Gonna broadcast this to my list of 84 friends and acquaintances, & post on FB. This is terrific! You're terrific! But I already knew that from reading Ladyparts. (Note: I'm a 68 yr old man)
Thank you for this informative article and your video interview with Dr Rachel Rubin. I was petrified (pun intended) I was going to just shrivel up and die down there - first from menopause-related affects and second from lack of action due to my separation from my husband. The thought of having sex again (whenever that will be) and feeling like an old dried up useless partner that no one would want has now changed for the better. Now I need to find a new OB/GYN down here in Charleston, to where I recently moved 1-1/2 years ago!
Insist on your right to a thick steak vulva might be my favorite new phrase :) Seriously though I use estradiol and have preached to many of my friends about its wonder. Thank you for writing this.
Thank you for writing about the link between sexual health and hormone therapy. I practiced gyn for over 20 years (with a focus on menopausal health) and am a huge advocate of MHT for many reasons. Two things:
1)MHT is expensive in the U.S., no doubt about it. If you find yourself in another country (like Mexico or Italy) you can stock up on your hormone therapy for a fraction of the cost. Go to a pharmacy and tell them what you want; most pharmacists in other countries speak English. For instance, my systemic MHT of choice is Angeliq, and my vaginal estrogen is Estring. Each costs about $300/mo in the US. In Italy, 12 euros (about $15). I only do this for "brand name" hormones, not generic.
2)Absolutely supplement your systemic estrogen with vaginal estrogen in any form you like: a vaginal tablet, ring, cream, or gel. Continue to adjust the dose until the tissue feels like it did when you were 25.
There are some caveats, of course. Not everyone can take estrogen safely. Spot on, as always, Deb.
Great article! Two thoughts. One: I think years from now (I wish it were months), there is going to be a major shift in older women's sexual health care and people are going to point to Ladyparts as one of the major catalysts for this. The NYT and other mainstream media will finally start giving it the attention it deserves but only after Ladyparts did the heavy lifting. Deborah, keep fighting the good fight! Readers-- keep nudging friends to subscribe! Two: Reminder to all women having intercourse and/or oral sex--- Pee immediately afterward! I ALWAYS got UTI after sex until I discovered Peeing After Sex. I have not had one since. Please tell your friends, your daughters, any teen/woman you care about.
I emailed my male concierge doc and asked him to prescribe Yuvafem. He is a believer in hormone replacement and phoned it in for me try. Started with it tonight. UTI’s becoming an issue and slight urinary incontinence- that was really getting to me! If the “feeling like 25” comes with this, I’ll be a Happy Camper!
YES, YES, YES!!! I feel like screaming from the rooftops: why does NO ONE EVER TALK ABOUT THIS? I have an MPH, work in women's health and I have been completely clueless about how to proceed with my own health in mid-life. It's as if the lower half of our bodies don't exist once we are past child-bearing years. Bringing this to my PCP pronto. Please keep fighting the good fight, Deb. We need you!!
Thank you for all of this! My next gyn appointment is coming up, will definitely discuss this with her. Regarding vaginal discharge: I have had this since puberty, and going through menopause didn't stop it, just made it change color from whitish to a sickly yellow. (Thank God they invented panty liners!) On a separate search for GERD relief, I discovered kefir, a fermented, probiotic drink (comes in water-based and milk-based forms, I prefer the latter). I drink 0.5 cup a day of it. Not only did my GERD symptoms disappear, SO DID MY VAGINAL DISCHARGE. Completely and unexpectedly. If, for some reason, I don't keep up the kefir, the discharge resumes after about 3 days. I've been consuming kefir for over 5 years, and my experience has been consistent. (I don't know if water-based kefir has the same effect.) When I switched to my current gyn, she was surprised at the relative health of my LadyParts (I'm 68). I've also told my PCP in the hope she'll also pass along the idea.
I literally just left a message for my gynecologist. This is a miraculously informative piece (and very funny). Thank you for working up your courage to write it.
I became a paying subscriber just so I could comment on this post, because I cannot let this misstatement slide: "our bodies need sex the same way we need food, sleep, air, and water." Have you not read Emily Nagoski's explanation in Come As You Are (p.226) about how sex is not a drive and it is not something we "need"? That is a myth that does not need perpetuating.
Humans will die without food, sleep, air, and water. Nobody ever died for lack of sex, or else monastics, or people who are celibate for whatever other reason, would not exist. Sex, as Nagoski explains it, is an "incentive motivation system," that can feel very much like a drive, but it's not. The "humans need sex" myth also plays dangerously into incel rape culture that women are withholding something these men "need" and so they are justified in taking it. This myth also marginalizes people who are asexual, a real thing that is part of the sexual orientation spectrum that describes people who do not experience sexual attraction. As someone with an asexual family member I am acutely aware of how isolating this experience can be when our culture assumes that everyone wants or feels the need for sex. Please walk this back and be accurate. That said, I am very much interested in the information about vaginal estrogen. As someone with breast cancer family history who has decided not to take MHT I will definitely look into it. The lack of mainstream awareness of menopausal sexual health is appalling, and I do appreciate your work to spread the word.
Gonna broadcast this to my list of 84 friends and acquaintances, & post on FB. This is terrific! You're terrific! But I already knew that from reading Ladyparts. (Note: I'm a 68 yr old man)
As always, I laughed, then cried. The endless fighting vs the patriarchy is exhausting. Thanks for your constant challenges and humor through it all.
Thank you for this informative article and your video interview with Dr Rachel Rubin. I was petrified (pun intended) I was going to just shrivel up and die down there - first from menopause-related affects and second from lack of action due to my separation from my husband. The thought of having sex again (whenever that will be) and feeling like an old dried up useless partner that no one would want has now changed for the better. Now I need to find a new OB/GYN down here in Charleston, to where I recently moved 1-1/2 years ago!
Insist on your right to a thick steak vulva might be my favorite new phrase :) Seriously though I use estradiol and have preached to many of my friends about its wonder. Thank you for writing this.
Thank you for writing about the link between sexual health and hormone therapy. I practiced gyn for over 20 years (with a focus on menopausal health) and am a huge advocate of MHT for many reasons. Two things:
1)MHT is expensive in the U.S., no doubt about it. If you find yourself in another country (like Mexico or Italy) you can stock up on your hormone therapy for a fraction of the cost. Go to a pharmacy and tell them what you want; most pharmacists in other countries speak English. For instance, my systemic MHT of choice is Angeliq, and my vaginal estrogen is Estring. Each costs about $300/mo in the US. In Italy, 12 euros (about $15). I only do this for "brand name" hormones, not generic.
2)Absolutely supplement your systemic estrogen with vaginal estrogen in any form you like: a vaginal tablet, ring, cream, or gel. Continue to adjust the dose until the tissue feels like it did when you were 25.
There are some caveats, of course. Not everyone can take estrogen safely. Spot on, as always, Deb.
Great article! Two thoughts. One: I think years from now (I wish it were months), there is going to be a major shift in older women's sexual health care and people are going to point to Ladyparts as one of the major catalysts for this. The NYT and other mainstream media will finally start giving it the attention it deserves but only after Ladyparts did the heavy lifting. Deborah, keep fighting the good fight! Readers-- keep nudging friends to subscribe! Two: Reminder to all women having intercourse and/or oral sex--- Pee immediately afterward! I ALWAYS got UTI after sex until I discovered Peeing After Sex. I have not had one since. Please tell your friends, your daughters, any teen/woman you care about.
Forgot to mention that I also emailed my doc
the link to the medical reprint.
I emailed my male concierge doc and asked him to prescribe Yuvafem. He is a believer in hormone replacement and phoned it in for me try. Started with it tonight. UTI’s becoming an issue and slight urinary incontinence- that was really getting to me! If the “feeling like 25” comes with this, I’ll be a Happy Camper!
YES, YES, YES!!! I feel like screaming from the rooftops: why does NO ONE EVER TALK ABOUT THIS? I have an MPH, work in women's health and I have been completely clueless about how to proceed with my own health in mid-life. It's as if the lower half of our bodies don't exist once we are past child-bearing years. Bringing this to my PCP pronto. Please keep fighting the good fight, Deb. We need you!!
Thank you for all of this! My next gyn appointment is coming up, will definitely discuss this with her. Regarding vaginal discharge: I have had this since puberty, and going through menopause didn't stop it, just made it change color from whitish to a sickly yellow. (Thank God they invented panty liners!) On a separate search for GERD relief, I discovered kefir, a fermented, probiotic drink (comes in water-based and milk-based forms, I prefer the latter). I drink 0.5 cup a day of it. Not only did my GERD symptoms disappear, SO DID MY VAGINAL DISCHARGE. Completely and unexpectedly. If, for some reason, I don't keep up the kefir, the discharge resumes after about 3 days. I've been consuming kefir for over 5 years, and my experience has been consistent. (I don't know if water-based kefir has the same effect.) When I switched to my current gyn, she was surprised at the relative health of my LadyParts (I'm 68). I've also told my PCP in the hope she'll also pass along the idea.
I literally just left a message for my gynecologist. This is a miraculously informative piece (and very funny). Thank you for working up your courage to write it.
I became a paying subscriber just so I could comment on this post, because I cannot let this misstatement slide: "our bodies need sex the same way we need food, sleep, air, and water." Have you not read Emily Nagoski's explanation in Come As You Are (p.226) about how sex is not a drive and it is not something we "need"? That is a myth that does not need perpetuating.
Humans will die without food, sleep, air, and water. Nobody ever died for lack of sex, or else monastics, or people who are celibate for whatever other reason, would not exist. Sex, as Nagoski explains it, is an "incentive motivation system," that can feel very much like a drive, but it's not. The "humans need sex" myth also plays dangerously into incel rape culture that women are withholding something these men "need" and so they are justified in taking it. This myth also marginalizes people who are asexual, a real thing that is part of the sexual orientation spectrum that describes people who do not experience sexual attraction. As someone with an asexual family member I am acutely aware of how isolating this experience can be when our culture assumes that everyone wants or feels the need for sex. Please walk this back and be accurate. That said, I am very much interested in the information about vaginal estrogen. As someone with breast cancer family history who has decided not to take MHT I will definitely look into it. The lack of mainstream awareness of menopausal sexual health is appalling, and I do appreciate your work to spread the word.