Explore every episode of the podcast Ageless and Outrageous

In this episode, I’m talking about one of the most overlooked threats to women’s health—heart disease—and the powerful role estrogen plays in protecting your cardiovascular system. Most people think of estrogen in relation to hot flashes, mood swings, or bone health, but it also keeps your blood vessels healthy and your heart protected. When estrogen levels drop at menopause, that protection fades, and your risk for heart problems can rise quickly.

I break down how estrogen impacts your blood vessels, why heart disease risk skyrockets after menopause, and the surprising reproductive and lifestyle factors that can raise your risk—many of which you’ve probably never heard about from your doctor. I’ll also share the simple, powerful steps you can take right now to protect your heart, improve your longevity, and feel your best as you age.

Here’s what I cover in this episode:

• How estrogen protects your arteries, reduces inflammation, and lowers LDL cholesterol
• Why heart disease is the number one killer of women—and why most women don’t realize it
• Reproductive and hormonal risk factors (PCOS, early menopause, pregnancy complications, persistent hot flashes)
• The hidden danger of central obesity and why fat distribution matters
• Key lifestyle strategies for heart health: movement, diet, and modifying controllable risks
• How hormone replacement therapy (HRT) can benefit both short-term symptoms and long-term heart protection
• Practical tips to start improving cardiovascular health in midlife and beyond

This episode is all about giving you the science, the numbers, and the tools you need to protect your heart—because when it comes to longevity, the odds are in your favor if you focus on the right risks.

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Let’s talk about something most doctors still aren’t saying clearly enough: estrogen matters for your brain. In this episode, I review what the research actually shows about HRT and long-term brain protection.

Alzheimer’s disease is the leading cause of death for women over 65 in the U.S. and Australia. And it’s not just because we live longer — women are more biologically vulnerable. One major reason? Estrogen loss.

Let's look at a 2023 comprehensive review of over 6 million women that looked at whether hormone therapy helps or harms brain health. Spoiler alert: timing matters. This episode is especially important for women in perimenopause or newly postmenopausal who are being told to “just wait it out.”

• The Alzheimer’s crisis in women
  • Over 2/3 of Alzheimer’s cases are women
  • Not just about longevity — estrogen plays a direct role in brain protection
• Major takeaways from the 2023 neuroscience meta-analysis
  • Over 6 million women studied
  • Combined randomized trials + real-world data
  • Main finding: Timing and type of hormone therapy make all the difference
• When hormone therapy helps protect your brain
  • Estrogen started in midlife (around age 50) reduced Alzheimer’s risk by 32%
  • Observational studies showed a 22% lower risk of Alzheimer’s and a 19% reduced risk of all-cause dementia
  • Women on estrogen-only therapy had better cognitive outcomes than those on estrogen + synthetic progestins
  • Longer duration (>6 years) of HRT use = greater brain benefit
• When it may not help — or may even increase risk
  • Women who start hormone therapy after age 65 or well past menopause may see no benefit or increased risk
  • This risk mostly applies to oral estrogen and progestins (synthetic, not bioidentical)
  • Think of it like sunscreen: starting after the damage has been done doesn’t help much
• The “Window of Opportunity” Concept
  • Best brain benefits come from starting HRT during perimenopause or early postmenopause (within 10 years of last period)
  • Estrogen is neuroprotective during this transition — but less effective if cognitive decline has already started
• Why synthetic progestins fall short
  • Studies consistently show better brain outcomes without progestins
  • We still lack data on bioidentical progesterone and brain health — more research needed
  • Bottom line: avoid synthetic versions if possible
• If you’re already over 65 — is it too late?
  • Not necessarily
  • HRT may still help with other issues like bone, sleep, or quality of life
  • But brain protection may not be as significant
  • Requires individualized risk-benefit analysis

Every woman deserves a personalized, balanced discussion about hormone therapy — not one-size-fits-all advice based on outdated studies. If you’re in your 40s or 50s, this is the time to have that conversation — not after problems start.

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In this episode I break down one of the most frustrating myths I hear in women’s health: that once you reach a certain age — usually 60 or 65 — you’re “too old” to start hormone therapy.

Spoiler alert: that is not true. And it’s long overdue that we challenge the outdated thinking behind it.

I walk you through how this myth started, what the science actually shows, and how a personalized, risk-based approach is what really matters — not your birthday.

• Where the “Too Old” Myth Started: The 2002 WHI study caused panic, but it was never designed to assess quality of life — and its flawed conclusions about age cutoffs still haunt modern care.
• The Real Impact of Stopping HRT After 60: Many women were forced off therapy overnight, leading to a resurgence of symptoms and long-term confusion among providers.
• The Truth About Vasomotor Symptoms (Hot Flashes & Night Sweats):
  • Can last 7–14 years or more
  • Up to 1 in 3 women over 65 still suffer from them
  • More severe and long-lasting in African American and Hispanic women
• Other Menopausal Syndromes That Persist or Worsen With Age:
  • Genitourinary Syndrome of Menopause (GSM): Dryness, pain with sex, urinary symptoms
  • Musculoskeletal Symptoms: Joint pain, frozen shoulder, hand stiffness
  • Sleep Disruption: Even without night sweats, quality of sleep drops significantly
  • Cognitive Decline: Brain fog, word-finding issues, memory trouble — not just “getting older”
• Why There’s No Magical Cutoff at Age 60 or 65: Menopause isn’t a finish line — it’s a transition. And most women spend 30–40 years post-menopause. We can’t ignore their needs for half their lives.
• What New Data Actually Shows:
  • Later follow-ups (13+ years) from WHI show no increased risk of heart disease or death in women 60+ on HRT
  • Slight increases in stroke and clot risk only apply to oral estrogen — not safer, modern non-oral methods
  • Estrogen-alone therapy may reduce risk of dementia-related death
  • Cognitive data still evolving — but timing, route, and type of hormone matter
• Why a Personalized Risk-Benefit Approach Is Critical: Your chronological age isn’t enough. I look at:
  • Bone density
  • Heart and brain health
  • Sleep quality
  • Symptom burden
  • Family history
• Final Takeaway: If you're being told you can't continue or start hormones because of your age — challenge it. Ask why. And if your provider can’t answer, find one who can.

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DHEA is one of the most overlooked hormones in the conversation around aging well, but it plays a powerful role in energy, mood, metabolism, and muscle maintenance. I often see patients who are doing everything right—eating clean, sleeping well, on hormone replacement—but still feel like something is missing. That something could be DHEA.

This hormone starts declining in your 30s and 40s, and without it, your body may struggle to produce testosterone, estrogen, and critical immune and brain chemicals. In this episode, I explain how DHEA works, how to know if you’re low, and how to safely supplement it if needed.

• What DHEA is and how it differs from other sex hormones
• Why DHEA levels start declining as early as your 30s
• Symptoms of low DHEA: fatigue, belly fat, low libido, poor muscle tone
• How DHEA supports bone growth, immune health, metabolism, and mood
• The connection between DHEA and cortisol (stress hormone)
• Best practices for testing and ideal blood level targets
• Over-the-counter vs. compounded supplements: what to watch out for
• DHEA’s use in vaginal health (including Intrarosa and compounded options)
• Common misconceptions about hair loss and DHEA
• When to consider DHEA as part of a broader HRT strategy

DHEA may not get the attention that estrogen and testosterone do, but it’s a foundational hormone that supports multiple systems in the body. From energy and fat metabolism to mood and immune defense, low DHEA can quietly affect how you feel, look, and function. Supplementing—when guided by lab testing and clinical signs—can help fill in the hormonal gaps and bring new vitality to your day-to-day life. With the right dose and delivery method, it might just be the missing link in your longevity and wellness plan.

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Most people associate estrogen loss with hot flashes and night sweats, but the truth is—estrogen affects nearly every part of the body. I often see women struggling with fatigue, brain fog, bladder irritation, joint pain, and sleep problems, and they’ve never been told these symptoms could be related to perimenopause or menopause. In this episode, I walk through the science of how estrogen functions in different tissues and share real examples from three patients in their 40s, 50s, and 70s—all experiencing very different symptoms tied to the same hormonal shift.

We have to move beyond the idea that menopause only affects the ovaries. When estrogen drops, the brain, bones, muscles, skin, and bladder all feel it—and understanding this opens the door to smarter, more personalized treatment.

• Why estrogen loss doesn’t always present as hot flashes
• The musculoskeletal syndrome of menopause: how estrogen protects joints and muscle
• How low estrogen disrupts sleep, mood, memory, and concentration
• The role of estrogen in preserving bone mass and preventing fractures
• Genitourinary syndrome of menopause (GSM): what happens to the vagina and bladder
• Why women can still have low estrogen symptoms even with regular periods
• Limitations of hormone blood tests in your 40s
• How I approach estrogen therapy in women in their 40s, 50s, and 70s
• What vaginal estrogen does (and why it doesn’t increase cancer risk)
• Why estrogen is essential—not optional—for aging well

Estrogen does so much more than regulate the menstrual cycle—it influences everything from our joints to our mood to our ability to sleep soundly at night. Understanding how deeply this hormone impacts the entire body is the first step toward reclaiming wellness during perimenopause, menopause, and beyond. Whether symptoms show up subtly or dramatically, they deserve to be taken seriously. With the right evaluation and a personalized treatment plan, it's possible to feel strong, clear, and supported again—at any age.

Read Dr J's blog to find out why personalized hormone replacement is best:  https://www.foundationsfl.com/post/precise-personalized-menopausal-hormone-therapy

And you can learn more about all thing hormone replacement here: https://www.foundationsfl.com/bioidentical-hormone-optimization

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In this episode of Ageless and Outrageous, I dive into one of my favorite add-ons for optimizing weight loss, improving recovery, and aging better: Sermorelin. While often confused with growth hormone itself, Sermorelin works upstream—by signaling your pituitary to produce more of your own natural growth hormone. It’s one of the most exciting ways to maintain muscle, reduce visceral fat, and support vibrant aging without shutting down your hormone system.

If you’re doing everything right—strength training, eating protein, balancing your hormones—but still feel like something’s missing, Sermorelin might be the next step.

• What Sermorelin is and how it differs from synthetic growth hormone
• How Sermorelin supports muscle growth, bone health, and visceral fat reduction
• Why growth hormone production naturally declines with age
• Benefits beyond body composition: improved sleep, mood, skin elasticity, and immune function
• Why Sermorelin is a safer alternative to direct growth hormone therapy
• Proper dosing protocols and why it mimics the body’s natural rhythm
• Important precautions: cancer screenings, thyroid health, and IGF-1 monitoring
• How Sermorelin can complement your weight loss or HRT program for stronger results

Whether you're working to lose weight, maintain muscle, improve your sleep, or simply feel more vibrant as you age, Sermorelin offers a powerful, science-backed tool to support your goals. It’s not a magic bullet, but when paired with resistance training, optimal protein intake, and balanced hormones, it can take your results to the next level. As always, it’s important to work with a qualified provider to ensure safe and effective use. If you’ve been looking for a way to rebuild from the inside out—Sermorelin might just be the boost your body has been waiting for.

Read Dr J's blog on Sermorelin injections here:  https://www.foundationsfl.com/post/sermorelin-could-be-your-secret-weight-loss-weapon

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Let's review a powerful new study on how testosterone therapy can improve mood, cognition, and libido in perimenopausal and menopausal women—even those already on hormone replacement therapy. If you've been struggling with brain fog, irritability, or a loss of motivation and joy, this episode offers a science-backed look at one often-overlooked solution.

Here’s what you’ll discover:

• 🧪 The results of a large study tracking 510 women who added testosterone to their HRT
• 🔄 Why common mood and cognitive symptoms may not be “just stress” or “just aging”
• 💥 A 47% improvement in mood and 52% boost in libido after only four months
• 🧠 The surprising link between testosterone and brain function in women
• 🚫 Why the “testosterone is only for men” myth needs to go
• 🧾 What it means when a treatment is off-label—and why that’s more common than you think
• 🩺 How I uses testosterone in her practice and what to consider if your current regimen isn’t working
• 💬 Tools to better describe and track your symptoms, so you can advocate for yourself confidently

Whether you’re already on hormone therapy or just starting to explore options, this episode offers a fresh, practical perspective on what testosterone could do for your quality of life. If you’ve been feeling unlike yourself lately—this conversation might be the missing piece.

Learn more about bioidentical hormone replacement here:

https://www.foundationsfl.com/testosterone-pellet-therapy-orlando

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In this timely episode, I am excited to share the brand-new 2025 clinical guidelines for treating Genitourinary Syndrome of Menopause (GSM)—a long-overdue update that prioritizes shared decision making and patient-centered care. Whether you’re a patient navigating vaginal dryness, bladder issues, or recurrent UTIs, or a clinician looking to stay current, this episode is a must-listen. We'll go over the science, dispel myths about estrogen safety, and learn how these guidelines shift the conversation around midlife women’s health.

What you’ll learn in this episode:

• 💡 Why the new GSM guidelines are revolutionary—and long overdue
• 🧠 What shared decision making really means in patient care
• 🌸 The real truth about vaginal estrogen safety (yes, even for breast cancer survivors)
• 🔍 How low hormones—estrogen AND testosterone—cause GSM symptoms
• 🧴 Treatment options beyond estrogen: DHEA, Ospemifene, and vaginal testosterone
• 🚽 How vaginal estrogen reduces bladder symptoms and cuts recurrent UTIs by 52%
• 🧬 Why package inserts are misleading—and how FDA labeling has confused patients for years
• 📢 A call to action for both providers and patients: know your options and advocate for your quality of life

This episode is a critical listen for both patients and providers alike. Whether you're experiencing GSM symptoms yourself or helping women manage this often-overlooked condition, the insights and updates shared here are essential for making empowered, evidence-based decisions.

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In this episode, I sit down with Dr. Christine Vaccaro to dive into the powerful connection between mindset, hormones, and overall well-being. Dr. Vaccaro shares her approach to integrative medicine, emphasizing how lifestyle choices, stress management, and personalized hormone optimization play a crucial role in longevity and quality of life. We explore how women can take control of their health by addressing both physical and emotional well-being.

Join us as we discuss:

• How stress and mindset directly impact hormonal balance and overall health
• Why personalized hormone therapy can be a game-changer for energy, mood, and longevity
• The critical role of gut health in inflammation and disease prevention
• Why conventional medicine often overlooks lifestyle factors in patient care
• Simple, actionable strategies to improve wellness, from nutrition to mindfulness practices

If you’re ready to take a proactive approach to your health and feel your best at any age, this episode is packed with valuable insights and practical tips! 🎧✨

Dr Christine Vaccaro is a double board certified and fellowship trained urogynecologist and sexual medicine specialist, who has been in practice for over 20 years. She is an associate professor of gynecologic surgery at the Uniformed Services University in Bethesda. She recently retired from the military, and was the Program Director for the Urogynecology Fellowship at Walter Reed, and now practices at the offices of Rachel Rubin, MD, located in Bethesda, MD. 

She is also involved in multiple national medical committees, and has extensively published in medical journals, medical textbooks and online. She is medical advisor for the SHE+ (Sexual Health Education PLUS) Foundation, which is a non-profit organization which supports women's sexual health through research, education, advocacy and grant funding. When not at work she enjoys hot yoga and attending her kid's sporting events.

Social Media & Links: 

Instagram: @drchristinevaccaro

Linktr.ee:  linktr.ee/drchristinevaccaro

Practice website: https://www.rachelrubinmd.com/

YouTube (practice): youtube.com/@DrRachelRubin

Thank you to Dr Vaccaro for this incredible episode!

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In this must-listen episode, I'm speaking with Dr. Amy Killen, a leading expert in hormone optimization and longevity medicine. Dr. Killen shares her journey from emergency medicine to preventive care, driven by the realization that our healthcare system often fails to keep people truly healthy. Together, we unravel the science behind hormone replacement therapy (HRT), debunk common fears surrounding estrogen and breast cancer, and discuss why bioidentical hormones matter.

Join us as we dive into:

• The difference between bioidentical and synthetic hormones—and why it matters
• Why most doctors aren’t trained in menopause medicine and how women can advocate for better care
• The real risks and benefits of hormone therapy, including its impact on heart, brain, and bone health
• How estrogen plays a critical role in everything from skin hydration to preventing osteoporosis
• Why hormone balance is a key factor in longevity and aging well

If you’ve ever had questions about hormone therapy, this episode delivers science-backed answers that every woman needs to hear! 🎧✨

Dr. Amy B. Killen, M.D. is a leading physician in regenerative and hormone optimization medicine, specializing in women's health and helping patients navigate their "Queen Phase™" with evidence-based interventions. A board-certified emergency physician turned longevity specialist, she combines cutting-edge treatments like stem cell therapy, hormone optimization, and peptides with practical lifestyle wisdom at her Utah and Texas clinics while sharing her expertise through international speaking engagements and educational content creation.

As Chief Medical Officer of Humanaut Health and founder of the Human Optimization Project (HOP), Dr. Killen continues to advance the field of longevity medicine with her "(r)Age Against the Mainstream" approach. 

She lives in Salt Lake City with her family of five.

Follow Dr Killen on social:

IG/FB: @dr.amybkillen, @hopboxlife , @humanauthealth

Twitter: KillenMD

Websites: www.dramykillen.com, www.humanauthealth.com, www.hopbox.life

Thank you Dr Killen for your wonderful insights!

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Today I sit down with Dr. Alicia Robbins to discuss the critical need for better education and support for women in perimenopause and menopause. Dr. Robbins shares how her background as a general OB/GYN led her to realize that many women in their late 30s and 40s were struggling with symptoms like sleep disturbances, mood swings, and weight gain—yet traditional training left her without the right tools to help them. Together, they break down the misinformation surrounding hormone therapy and why menopause care needs to be a recognized specialty.

Tune in as we explore:

• The lack of perimenopause education in traditional medical training
• Why hormone therapy is often misunderstood and underutilized
• How women can advocate for themselves when their doctors dismiss menopause symptoms
• The importance of sleep and how hormones impact mood, weight, and long-term health
• Why today’s women are demanding better menopause care compared to previous generations

This episode is essential listening for women of all ages—whether you’re approaching menopause, in the midst of it, or just want to be better prepared for what’s ahead. 🎧🔥

Dr Alicia Robbins is a board-certified OBGYN, menopause practitioner and lifestyle medicine doctor. Originally from southern Arizona, she completed her undergraduate studies at Vanderbilt University and graduated medical school and residency at Mount Sinai Hospital in New York City.

She then worked at Mount Sinai Hospital in New York City as a full-time faculty member and received several teaching awards during her time there. In addition to teaching residents, she sat on the admission committee at Mount Sinai. 

Once she turned 40, she realized there was not a lot of guidance for women in their 40s and 50s on how to optimize health and feel better.

After more than decade in NYC, she and her husband and moved to Greenwich, CT where she has been working for 5 years performing obstetrics and surgery at Greenwich Hospital. She is a certified Peri/Menopause Practitioner and a Lifestyle Medicine physician. She speaks regularly on women's health and has been featured in Allure Magazine, The New York Times, ABC channel 7, Parents magazine and several podcasts. 

She is married to Dr. Tarek Korban, an oral-maxillofacial surgeon in NY and is the mother of 3 young boys. She is an active member of her community and is passionate about supporting the women in her community and especially hte female-founded local businesses. She cherishes spending time with her family and friends and tries to remember that the simple things in life bring the most pleasure. 

Follow Dr Robbins on social:

Intstagram: https://www.instagram.com/aliciarobbinsmd/

Facebook: https://www.facebook.com/people/The-Elm-Greenwich/61552052893831/

Visit Dr Robbins at her practice, The Elm, in Greenwich, CT: https://theelmgreenwich.com/

Thank you Dr Robbins for your amazing information!

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Listen in as Dr. Jackson and Dr. Krapf discuss:

• The lack of education around vulvar and vaginal disorders in traditional OB/GYN training
• What genitourinary syndrome of menopause (GSM) is and why it’s more than just vaginal dryness
• The autoimmune nature of lichen sclerosis and how to manage it properly
• The role of testosterone in female sexual health and how it impacts the vulva
• How to advocate for better vulvar care and find a specialist for chronic pain conditions

This episode is a must-listen for anyone experiencing vaginal discomfort, pain, or hormonal changes—or for those looking to better understand how to optimize their sexual health at any age. 🎧✨

Dr. Jill Krapf is a board-certified Obstetrician Gynecologist specializing in female sexual pain disorders and Director of the Center for Vulvovaginal Disorders Florida in Tampa, Florida, USA.  She is active in research and has published chapters and peer-reviewed articles on vulvodynia and vulvar lichen sclerosus.  She is Associate Editor for the medical journal Sexual Medicine, as well as for the textbook Female Sexual Pain Disorders, 2nd Edition.  She is a Fellow of the International Society for the Study of Vulvovaginal Disease (ISSVD) and a Fellow and Board Member of the International Society for the Study of Women’s Sexual Health (ISSWSH), serving on the Education Committee and Chair of the Social Media Committee.  Dr. Krapf is a co-author on the trade book “When Sex Hurts: Understanding and Healing Pelvic Pain.” She shares educational content on social media @jillkrapfmd.

Jill Krapf MD

Center for Vulvovaginal Disorders Florida

3216 W Azeele St., Suite 2

Tampa, Florida 33609

appointments@jillkrapfmd.com

813-358-7634

When Sex Hurts: Understanding and Healing Pelvic Pain

(sale proceeds go directly to the National Vulvodynia Association to support research)

https://www.hachettebookgroup.com/titles/andrew-goldstein-md/when-sex-hurts/9780306827419/?lens=balance

Female Sexual Pain Disorders: Evaluation and Management

https://onlinelibrary.wiley.com/doi/book/10.1002/9781119482598

ISSWSH 2024-25 Virtual Genitopelvic Pain Course

https://www.isswshcourse.org/genitopelvic-pain-course-2024-25

Thank you to Dr Krapf for sharing her expertise!

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In this powerful episode, Dr. Kristin Jackson sits down with breast surgeon and fitness advocate Dr. Devina McCray. Dr. McCray shares her personal journey from being an overworked physician struggling with her health to becoming a competitive bodybuilder. She dives into how muscle-building is essential for longevity, cancer prevention, and overall health—especially for women.

Tune in as Dr. McCray and Dr. Jackson discuss:

• The rising rates of breast cancer and why it affects even those without risk factors
• How lifestyle choices, including diet and exercise, can dramatically reduce cancer risk
• The connection between strength training, metabolism, and hormone balance
• Why building muscle is the key to aging well and preventing osteoporosis, falls, and frailty
• Practical tips for incorporating strength training into any lifestyle—whether you’re a beginner or looking to push your limits

This episode is a must-listen for anyone looking to take control of their health and age with strength, confidence, and resilience! 🎧💪

Devina McCray, MD, is a breast surgical oncologist who is board certified in general surgery. She specializes in benign and malignant breast disease. Her areas of surgical expertise include breast conservation surgery, sentinel lymph node biopsy, axillary node dissection, skin and nipple sparing mastectomy, oncoplasty, and intraoperative radiation therapy (IORT). Dr. McCray received her medical degree from the University of Colorado Health Sciences Center, School of Medicine. Her residency in general surgery was completed at Florida Hospital Orlando, followed by a fellowship in breast surgical oncology at the Cleveland Clinic in Ohio. She is a member of the American Society of Clinical Oncology, the American Society of Breast Surgeons, and the Society of Surgical Oncology.

Thank you Dr McCray for sharing your insights!

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The podcast discusses challenges of experiencing painful intercourse and how it can be treated effectively. It raises the importance of conversation about sexual health in medical settings and sheds light on genitourinary syndrome of menopause, a common issue affecting post-menopausal women related to the ageing process.

Want to consider non-medication options to improve painful intercourse? Check out the options here: https://www.foundationsfl.com/vaginal-rejuvenation

Or consider options to strengthen and enhance orgasm here: https://www.foundationsfl.com/orgasmenhancement

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Let’s talk about the pelvic floor—one of the most important and misunderstood muscle groups in the body. In this episode, I’m dicussing everything you need to know about your pelvic floor: what it is, what it does, and why it’s crucial to your overall health. Whether you’re dealing with postpartum changes, menopause symptoms, or just want to understand your body better, this episode is for you.

I’ll share insights into common pelvic floor issues, like urinary incontinence, bowel problems, and painful intercourse, and explain how life stages like childbirth and aging impact these muscles. We’ll also talk about practical solutions, including when to seek pelvic floor therapy, how to do Kegels correctly (spoiler: they’re not for everyone!), and the role of lifestyle changes. This episode will empower you to take control of your pelvic health and improve your quality of life.

• What is the pelvic floor? A breakdown of its anatomy and functions.
• Common pelvic floor issues: Including urinary incontinence, bowel dysfunction, painful intercourse, and prolapse.
• The role of life stages: How childbirth, menopause, and aging impact pelvic floor health.
• Pelvic floor dysfunction vs. muscle strength: How to identify weak or tight pelvic floor muscles.
• Pelvic floor therapy: When to seek physical therapy and what it involves.
• Kegels and beyond: A guide to exercises that strengthen (or relax) the pelvic floor.
• Lifestyle factors: The importance of diet, hydration, posture, and stress management.
• Misconceptions about pelvic floor health: Debunking myths and addressing the stigma.

Whether you’re looking to address a specific issue or simply want to stay informed, this episode empowers listeners to prioritize their pelvic floor health for improved quality of life.

Learn more about therapy with the Emsella chair here: https://www.foundationsfl.com/btl-emsella

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In this episode, I’m looking into a topic that’s close to my heart: the safety of testosterone therapy for women. I’ll share the latest research showing how testosterone improves quality of life, libido, cardiovascular health, and even bone and brain health—all without increasing risks like breast cancer or cardiovascular events. If anything, the data points to some surprising benefits that could make a huge difference, especially when therapy starts early.

I’ll also address misconceptions, like the so-called “lack of safety data” often cited by critics, and unpack why the timing of therapy plays such a crucial role in its effectiveness. If you’ve ever wondered whether testosterone therapy might be right for you, or if you’re just curious about the science, this episode has answers you won’t want to miss.

Key Takeaways from This Episode:

• Testosterone therapy is not only safe for women but has proven benefits for libido, heart health, and more.
• Long-term studies show no increased breast cancer risk and even suggest potential reductions.
• Starting hormone replacement therapy earlier leads to better outcomes, supporting the "timing hypothesis."
• Current FDA-approved options for women are limited, but working with a specialist can help you find the best personalized approach.

If you’ve been on the fence about hormone therapy or just want to learn more, this episode is packed with evidence, insights, and a little dose of my usual candor. Let’s break it all down together!

Learn more about testosterone replacement therapy here: https://www.foundationsfl.com/testosterone-pellet-therapy-orlando

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In this episode, I tackle the uncomfortable yet important topic of recurrent urinary tract infections (rUTIs), a challenge many women face. I draw on my 25 years of expertise to explain the causes, symptoms, and cutting-edge diagnostic tools for managing rUTIs effectively. I dispels common myths, highlights the limitations of traditional urine cultures, and discusses the potential role of advanced molecular testing.

Key topics in this episode:

The Basics:

• What qualifies as a recurrent UTI (rUTI).
• Differences between persistent infections and rUTIs.
• How UTI symptoms evolve with age and menopause.

Testing Options:

• Urine dipsticks, microscopy, and the limitations of traditional urine cultures.
• Benefits and use of molecular (PCR) testing.
• Challenges of clean-catch urine samples versus catheterized urine specimens.

Revolutionizing UTI Management:

• The importance of treating active infections before switching to prevention.
• Understanding biofilms and their role in recurrent infections.
• Suppressive antibiotics: how low doses work to prevent recurrence.

Myth-Busting Common UTI Advice:

• Why urinating before and after sex doesn't prevent UTIs.
• The lack of evidence supporting cranberry products and probiotics for prevention.
• Debunking the importance of wiping direction.

Prevention Strategies:

• The role of vaginal estrogen in reducing rUTIs, particularly for menopausal women.
• Why systemic estrogen may not suffice for vaginal and bladder health.
• Practical hydration tips and the link between sugar intake and infections.

The Future of UTI Care:

• Antibacterial stewardship and avoiding overuse of antibiotics.
• How advanced testing and emerging research may reshape UTI treatment.

From the importance of personalized care to practical strategies for prevention, including the game-changing benefits of vaginal estrogen, Dr. Jackson emphasizes empowering women with accurate information and effective solutions. Tune in for science-backed advice and tips to keep your bladder healthy and your holidays UTI-free!

With Dr. Jackson's expertise, you’ll walk away with the knowledge to tackle rUTIs confidently and stay healthy through the holidays and beyond.

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In this episode, I discuss the fascinating world of muscle health, exploring why muscle is not just about strength but also a critical component of long-term vitality. From the biology behind muscle growth to its surprising role in hormone regulation, aging, and even metabolism, this conversation is packed with insights that will change how you think about fitness and health. We discuss the natural decline of muscle mass with age, its impact on overall health, and actionable strategies to maintain and rebuild it—whether you're in your 30s, 50s, or beyond.

Key points in this episode:

The Importance of Muscle Health

• Muscle as a key to strength, metabolism, and overall vitality.
• The role of muscle in aging well and maintaining independence.
• The impact of sarcopenia (age-related muscle loss) on health and mobility.

How Muscle Functions Beyond Strength

• Muscle’s role in calorie burning and blood sugar regulation.
• How muscle contributes to hormone production and immune function.

The Science of Muscle Growth

• Hypertrophy: How muscles grow through resistance training.
• The critical role of protein in muscle repair and maintenance.
• Factors influencing muscle growth, including exercise and nutrition.

Hormones and Muscle Health

• Testosterone’s role in muscle mass and strength.
• Estrogen’s influence on muscle recovery and function.
• Growth hormone’s contribution to tissue repair and muscle maintenance.

The Impact of Hormonal Decline

• How menopause and andropause accelerate muscle loss.
• The benefits of hormone replacement therapy (HRT) for muscle health.

Strategies to Build and Maintain Muscle

• The importance of regular strength training for all ages.
• Recommended protein intake for muscle repair and growth.
• Recovery practices like rest and sleep for optimal muscle function.
• The role of HRT in mitigating age-related muscle decline.

The Link Between Muscle and Longevity

• Muscle mass as a predictor of overall health and reduced chronic disease risk.
• Muscle’s role in supporting metabolism, mobility, and energy levels as we age.

Tune in to uncover expert tips on integrating resistance training, optimizing protein intake, and leveraging hormone therapies to maximize your muscle potential and longevity. Whether you’re looking to elevate your physical performance, improve your health outcomes, or simply age with strength and grace, this episode provides the roadmap to achieving it all. Don’t forget to subscribe and share with anyone who’s ready to take charge of their health!

Learn more about testosterone replacement therapy here: https://www.foundationsfl.com/testosterone-pellet-therapy-orlando

Need a muscle boost? Find out about the Emsculpt Neo machine in Dr J's blog here: https://www.foundationsfl.com/post/top-7-benefits-of-emsculpt-neo-treatment

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In this episode, I dive into a groundbreaking study featured in the prestigious Obstetrics and Gynecology (the Green Journal), which is the American Congress of Obstetricians and Gynecologists' leading publication. Join me as I explore the insights shared by two renowned experts, Dr. Barbara Levy and Dr. James Simon, on the evolving landscape of menopausal hormone therapy.

Key moments in this episode are:

• The Importance of Individualized Hormone Therapy: Tailoring formulations to meet specific patient needs.
• Advancements in Menopause Medicine: Exploring new approaches and updated recommendations for hormone therapy.
• The Role of Evidence-Based Care: How research empowers providers and patients to make informed decisions about menopausal health.
• Addressing Common Misconceptions: Breaking down myths and stigmas surrounding hormone replacement therapy.
• Why This Study Matters: The impact of this research on improving care for menopausal women.

Tune in to discover how these findings could redefine care for menopausal women and empower both patients and providers with evidence-based solutions. Whether you're a healthcare professional or someone curious about optimizing your wellness during menopause, this episode is packed with essential insights you won't want to miss!

Learn more about personalized menopausal care here: https://www.foundationsfl.com/bioidentical-hormone-optimization

Read Dr J's blog about Estrogen and Breast Cancer here: https://www.foundationsfl.com/post/estrogen-and-breast-cancer-dispelling-the-myths

And read my strong opinion about the WHI study here: https://www.foundationsfl.com/post/getting-rid-of-whi-once-and-for-all

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In this episode, I explore the complex relationship between menopause, hormone fluctuations, and mood disorders. I

Key Topics Covered:

• How estrogen and progesterone decline impacts neurotransmitters in the brain.
• The connection between menopause and increased risks of depression and anxiety.
• Role of estrogen in regulating serotonin, dopamine, and GABA to maintain mood stability.
• The HPA axis: how menopause amplifies stress response and cortisol levels.
• Estrogen's influence on neuroplasticity, neurogenesis, and cognitive function.
• Exploring neuroinflammation and oxidative stress in relation to menopause and mood disorders.
• Psychosocial factors and life stressors contributing to mood changes during menopause.
• Treatment options for mood disorders: SSRIs vs. hormone replacement therapy.
• Benefits of lifestyle modifications like exercise, stress management, and meditation.
• Why an individualized, holistic approach is crucial for treating menopause-related mood issues.
• The need for more long-term studies on hormone therapy’s impact on brain health and dementia risk.

Listen as I share insights on supporting mental and emotional well-being during menopause. Don't forget to follow for more expert insights into women's health and wellness!

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In this episode, I'm diving into the often-misunderstood world of chronic bladder pain. What might be causing that unrelenting discomfort if it's not a bladder infection??

If you've ever been told you have a UTI but the pain persists even after treatment, you may be dealing with something more complex, like interstitial cystitis (IC) or painful bladder syndrome (PBS). I explain the overlapping symptoms of these conditions and discuss why they’re often misdiagnosed. We’ll explore the theories behind the cause of these conditions as well as potential treatments. Here's what you can expect:

• Interstitial Cystitis (IC) vs. Painful Bladder Syndrome (PBS): How these conditions overlap in symptoms but differ in underlying causes.
• Symptoms of IC and PBS: Common signs like urgency, frequency, and pain, and why they often resist standard UTI treatments.
• Possible Causes: Exploring theories behind IC and PBS, including autoimmune factors, chronic inflammation, nerve sensitivity, and mast cell dysfunction.
• Diagnosis Challenges: Why patients often see multiple doctors before getting an accurate diagnosis, and the role of cystoscopy in the diagnostic process.
• Treatment Options: From bladder lavages to dietary changes, pelvic floor therapy, and medications like Elmiron, gabapentin, and amitriptyline.
• Managing Bladder Pain Flare-ups: Practical tips on hydration, identifying bladder irritants, and using hot or cold packs.
• When to See a Specialist: Why persistent bladder pain warrants a consultation with a urologist or urogynecologist to rule out other possible issues.

This episode is packed with insights to help you better understand and manage chronic bladder pain!

Here is the link to the list of common bladder irritants: https://www.canva.com/design/DAFA5Kxbclc/TRgeCGWV2MFegmSbVekqkQ/view?utm_content=DAFA5Kxbclc&utm_campaign=designshare&utm_medium=link&utm_source=editor

And of course, follow me as well!

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In this episode, I dive into one of the most overlooked aspects of women’s health—testosterone. Learn about this powerhouse hormone, including:

• Why this hormone is often misunderstood as a male-only hormone
• The crucial role of testosterone in women’s well-being and aging
• Getting rid of common myths surrounding testoterone use
• Why so many women are unaware of the powerful benefits of testosterone
• Groundbreaking research by experts like Dr. Abraham Morgentaler and Dr. Rebecca Glaser
• The potential of testosterone to improve women’s mood, energy, and muscle tone
• Even testosterone's ability to reduce risks of heart disease and breast cancer

If you’re curious about how testosterone might be a game-changer for women’s health, this episode is a must-listen. Don’t forget to subscribe for more expert insights on hormones, aging, and wellness, and share your thoughts with us through a review!

To find a certified menopause provider in your area, use these resources:

NAMS (The North American Menopause Society) Physician Finder: https://portal.menopause.org/NAMS/NAMS/Directory/Menopause-Practitioner.aspx

ISSWSH (International Society for the Study of Women's Sexual Health) Physician Finder: https://app.v1.statusplus.net/membership/provider/index?society=isswsh

And of course, follow me as well!

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What if sex education didn’t stop at puberty? In this episode, I talk about "Sex Ed 202"—the essential health education that women need after their teenage years, especially as they transition into their 20s and beyond.

Reflecting on a lively discussion that took place during my niece’s bridal shower, I explore the surprising curiosity young women have about menopause and the hormonal changes that come with aging. This episode is packed with insights on how women can prepare for the shifts they'll experience over the next few decades, from understanding hormone cycles in their 20s to knowing what symptoms to watch for as they approach menopause.

Key topics in this episode:

• The gaps in traditional sex education and why women need "Sex Ed 202" beyond puberty
• The importance of understanding natural hormone cycles in your 20s and their protective role for heart, brain, bones, and skin
• How hormonal changes start as early as the late 30s, with perimenopausal symptoms often appearing a decade before menopause
• Common symptoms of declining hormone levels: fatigue, brain fog, muscle loss, low libido, dry skin, joint pain, and urinary issues
• The case for hormone replacement therapy (HRT) as a way to maintain quality of life and reduce long-term health risks
• Why muscle maintenance through strength training is the ultimate anti-aging tool
• Tips for a hormone-friendly lifestyle: high-protein diet, minimized processed sugar, and stress management techniques
• The critical role of managing stress to avoid chronically high cortisol levels that can disrupt healthy hormone balance
• Empowering young women to recognize symptoms and advocate for appropriate care as they age

Tune in to learn practical tips on maintaining hormone health, building muscle, managing stress, and demanding proper care as you age gracefully. Whether you’re in your 20s or 50s, there’s something here for every woman looking to be empowered and informed about her body’s journey.

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• The types of sexual changes that can occur after cancer treatment and how they affect women
• The differences in addressing male vs female sexual health concerns post-cancer treatment
• The lack of physicians' formal training in female sexual health and the resulting reluctance to offer solutions
• The challenges of vaginal dryness, loss of libido, and pain with intercourse after cancer treatment, along with effective solutions and treatments
• The use of testosterone in breast cancer patients and its impact on sexual wellness

In my first every interview episode, I have my special guest, talented urogynecologist and close friend Dr. Sarah St. Louis. We will dive deep into the often misunderstood aspects of female anatomy and vaginal health. There is such a lack of comprehensive education about women's bodies, so we will discuss the importance of understanding of just what our anatomy is! We also advocate for better sexual health education for both men and women, promoting enhanced intimate relationships and overall female well-being. Our goal is to empower women with knowledge, teach them to enhance their sexual pleasure, and understand how to get help for common pelvic floor ailments.

Read more about Dr Cigna here: https://gwdocs.com/profile/sarah-cigna

To find a certified menopause provider in your area, use these resources:

NAMS (The North American Menopause Society) Physician Finder: https://portal.menopause.org/NAMS/NAMS/Directory/Menopause-Practitioner.aspx

ISSWSH (International Society for the Study of Women's Sexual Health) Physician Finder: https://app.v1.statusplus.net/membership/provider/index?society=isswsh

Check out these vetted Instagram content creators for valid and data-backed information:

@drsarahcigna

@gwsagacenter

@drrachelrubin

@gynogirl

@drchaileemoss

@hormonally.us

@heatherhirschmd

@showcenterdrq

@jillkrapfmd

@kellycaspersonmd

@drmaryclaire

And of course, follow me as well!

Instagram @foundationskristinjacksonmd

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FB facebook.com/advancedurogynecology

Loved this episode? Share with a friend.

• Understanding how collagen is produced and the various types of collagen present in our skin
• The difference between intrinsic and extrinsic factors that influence collagen levels and skin aging
• Evaluating the effectiveness of collagen supplements and explore alternative methods to increase collagen production
• Discovering the role of essential nutrients like Vitamin C and Vitamin A derivatives in supporting collagen synthesis
• Exploring advanced aesthetic treatments such as chemical peels, red light therapy, microneedling, PRP, laser resurfacing, and ultrasound for stimulating collagen production and rejuvenating the skin

Learn more about chemical peels here: https://www.foundationsfl.com/chemical-peels

Find out about microneedling here: https://www.foundationsfl.com/morpheus8

Read about PRP here: https://www.foundationsfl.com/prp

See laser resurfacing here: https://www.foundationsfl.com/halo-laser

Learn about Sofwave ultrasound technology here: https://www.foundationsfl.com/sofwave

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• The origins of urogynecology and the different paths that lead physicians to this specialized field
• The differences between OBGYN and urology backgrounds in urogynecology
• Normal bladder habits, including how to identify "Teacher Bladder" or "Nurse Bladder"
• How to master the art of proper urination
• Common bladder issues such as stress urinary incontinence (SUI) and overactive bladder (OAB), along with treatments and procedures available for both
• The taboo topic of leaking during sex and leaking upon standing

Read my story here:  https://www.foundationsfl.com/about-us

Check out the amazing Emsella chair here: https://www.foundationsfl.com/btl-emsella

In this episode, I sit down with Allie Demers, a seasoned pelvic floor therapist and owner of Anchor Pelvic Physical Therapy in Winter Park, Florida. Together, we dive into all things pelvic floor, a vital yet often overlooked aspect of women’s wellness.

Allie shares her journey from motherhood to becoming an advocate for pelvic health, offering you a comprehensive understanding of the pelvic floor, its impact on overall well-being, and the transformative power of specialized pelvic floor therapy. We also review practical tips for day-to-day living to keep your pelvic floor strong and functional.

Whether you're a healthcare professional or someone curious about the role of pelvic health in daily life, this episode is packed with valuable insights and practical advice for strengthening your core from the inside out. Tune in to learn how to take control of your pelvic health and improve your quality of life.

Learn more about Anchor Pelvic Physical Therapy here: https://www.anchorpelvicpt.com/

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Discover the intricate world of progesterone and its vital role in women's hormonal balance. From its origins in the body to its functions in pregnancy and beyond, this episode delves deep into the benefits of maintaining optimal progesterone levels.

• Learn the role of progesterone and the organs that make it
• Understand the symptoms associated with low progesterone
• Recognize the association between stress and progesterone production
• Take control over your life to increase natural levels of progesterone

Key moments in this episode:

01:11 Where progesterone is made

01:52 Roles of progesterone

03:04 Symptoms of low progesterone

03:47 Progesterone effects in our brain

05:17 The connection between stress and progesterone

07:04 Other reasons for low progesterone

07:28 Are your symptoms related to low progesterone?

08:44 The difference between normal and optimal hormones

09:49 Foods to help increase our progesterone

11:18 Supplements to support progesterone

11:57 Managing stress to increase progesterone

Find out more about balancing hormones here:  https://www.foundationsfl.com/bioidentical-hormone-optimization

In my first every interview episode, I have my special guest, talented urogynecologist and close friend Dr. Sarah St. Louis. We will dive deep into the often misunderstood aspects of female anatomy and vaginal health. There is such a lack of comprehensive education about women's bodies, so we will discuss the importance of understanding of just what our anatomy is! We also advocate for better sexual health education for both men and women, promoting enhanced intimate relationships and overall female well-being. Our goal is to empower women with knowledge, teach them to enhance their sexual pleasure, and understand how to get help for common pelvic floor ailments.

Read more about Dr St Louis here:

https://orlandostylemagazine.com/sarah-m-st-louis-md-facog/

Follow us!

Instagram @foundationskristinjacksonmd

Website https://www.foundationsfl.com/

FB facebook.com/advancedurogynecology

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Delve into the intriguing history of vaginal pessaries and their use in treating pelvic organ prolapse. From ancient times to the modern era, discover the unconventional remedies and treatments that were employed, as well as advancements made through the centuries.

If you or a loved one has dealt with pelvic organ prolapse, you'll love hearing the colorful history of vaginal pessaries!

Key Moments in this episode:

01:16 What a pessary does and how we use it today

02:14 Origin of the word pessary

02:27 First recorded history of pessaries

02:55 Honey

03:21 Succussion

03:49 Hot oil and wool balls

04:40 Pomegrantes

05:29 Greek physician Soranus and "disagreeable odors"

06:41 Roman writer Celsus and bronze cones

08:33 Paulus Agena in the middle ages

10:05 Jonas Platerious

10:34 The first recorded vaginal hysterectomy

12:01 Perforated cork

12:35 The insane story of Faith Howard

13:49 18th and 19th century advances

Read information on prolapse from AUGS here:  https://www.augs.org/assets/2/6/POP.pdf

Find out AUGS information on modern pessaries here: https://www.augs.org/assets/2/6/POP.pdf

Today's episode discusses the various symptoms and changes that women may experience as they navigate the menopausal transition, specifically focusing on perimenopause. Many women have no understanding at all about the symptoms that can occur at the end of their reproductive life.  Dr J will explore:

• What are the stages that women go through
• The typical age of the menopausal change, and when is it considered too young
• Hot flashes and night sweats
• Additional symptoms that you may not recognize go along with the menopausal change
• How to find a qualified menopause provider to help

My goal today aims to shed light on the often misunderstood and under-recognized symptoms of perimenopause, and provide valuable information and guidance for women going through this transformative stage.

Key Moments in the episode are:

01:18 Stages in a woman's life

02:14 The menopause transition

03:12 Changes to the menstrual cycle

05:07 Vasomotor symptoms

06:41 Differences in ethnicities with respect to vasomotor symptoms

07:25 Depression, anxiety and irritabililty

08:22 Sleep disturbances

08:38 Brain fog

09:08 Skin and hair changes

09:54 What to do about it

11:10 What to expect with a menopause specialist

12:15 What else could it be?

Read more about bioidentical hormone replacement therapy here: https://www.foundationsfl.com/bioidentical-hormone-optimization

Does your vagina feel dry, sandpapery, filled with paper cuts or ground glass? If so, you are not alone. While perimenopause and menopause are a major cause of this condition, there are also many other culprits.

• Learn how GSM, or genito-urinary syndrome of menopause, causes vaginal dryness
• The safety of vaginal estrogen products
• Medications that lead to vaginal dryness
• How medical conditions like diabetes and other autoimmune diseases cause dryness
• Pain and vaginal muscle spasm leading to dryness
• Lubrication ingredients that may be drying

By examining all the factors contributing to vaginal dryness, you can make an informed decision about  improving your quality of life.

Key moments in this episode are:

00:52 GSM, genito-urinary syndrome of menopause

03:12 Estrogen to treat GSM

03:22 Safety of vaginal estrogen

07:10 Non-estrogen treatments for GSM

08:07 Medications that cause vaginal dryness

09:02 Diabetes as a cause for vaginal dryness

10:12 Auto-immune disorders and vaginal dryness

12:00 Vaginal pain associated with dryness

15:35 Lubrication ingredients that may cause dryness

Read ACOG's statement on the safety of vaginal estrogen here: ACOG Clinical Guidance

Stress urinary incontinence, a condition characterized by urine leakage during activities such as coughing, sneezing, or physical exertion, can be both bothersome and embarrassing. Today's episode offers a comprehensive understanding of stress incontinence:

• What causes this type of urine leakage
• Activities that can make the leakage worse
• When is the best time to treat it
• Can I solve it with Kegels?
• More effective types of therapy
• Non-surgical treatment options
• Are mesh slings safe?
• What non-mesh surgeries are available

While stress urinary incontinence may be common, especially as we age, it is not normal and you should not just learn to live with it. Listen today to learn all of the treatment options so you can find one that best fits your lifestyle.

Key moments in this episode are:

00:52 Common does NOT mean normal

01:16 The cause of stress incontinence

02:30 Activities that worsen leakage

05:35 Can Kegels solve the problem?

06:37 Types of therapy to strengthen the muscle

08:59 Incontinece pessaries

11:52 Midurethral slings for SUI

13:08 Abdominal surgery for SUI

14:45 Are mesh slings safe?

16:58 Non-mesh sling options

18:06 Urethral bulking procedure

20:05 Types of bulking materials

Learn more about stress incontinence here: https://www.augs.org/assets/2/6/SUI.pdf

Find out about suburethral slings here: https://www.augs.org/assets/2/6/Mid-urethral_Sling.pdf

See the Emsella chair in action here: https://www.foundationsfl.com/btl-emsella

Menopause is a complex journey for women, but we hear all kinds of terms used to describe it--premenopause, postmenopause, perimenopaus.  Today we dive into what it all means, as well as the stages of the menopause transition as women enter midlife.

• Hear about the scope of the condition, and how many women it affects both worldwide and in the USA
• Understand the reproductive stage, the menopause transition, and the postmenopausal stage
• Learn what happens during the menopause transition
• It's not just hot flashes and night sweats; find out what else might be expected during menopause transition
• Sort through the alphabet soup of options to treat this condition

Understanding these stages is crucial so that both men and women can know what to expect, and be better prepared to manage the changes at this time.

Key Moments in this episode are:

00:28 The worldwide population of women over age 50

01:50 A basic division of the reproductive and menopausal stages

02:37 Menstrual changes during the menopause transition

04:09 Fertility during the menopause transition

04:31 Entering the postmenopause timeframe

06:07 Acronyms used to describe hormone replacement therapy

06:56 Understanding bioidentical hormones

08:18 Just exactly where Premarin comes from

09:17 The role of compounding pharmacies

Hair loss is a common and troublesome issue affecting millions of Americans. Today we look into the common cause of hair loss and how to improve hair growth, thickness and coverage.  Listen to discover:

• What stages hair goes through as it grows
• How hormones and hormone replacement affects hair growth
• Autoimmune conditions that cause hair loss
• How medical conditions, stress and life changes can cause loss of hair
• The length of time it takes to regrow hair
• Over the counter and prescription medications to enhance hair growth
• How PRP can enhance our hair
• The benefit of exosomes
• Using procedures like light therapy and microneedling to avoid surgery
• Hair transplant options

If you're noticing thinning hair or a receding hairline, this is one episode you don't want to miss!

Key Moments in this episode are:

01:28 Stages of hair growth

04:35 Androgenic alopecia

05:47 Telogen effluvium

08:21 Alopecia areata

09:18 Other causes of hair loss

11:31 Can hair regrow on its own?

12:01 Simple changes to enhance hair growth

13:52 Minoxidil for hair loss

14:47 Finasteride for hair loss

16:55 Duasteride for hair loss

17:56 Spironolactone for hair loss

19:12: PRP (platelet-rich plasma) for hair loss

20:32 Exosomes for hair loss

24:59 Low level laser therapy for hair loss

27:10 Microneedling for hair loss

28:29 Hair restoration surgeries

For years, it has been believed that metabolism slows with age, leading to weight gain. However, new studies suggest that the decrease in metabolic rate is not as significant as previously thought. The control of our eating and weight is highly influenced by hormones like leptin and ghrelin. In today's episode, we look at:

• Leptin, the "I am full" hormone
• Ghrelin, the "I need to eat" hormone
• How leptin resistance affects us
• Menopausal changes and how they affect leptin and ghrelin
• The effect of hot flashes on cortisol
• Insomnia and it's role in menopausal weight gain
• Lifestyle changes and treatments to counteract weight gain

While every woman will go through menopause, we don't have to accept the weight gain associated with it. Understanding the hormonal control of eating and making targeted interventions can help you combat weight gain during the aging process.

Key moments in this episode are:

01:41 How metabolism changes as we age

03:00 Leptin and ghrelin: hormones that control our appetite

03:43 Discovery of leptin

04:52 Discovery of ghrelin

05:11 Balancing these 2 hormones

06:41 Evolution not keeping up with our environment

07:02 Leptin resistance

07:50 How menopause affects leptin and ghrelin

10:20 The role of insomnia and weight gain

11:01 How treatment of hot flashes combats menopausal weight gain

13:05 Addressing insomnia to help with menopausal weight gain

14:33 Using Myplate for better eating habits

15:37 The difference between and apple and a glass of apple juice

Find out more about weight loss options here: https://www.foundationsfl.com/weight-loss

This episode delves into the basics of the pelvic floor, explaining its anatomy and function. It highlights how the pelvic floor is an essential support system for the organs in the pelvic region. Pelvic floor dysfunction, which can occur due to weakness or spasms in the pelvic floor muscles, is discussed along with its associated symptoms. The importance of pelvic floor therapy and the role of pelvic floor therapists are emphasized in improving pelvic floor health. The concept of prehab, which involves strengthening the pelvic floor muscles before childbirth or surgery, is introduced. The effectiveness of different interventions, such as Kegel exercises, weighted kegels, electrical stimulation, and biofeedback devices, is explored. The differences between electrical stimulation and electromagnetic stimulation for the pelvic floor are highlighted, with electromagnetic stimulation showing superior and longer-lasting results. The podcast concludes by emphasizing the importance of increasing awareness and taking steps to protect and repair the pelvic floor to maintain optimal function.

Key moments in this episode are:

00:51 Pelvic bones create a bowl

01:31 Pelvic floor as bottom of the bowl

01:45 Function of the pelvic floor

03:32 The under-recognized high tone pelvic floor

04:25 What a pelvic floor therapist does

06:54 Insurance coverage for pelvic floor therapy

07:28 The concept of "pre-hab" rather than rehab

08:19 The Kegel exercise

10:24 Dr Arnold Kegel

10:59 Ben-wa balls

11:57 Electrical stimulation to the pelvic floor

12:54 Evidence for benefit of vaginal weights and electrical stimulation

13:49 Limitations of studies on electrical stimulation

15:10 Animal studies of the pelvic floor

16:16 Biofeedback devices for pelvic floor

17:24 Which therapy is best for you?

18:40 Excessive marketing claims of over-the-counter devices

21:22 Electromagnetic therapy to the pelvic floor

22:07 Data about electromagnetic therapy

Here's the study comparing Kegels, electrical stimulation and vaginal cones: Castro RA, Arruda RM, Zanetti MR, Santos PD, Sartori MG, Girão MJ. Single-blind, randomized, controlled trial of pelvic floor muscle training, electrical stimulation, vaginal cones, and no active treatment in the management of stress urinary incontinence. Clinics (Sao Paulo). 2008 Aug;63(4):465-72. doi: 10.1590/s1807-59322008000400009. PMID: 18719756; PMCID: PMC2664121.

This study used vaginal biopsies to show beneficial effect from electrical stimulation: Sarmento ALC, Sá BS, Vasconcelos AG, Arcanjo DDR, Durazzo A, Lucarini M, Leite JRSA, Sousa HA, Kückelhaus SAS. Perspectives on the Therapeutic Effects of Pelvic Floor Electrical Stimulation: A Systematic Review. Int J Environ Res Public Health. 2022 Oct 28;19(21):14035. doi: 10.3390/ijerph192114035. PMID: 36360918; PMCID: PMC9658412.

And this one shows the deeper effects of electromagnetic stimulation to the pelvic floor: Sylantieva E., Zarkovic D., Soldatskaia R., Evgeniia A., Orazov M. Electromyographic evaluation of the pelvic muscles activity after high-intensity focused electromagnetic procedure and electrical stimulation in women with pelvic floor dysfunction. Sex. Med. 2020;8:282–289.

Let's take a journey through the history of personal lubricants, from ancient remedies to modern options. Today we explore the different types of lubricants, their ingredients, and when to use them. Discover the pros and cons of water-based, oil-based, and silicone-based lubricants.  Learn about the importance of choosing body-safe ingredients., and what ingredients are best to avoid.  Whether you're young or older, lubrication can enhance sexual pleasure and reduce discomfort. Dive into the world of lubricants and find the perfect one for you.

Key moments in this episode are:

00:21 History of lubricants

01:34 Water-based lubricants

01:54 Glycerin and osmolality of water-based lubes

03:38 Pros and cons of water-based lube

04:20 Parabens in water-based lubes

04:37 Capsasian in water-based lubes

04:56 Lidocaine or benzocain in water-based lubes

05:18 Oil-based lubricants

05:44 Pros and cons of oil-based lube

07:39 Silicone-based lubricants

08:39 Pros and cons of silicone-based lubes

09:04 Body-safe silicones

09:39 Testing your lube if you're sensitive

10:08 Hydroxycellulose in lubricants

10:24 Is lube safe in pregnancy?

11:01 Is lube safe when trying to conceive?

11:34 Are flavored lubes safe?

Body-safe silicones we discussed in this podcast:  

Cyclomethicone

Cyclopentasiloxane

Dimethicone

Dimethicone Crosspolymer

Dimethiconol

Phenyl trimethicone

Many women struggle to have solely have orgasms through vaginal penetration, and today's podcast episode dives into the reasons behind it. Through an understanding of female anatomy, it becomes clear that direct clitoral stimulation is often essential for orgasm. The podcast also discusses how the position of the clitoris relative to the vaginal opening affects a woman's likelihood of experiencing orgasm during penetration. Supporting data is presented, highlighting the significance of clitoral stimulation. Techniques such as double stimulation, using specific vibrators, and improving anterior vaginal wall stimulation are explored as well as ways to increase the chances of orgasm with penetration. The concept of the G-spot is examined, with emphasis on the need for more research. Lifting the pelvic floor and utilizing its strength during penetration is also discussed as a technique for enhancing stimulation. The episode concludes by suggesting that the best approach may involve combining multiple techniques to find what works best for each individual.

Key moments in this episode are:

01:01 Homology in male and female structures

02:30 Need for direct clitoral stimulation

03:39 Research on distance between clitoris and vaginal opening

04:42 Why women have differing distances between clitoris and vaginal opening

05:52 Our debt to Marie Bonaparte

07:05 First technique--double stimulation

09:02 Intro to the G spot

09:35 History of Dr Graffenberg

11:27 Research to identify the G spot subjectively

12:27 Research to identify the G spot with ultrasound

13:33 Second technique--improve G spot stimulation

14:42 Third technique--lift the pelvic floor

This episode delves into the fascinating world of botulinum toxin. We take a comprehensive journey through the mechanisms behind how botulinum toxin operates, exploring the fundamental principles of how nerves trigger muscle contractions, and how botulinum toxin works to interfere with that.  We unravel the rich history of the medical discovery of botulinum toxin and its evolution into an FDA-approved product with various therapeutic and cosmetic applications.  Listen in to hear about:

• Botox treatment for crossed eyes, neck spasm, overactive bladder and more
• Cosmetic uses of Botox for frown lines, forehead lines, and crow's feet
• Off-label uses of Botox, for facial slimming, neck slimming, and correction of wrinkles all over the face and neck
• Promising uses of Botox for depression and premature ejaculation
• Interesting uses of Botox to treat abnormal heart rhythms and cold hands
• Touching use of Botox after surgery for cleft lip and palate
• A unique use of Botox for vaginismus
• Side effects and safety of Botox injections

Join us as we explore not just the sanctioned uses of Botox, but also the intriguing off-label applications, including its surprising potential to address a whole host of symptoms.

Key moments in this episode are:

00:19 How botulinum toxin works

01:04 How a nerve causes a muscle to contract

02:02 Brand names for botulinum toxin

02:23 History of discovery of botulinum toxin for medical use

03:21 FDA categories of use for Botox

03:29 Therapeutic uses for Botox

04:43 FDA-approved cosmetic uses for Botox

05:01 Off-label cosmetic uses for Botox

05:54 Botox for treatment of depression

07:05 Botox for treatment of premature ejaculation

07:15 Botox to prevent abnormal heart rhythms

07:30 Botox for the treatment of very cold hands

08:05 Botox to prevent scarring after surgery for cleft lip

08:55 Botox for treatment of painful intercourse

09:34 Side effects from Botox injections

10:50 Botox migration

Learn more about Botox injections here:  https://www.foundationsfl.com/botox

Here's the link to the cold hand clinic at University of Chicago: https://www.uchicagomedicine.org/conditions-services/plastic-reconstructive-surgery/cold-hands-syndrome/treatment

Step into the incredible world of estrogen in our latest podcast episode. We unpack staggering statistics, explore the historical perceptions surrounding menopause, and unravel the intricate changes in women's bodies as they transition through this natural phase. From the gradual decline in egg count to the hormonal shifts that mark this milestone, we delve into the nitty-gritty details of menopause, shedding light on its far-reaching impacts beyond just the cessation of menstrual cycles.  Plus hear the surprising health benefits of estrogen in men as well.  Learn about:

• The number of women in menopause in the US
• Menopause from a historical perspective
• How our eggs are depleted with age
• Why many aging symptoms are inappropriately labeled as menopause symptoms
• The effects of estrogen loss on the heart, bones, and brain
• The specific changes to the vagina and bladder without estrogen
• How men need proper estrogen levels as well

This episode is a holistic exploration of menopause, offering insights that go beyond the surface to empower understanding and discussions about this crucial life stage.

Key moments in this episode are:

00:25 Menopause statistics

01:01 Were women ever expected to enter menopause??

02:33 How women lose eggs as we age

03:54 What happens to menstrual cycles as we approach menopause

04:28 Hormone changes at menopause

06:26 Overlap of menopause symptoms as aging symptoms

06:49 Vasomotor symptoms

07:27 What happens to the heart without estrogen

10:27 What happens to our bones without estrogen

11:30 At what age women reach maximum bone mass

12:43 It's what happens after a bone fracture that is harmful

14:42 What happens to our brain without estrogen

15:36 Progestins reversing benefits of estrogen

16:36 What happens to the vagina and bladder without estrogen

19:07 What happens to men without estrogen, or with too much estrogen

Learn more about the benefits of hormone optimization in men and women here: https://www.foundationsfl.com/bioidentical-hormone-optimization

Here's the 2014 study showing lower cardiovascular risks in women using ERT vs those taking statins: erglind IA, Andersen M, Citarella A, Linder M, Sundström A, Kieler H. Hormone therapy and risk of cardiovascular outcomes and mortality in women treated with statins. Menopause. 2015 Apr;22(4):369-76. doi: 10.1097/GME.0000000000000345. PMID: 25335101; PMCID: PMC4470525.

Here's the 2012 study showing improved outcomes in women treated with HRT vs no treatment: Schierbeck LL, Rejnmark L, Tofteng CL, Stilgren L, Eiken P, Mosekilde L, Køber L, Jensen JE. Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women: randomised trial. BMJ. 2012 Oct 9;345:e6409. doi: 10.1136/bmj.e6409. PMID: 23048011.

Here's the 2009 study stratifying men's cardiovascular risk based on their estradiol levels: Jankowska EA, Rozentryt P, Ponikowska B, Hartmann O, Kustrzycka-Kratochwil D, Reczuch K, Nowak J, Borodulin-Nadzieja L, Polonski L, Banasiak W, Poole-Wilson PA, Anker SD, Ponikowski P. Circulating estradiol and mortality in men with systolic chronic heart failure. JAMA. 2009 May 13;301(18):1892-901. doi: 10.1001/jama.2009.639. PMID: 19436016.

And all the other studies I discussed are available as well; please message me to get the links!

• Changes to the vagina related to childbirth, aging, and hormonal fluctuations
• The role of vaginal estrogen in maintaining healthy tissue
• Non-surgical treatments to tighten the labia
• The role of labioplasty to alter labial appearance
• Vaginal lasers for resurfacing and treatment of vaginal dryness
• Surgical tightening of the vagina
• How to choose the best surgeon to perform your procedure
• Therapies to strengthen the pelvic floor muscles

By focusing on restoration rather than "rejuvenation", you can help to revive the vagina and vulva back to what they once were!

Key moments in this episode are:

00:12 What is vaginal rejuvenation

01:08 Changes that can occur to the vaginal and vulva

02:27 Symptoms associated with damage to pelvic floor

03:58 Bringing this issue to the forefront of discussion

04:44 What women are asking for with vaginal rejuvenation

06:26 Non-surgical treatments to improve labial appearance

07:39 Surgical options to alter labia

08:50 Who should you choose to perform a surgery

12:11 Radiofrequency alone as a treatment

13:32 Role of vaginal estrogen in rejuvenation

14:35 Types of vaginal lasers

16:57 Hybrid vaginal lasers

17:44 Surgical options to tighten vagina

20:30 Strengthening the pelvic floor muscles

• What is erectile dysfunction (ED)
• Vascular causes of ED
• Neurogenic causes of ED
• Hormonal causes of ED
• Treatment options for ED
• Premature ejaculation and treatment strategies
• Impact of prostate cancer on sexual health

Obesity has become a pressing issue in the United States, with a significant increase in its prevalence over the past few decades. This episode explores the factors contributing to weight gain,  genetics that may predispose individuals to obesity, and the environment in which we live., highlighting the control we each have over our weight and the potential to modulate genetic influences. We also discuss the impact of obesity on various medical conditions such as heart disease, stroke, hypertension, and diabetes. Obesity needs to be understood as a chronic and relapsing medical condition, rather than solely a cosmetic concern.  Listen in to learn more:

• Plenity; a supplement that expands in the stomach to creates a sensation of fullness
• Cell Press, a similar supplement with celluose, to help control portion size
• Calcium Pyruvate, a substance that enhances the conversion of food into energy
• Orlistat, an over-the-counter medication to block fat absorption
• Hormonal control of weight using Semaglutide and Tirzepatide
• The role of the hypothalamus in eating and hunger
• The role of the mesolimbic reward system in controlling cravings
• Contrave, a prescription medication working in the brain to reset hunger controls
• Qsymia, a prescription medication working in the brain with the hunger and craving centers
• Bariatric surgery as an option

Gain insight to understand obesity's medical complexities to explore various interventions, empowering you to make an informed choice for healthier living and weight management.

• The analogy of a waterfall, and how boulders get in the way of a fantastic orgasm
• Common challenges to reaching orgasm
• Causes of pain during orgasm
• Treating dryness and atrophy
• High tone pelvic floor disorder
• Evaluating for vulvodynia
• How low libido diminishes orgasm
• When you cannot reach orgasm with penetration alone
• Enhancing the sensitivity of the vagina
• Strengthening the pelvic floor for intense contractions
• Psychosocial factors that interfere with pleasure

• Learn the proper anatomy of the vulva and vagina
• Understand both vaginal and vulvar yeast infections and how they present with different symptoms
• What's new in the treatment of yeast infections
• Atrophy as a cause of vulvar itching
• What is lichen sclerosis and how is it managed
• How lichen planus presents and is treated
• Proper hygiene and care of the vagina and vulva

• Find out why testosterone is Dr J's favorite hormone to balance for her patients
• List the common misconceptions surrounding testosterone
• Understand some of the many many benefits of healthy testosterone levels
• Be comfortable with the safety of proper testosterone replacement

Hormone replacement therapy (HRT) and breast cancer risk has long been overestimated. For too long, both patients and providers have overestimate the risk of hormone replacement therapy and undervalued its value. Despite the fear surrounding HRT and breast cancer, the actual risks are relatively low. 

• The Womens' Health Initiative study (WHI), which played a significant role in shaping opinions, has been criticized for its flaws and limitations, resulting in skewed headlines that caused widespread anxiety.
• Understanding the study's flaws and limitations is crucial to interpreting its results correctly.
• The study's patient population skewed towards older women, which impacted the results and made them less applicable to menopausal women in their 50s.
• HRT can offer various benefits, such as reducing heart disease, stroke, and osteoporosis risk. 
• The results of the study are only applicable to conjugated equine estrogens (CEE) and medroxyprogesterone acetate, a synthetic progestin.
• Using bioidentical hormones, particularly micronized progesterone, can be a safer alternative.
• The critical window for starting HRT, typically in the perimenopause and early menopause stages, is highlighted as an important factor in determining the benefits and risks of hormone use.

By debunking the fear surrounding hormones and breast cancer, the aim is to empower women to make informed decisions and seek guidance from hormone specialists.

Key moments in this episode are:

0:00 Intro and facts about breast cancer

1:05 Current screening guidelines for breast cancer

1:53 Looking at how the WHI study was set up

3:35 What the headlines about WHI said

3:59 Behind the headlines

5:23 WHI from a personal perspective

7:18 Understanding the numbers

8:37 Risks of oral estrogens

10:30 What was causing the breast cancer risk?

11:08 Benefits of taking HRT

12:10 Alternates to synthetic progestins

Check out Dr Jackson's blog on the WHI here:  

https://www.foundationsfl.com/post/getting-rid-of-whi-once-and-for-all

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• Reasons for hysterectomy, such as pain, fibroids, heavy bleeding, endometriosis, or cancer
• The different types of hysterectomy
• The impact of hysterectomy on sexual health and hormones
• The importance of open communication with your surgeon
• Significance of regular pelvic exams even after hysterectomy
• Potential complications like scar tissue formation and pelvic floor spasms