Dr. Nirit Rosenblum

Just like any big city, we have lots of people who are

treating these issues, whether it be plastic surgeons, gynecologists, concierge physicians.

I have some there are some physical therapists in New York who are actually doing treatments.

They're fitting women with vaginal devices for stress incontinence.

So there's all kinds of providers out there, you know, and probably that gets back to Karen's point that there's just such a large demand and need and there are not enough providers to fill that role.

But I think in general, I don't get any pushback.

I think we all use physical therapy quite a bit at all ages, by the way.

Vaginal estrogen is something I've been prescribing my entire practice, even with all the years of the warnings that you had to take the time to educate the patient.

I think now that they're going to lift those warnings, it's going to get hopefully much easier.

And I've actually had a few colleagues, general urologists, reach out to me asking questions

if they should be prescribing vaginal estrogen, and is there a reason not to?

And I basically said, you should be prescribing it to any woman with vaginal symptoms, recurring infections, all the things we talked about.

So hopefully that's going to become more commonplace, even amongst people who aren't subspecialty trained like us.

I do a fair amount of labiaplasty as well.

And I

I think patients that come to me are sort of shocked that I tell them that most of the time it is covered because most of the patients I'm treating actually have physical symptoms, as we discussed, chafing, it gets in the way, pain with sex.

I actually had a few women

who have neurogenic bladders and self-catheterize.

And as they age, the labia enlarged quite a bit, and it became problematic for them to catheterize.

So there are interesting indications for that.