Dr. Rachel Pope explains how her sister's cancer diagnosis and a patient in Malawi asking "can you fix my vagina" opened her eyes to the massive gap in sexual health education within gynecology.

As a fistula repair surgeon working in Sub-Saharan Africa for four years, Dr. Pope realized that even after successfully repairing bladder leaks, many patients couldn't have intercourse due to vaginal scar tissue yet providers never asked about sexual function.

Meanwhile, her sister battling cancer was asking basic questions about intimacy that Dr. Pope, despite all her training and a fellowship, couldn't answer.

These twin revelations led Dr. Pope to pursue sexual medicine education and eventually building Cleveland's first female sexual health division that spans multiple departments.

Her unique background in global women's health, fistula repair, and reconstructive gynecology informs her holistic approach to sexual medicine and menopause care.

The conversation also explores Dr. Pope's current research focus on perimenopause and cardiovascular health, believing this critical 10-year window before menopause holds the key to prevention rather than just treatment. She shares her proactive approach to her own perimenopause, including checking baseline testosterone levels at peak ovulation to guide future hormone therapy decisions.

Highlights:

• Sexual function should be assessed after every pelvic surgery, not just assumed
• Obstetric fistulas are still happening globally but were eliminated in the US once C-sections became accessible.
• Building a sexual medicine division works best when spanning multiple departments for true biopsychosocial care.
• The fellowship program accepts both urology and OBGYN applicants, with only two OBGYN programs in the country.
• Her work continues in Africa doing shorter trips and training local surgeons.

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