What happens when your family stages an intervention because they've been avoiding you 10 days every month?

I'm sharing the story of a patient who had a complete breakdown at Christmas dinner. She snapped at her husband, her kids, her mom, her in-laws—everyone. A few hours later, her family told her: "We love you, but for 10 days every month, we actively avoid you."

She came to me asking: Am I bipolar? Am I manic? What's happening to me?

This is PMDD premenstrual dysphoric disorder. And when it collides with perimenopause, it becomes a perfect storm. This is not just PMS. This isn't you being dramatic. It's a real biochemical thing happening in your brain an abnormal response to normal hormonal changes.

I discuss the science of PMDD: how GABA receptors respond to progesterone metabolites, why some brains are change sensitive, and why the hormonal volatility of perimenopause (erratic estrogen, declining progesterone, unpredictable timing) makes everything exponentially worse. I explain treatment options from luteal-phase SSRIs to Yaz to Duavee for refractory cases, and why tracking your symptoms for at least two cycles is critical for diagnosis.

Highlights:

1. Why "I feel like I'm watching myself burn down my life and can't stop it" is the hallmark of PMDD.
2. The DRSP tracking tool: why you need 2 cycles to diagnose PMDD properly.
3. Why Vitex (chasteberry) might help mood swings and breast pain.
4. What Duavee is and why it works for women who can't tolerate progestins.
5. Why Dr. Tammy Rowan calls PMDD a progesterone sensitivity issue.
6. Ulipristal: the emergency contraception drug being studied for PMDD.

If you've ever felt like your brain gets hijacked on a schedule, if you've felt completely out of control, this episode is for you. Track your symptoms. Find a clinician who takes cyclic mood symptoms seriously. You don't have to live like this. Please share this episode with someone you know might be experiencing this or a clinician you think would benefit from it.

Resource:

DRSP

Dr. Tami Rowen

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GSM Collective

The GSM Collective - Chicago

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What does it mean when 6,000 women a day enter menopause but there are only 4,100 certified clinicians to treat them?

In this year end solo episode, I'm reflecting on 2025 in women's health.

It was a year that felt heavy at the start personally for me after losing my mother, and globally with so much suffering and injustice. But even in all of that, women's health moved forward in meaningful ways. Not perfectly. Not fast enough. But enough that it deserves reflection.

I'm covering the moments that shifted conversations this year from the FDA removing the black box warning on estrogen to new cervical cancer screening guidelines allowing self-collection HPV tests. From Addyi finally being approved for women under 65 to the release of comprehensive GSM guidelines that make genitourinary syndrome everyone's business, not just gynecologists'.

And I'm getting personal about why I launched a concierge practice this year, what it taught me about the broken healthcare system, and why sexual health cannot be practiced in 10-minute appointments.

Highlights:

• Why you're not too old for screening and what "safe exit criteria" really means.
• Menopause certification jumped from under 1,000 to over 4,100 practitioners in 2025.
• Menopause divorce vs. midlife clarity: Why hormonal chaos shouldn't decide your marriage.
• DARE to PLAY is a new, topical sildenafil launching in 2026 for female arousal disorder.
• Treating male partners reduces recurrent BV by 50% (New England Journal of Medicine).
• Hormone therapy for prevention: The nuanced conversation about bone health and cardiovascular risk.
• Why I launched a concierge practice and what it revealed about what women actually need.

Thank you for being here for another year of Gyno Girl Presents: Sex, Drugs & Hormones. Your support, your messages, and your stories are what keep me going you are my why.

If this year-in-review resonated with you, please share it with someone who needs to hear that they're not broken, not dramatic, and not asking for too much. And keep following the show in 2026 we've got incredible conversations lined up.

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What happens when a medication designed to help you lose weight also changes what brings you pleasure?

In this solo episode, I'm doing a deep dive into what nobody's discussing about GLP-1 medications (Ozempic, Wegovy, Mounjaro, Zepbound) and what they do to your sex life.

These medications have been absolutely transformational for metabolic disease, obesity, and cardiovascular health. But they don't just work on your gut and pancreas they work centrally in your brain, in your reward pathways, in your pleasure centers.

I'm sharing stories from my practice: the glamorous patient who suddenly didn't want to shop anymore. The wine connoisseur who lost interest in drinking. The foodies who can't stand restaurants. And yes, the patients whose sexual desire completely disappeared because their brain stopped experiencing reward the same way.

Highlights:

1. Why GLP-1 medications are actually anti-inflammatory powerhouses (and what that means for PCOS, endometriosis, even PGAD).
2. How these drugs modulate dopamine and serotonin the same pathways that control sexual desire.
3. Why improving body image doesn't always improve sexual function (the biopsychosocial model).
4. The emerging science on GLP-1s reducing alcohol cravings, substance use, and compulsive behaviors.
5. What SHBG changes mean for your free testosterone and libido.
6. Why your brain doesn't compartmentalize pleasure food, shopping, alcohol, and sex all use the same reward circuits.
7. The informed consent conversation every doctor should be having (but isn't).

If you're on a GLP-1 medication or considering starting one, ask your doctor about how it might affect what brings you pleasure including sex. With great power comes great responsibility, and sexual health is health. Period.

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GSM Collective

The GSM Collective - Chicago

GSM Collective

One of my brave patients shares her story with lichen sclerosis from being dismissed and told it was "all in her head" to finding proper treatment and relief.

I'll never forget the day Jess walked into my office. By the time she found me, she'd already been dismissed by multiple doctors including specialists at what was supposed to be one of Chicago's premier women's health centers. They told her the severe pain and skin changes she was experiencing were "all in her head." Two different physicians suggested she needed a therapist, not medical treatment. Her depression history was weaponized against her, used as proof that she was just being hysterical.

But Jess wasn't hysterical. She had advanced lichen sclerosis, and her vulvar skin was literally fusing together. Had she not found proper treatment, she would never have been able to have penetrative sex again. Even worse, without treatment, her risk of vulvar cancer would have climbed from 1% to 3-5%. Yet nobody had explained any of this to her. She'd been handed a tube of clobetasol and essentially told to figure it out herself which she did, on YouTube, learning the proper application technique that her doctors never bothered to teach her.

In this episode, Jess bravely shares her journey living with lichen sclerosis—from the devastating experience of being gaslit by female physicians to finding relief through injectable steroids and surgical lysis of adhesions. We talk about how her symptoms worsened when she entered menopause in her mid-40s (common with autoimmune conditions), the complete loss of libido that left her sobbing when a doctor said "it's never coming back," and the body changes that made her feel like a "potato."

But this conversation is about more than just lichen sclerosis. It's about the failures of our healthcare system, the importance of advocating for yourself even when you're furious and exhausted, and learning to accept yourself exactly where you're at. Jess's story will resonate with anyone who's ever been dismissed, anyone struggling with vulvar health issues, and anyone navigating the chaos of menopause while trying to hold onto their sense of self-worth.

Highlights:

Why most gynecologists miss lichen sclerosis (hint: they're not actually looking at your vulva).

The proper way to apply clobetasol that doctors don't teach.

How vaginismus became a catch-all diagnosis for any woman with painful sex.

The We Do Not Care Club movement and redefining your value at midlife.

What it means when influencers are the face of menopause marketing.

If you've been dismissed or told your vulvar symptoms are "all in your head," this episode validates your experience and shows you're not alone. And if you're a clinician, this is your wake-up call we can no longer dismiss women's symptoms as psychological when real physical disease is staring us in the face.

Please share this with someone who needs to hear that their symptoms are real and treatment is available.

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Have you ever wondered why trauma seems to "live" in the body? Or why so many women struggle with sexual dysfunction after difficult childbirth experiences that they're told they should just be "grateful" for?

Join me as we explore the profound connection between trauma and sexual health with Erika Kelley, an award-winning clinical psychologist who specializes in women's sexual medicine and trauma treatment.

Erika Kelley is revolutionizing how we understand and treat the intersection of PTSD and sexual dysfunction. Winner of the prestigious Irwin Goldstein Award at ISSWSH for her groundbreaking research on childbirth-related PTSD, Erika shares insights from her years of experience helping women reclaim their bodies and sexuality after trauma.

Together, we discuss the often overlooked reality of "smiling PTSD" the postpartum trauma that women hide behind societal pressure to appear only joyful after childbirth. Erika explains how trauma becomes physically embedded in the body through the fight-flight-freeze response, creating real physiological changes that impact everything from pelvic floor function to sexual desire.

She also shares the evidence based psychotherapies that are proven to help, including Prolonged Exposure Therapy and Cognitive Processing Therapy, and how these treatments can be integrated with pelvic floor physical therapy and sexual medicine approaches for comprehensive care.

Erika's commitment to building trust with marginalized communities through community-based participatory research demonstrates how we can address healthcare disparities while advancing trauma care. Her work with Black women and perinatal mental health is paving the way for more inclusive and effective treatment.

This episode is essential listening for anyone who has experienced trauma, healthcare providers who work with trauma survivors, and anyone interested in understanding how our bodies truly do "keep the score." By listening, you'll gain crucial knowledge about recognizing trauma symptoms, accessing appropriate treatment, and advocating for yourself or your patients.

TRIGGER WARNING: This episode contains discussions of sexual assault, traumatic childbirth experiences, medical trauma, PTSD symptoms, and obstetric complications. Please listen with care and reach out for support if needed.

• How PTSD manifests physically in the body and affects sexual health.
• Dr. Kelley's award-winning research on childbirth trauma and sexual dysfunction.
• Why "smiling PTSD" prevents women from getting help after traumatic births.
• Evidence-based treatments that work: Prolonged Exposure Therapy, CPT, and EMDR.
• How to prepare for subsequent pregnancies after traumatic childbirth.
• Trauma-informed care and why communication during emergencies is critical.
• Healthcare disparities affecting BIPOC women and community-based solutions

If this episode resonated with you, please rate and review the show on Apple Podcasts or Spotify it helps other women find this life changing information. Share this episode with someone who needs to hear that their trauma is real and treatment is available.

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It's our 100th episode! I celebrate this milestone with Karen Bradley, NP, discussing the biggest wins, most common questions, and key themes from nearly two years of podcasting about women's sexual health and menopause.

We dive into the FDA's recent decision to remove the boxed warning from vaginal estrogen a huge victory for women's health advocacy. This warning has prevented countless women from getting treatment for painful sex, recurrent UTIs, and other symptoms of genitourinary syndrome of menopause.

I share a powerful story of a patient with breast cancer history who was denied hormone therapy by her oncology team, only to have them completely reverse course once the boxed warning was removed.

The conversation covers the most frequently asked questions from listeners: Is it perimenopause or just stress? (It's both.) Why is my libido gone? (Biology, psychology, and life circumstances all play a role.) Why do I keep getting UTIs after sex? (Often it's vestibulodynia or changes in the vaginal microbiome from estrogen deficiency.) How do I talk to my partner about sex? (Communication is key, and sometimes you need a sex therapist to help.)

We also discuss the reality of midlife weight gain, the role of GLP-1 medications like Wegovy and Zepbound, and why building muscle matters more than endless cardio. This episode is a celebration of how far we've come and a reminder that you don't have to suffer through menopause.

Highlights:

• The FDA removed the boxed warning from vaginal estrogen—what this means for access to care
• The biology behind midlife low libido and why it's not "all in your head"
• Why recurrent UTIs after sex might actually be vestibulodynia or vaginal microbiome changes.
• How to talk to your partner about sex when you've never had those conversations
• The truth about midlife weight gain and what hormones can and can't do
• GLP-1 medications: FDA approvals for weight loss, cardiovascular protection, MASH, and sleep apnea

Thank you for being here for 100 episodes. Honestly, there have been times I've wanted to stop, but then I get a DM from someone saying they heard something on the podcast that changed their care, or a patient tells me they finally found answers here. That's what keeps me going.

The biggest way you can help me keep doing this work is simple: share this show with someone who needs it and hit subscribe. When you share an episode with a friend who's struggling, a family member who's been dismissed by doctors, or post about it on social media, you're helping me reach more women who deserve better care.

Thank you for listening, for learning, and for advocating alongside me. Here's to the next 100.

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Dr. Noor Al-Humaidhi is a general practitioner from New Hampshire who discovered a massive gap in midlife women's healthcare.

After experiencing perimenopausal symptoms herself and realizing how little she understood about the connection between hormones and chronic disease, she started Lifestyles by Dr. Noor a multidisciplinary practice focused on prevention, metabolic health, and helping women stop suffering through menopause.

We discuss why stress management isn't just "woo woo" but creates measurable biological changes in blood sugar and cardiovascular health, how continuous glucose monitors reveal the real-time impact of stress on your body, and why women in the Middle East face unique barriers to hormone therapy access.

Dr. Noor shares her approach to building a practice with dietitians, mind-body therapists, and weightlifting programs because hormones alone aren't the answer it's about addressing sleep, muscle, nutrition, and stress together.

The conversation covers why sleep is so under treated in perimenopausal women, the cultural differences in how menopause is experienced across the world, and why there's such a high tolerance for women's suffering. Dr. Noor explains why she refuses to give up on helping women access care, even when hormone therapy isn't available in their countries.

Highlights:

• Why stress creates measurable biological changes in blood sugar and blood pressure.
• How continuous glucose monitors show real-time impact of stress on your health.
• The importance of CBTI (cognitive behavioral therapy for insomnia) over sleeping pills.
• Why weightlifting with proper form matters more than endless cardio.
• Cultural differences in menopause experience between the Middle East and the US.
• Why suffering through menopause isn't noble you deserve to feel better.

You're part of a growing community of women who refuse to accept suffering as inevitable. If you found value in this conversation, subscribe and help us spread the message that midlife women deserve comprehensive, compassionate care.

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GSM Collective

The GSM Collective - Chicago

GSM Collective

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.

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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.

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GSM Collective

The GSM Collective - Chicago

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 Network

INOCA

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