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Menopause has gotten plenty of media attention. What it hasn't gotten is day-to-day direction, especially on the parts nobody likes to say out loud. This week I sat down with Dr. Cat Brown, a board-certified OB-GYN and the medical director at Winona, to talk about why a little dab of vaginal estrogen can protect you from recurring UTIs (and the urosepsis they can lead to), why the age-60 guideline doesn't mean what you think it means, and how one badly handled study cost a generation of women their care. If you've been told hormone therapy isn't for you, this episode is worth your 35 minutes.
Who is Dr. Cat BrownBoard-certified OB-GYN and medical director at Winona, an online telemedicine platform created to bridge the gap for low-risk women who are good candidates for hormone therapy but don't have a doctor willing, or experienced enough, to prescribe it. She came to this personally, too: most of her own menopause education was self-directed after she hit roadblocks seeking care following her hysterectomy.
What we actually talk aboutWhat Winona is, and what telemedicine can't do (00:38–02:19) — Winona was born during COVID, when nobody was prescribing hormone therapy by telemedicine. Dr. Cat is upfront that it's a bridge, not a replacement: you still need an in-person gynecologist, a breast exam, and a Pap smear if you have a cervix.
You don't have to be a patient to use it (02:19–04:20) — A quiz, a library of free education on the long list of menopause symptoms, the Winona Women's app, and a Winona Women's Facebook group. Dr. Cat points to research showing that women with strong female friendships live healthier, longer lives, which is why community is part of the model.
Why estrogen matters, and why it starts in perimenopause (04:21–09:05) — The Women's Health Initiative backstory, and why Dr. Cat says headlines reached the media before other doctors had peer reviewed the results. Then the case for estrogen as the hormone that fuels skin, joints, blood vessels, the heart, and the brain, plus why the goal isn't your 20-year-old hormone levels and why she says "hormone therapy," not "replacement." Her reframe: let menopause be the pause that makes you reevaluate what you're feeding your body and your soul.
Why UTIs spike after menopause (09:06–11:43) — Estrogen loss thins the tissue around the urethral opening and weakens the barrier that keeps normal vaginal bacteria out of the bladder. That's the same reason we're taught to pee after sex. Left to recur, UTIs can lead to urosepsis, which Dr. Cat calls deadly for older women.
Vaginal estrogen is not "taking hormones" (11:43–13:44) — Cream applied around the urethral opening treats the surface changes of menopause, with very little absorbed systemically. Dr. Cat says even women who can't take systemic hormones, including those with a history of breast cancer or blood clots, are safe to use it, and that menopause providers think it should be sold over the counter.
Cream, tablets, rings, and painful sex (13:44–16:08) — Your options for vaginal estrogen, including a heads-up that some rings are designed to release hormone systemically. Plus the negative feedback loop of painful intercourse and what it does to long-term relationships. Dr. Cat's observation: every man gets the little blue pill, and most women get nothing for their own tissue.
The estrogen face cream (16:09–18:36) — Estriol plus tretinoin, what it does for texture and fine lines, why it's controversial in the medical community, and why Dr. Cat says it's still a personal decision. I use it, and it feels great.
The age-60 question (18:37–22:06) — Why 60 is Winona's line for starting hormone therapy by telemedicine, and what it is not: it isn't a deadline for stopping. Dr. Cat explains the window of opportunity (within 10 years of menopause), the slightly higher clotting risk when starting after 60, and why starting in early perimenopause, before your final period, gets you more heart and bone protection. Her analogy: don't wait for the gas tank to hit empty.
If you're over 60 and curious (22:07–23:32, 29:29–29:47) — You're not locked out, you just need a different front door. Dr. Cat recommends an in-person menopause provider who can work with your other physicians and monitor you closely, and The Menopause Society has a zip code search to find one.
The black box warning, birth control, and breast cancer risk (25:36–27:05) — Dr. Cat on why the warning never applied to topical estrogen, why she says birth control carries higher hormone doses and more clot risk than hormone therapy, and why she says daily alcohol is a much bigger breast cancer risk factor. (Yes, there goes the wine.)
Patch, pill, or cream? (27:06–29:28) — Why Dr. Cat generally recommends transdermal, why she still prescribes pills, and her rule: the best method is the one you'll actually use consistently. Hormone therapy is like trying on jeans. Five women, five different cuts.
Tell your doctor everything (30:12–31:22) — Even if they won't prescribe. Dr. Cat shares how patients' in-person doctors came around after seeing their labs and how much better they felt. "We've converted another doctor."
The physician education gap (31:23–34:14) — Dr. Cat was taught in residency to learn this for the exams and never prescribe it. She mentions a large grant from Melinda Gates's foundation to The Menopause Society to educate physicians, why we should talk to younger women about menopause the way we talk about first periods, and why answering surveys and showing up is how the black box warning came off in the first place.
Resources mentionedThis episode is education, not a prescription, and Dr. Cat's own point is that telemedicine doesn't replace in-person care. If you have a history of breast cancer or blood clots, or you're over 60 and thinking about starting, take these questions to your own doctor or an in-person menopause specialist. Use this episode to ask better questions.
Enjoyed this one? Leave a review. It helps other women find the show. And if you want more of this in your inbox between episodes, sign up for the Rebellious Wellness Lifestyle newsletter.
Nobody prepares us to become a caregiver for our own parents, but Nicole Hilgenkamp did it twice, with both of her parents, and turned what she wishes she'd known into a system for the rest of us.
Nicole is the founder of Your Parents' Keeper, a caregiver education company built around 12 essential documents and a 7-phase roadmap from independence to end of life.
In this episode:
Nicole lost her mother this past June. This conversation is the guide she wishes someone had handed her first.
Resources: Your Parents' Keeper — yourparentskeeper.com
Enjoyed this one? Leave a review — it helps other rebellious spirits find the show.
Biochemist Dr. Nathan Bryan has spent 30 years researching nitric oxide (NO) — a molecule he calls the earliest event in the onset of every chronic disease.
But despite all the supplements, powders, gummies, and health claims surrounding nitric oxide, much of what people are being sold isn't backed by the science.
In this episode, we sort the real science from the Instagram-ad noise and explore what nitric oxide actually does, how your body makes it, and the everyday habits that may be shutting down your body's own production.
In this episode we cover:
Dr. Nathan Bryan is a biochemist and one of the world's leading researchers on nitric oxide. His work explores the role nitric oxide plays in cardiovascular health, mitochondrial function, aging, and chronic disease.
Find Dr. Nathan Bryan at N101.com.
His book, The Secret of Nitric Oxide: Bringing the Science to Life, is also available now.
Instagram: @drnathansbryan
X: @DrNitric
Most everyday pain isn't “just aging”, and it's not permanent. This week, chiropractic physician Dr. Ya-Ling joins the show to talk about why so much everyday pain — stiff necks, cranky backs, tight shoulders — is actually retrainable.
We get into:
Dr. Ya-Ling practices in Seattle and is the author of Fix the Fire Damage and What's Your Pain Personality? Find her books, her free Pocket Pain Relief app, and more at ya-ling.com.
Enjoyed this episode? Leave a review — it helps other rebellious spirits find the show.
Neurosurgeon Dr. Ravi Kumar returns to break down what the science actually says about melatonin — including a new study linking long-term use to heart failure — plus why popular sleep meds like Ambien and Benadryl come with hidden costs, his real sleep protocol (temperature, timing, screens), and two blood tests you should ask for once in your life: Lp(a) and ApoE4.
In this episode:
Full protocol PDF and more research: drkumardiscovery.com
No guest this week — just me, and a confession-style rundown of nine habits I let slide and am now recommitting to. I call the phenomenon behind it “magical thinking”: the quiet belief that staying generally healthy day-to-day means the little stuff doesn't apply to you. Here's what made the list, and what finally got me to stop skipping each one.
1. Resistance training — the wake-up call was a 25-lb bag of soil, not a scale number.
2. Balance — how to fold single-leg practice into things you already do daily, like brushing your teeth.
3. Flossing — the real link between gum health and heart disease, and a simple habit-stacking fix.
4. Fiber — the 21-gram target for women over 50, why it's harder to hit than it sounds, and what I actually eat instead of Metamucil.
5. Hydration — why sipping all day beats chugging, and the surprising kidney-heart connection.
6. The melatonin story — what a neurosurgeon told me about how melatonin really works, and why I ditched my nightly gummy.
7. Grip strength — the data linking it to longevity, and the cheap tool I use to practice it.
8. The sitting-rising test — a real clinical test for functional fitness, and why I look like “a creature made of dough” attempting it.
9. Cardio and VO2 max — why this number matters more than most blood markers, and how I lost ground during a recovery period.
Got one of these you're ready to add back in? Post it in the comments on the podcast page or email me at gregory@rebelliouswellnesslifestyle.
Dr. Carolyn Dean — MD, ND, and author of The Magnesium Miracle — has spent 50+ years connecting mineral deficiency to chronic illness. In this episode, she breaks down why magnesium is the foundation everything else is built on, what the biohacking world is missing, and how her Maui study reversed biological aging by an average of four years in six months.
In this episode:
Guest resources:
"If you don't have enough magnesium, you're going around trying to treat the symptoms of magnesium deficiency with ashwagandha and NAC and creatine — and missing the whole point." — Dr. Carolyn Dean
Laura Richards spent 32 years married to a covert narcissist — someone who looked like “the nice guy” to everyone outside the marriage while quietly breaking her down inside it. After her divorce, she became a bestselling author (“Married to a Nice Guy,” “You’re Not Crazy”), podcaster, and coach helping other women recognize the same patterns she lived through.
In this conversation, Laura and Greg dig into:
Laura’s full library of books, coaching, community, and resources is at thatswhereimatpodcast.com.
If you've wondered whether your mental and emotional state affects your body's ability to heal cancer, the answer — backed by 50+ years of science — is yes.
Avinoam Lerner is a holistic therapist, clinical hypnotherapist, and cancer recovery coach with 25 years of experience working at the intersection of trauma and cancer recovery.
In this episode, we cover:
• Why unresolved trauma creates chronic immune suppression — and how that connects to cancer
• The science of psychoneuroimmunology (PNI): what it is, why your oncologist doesn't mention it, and why that's not the whole story
• The difference between conscious and subconscious mind — and why treating only the physical body leaves half the healing equation unaddressed
• How clinical hypnotherapy bypasses the conscious mind to update the patterns driving stress and immune dysfunction
• Why self-blame is both scientifically inaccurate and actively harmful to recovery
• When to start this work — and why stage doesn't matter as much as you think
• Avinoam's new book, Mindful Remission, and how to access his programs
Mindful Remission: The Mental Science of Healing CancerAvinoam’s new book https://www.avinoamlerner.com/shop/p/the-new-cancer-paradigm-3lte7
Mindful Remission Program: Support for people navigating cancer diagnosis, treatment, and recovery.
TEDx Talk: “The New Cancer Paradigm” https://www.avinoamlerner.com/videos
Connect with Avinoam Lerner https://www.avinoamlerner.com/
When a health event, financial shift, or relationship change hits, most support systems treat each issue in isolation. The Meraki Project, founded by Stephanie Geprges, was built on research with 1,000 women to do the opposite — centering dignity, connection, and agency at life's hardest inflection points.
In this episode:
• Why midlife transitions never stay in their lane — and why that matters for how we get help
• What dignity actually means, and why it's more useful than empowerment as an organizing principle
• The $38 trillion wealth transfer to women — and why so much wellness noise is pointed directly at midlife women
• How the Meraki Project platform works, including Sophie the AI navigator
• The Dignity Report: how aggregate data becomes a tool for systemic change
• Clarity → Confidence → Agency: the framework at the heart of the platform
The beta is open now at merakidignity.com — no cost, no coaching, no advice. Just your experience contributing to something that's trying to get this right.
From the publisher's feed