justASK with Dr. Heather Quaile

Context: This national needs assessment study explores the knowledge, attitude, beliefs, and practices (KABP) gaps related to vasomotor symptoms (VMS) associated with menopause among primary care and OB/GYN clinicians. VMS significantly impacts healthcare costs, workplace productivity, and patient psychosocial health, but a notable disconnect exists between healthcare providers and patients, with provider reticence and knowledge gaps playing a contributing role.

Objectives: This study aims to identify and propose optimal educational strategies to address these barriers, with attention to health disparities affecting women of color.

Methods: Methods employed include a multimodal approach of literature review, expert opinion, qualitative interviews, surveys, focus groups, and case studies, ensuring diverse clinician input. Data collection involved in-depth clinician interviews, a nationally disseminated clinician survey, and focus groups.

Results: Results indicate a critical deficiency in healthcare providers' understanding and management of VMS, especially among OB/GYN residents, with 75 % showing limited knowledge. The study also highlights the disproportionate impact of knowledge gaps on women of color, emphasizing the need for a culturally informed approach in medical training and practice. There's a notable discrepancy between clinicians' current and desired abilities in managing VMS, indicating a need for ongoing professional development. Significant variability in approaches to diagnosing and treating VMS, as well as substantial knowledge gaps about treatment options, underscore the need for evidence-based protocols.

Conclusions: Although VMS are a normal aspect of aging, they can significantly disrupt quality of life for many women, necessitating intervention. Beyond the immediate discomfort, VMS can impact quality of life and trigger insomnia and mood disturbances. This study exposes both new and previously recognized gaps in healthcare providers' knowledge and management skills concerning VMS treatment options, particularly regarding hormonal and nonhormonal therapies. Furthermore, our findings highlight the need for a deeper understanding of how VMS uniquely impacts women of diverse backgrounds. Research, including the Study of Women's Health Across the Nation (SWAN), suggests that the experience and severity of VMS may be influenced by socioeconomic status, race/ethnicity, body mass index (BMI), and smoking status. However, the complex interplay of these factors and their relative contributions remain unclear. Further investigation is crucial to facilitate equitable access to effective treatment for all women. To bridge these gaps, improved education starting as early as residency is essential. This education should address common misconceptions about VMS and its management. Healthcare providers must enhance their competence in discussing the broad spectrum of VMS impacts and employ effective communication strategies to ensure that patients are well-informed about their symptoms and available treatment options.

Heather- www.theshowcenter.com
Jackie- https://www.mymonarchhealthco.com
Heather- @drquailenp
Jackie- @jackiep_gynnp
Menopause and Midlife Course 
The course is live and available at:
the-dr-heather-quaile-private-business-and-mentorshi.teachable.com/p/the-hive-justask-a-menopause-midlife-seminar-series2

Enthusiasm for the use of hormones to ameliorate symptoms of perimenopause and menopause has waxed and waned over the years. Both treatment for symptoms and training of women's health care practitioners in the management of menopause have sharply declined since publication of the Women's Health Initiative initial results in 2002. Findings from that trial, which treated a population of older, asymptomatic patients, have been extrapolated over the past 21 years to all estrogen products, all menopausal women, and all delivery mechanisms. Our patients deserve a more nuanced, individualized approach. Conjugated equine estrogens and medroxyprogesterone acetate are no longer the predominant medications or medications of choice available for management of menopausal symptoms. All hormones are not equivalent any more than all antiseizure medications or all antihypertensives are equivalent; they have different pharmacodynamics, duration of action, and affinity for receptors, among other things, all of which translate to different risks and benefits. Consideration of treatment with the right formulation, at the right dose and time, and for the right patient will allow us to recommend safe, effective, and appropriate treatment for people with menopausal symptoms.

Dr. James A. Simon is a board-certified ob/gyn, reproductive
endocrinologist, and AASECT-Certified Sexuality Counsellor. He serves as Clinical
Professor at George Washington University and has a private practice,
IntimMedicine Specialists® in Washington, D.C. Dr. Simon has received numerous
awards including: “Top Washington Physicians,” “America’s Top Obstetricians and
Gynecologists,” “Super Doctors of Washington DC-Baltimore-Northern Virginia,”
and “The Best Doctors in America.” He is the only physician to serve as President
of both The Menopause Society and the International Society for the Study of
Women’s Sexual Health. Nicknamed “The Menopause Whisperer,” Dr. Simon is an
established researcher and author--completing more than 400 research trials, and
more than 800 published articles, abstracts, chapters, and the paperback book:
Restore Yourself: A Woman’s Guide to Reviving Her Sexual Desire and Passion for
Life.

To Follow US check out: 
Dr. Simon- @menopaue.whisperer
https://intimmedicine.com/

Heather- www.theshowcenter.com
Jackie- https://www.mymonarchhealthco.com
The podcast- @justaskhive
Heather- @drquailenp
Jackie- @jackiep_gynnp

Menopause and Midlife Course 
The course is live and available at:
the-dr-heather-quaile-private-business-and-mentorshi.teachable.com/p/the-hive-justask-a-menopause-midlife-seminar-series2

Testosterone therapy (TTh) has been shown to improve libido in women with sexual dysfunction, but its utilization has been limited due to concern for cardiovascular events and past studies reporting highly variable results.

the goal was to assess the association of TTh in women with major adverse cardiac events (MACEs), including heart attack, stroke, or death, using a large database.
The results contribute to safety data on TTh, a therapy for sexual dysfunction in women. And they  found a decreased risk of MACE among women with TTh as compared with matched controls and a similar risk of MACE in postmenopausal women while demonstrating a similar or significantly lower risk of breast cancer on age-based subanalysis.

Article here:
https://pubmed.ncbi.nlm.nih.gov/38459625/
To Follow US check out: 
Heather- www.theshowcenter.com
Jackie- https://www.mymonarchhealthco.com
The podcast- @justaskhive
Heather- @drquailenp
Jackie- @jackiep_gynnp


The course is live and available at:
the-dr-heather-quaile-private-business-and-mentorshi.teachable.com/p/the-hive-justask-a-menopause-midlife-seminar-series2

In this episode we talk about the bias and stigma around women and sexual health and particular what his looks like for Muslim  women.  We talk about religious, culture and family views as well as societal taboos around sexual health.

Dr. Rahman is a board-certified OB/GYN who has tailored her practice to meet the needs of women for gynecologic and cosmetic services. After years of practicing obstetrics and gynecology in a variety of large academic settings and locations, Dr. Rahman started her own practice to focus on her special areas of interest to ensure patients have their best quality of life. Through her research and dedication, she is one of the few physicians nationally to receive the designation of ISSWSH (International Society for the Study of Women’s Sexual Health ) Fellow (IF) and is actively involved with cutting edge approaches to sexual pain and sexual dysfunction. She also is an active member of the IPPS, International Pelvic Pain Society, and specializes in a multidisciplinary approach to chronic pelvic pain. For midlife women, Dr. Rahman is also a specialist in menopause management with the designation of Certified Menopause Physician through the North American Menopause Society (NCMP).

Dr. Rahman was raised in the south in North Carolina and as you will see from her rapport, she understands what good ole southern hospitality means. She attended Duke University for her B.S. degree in Biology where she also specialized in Women’s Studies. She then continued in her home state at the University of North Carolina at Chapel Hill for her M.D. As women’s health care and women’s issues have always been on the forefront of concerns for her, she moved up north for her residency in Massachusetts in Obstetrics and Gynecology at the University of Massachusetts. After completing her residency, she made her way out west to Los Angeles, California where she spent four years on the faculty at the University of Southern California, Keck School of Medicine . In L.A., she spent a great deal of her time on resident and medical student education and simulation training in obstetrics and surgery. She also spent her personal time performing medical missions internationally with a variety of international women’s organizations as well as working with at the WHO in Switzerland.

She has taken extra time to explore areas of aesthetic medicine with the American Board of Aesthetic Medicine, including anti-aging and laser technology and improving sexual health through additional work in aesthetic vaginal procedures in southern California.

Currently, Dr. Rahman is a Clinical Assistant Professor of OB/GYN at the Northwestern Feinberg School of Medicine in downtown Chicago. She previously worked at Northshore University Health Systems and was on the faculty at the University of Chicago. She is a member of the American Congress of Obstetricians and Gynecologists and American College of Aesthetic and Cosmetic Physicians and a Fellow of The American College of Obstetrics and Gynecology.

With her experience and expertise, she decided to venture on her own opening the Center for Gynecology and Cosmetics and tailors her practice to your needs!

In her spare time, she enjoys spending time with her children and family, running outdoors no matter the season, and traveling with her children in tow.

To Follow US check out: 
Dr. Rahman- @gynogirl
https://www.cgcchicago.com/

Heather- www.theshowcenter.com
Jackie- https://www.mymonarchhealthco.com
The podcast- @justaskhive
Heather- @drquailenp
Jackie- @jackiep_gynnp

Menopause and Midlife Course 
The course is live and available at:
the-dr-heather-quaile-private-business-and-mentorshi.teachable.com/p/the-hive-justask-a-menopause-midlife-seminar-series2

New this episode Tara (Pharm D) and I discuss meds for female sexual health this is a recording from the lecture we did at the American Academy  of Nurse Practitioners. 

To Follow Tara 
Tara-@thesexualhealthpharmacist
To Follow US check out: 
Heather- www.theshowcenter.com
Jackie- https://www.mymonarchhealthco.com
The podcast- @justaskhive
Heather-@drquailenp
Jackie- @jackiep_gynnp


The course is live and available at:
the-dr-heather-quaile-private-business-and-mentorshi.teachable.com/p/the-hive-justask-a-menopause-midlife-seminar-series2

Low sexual desire in women partnered with men is typically presumed to be a problem—one that exists in women and encourages a research agenda on causation and treatment targeting women. In this paper, we present a distinct way forward for research on low sexual desire in women partnered with men that attends to a more structural explanation: heteronormativity. A heteronormative worldview assumes that relationships and structures are heterosexual, gender (usually conflated with sex) is binary and complementary, and gender roles fit within narrow bounds including nurturant labor for women. We propose the heteronormativity theory of low sexual desire in women partnered with men, arguing that heteronormative gender inequities are contributing factors. We outline four hypotheses and their predictions related to: inequitable divisions of household labor, blurring of partner and mother roles, objectification of women, and gender norms surrounding sexual initiation. We discuss some mechanisms—social, physiological, and otherwise—for the heteronormativity theory, especially related to stress, objectification, and nurturance. We close by noting some limitations of our paper and the ways that the heteronormativity theory of low sexual desire in women partnered with men provides a rigorous, generative, and empirical way forward....Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8382213/

Andrea Martin, DNP, CRNP, WHNP

Andrea is a board-certified Women’s Health Nurse Practitioner, which enables her to offer reproductive and sexual health care to all genders. She obtained a bachelor’s degree in Animal Science from Rutgers University as well as a bachelor’s in Nursing Science from William Paterson University. She received her master’s degree in Nursing Science from Rutgers University, and a doctorate degree in Nursing Science from Misericordia University. Her nursing experience includes inpatient medical-surgical and telemetry care, and nurse practitioner expertise has encompassed Family Planning, Gynecology, Urogynecology, and Sexual Medicine. She is an active member of the International Society for the Study of Women’s Sexual Health and currently works at Virtua Sexual Wellness & Pelvic Health in Southern New Jersey. In her free time she enjoys caring for her pets as well as cross-stitching nerdy medical humor designs. You can find her on Instagram @andrea.sexplains.it.all.

To Follow US check out: 
Heather- www.theshowcenter.com
Jackie- https://www.mymonarchhealthco.com
The podcast- @justaskhive
Heather- @drquailenp
Jackie- @jackiep_gynnp
Tara @thesexualhealthpharmacist
The Midlife and Menopause seminar series is live and available at:
the-dr-heather-quaile-private-business-and-mentorshi.teachable.com/p/the-hive-justask-a-menopause-midlife-seminar-series2

In this episode we are going to 
•Define Trauma 

•Discuss the science of neurobiology of trauma

•Understand the continuum of the impact of trauma on sexual health

This was a Ted Talk done for the NPWH/ISSWSH Conference we wanted to share. 

To Follow US check out: 
Heather- www.theshowcenter.com
Jackie- https://www.mymonarchhealthco.com
The podcast- @justaskhive
Heather- @drquailenp
Jackie- @jackiep_gynnp
Tara @thesexualhealthpharmacist
The Midlife and Menopause seminar series is live and available at:
the-dr-heather-quaile-private-business-and-mentorshi.teachable.com/p/the-hive-justask-a-menopause-midlife-seminar-series2

We took some time to discuss this recent article which is very timely and it compared weight loss response and changes in cardiometabolic risk markers in postmenopausal women using semaglutide with and without menopause hormone therapy (HT) use. In postmenopausal women with overweight or obesity treated with semaglutide, HT use was associated with an improved weight loss response. It was a small study size of 60 women but nonetheless good data. Larger studies should be conducted to confirm these results.

Article: https://pubmed.ncbi.nlm.nih.gov/38446869/
To Follow US check out: 
Heather- www.theshowcenter.com
Jackie- https://www.mymonarchhealthco.com
The podcast- @justaskhive
Heather- @drquailenp
Jackie- @jackiep_gynnp
Tara @thesexualhealthpharmacist

The course is live and available at:
the-dr-heather-quaile-private-business-and-mentorshi.teachable.com/p/the-hive-justask-a-menopause-midlife-seminar-series2

Launching Today 3/18/2024
The JustAsk! A Menopause + Midlife Seminar Series Course

"Feeling unseen, unheard and like no one is listening to your health concerns? Were you told this is normal midlife and nothing you can do about it? This course will arm you with everything you need to talk to your provider about menopause hormone therapy and empower you to be heard!"

Are you a woman aged 35-60?

• Interested in peri/menopause hormone and non-hormone options
• Experiencing low libido
• Gaining weight
• Brain Fog
• Not sleeping
• Hot Flashes and Night Sweats
• Mood Swings and Irritability
• Genitourinary symptoms
• and numerous other symptoms

then this seminar series is for you!

HERE IS WHAT YOU WILL LEARN

We have included over 2.5 hours of content as well as a robust toolbox on how to talk to your provider about your menopause and midlife concerns. 

The program includes 11 modules:

1. Getting to Know Menopause

2. Your Body in Menopause

3. Lifestyle Pearls for Midlife and Menopause

4. The Menopause Work-up: What’s important

5. Hormone Therapy + Non-Hormonal Options

6. Sexual Health in Menopause

7. Menopause & Mental health

8. Menopause & Weight

9. Menopause & Sleep

10. Menopause & Bone health

11. How to Talk About Menopause with Your Healthcare Provider

The toolbox includes: Helpful Resources and Articles for Perimenopause an Menopause,

A Q and A guide for vaginal estrogen use and Questionnaires and Rating Scales

The course is live and available at:
the-dr-heather-quaile-private-business-and-mentorshi.teachable.com/p/the-hive-justask-a-menopause-midlife-seminar-series2

To Follow US check out: 
Heather- www.theshowcenter.com
Jackie- https://www.mymonarchhealthco.com
The podcast- @justaskhive
Heather- @drquailenp
Jackie- @jackiep_gynnp

Menopause deserves care and attention! Just because it is a normal process of aging doesn’t mean that women should be forced to grin and bear the multitude of symptoms that are associated with menopause not to mention the significant health consequences that are associated with the hormone decline of aging. We are in total agreement that we need to have a balance conversation around menopause and that we should very much reframe the conversation but this does not mean taking us back in time and pulling all the progress that we’ve made over the last 20 years since the WHI (Women's Health Initiative) trial was released, this means pressing forward with a conversation that empowers women to take full control of their menopause journey regardless of their treatment decisions. 

Here is the Link to the article in the Lancet to make your own informed decisions around care:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00462-8/fulltext

To Follow US check out: 
Heather- www.theshowcenter.com
Jackie- https://www.mymonarchhealthco.com
The podcast- @justaskhive
Heather- @drquailenp
Jackie- @jackiep_gynnp
The Midlife and Menopause seminar series is live and available at:
the-dr-heather-quaile-private-business-and-mentorshi.teachable.com/p/the-hive-justask-a-menopause-midlife-seminar-series2