Dr. Streicher’s Inside Information: Menopause, Midlife, and More

• S4 Ep175: Your BONES On and Off ESTROGEN

  When women think about the benefits of menopausal hormone therapy, things like hot flashes, insomnia and vaginal dryness come to mind.  But for many women, bone health is, or should be, at the top of the list.   In this episode, I speak with Dr. Risa Kagan about the role of estrogen, progesterone, and testosterone in bone health. Definition of Low Bone Mass (Osteopenia) and Osteoporosis The Difference Between a T score and a Z score  FRAX- Fracture Risk Assessment Tool When Bone Mass Peaks How to Maximize Bone Health Before Menopause Hits Role of Estrogen in Young Women The Danger Zone- When Most Women Lose the Majority of Their Bone Mass The Role of Birth Control Pills and Prevention of Bone Loss If Exercise is Enough The Relationship Between Hot Flashes and Osteoporosis Bone Loss Post Menopause Impact of Menopausal Estrogen Therapy on Bones Taking Menopausal Hormone Therapy (MHT) in the Absence of Hot Flashes to Protect Bones The Difference Between Bone Density and Bone Quality When it is Appropriate to Take an Anabolic Agent If the TYPE of Estrogen you take matters (Conjugated, Synthetic, Bioidentical) What DOSE of Estrogen is Needed to Prevent Fractures If it is Appropriate to Monitor Estradiol Blood Levels When Taking Transdermal MHT The Target Estradiol Level for Bone Health What Happens to Bone Density When MHT is Discontinued If MHT Should Be Taken Forever If Progestogens Plays a Role in Bone Health The Role of Bazodoxifene (Duovee™) in Bone Health The Role of TESTOSTERONE therapy in Bone Health Another Podcast with Dr. Kagan: When Progesterone is a Problem   Dr. Risa Kagan is a Clinical Professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the University of California San Francisco, and a consulting gynecologist with Sutter Health. Dr. Kagan has published over 100 scientific papers  on post menopause bone health and hormone therapy.  Dr. Streicher is on SUBSTACK      DrStreicher.Substack.com Articles Monthly newsletter All COME AGAIN podcast episodes Monthly News Flash Reports on recent research  Monthly Zoom Ask Me Anything Webinar   Information on Dr. Streicher's COME AGAIN Podcast- Sexuality and Orgasm Lauren Streicher MD, is a clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine, the founding medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause, and a Senior Research Fellow of The Kinsey Institute, Indiana University. She is a certified menopause practitioner of The Menopause Society. She is the Medical Director of Community Education and Outreach for Midi Health.   Dr. Streicher is the medical correspondent for Chicago’s top-rated news program, the WGN Morning News, and has been seen on The Today Show, Good Morning America, The Oprah Winfrey Show, CNN, NPR, Dr. Radio, Nightline, Fox and Friends, The Steve Harvey Show, CBS This Morning, ABC News Now, NBCNightlyNews,20/20, and World News Tonight. She is an expert source for many magazines and serves on the medical advisory board of The Kinsey Institute, Self Magazine, and Prevention Magazine. She writes a regular column for The Ethel by AARP and Prevention Magazine.    LINKS Subscribe To Dr. Streicher’s Substack Information About the COME AGAIN Podcast Dr. Streicher’s CV and additional bio information To Find a Menopause Clinician and Other Resources  Glossary Of Medical Terminology Books by Lauren Streicher, MD  Slip Sliding Away: Turning Back the Clock on Your Vagina-A gynecologist’s guide to eliminating post-menopause dryness and pain Hot Flash Hell: A Gynecologist's Guide to Turning Down the Heat Sex Rx- Hormones, Health, and Your Best Sex Ever The Essential Guide to Hysterectomy                                       Dr. Streicher’s Inside Information podcast is for education and information and is not intended to replace medical advice from your personal healthcare clinician. Dr. Streicher disclaims liability for any medical outcomes that may occur because of applying methods suggested or discussed in this podcast.              

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• S4 Ep174: Is Your Transdermal ESTROGEN... Getting ABSORBED?

  Transdermal estrogen in the form of a patch, gel, or cream is often the preferred delivery method for menopausal hormone therapy. Unlike oral estrogen, in addition to other advantages, transdermal estrogen does not increase the risk of blood clots.  But a new study, published in the journal Menopause, indicates that your transdermal estrogen… may not be doing what you think it’s doing. Today, I am speaking with one of the authors of that study, Dr. Louise Newson.  My Substack post summarizing the study:  https://drstreicher.substack.com/p/is-your-estrogen-patch-gel-or-spray?r=740mq Link to article: https://pubmed.ncbi.nlm.nih.gov/39689249/ We discuss: The advantages of transdermal estrogen The realization that blood levels of transdermal estrogen may be below what is expected What the study looked at Results of the study What factors may cause decreased absorption of transdermal estrogen Why decreased levels of estrogen are problematic Ways to maximize absorption Options if serum estrogen levels are low on standard doses of transdermal estrogen Concerns of using a higher than standard dose The pushback in the UK regarding Dr. Newson’s work If it should be routine to measure blood levels of estrogen if using a transdermal product For more information on Dr. Newson, visit DrLouise Newson.com Dr. Streicher is on SUBSTACK      DrStreicher.Substack.com Articles Monthly newsletter All COME AGAIN podcast episodes Monthly News Flash Reports on recent research  Monthly Zoom Ask Me Anything Webinar Lauren Streicher, MD is a clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine, the founding medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause, and a Senior Research Fellow of The Kinsey Institute, Indiana University. She is a certified menopause practitioner of The Menopause Society. She is the Medical Director of Community Education and Outreach for Midi Health.     Dr. Streicher is the medical correspondent for Chicago’s top-rated news program, the WGN Morning News, and has been seen on The Today Show, Good Morning America, The Oprah Winfrey Show, CNN, NPR, Dr. Radio, Nightline, Fox and Friends, The Steve Harvey Show, CBS This Morning, ABC News Now, NBCNightlyNews,20/20, and World News Tonight. She is an expert source for many magazines and serves on the medical advisory board of The Kinsey Institute, Self Magazine, and Prevention Magazine. She writes a regular column for The Ethel by AARP and Prevention Magazine.       Links: Subscribe To Dr. Streicher’s Substack Information About the COME AGAIN Podcast Dr. Streicher’s CV and additional bio information Glossary Of Medical Terminology Books by Lauren Streicher, MD  Slip Sliding Away: Turning Back the Clock on Your Vagina-A gynecologist’s guide to eliminating post-menopause dryness and pain    Hot Flash Hell: A Gynecologist's Guide to Turning Down the Heat Sex Rx- Hormones, Health, and Your Best Sex Ever The Essential Guide to Hysterectomy                                      To Find a Menopause Clinician Midi Health   www.Joinmidi.com Midi Health is a telehealth company that provides high-level menopause care and takes insurance in all 50 states. Dr. Streicher is Midi’s Medical Director of Education and Community Outreach and is familiar with their medical protocols, which are all regularly updated and set by the top academic menopause experts in the country.    The Menopause Society- Certified Menopause Practitioner List Menopause.org To find a menopause practitioner: https://portal.menopause.org/NAMS/NAMS/Directory/Menopause-Practitioner.aspx Put in your zip code and designate NCMP or CMSP to get a certified menopause practitioner. While all people on this list have passed a competency examination, Dr. Streicher does not vouch for every one of these clinicians. Most are excellent. Major Medical Centers It also may be helpful to check with major medical centers in your area. Many have menopause clinics or lists of doctors who have an interest and expertise in menopause.        Dr. Streicher’s Inside Information podcast is for education and information and is not intended to replace medical advice from your personal healthcare clinician. Dr. Streicher disclaims liability for any medical outcomes that may occur because of applying methods suggested or discussed in this podcast.    

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• S4 Ep173: Two Clinicians- Twelve Questions

  I get lots of questions on various platforms. But I never get to all of them. So, today is Q and A day.  I asked my friend and colleague, Dr. Heidi Flagg to join me because it’s always good to get another point of view. Dr. Flagg is, above all, a clinician. She is in her office in NY city, day in and day out, helping women navigate peri menopause and menopause. And unlike many people out there who are new to the scene, Dr. Flagg brings decades of real-world experience to the table.   QUESTIONS Do you need to be 12 months without a period to start hormone therapy? I am getting a period every 3-4 months, so I assume I am in perimenopause. I am having a lot of symptoms, so I went to my doctor, and she suggested I go on birth control pills. I’m not even having sex. I don’t need birth control.  I am 48 years old. I had a hysterectomy 5 years ago because of fibroids. I am now having hot flashes, brain fog, and mood swings. What hormone levels should I check to see if I am ready for hormone therapy?  I started using an estrogen patch around 3 months ago. I am still having hot flashes. Do I need to give it more time or do I need more estrogen?   Is it OK to substitute a brand name patch with a generic patch?  I am 62. My last period was 13 years ago. Is it too late for me to state hormone therapy? Since I started using local vaginal estrogen, I have an accumulation under my clitoral hood. How best to clean it? Is it OK to put vaginal lubricant inside the vagina?  Will hormone therapy trigger the recurrence of endometriosis?  I have high cholesterol and want to know if Duovee™ is a good product for someone with high cholesterol. Would it be better to use a transdermal estrogen? Is it safe to use systemic estrogen and local estrogen at the same time? I had a hysterectomy last year because of uterine cancer. Can I take estrogen? I am taking low doses of testosterone, and I am pretty sure my voice is getting lower.  My doctor said my levels are fine.  I thought that only happened with high doses. If I go off, will it go back to how it was? I am 45 years old and scheduled for a hysterectomy because of fibroids that bleed a lot. Is my sex life going to change?   A menopause coach who wants to know how to help women getting conflicting information on social media.                                           Heidi Flagg MD     IG @m_pause Dr. Heidi Snyder Flagg is a founder and managing partner of Spring ObGyn, a private practice in NYC. Since completing her ObGyn residency at Brown’s Woman & Infant’s Hospital Dr. Flagg’s clinical interests have spanned the woman’s reproductive cycle with a current focus on peri menopausal and menopause.Dr. Flagg is a medical advisor to Flow Health and Let’s Talk Menopause.  Information on COME AGAIN-Sexuality and Orgasm Ways to Ask a Question I am not able to answer individual questions directly, but if you submit a question, I will do my best to get it answered during a podcast episode, Ask Me Anything Webinar, or a future Substack Article. The least likely place for me to see a question is on social media. (Instagram/Facebook) I do not check regularly.  1. Record a Question-Use this link to record your question. 2. Ask Me Anything Webinars Paid Substack subscribers can attend or submit a question in advance. The replays are available on my Substack platform. For more information or to become a subscriber, DrStreicher.Substack.com/subscribe.  3. Substack Chat    Subscribers can submit a question on my Substack chat. Dr. Streicher is on SUBSTACK      DrStreicher.Substack.com Articles Monthly newsletter All COME AGAIN podcast episodes Monthly News Flash Reports on recent research  Monthly Zoom Ask Me Anything Webinar Lauren Streicher, MD is a clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine, the founding medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause, and a Senior Research Fellow of The Kinsey Institute, Indiana University. She is a certified menopause practitioner of The Menopause Society. She is the Medical Director of Community Education and Outreach for Midi Health. Dr. Streicher is the medical correspondent for Chicago’s top-rated news program, the WGN Morning News, and has been seen on The Today Show, Good Morning America, The Oprah Winfrey Show, CNN, NPR, Dr. Radio, Nightline, Fox and Friends, The Steve Harvey Show, CBS This Morning, ABC News Now, NBCNightlyNews,20/20, and World News Tonight. She is an expert source for many magazines and serves on the medical advisory board of The Kinsey Institute, Self Magazine, and Prevention Magazine. She writes a regular column for The Ethel by AARP and Prevention Magazine.    Links: To receive Dr. Streicher’s FREE Insider Newsletter Glossary Of Medical Terminology Subscribe To Dr. Streicher’s Substack Information About COME AGAIN Podcast Dr. Streicher’s CV and additional bio information Books by Lauren Streicher, MD  Slip Sliding Away: Turning Back the Clock on Your Vagina-A gynecologist’s guide to eliminating post-menopause dryness and pain   Hot Flash Hell: A Gynecologist's Guide to Turning Down the Heat Sex Rx- Hormones, Health, and Your Best Sex Ever The Essential Guide to Hysterectomy                                      To Find a Menopause Clinician Midi Health   www.Joinmidi.com Midi Health is a telehealth company that provides high-level menopause care and takes insurance in all 50 states. Dr. Streicher is Midi’s Medical Director of Education and Community Outreach and is familiar with their medical protocols, which are all regularly updated and set by the top academic menopause experts in the country.  The Menopause Society- Certified Menopause Practitioner List Menopause.org To find a menopause practitioner: https://portal.menopause.org/NAMS/NAMS/Directory/Menopause-Practitioner.aspx Put in your zip code and designate NCMP or CMSP to get a certified menopause practitioner. While all people on this list have passed a competency examination, Dr. Streicher does not vouch for every one of these clinicians. Most are excellent. Major Medical Centers It also may be helpful to check with major medical centers in your area. Many have menopause clinics or lists of doctors who have an interest and expertise in menopause.     Dr. Streicher’s Inside Information podcast is for education and information and is not intended to replace medical advice from your personal healthcare clinician. Dr. Streicher disclaims liability for any medical outcomes that may occur because of applying methods suggested or discussed in this podcast.

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• S3 Ep172: COME AGAIN!

  Welcome to COME AGAIN:  Sexuality and Orgasm Podcast What if suddenly your tried-and-true maneuvers that consistently ended in orgasm no longer worked? Or it took so long and the climax so pathetic it was hardly worth the effort? Along with hot flashes, sandpaper sex, and a loss of libido, add the inability to have an orgasm to the list of post-menopause surprises your mom "forgot" to warn you about. In this episode you will hear the first two episodes of COME AGAIN-a new podcast series  with science-based information to get your libido to kick in and your clitoral nerve endings to wake up while also being wildly entertaining                             For more INFORMATION and to SUBSCRIBE COME AGAIN:  Sexuality and Orgasm is a limited podcast series  Part One- Sexual Function and Obstacles to Orgasm §  An overview of female sexuality, arousal and obstacles to orgasm.  §  What it takes for an orgasm to occur §  What can happen as a consequence of menopause, aging, medications and  medical conditions such as diabetes, heart disease, cancer  Part Two - Everyone Come! Part Two focuses on hormonal and non-hormonal solutions to   eliminate pain  boost arousal  wake up your clitoris  COME AGAIN is intended for both healthcare professionals and the general public.                               For more INFORMATION and to SUBSCRIBE Lauren Streicher, MD is a clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine, the founding medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause, and a Senior Research Fellow of The Kinsey Institute, Indiana University. She is a certified menopause practitioner of The Menopause Society. She is the Medical Director of Community Education and Outreach for Midi Health. Dr. Streicher is the medical correspondent for Chicago’s top-rated news program, the WGN Morning News, and has been seen on The Today Show, Good Morning America, The Oprah Winfrey Show, CNN, NPR, Dr. Radio, Nightline, Fox and Friends, The Steve Harvey Show, CBS This Morning, ABC News Now, NBCNightlyNews,20/20, and World News Tonight. She is an expert source for many magazines and serves on the medical advisory board of The Kinsey Institute, Self Magazine, and Prevention Magazine. She writes a regular column for The Ethel by AARP and Prevention Magazine.  DrStreicher.com Instagram @DrStreich Facebook @DrStreicher YouTube @DrStreicherTV LinkedIn @DrStreicher                   Sign up to receive DR. STREICHER’S FREE NEWSLETTER     Books by Lauren Streicher, MD  Slip Sliding Away: Turning Back the Clock on Your Vagina-A gynecologist’s guide to eliminating post-menopause dryness and pain   Hot Flash Hell: A Gynecologist's Guide to Turning Down the Heat   Sex Rx- Hormones, Health, and Your Best Sex Ever   The Essential Guide to Hysterectomy                                        To Find a Menopause Clinician Midi Health   www.Joinmidi.com Midi Health is a telehealth company that provides high-level menopause care and takes insurance in all 50 states. Dr. Streicher is Midi’s Medical Director of Education and Community Outreach and is familiar with their medical protocols, which are all regularly updated and set by the top academic menopause experts in the country.    The Menopause Society- Certified Menopause Practitioner List Menopause.org To find a menopause practitioner: https://portal.menopause.org/NAMS/NAMS/Directory/Menopause-Practitioner.aspx Put in your zip code and designate NCMP or CMSP to get a certified menopause practitioner. While all people on this list have passed a competency examination, Dr. Streicher does not vouch for every one of these clinicians. Most are excellent.   Major Medical Centers It also may be helpful to check with major medical centers in your area. Many have menopause clinics or lists of doctors who have an interest and expertise in menopause.    If you are in the Chicago area, the center founded by Dr. Streicher:  The Northwestern Medicine Center for Sexual Medicine and Menopause Sexmedmenopause.nm.org        Dr. Streicher’s Inside Information podcast is for education and information and is not intended to replace medical advice from your personal healthcare clinician. Dr. Streicher disclaims liability for any medical outcomes that may occur because of applying methods suggested or discussed in this podcast.

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• S3 Ep171: TEETH TALK with Whitney DiFoggio MA, RDH

  As our bodies age, so do our teeth. And, no surprise, menopause also has an impact on dental health. My guest, Whitney Difoggio, AKA Teeth Talk Girl ,knows it all when it comes to dental hygiene ,anti-aging tips and post menopause teeth, gums, and tongues. Whitney DiFoggio, founder of teethtalkgirl.com, is a passionate dental health communicator and registered dental hygienist, recognized as "Teeth Talk Girl" on social media (@teethtalkgirl). With a bachelor’s degree in biology from the University of Illinois Chicago and a master’s degree in health communication from Arizona State University, she is currently pursuing her doctorate in health science at Eastern Virginia Medical School. Whitening  Dentures Dry mouth Burning mouth Fluoride Flossing (and other uses for dental floss!)  Electric toothbrushes Losing teeth Website: teethtalkgirl.com YouTube: YouTube.com/TeethTalk Instagram: @teethtalkgirl TikTok: @teethtalkgirl Facebook: @teethtalkgirl Please take my survey about the relationship between vaginal dryness and dry mouth. It will take no more than 3 minutes to fill out. As a thank you, I am giving away 10 free subscriptions to my paid substack for the year! DrStreicher.Substack.com If you are willing to give me your e-mail at the end, I will enter you.  If you prefer to take it anonymously, known you are making a major contribution to menopause research! https://www.surveymonkey.com/r/HOWDRYIAM   Lauren Streicher, MD is a clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine, the founding medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause, and a Senior Research Fellow of The Kinsey Institute, Indiana University. She is a certified menopause practitioner of The Menopause Society. She is the Medical Director of Community Education and Outreach for Midi Health. Dr. Streicher is the medical correspondent for Chicago’s top-rated news program, the WGN Morning News, and has been seen on The Today Show, Good Morning America, The Oprah Winfrey Show, CNN, NPR, Dr. Radio, Nightline, Fox and Friends, The Steve Harvey Show, CBS This Morning, ABC News Now, NBCNightlyNews,20/20, and World News Tonight. She is an expert source for many magazines and serves on the medical advisory board of The Kinsey Institute, Self Magazine, and Prevention Magazine. She writes a regular column for The Ethel by AARP and Prevention Magazine.  DrStreicher.com Instagram @DrStreich Facebook @DrStreicher YouTube @DrStreicherTV LinkedIn @DrStreicher                   Sign up to receive DR. STREICHER’S FREE NEWSLETTER   Books by Lauren Streicher, MD  Slip Sliding Away: Turning Back the Clock on Your Vagina-A gynecologist’s guide to eliminating post-menopause dryness and pain   Hot Flash Hell: A Gynecologist's Guide to Turning Down the Heat Sex Rx- Hormones, Health, and Your Best Sex Ever The Essential Guide to Hysterectomy                                      To Find a Menopause Clinician Midi Health   www.Joinmidi.com Midi Health is a telehealth company that provides high-level menopause care and takes insurance in all 50 states. Dr. Streicher is Midi’s Medical Director of Education and Community Outreach and is familiar with their medical protocols, which are all regularly updated and set by the top academic menopause experts in the country.    The Menopause Society- Certified Menopause Practitioner List Menopause.org To find a menopause practitioner: https://portal.menopause.org/NAMS/NAMS/Directory/Menopause-Practitioner.aspx Put in your zip code and designate NCMP or CMSP to get a certified menopause practitioner. While all people on this list have passed a competency examination, Dr. Streicher does not vouch for every one of these clinicians. Most are excellent.   Major Medical Centers It also may be helpful to check with major medical centers in your area. Many have menopause clinics or lists of doctors who have an interest and expertise in menopause.    If you are in the Chicago area, the center founded by Dr. Streicher:  The Northwestern Medicine Center for Sexual Medicine and Menopause Sexmedmenopause.nm.org        Dr. Streicher’s Inside Information podcast is for education and information and is not intended to replace medical advice from your personal healthcare clinician. Dr. Streicher disclaims liability for any medical outcomes that may occur because of applying methods suggested or discussed in this podcast.

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