How you can achieve your health goals in 2026 and in all the years to come? Life can (and does) get busy, and time can move by quickly. Self-care doesn't always feel easy, but prioritizing self-care is so important if you want to achieve a truly optimal state of health

Many people struggle to intentionally dedicate time to their selfcare. Why? It's often due to putting other people's health and wellness before our own, and this is especially true for women. For me, rest is going to be at the top of my priority list this year. I have a lot of obligations, responsibilities, and goals, and if I want to do all those things well I need to maintain a feeling of restoration and balance.

Our culture of achievement has its upsides. It pushes us to do more and pursue our goals, but if you want to be at your best to accomplish those things, you have to be at the top of your game. And being at the top of your game requires the best, most cared-of version of yourself.

When you take care of yourself, you're better able to deal with stress. You don't have to fight through fatigue or brain fog while working towards your goals. Self-care looks different for everybody, but for me it includes doing activities I enjoy (like pickleball and reading) and getting lots of sleep.

For you, self-care activities could include balanced hormones and hormone therapy. It may also mean eating well and getting outside. You can also include what you love to do, whether that's yoga, a community activity, or somewhere else you feel your best. I hope you'll go into each week this year remembering to put yourself first.

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 are continuing our conversation on women's urinary health and the issues that arise during and after menopause such as loss of elasticity, vaginal discomfort, and urinary incontinence. These changes are all related to the loss of estrogen over time. Other conditions can impact estrogen production too, for example PCOS, certain medications, and eating disorders.

Understanding the core issue of estrogen loss, regardless of the woman's age, is extremely important. Estrogen therapy can make a significant difference for women struggling with urinary issues. Estrogen promotes healthy skin elasticity, which can support the bladder as it typically holds around 300-500ml of urine.

Estrogen therapy doesn't just increase estrogen in the body, but pellet therapy, for instance, can offer more stable levels of estrogen over time. More consistent levels of estrogen can help manage weight gain, which is another issue many women struggle with during and after menopause. It also promotes a healthier sleep, and quality of sleep heavily impacts a woman's quality of life.

It's crucial that you don't ignore these urinary issues once they begin to develop. A loss of elasticity is difficult to reverse the longer it goes on. The sooner you start hormone therapy, the more effective it will be in reducing the impact of menopause. Early intervention can keep some of the most difficult urinary challenges from becoming permanent struggles.

As a woman, incontinence is something that's likely to happen, especially if you don't address it quickly. You deserve to age with dignity and a high quality of life and not with fear about tools like estrogen therapy which can actually support you later in 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/

In today's episode I'm talking about urinary health and the problems that can arise during and after menopause. These urinary problems can become an ongoing or worsening problem as time goes on. So what's happening to the urinary tract as we age? The problems start in perimenopause, primarily beginning with an increase in urgency.

Sometimes this change is subtle; an increase in getting up during the night to empty your bladder. It's disturbing to your sleep, but it may not necessarily stand out at first. Increased urgency, frequency, and discomfort can also be a typical presentation of interstitial cystitis.

These are also the same signs of a urinary tract infection (UTI). However, with a UTI, there tends to be more discomfort and pain at the end of voiding. Another urinary issue is urinary incontinence, such as urge incontinence, stress incontinence, or both. Involuntary leakage can vary depending on the woman experiencing it. These types of incidents can be extremely debilitating.

Even though many women in their 8th decade of life experience incontinence, they tend not to bring it up with their doctor. As a result, they may not know the different treatments available, including lasers, PRP injections, hormone injections, and more. Most of the options for treatment are also affordable and can actually save you money on incontinence pads and diapers moving forward.

Untreated urinary incontinence comes with health consequences like chronic UTIs, skin irritation, and an increase in falling and injuries. It can also lead to stress, anxiety, and depression. These issues naturally arise as estrogen declines, making it a normal part of the aging process for women. However, that doesn't mean women shouldn't explore the support that's available for them, especially if it can increase their quality of 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/

This week, let's wrap up our series on lichen sclerosus by discussing more of the therapies available for treatment. If diagnosed and treated early, the condition can be greatly improved—especially if you're using a hormone replacement therapy approach that's been optimized.

Aside from steroid medication, tacrolimus, estrogen therapy, and testosterone therapy (which were all options discussed in a previous episode), there are other treatment options like platelet-rich plasma, which can be injected to improve vaginal and sexual wellness.

PRP is gaining in popularity because it's considered to be minimally invasive. It's done under topical anesthesia, and although the vaginal tissues may be sensitive after, there are very few side effects. PRP treatment can improve itching and burning, and may even support regeneration of healthier skin. However, it does need to be injected in the area that is impacted the most to be effective.

The major downside to PRP therapy is cost. It is considered experimental, so no insurance plan will cover it. It's also important to know that results may vary. While some patients experience great success, others see little effect. The success depends greatly on the overall regenerative capacity of the individual.

Exosomes are a useful alternative to PRP and may even work better in women of an older age (or younger women with autoimmune issues or nutrient deficiencies). Exosomes are transport molecules that facilitate communication between the cells. Injecting exosomes locally or applying topically may reduce symptoms associated with lichen sclerosus or potentially eliminate them completely. Just like PRP, exosomes are considered experimental and not covered by insurance.

Connect with Dr. Cernaianu

https://www.herabeautyandwellness.com/

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

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

Let's continue our conversation about lichen sclerosus, specifically focusing on treatment options this time. The treatments and therapies I'm discussing in this episode can actually be quite useful for many vaginal conditions and are something all women should know about.

The first line of approved care for lichen sclerosus is a local application of a steroid medication, usually in an ointment form. Prolonged use of a steroid medication can lead to thinning of the skin, but it is particularly useful for women dealing with significant itching and plaque formation. Keep in mind that treatment does not mean reversing the course of the disease.

Another treatment option—one I rarely use due to side effects and cost—is a topical tacrolimus. Tacrolimus is a potent immune system suppressant, and it can decrease the inflammation associated with this skin condition (as well as some others). It is only intended for short-term use, and can be compounded for application.

There are also some unconventional options for care, including topical estrogen. It can improve dryness, reduce pain during sex, and support elasticity. Estrogen can also be used as treatment in the form of pellet therapy. This treatment option can help women return to more comfortable intimacy in as little as 4-6 weeks. Nothing is perfect, but estrogen pellets offer more consistent exposure than other options.

Testosterone is another hormone that can be used in the treatment of lichen sclerosus. This hormone plays an important role in skin quality, and it has been demonstrated in improving skin elasticity and strength. Side effects and an adjustment of dose can reduce the risk of unwanted side effects.

Connect with Dr. Cernaianu

https://www.herabeautyandwellness.com/

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

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

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/