active in research and has published chapters and peer-reviewed articles on vulvodynia and vulvar lichen sclerosus.  She is Associate Editor for the medical journal Sexual Medicine, as well as for the textbook Female Sexual Pain Disorders, 2nd Edition.  She is a Fellow of the International Society for the Study of Vulvovaginal Disease (ISSVD) and a Fellow and Board Member of the International Society for the Study of Women’s Sexual Health (ISSWSH), serving on the Education Committee and Chair of the Social Media Committee.  Dr. Krapf is a co-author on the trade book “When Sex Hurts: Understanding and Healing Pelvic Pain.” She shares educational content on social media @jillkrapfmd.

Jill Krapf MD

Center for Vulvovaginal Disorders Florida

3216 W Azeele St., Suite 2

Tampa, Florida 33609

[email protected]

813-358-7634

When Sex Hurts: Understanding and Healing Pelvic Pain

(sale proceeds go directly to the National Vulvodynia Association to support research)

https://www.hachettebookgroup.com/titles/andrew-goldstein-md/when-sex-hurts/9780306827419/?lens=balance

Female Sexual Pain Disorders: Evaluation and Management

https://onlinelibrary.wiley.com/doi/book/10.1002/9781119482598

ISSWSH 2024-25 Virtual Genitopelvic Pain Course

https://www.isswshcourse.org/genitopelvic-pain-course-2024-25

Thank you to Dr Krapf for sharing her expertise!

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In this powerful episode, Dr. Kristin Jackson sits down with breast surgeon and fitness advocate Dr. Devina McCray. Dr. McCray shares her personal journey from being an overworked physician struggling with her health to becoming a competitive bodybuilder. She dives into how muscle-building is essential for longevity, cancer prevention, and overall health—especially for women.

Tune in as Dr. McCray and Dr. Jackson discuss:

• The rising rates of breast cancer and why it affects even those without risk factors
• How lifestyle choices, including diet and exercise, can dramatically reduce cancer risk
• The connection between strength training, metabolism, and hormone balance
• Why building muscle is the key to aging well and preventing osteoporosis, falls, and frailty
• Practical tips for incorporating strength training into any lifestyle—whether you’re a beginner or looking to push your limits

This episode is a must-listen for anyone looking to take control of their health and age with strength, confidence, and resilience! 🎧💪

Devina McCray, MD, is a breast surgical oncologist who is board certified in general surgery. She specializes in benign and malignant breast disease. Her areas of surgical expertise include breast conservation surgery, sentinel lymph node biopsy, axillary node dissection, skin and nipple sparing mastectomy, oncoplasty, and intraoperative radiation therapy (IORT). Dr. McCray received her medical degree from the University of Colorado Health Sciences Center, School of Medicine. Her residency in general surgery was completed at Florida Hospital Orlando, followed by a fellowship in breast surgical oncology at the Cleveland Clinic in Ohio. She is a member of the American Society of Clinical Oncology, the American Society of Breast Surgeons, and the Society of Surgical Oncology.

Thank you Dr McCray for sharing your insights!

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The podcast discusses challenges of experiencing painful intercourse and how it can be treated effectively. It raises the importance of conversation about sexual health in medical settings and sheds light on genitourinary syndrome of menopause, a common issue affecting post-menopausal women related to the ageing process.

Want to consider non-medication options to improve painful intercourse? Check out the options here: https://www.foundationsfl.com/vaginal-rejuvenation

Or consider options to strengthen and enhance orgasm here: https://www.foundationsfl.com/orgasmenhancement

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Let’s talk about the pelvic floor—one of the most important and misunderstood muscle groups in the body. In this episode, I’m dicussing everything you need to know about your pelvic floor: what it is, what it does, and why it’s crucial to your overall health. Whether you’re dealing with postpartum changes, menopause symptoms, or just want to understand your body better, this episode is for you.

I’ll share insights into common pelvic floor issues, like urinary incontinence, bowel problems, and painful intercourse, and explain how life stages like childbirth and aging impact these muscles. We’ll also talk about practical solutions, including when to seek pelvic floor therapy, how to do Kegels correctly (spoiler: they’re not for everyone!), and the role of lifestyle changes. This episode will empower you to take control of your pelvic health and improve your quality of life.

• What is the pelvic floor? A breakdown of its anatomy and functions.
• Common pelvic floor issues: Including urinary incontinence, bowel dysfunction, painful intercourse, and prolapse.
• The role of life stages: How childbirth, menopause, and aging impact pelvic floor health.
• Pelvic floor dysfunction vs. muscle strength: How to identify weak or tight pelvic floor muscles.
• Pelvic floor therapy: When to seek physical therapy and what it involves.
• Kegels and beyond: A guide to exercises that strengthen (or relax) the pelvic floor.
• Lifestyle factors: The importance of diet, hydration, posture, and stress management.
• Misconceptions about pelvic floor health: Debunking myths and addressing the stigma.

Whether you’re looking to address a specific issue or simply want to stay informed, this episode empowers listeners to prioritize their pelvic floor health for improved quality of life.

Learn more about therapy with the Emsella chair here: https://www.foundationsfl.com/btl-emsella

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In this episode, I’m looking into a topic that’s close to my heart: the safety of testosterone therapy for women. I’ll share the latest research showing how testosterone improves quality of life, libido, cardiovascular health, and even bone and brain health—all without increasing risks like breast cancer or cardiovascular events. If anything, the data points to some surprising benefits that could make a huge difference, especially when therapy starts early.

I’ll also address misconceptions, like the so-called “lack of safety data” often cited by critics, and unpack why the timing of therapy plays such a crucial role in its effectiveness. If you’ve ever wondered whether testosterone therapy might be right for you, or if you’re just curious about the science, this episode has answers you won’t want to miss.

Key Takeaways from This Episode:

• Testosterone therapy is not only safe for women but has proven benefits for libido, heart health, and more.
• Long-term studies show no increased breast cancer risk and even suggest potential reductions.
• Starting hormone replacement therapy earlier leads to better outcomes, supporting the "timing hypothesis."
• Current FDA-approved options for women are limited, but working with a specialist can help you find the best personalized approach.

If you’ve been on the fence about hormone therapy or just want to learn more, this episode is packed with evidence, insights, and a little dose of my usual candor. Let’s break it all down together!

Learn more about testosterone replacement therapy here: https://www.foundationsfl.com/testosterone-pellet-therapy-orlando

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In this episode, I tackle the uncomfortable yet important topic of recurrent urinary tract infections (rUTIs), a challenge many women face. I draw on my 25 years of expertise to explain the causes, symptoms, and cutting-edge diagnostic tools for managing rUTIs effectively. I dispels common myths, highlights the limitations of traditional urine cultures, and discusses the potential role of advanced molecular testing.

Key topics in this episode:

The Basics:

• What qualifies as a recurrent UTI (rUTI).
• Differences between persistent infections and rUTIs.
• How UTI symptoms evolve with age and menopause.

Testing Options:

• Urine dipsticks, microscopy, and the limitations of traditional urine cultures.
• Benefits and use of molecular (PCR) testing.
• Challenges of clean-catch urine samples versus catheterized urine specimens.

Revolutionizing UTI Management:

• The importance of treating active infections before switching to prevention.
• Understanding biofilms and their role in recurrent infections.
• Suppressive antibiotics: how low doses work to prevent recurrence.

Myth-Busting Common UTI Advice:

• Why urinating before and after sex doesn't prevent UTIs.
• The lack of evidence supporting cranberry products and probiotics for prevention.
• Debunking the importance of wiping direction.

Prevention Strategies:

• The role of vaginal estrogen in reducing rUTIs, particularly for menopausal women.
• Why systemic estrogen may not suffice for vaginal and bladder health.
• Practical hydration tips and the link between sugar intake and infections.

The Future of UTI Care:

• Antibacterial stewardship and avoiding overuse of antibiotics.
• How advanced testing and emerging research may reshape UTI treatment.

From the importance of personalized care to practical strategies for prevention, including the game-changing benefits of vaginal estrogen, Dr. Jackson emphasizes empowering women with accurate information and effective solutions. Tune in for science-backed advice and tips to keep your bladder healthy and your holidays UTI-free!

With Dr. Jackson's expertise, you’ll walk away with the knowledge to tackle rUTIs confidently and stay healthy through the holidays and beyond.

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In this episode, I discuss the fascinating world of muscle health, exploring why muscle is not just about strength but also a critical component of long-term vitality. From the biology behind muscle growth to its surprising role in hormone regulation, aging, and even metabolism, this conversation is packed with insights that will change how you think about fitness and health. We discuss the natural decline of muscle mass with age, its impact on overall health, and actionable strategies to maintain and rebuild it—whether you're in your 30s, 50s, or beyond.

Key points in this episode:

The Importance of Muscle Health

• Muscle as a key to strength, metabolism, and overall vitality.
• The role of muscle in aging well and maintaining independence.
• The impact of sarcopenia (age-related muscle loss) on health and mobility.

How Muscle Functions Beyond Strength

• Muscle’s role in calorie burning and blood sugar regulation.
• How muscle contributes to hormone production and immune function.

The Science of Muscle Growth

• Hypertrophy: How muscles grow through resistance training.
• The critical role of protein in muscle repair and maintenance.
• Factors influencing muscle growth, including exercise and nutrition.

Hormones and Muscle Health

• Testosterone’s role in muscle mass and strength.
• Estrogen’s influence on muscle recovery and function.
• Growth hormone’s contribution to tissue repair and muscle maintenance.

The Impact of Hormonal Decline

• How menopause and andropause accelerate muscle loss.
• The benefits of hormone replacement therapy (HRT) for muscle health.

Strategies to Build and Maintain Muscle

• The importance of regular strength training for all ages.
• Recommended protein intake for muscle repair and growth.
• Recovery practices like rest and sleep for optimal muscle function.
• The role of HRT in mitigating age-related muscle decline.

The Link Between Muscle and Longevity

• Muscle mass as a predictor of overall health and reduced chronic disease risk.
• Muscle’s role in supporting metabolism, mobility, and energy levels as we age.

Tune in to uncover expert tips on integrating resistance training, optimizing protein intake, and leveraging hormone therapies to maximize your muscle potential and longevity. Whether you’re looking to elevate your physical performance, improve your health outcomes, or simply age with strength and grace, this episode provides the roadmap to achieving it all. Don’t forget to subscribe and share with anyone who’s ready to take charge of their health!

Learn more about testosterone replacement therapy here: https://www.foundationsfl.com/testosterone-pellet-therapy-orlando

Need a muscle boost? Find out about the Emsculpt Neo machine in Dr J's blog here: https://www.foundationsfl.com/post/top-7-benefits-of-emsculpt-neo-treatment

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In this episode, I dive into a groundbreaking study featured in the prestigious Obstetrics and Gynecology (the Green Journal), which is the American Congress of Obstetricians and Gynecologists' leading publication. Join me as I explore the insights shared by two renowned experts, Dr. Barbara Levy and Dr. James Simon, on the evolving landscape of menopausal hormone therapy.

Key moments in this episode are:

• The Importance of Individualized Hormone Therapy: Tailoring formulations to meet specific patient needs.
• Advancements in Menopause Medicine: Exploring new approaches and updated recommendations for hormone therapy.
• The Role of Evidence-Based Care: How research empowers providers and patients to make informed decisions about menopausal health.
• Addressing Common Misconceptions: Breaking down myths and stigmas surrounding hormone replacement therapy.
• Why This Study Matters: The impact of this research on improving care for menopausal women.

Tune in to discover how these findings could redefine care for menopausal women and empower both patients and providers with evidence-based solutions. Whether you're a healthcare professional or someone curious about optimizing your wellness during menopause, this episode is packed with essential insights you won't want to miss!

Learn more about personalized menopausal care here: https://www.foundationsfl.com/bioidentical-hormone-optimization

Read Dr J's blog about Estrogen and Breast Cancer here: https://www.foundationsfl.com/post/estrogen-and-breast-cancer-dispelling-the-myths

And read my strong opinion about the WHI study here: https://www.foundationsfl.com/post/getting-rid-of-whi-once-and-for-all

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In this episode, I explore the complex relationship between menopause, hormone fluctuations, and mood disorders. I

Key Topics Covered:

• How estrogen and progesterone decline impacts neurotransmitters in the brain.
• The connection between menopause and increased risks of depression and anxiety.
• Role of estrogen in regulating serotonin, dopamine, and GABA to maintain mood stability.
• The HPA axis: how menopause amplifies stress response and cortisol levels.
• Estrogen's influence on neuroplasticity, neurogenesis, and cognitive function.
• Exploring neuroinflammation and oxidative stress in relation to menopause and mood disorders.
• Psychosocial factors and life stressors contributing to mood changes during menopause.
• Treatment options for mood disorders: SSRIs vs. hormone replacement therapy.
• Benefits of lifestyle modifications like exercise, stress management, and meditation.
• Why an individualized, holistic approach is crucial for treating menopause-related mood issues.
• The need for more long-term studies on hormone therapy’s impact on brain health and dementia risk.

Listen as I share insights on supporting mental and emotional well-being during menopause. Don't forget to follow for more expert insights into women's health and wellness!

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