Hormone Optimizing Warrior M.D.

Let's talk about a surprisingly common skin condition that impacts women after menopause: Lichen sclerosus. It's a chronic inflammation of the skin which creates a pathological change at the vaginal entrance. These skin changes are often underdiagnosed and even misdiagnosed, sometimes even for years.

This debilitating skin condition can cause persistent and uncomfortable itching, white patches on the skin, and may also result in thinning of the skin. It can cause a disappearance of sensitive skin areas where certain tissue areas fuse. The skin can also crack, resulting in irritation and pain.

Many women, after visiting their gynecologist, are shocked to find out their doctor missed their lichen sclerosus diagnosis. Often this means they've suffered with the symptoms for years without knowing the root cause of their issues. Unfortunately, the reality is many doctors mistake this condition for atrophy during menopause.

If you're experiencing painful sex, this skin condition is something worth investigating—especially if the initial stages of intimacy and penetration is where the discomfort happens. This condition is diagnosed through a skin biopsy. For accurate results, you'll have to ask your doctor specifically to rule out lichen sclerosus.

There are many skin disorders that can create inflammation and skin changes of the vaginal area. Many are accompanied by dryness and hinder the act of sexual penetration. Telling a woman to simply use a lubricant is subpar medical care, as it's an important part of a woman's wellness and life.

Connect with Dr. Cernaianu

https://www.herabeautyandwellness.com/

https://www.instagram.com/herabeautyandwellness/

https://www.facebook.com/people/Hera-Healthcare-Mirela-Cernaianu-MD/100063462643162/

Today we're continuing our conversation about natural solutions for vaginal wellness after menopause. There are various issues that can arise after menopause due to a drop in estrogen, and vaginal lubrication is one of the main ones that women seek to address.

The tissues in the vaginal canal and opening are very sensitive, and after menopause, the area can be dry and the skin begins thinning. One of my favorite solutions is DHEA (dehydroepiandrosterone)—a hormone typically made by the adrenal gland but that can also be obtained through supplementation. For purposes of vaginal wellness, DHEA has to be applied directly to the tissue to be effective.

Maintaining vaginal wellness isn't just for women who have a partner, it's also for women who are single too. When you find a man who you want to be intimate with, taking care of your vaginal health now will ensure that you're ready. That's where the specific devices designed to support the health of vaginal tissues can come in.

I carry a device in my office to help with this particular issue. It's a home use, red-light therapy device used purely for medical issues like vaginal atrophy. There is an 80-90% chance of improvement when used as recommended: three times a week for a maximum of ten minutes. When the desired outcome is achieved, it can be used just once a week.

Women entering menopause, or going through it, should have an exam with an experienced gynecological doctor to assess tissue changes and to get support as quickly as possible. If your annual exam is already uncomfortable, it's a sign that vaginal intercourse will also be uncomfortable. The sooner you address these changes, the less you will have to deal with difficult symptoms.

Connect with Dr. Cernaianu

https://www.herabeautyandwellness.com/

https://www.instagram.com/herabeautyandwellness/

https://www.facebook.com/people/Hera-Healthcare-Mirela-Cernaianu-MD/100063462643162/

There has been very little research done in the area of urinary and vaginal wellness for menopausal and perimenopausal women, despite the number of women experiencing these issues increasing. This week, I'm starting a series of episodes about non-hormonal options available to women to overcome these concerns.

Urinary tract infections (UTIs) tend to increase as women age, and staying hydrated is one thing that can help flush bacteria from the bladder wall, reducing the instance of infection. Cranberry juice can also protect the bladder from bacteria, but it has to be unsweetened (or you can take cranberry in supplement form).

Our digestive health is interconnected with our vaginal health. Probiotics help maintain a healthy gut microbiome, and they can also support a healthy vaginal microbiome. There are even specific probiotic brands available for vaginal health.

Good hygiene is also key to a woman's urinary and vaginal health. Avoiding douching, holding in urine, and getting dehydrated can help. Women should also change their underwear after a workout. Some women may need to take antibiotics to protect themselves during times of sexual activity. Uva ursi (also known as bearberry) and goldenseal are herbs that can support urinary wellness, thanks to their anti-microbial elements.

During menopause, many women experience vaginal dryness and irritation. Vaginal moisturizers can be used to reduce tears in the urethra and vaginal opening, which also supports a reduction in urinary tract infections. Coconut oil is an all-natural, safe vaginal lubricant that is widely available.

Connect with Dr. Cernaianu

https://www.herabeautyandwellness.com/

https://www.instagram.com/herabeautyandwellness/

https://www.facebook.com/people/Hera-Healthcare-Mirela-Cernaianu-MD/100063462643162/

We're getting intro part 2 of our conversation about vaginal estrogen and its usefulness for treating GSM (genital urinary syndrome of menopause) symptoms in this episode. Last time, we began discussing the importance of timing for hormone replacement therapy, including estrogen therapy.

When you act early—before your symptoms get worse—it can make a big difference. The vaginal walls and vaginal lining will lose lubrication and architectural support over time without estrogen. This is also called vaginal atrophy. The loss of moisture, which is the main symptom, is directly linked to a decrease in estrogen.

Exposing your body to increased estrogen, like through vaginal estrogen for example, won't lead to a quick fix. It can take months of treatment before you start to notice a decrease in uncomfortable symptoms. Bringing your body back to a place where you feel a desire, or even a comfortability, with increased intimacy requires patience.

Women have a right to know how valuable estrogen is to their intimacy. Portraying this hormone as the enemy when it's actually a vital hormone leads to a lot of suffering. There are safe products available on the market for women, and everyone should know about them. This includes vaginal suppositories and estrogen creams.

The differing options of vaginal estrogen each come with their own benefits and potential side effects. When exploring your options, remember that, in large part, the fear behind estrogen is generally unfounded. After menopause, women should be getting an annual pelvic ultrasound and discuss estrogen treatment options with their doctor if desired.

Connect with Dr. Cernaianu

https://www.herabeautyandwellness.com/

https://www.instagram.com/herabeautyandwellness/

https://www.facebook.com/people/Hera-Healthcare-Mirela-Cernaianu-MD/100063462643162/

Today we're talking about GSM: genitourinary syndrome of menopause. This new term encompasses the vaginal and urinary changes that happen during menopause. These changes don't just impact women during menopause—they have long-lasting implications post-menopause as well.

Some of these changes include increased urinary frequency and urgency, plus recurrent vaginal infections. Menopausal women may also experience urinary tract infections differently: they aren't as painful. While this could be seen as a positive, it also makes it much more difficult to identify when the woman is experiencing a UTI.

Many of the symptoms associated with GSM can be prevented when treated with vaginal estrogen. Vaginal estrogen is safe for women who have been diagnosed and treated for breast cancer, for women who have clotting disorders, and for women who have suffered heart attacks and strokes.

Contrary to prior beliefs, the purpose of estrogen in a woman's body is not limited to reproduction. Estrogen plays a significant role in making us feel good. So why shouldn't we replace it when it's lost? Vaginal estrogen can be used for specific, local effects, targeting the actual area it's being administered too.

Vaginal estrogen can be used by women who are also using other forms of hormone replacement therapy. Whether you're already taking another type of estrogen, or you haven't been but you want to explore vaginal estrogen to help manage your GSM, the sooner you talk to your health professional about it, the better. There is relief for your vaginal, sexual, and urinary wellness symptoms caused by a lack of estrogen.

Connect with Dr. Cernaianu

https://www.herabeautyandwellness.com/

https://www.instagram.com/herabeautyandwellness/

https://www.facebook.com/people/Hera-Healthcare-Mirela-Cernaianu-MD/100063462643162/

Get ready to learn all about the timing for estrogen therapy and exactly when you should start hormone therapy for menopause. Timing is crucial because many women don't know when the best time to use it is, often realized when there have been irreversible changes and it's too late to undo them.

Previous studies done on estrogen have scared women away from taking advantage of its benefits as a therapy earlier on. Yet, one of the main studies that led to widespread misinformation used oral synthetic estrogens. Keep in mind this hormone was one of the main ones available at the time.

As soon as transdermal estrogen became available, the benefits it had over oral estrogen were clear. It works well and is associated with less risks than oral synthetic options. The median average age of the women in this study was 63 years old, which means these women had been in menopause for at least the last decade. At this stage, the benefits of estrogen therapy have been limited.

Based on the issues contained in this study, the outcomes are skewed. What you have been told about the dangers of estrogen is simply not true. They have led to a lot of harmful myths about estrogen, even in cases where hormone replacement therapy with estrogen could actually be helpful.

Using synthetic progestin should also be avoided. Instead, ask your doctor for bioidentical progesterone, which is highly available since its approval decades ago. The timing of your hormone replacement therapy is critical to the outcome. The earlier the better, especially if you want to proactively protect your health.

Connect with Dr. Cernaianu

https://www.herabeautyandwellness.com/

https://www.instagram.com/herabeautyandwellness/

https://www.facebook.com/people/Hera-Healthcare-Mirela-Cernaianu-MD/100063462643162/

In this episode we're bringing our conversation about the WHI study about estrogen to a close. This study scared many health care professionals (and their patients) out of using estrogen therapy. Today, we're focusing on the reality of the risks associated with estrogen replacement therapy, especially whether or not there are actually any cancer-related risks.

The breast cancer incidence in the women who took part in this study but did not receive hormone therapy (the placebo group) was almost identical to the women who received hormone treatment. The results, percentage wise, presented in this study were misleading.

Another part of the study not explored was that women who took part who also had a hysterectomy showed a decrease in the incidence of cancer. Another idea not explored is the benefit of using estrogen and progesterone together, as it's critical to balance these hormones in women.

Long term birth control use can increase a woman's risk for cancer, yet birth control is widely prescribed. Further to this point, when a woman who has used birth control most of her life and hormone replacement therapy after menopause gets cancer, no one will talk about the birth control. The people around her will likely point to the estrogen therapy as the culprit, even if she has been on it a very short amount of time.

It takes courage to move even a single step towards what you feel is right for you. Don't let the misconceptions about estrogen (and misleading public opinion) stop you from taking action and improving your life. I hope the takeaway for you today is that estrogen is not what some people would have you believe!

Connect with Dr. Cernaianu

https://www.herabeautyandwellness.com/

https://www.instagram.com/herabeautyandwellness/

https://www.facebook.com/people/Hera-Healthcare-Mirela-Cernaianu-MD/100063462643162/

Today we're continuing our conversation about the WHI study that led to some serious misconceptions about estrogen therapy. This study involved oral estrogen, synthetically made from pregnant horse urine, given to women 10+ years past menopause. It's important to remember that by this time, these women had experienced irreversible changes due to how far into menopause they had been.

This study looked specifically at the effect of estrogen in cardiovascular health in women. Estrogen therapy can help improve various unwanted symptoms in women, even past menopause. However, once you have plaque in your arteries, it's nearly impossible to reverse it.

The options for estrogen administration have also expanded since this study. At the time this research was conducted, transdermal patches hadn't been embraced on the scale they would be. Many hormone specialists have criticized how this research was done and point out the many things they would have done differently at the time the study was done and today.

I, and many doctors like me, do not use oral estrogen therapy with clients. Transdermal estrogen bypasses the liver, which is just one reason why it's superior to oral estrogen. It therefore also has a much different risk profile than oral estrogen.

Many women who are prescribed this potentially life-changing therapy feel dissuaded by FDA warnings and labels. It's been designated as a warning for all estrogen products indiscriminately, when it should have been applied to oral estrogen products only. As a result of these labels, so many women are missing out on this life saving treatment.

Connect with Dr. Cernaianu

https://www.herabeautyandwellness.com/

https://www.instagram.com/herabeautyandwellness/

https://www.facebook.com/people/Hera-Healthcare-Mirela-Cernaianu-MD/100063462643162/

For the next few episodes, I'm going to be focusing on the misconceptions around the relationship between estrogen and breast cancer. Many women are surrounded by people (even healthcare professionals) who tell them that estrogen is dangerous after menopause. However, this simply isn't true.

Recently, I have had a few women come to me with similar issues related to menopause. These patients spent years suffering as opposed to seeking options for support. But if we can prevent significant loss of function, why not try it? That's where hormone replacement therapy comes in.

Most women I see who decide to start hormone replacement therapy after menopause are so happy that they did. Instead of following their social conditioning to wait, or even suffer in silence, they decide to set themselves and their health as a priority. The mental shift I'd like to highlight here is instead of thinking "it's not broken, let's not fix it", the thinking should be "it's not broken, let's maintain it."

Many women, including those who are already on hormone therapy, are afraid of taking estrogen due to the misconceptions about its role in breast cancer. For decades, estrogen therapy was recommended as a treatment for women during menopause. But in the early 2000s, a study was released that misled the public on how estrogen impacts women.

It's important to keep in mind this study was also run by cardiologists, not hormone specialists. In the next few episodes, I'll be shedding more light on this topic, including how this study was done on the wrong women using the wrong medication and method of administration.

Connect with Dr. Cernaianu

https://www.herabeautyandwellness.com/

https://www.instagram.com/herabeautyandwellness/

https://www.facebook.com/people/Hera-Healthcare-Mirela-Cernaianu-MD/100063462643162/

In this episode we'll continue to explore the true value of estrogen and why it's so important for women. It's important to recognize that there are limiting factors as to why more women don't invest in hormone replacement therapy treatments like estrogen. One of those factors is the cost, especially for women who put their wallet over their wellness.

The health issues caused by menopause can be quite significant, and I believe hormone therapy should be much more accessible for women. It is the responsibility of health care professionals everywhere to convey why estrogen therapy is so valuable and how it can make a difference in their patient's lives.

The problem is most doctors aren't trained in hormone replacement therapy (although this doesn't necessarily stop them from talking badly about it). The idea that estrogen replacement could be harmful is illogical. Think about it: You have it in your body for decades before it's lost during menopause.

Of course, there are other drugs you can take to help you manage the various symptoms of menopause. Keep in mind that these drugs come with side effects, but estrogen replacement can come with a lot of benefits. The slanderous campaign against estrogen is unfounded.

Without exposure to estrogen, a young girl would never become a young woman. She would have no secondary sex characteristics or puberty. Without estrogen, she'll experience early cardiovascular issues and events. Estrogen doesn't increase the risk of cancer—but the lack of it does increase the risk of various health issues.

Connect with Dr. Cernaianu

https://www.herabeautyandwellness.com/

https://www.instagram.com/herabeautyandwellness/

https://www.facebook.com/people/Hera-Healthcare-Mirela-Cernaianu-MD/100063462643162/