Everyone thinks hormone therapy is finally getting attention but no one’s really talking about the fact that estrogen can be life-saving. The data is right there: lower mortality, fewer hospitalizations, less sepsis. So why is it still being overlooked?

In my practice, I see patients every day who are silently suffering dealing with UTIs, vaginal dryness, painful sex, and bladder issues they think are just part of aging. But these symptoms often point to something much bigger: Genitourinary Syndrome of Menopause. And what’s worse, it’s still widely misunderstood or ignored.

A recent study with new data stopped me in my tracks. Over 11 million patient records showed that vaginal estrogen doesn’t just improve quality of life it dramatically reduces serious outcomes like sepsis and even death. That kind of impact should be front-page news in every medical journal, yet here we are… still debating whether it’s “necessary.”

We also talked about the brand new AUA guidelines, which now make it clear: local estrogen is first-line therapy. It's safe, even for many patients who were once told they couldn't use hormones. These guidelines finally reflect what we’ve known clinically for years that low-dose vaginal estrogen isn’t just symptom relief. It’s prevention.

There’s still a lot of confusion about systemic absorption, cancer risk, and when to refer out. So in this episode, I’m breaking down what’s new, what’s misunderstood, and what every patient and provider needs to know. I’m also sharing how I approach treatment options from estrogen and DHEA to pelvic floor therapy and even energy-based devices (yes, we go there).

If you’ve ever been told this is just part of aging, or you’re not sure what your options are, I hope this gives you clarity—and maybe a little validation, too.

 Highlights:

• Why vaginal estrogen can lower mortality, sepsis, and hospital stays.
• What the AUA’s 2025 GSM guidelines say—and why they matter.
• Clearing up myths about hormone absorption and cancer risk.
• When to consider DHEA, Ospemifene, or non-hormonal options.
• The role of pelvic floor therapy in managing GSM.

Resources:

AUA’s Guidelines

Gyno Girl-GSM Video

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