Dr. Rachel Rubin

This is the thing we just call the vulvovaginal atrophy. And we said, well, if you have pain with sex or a little vaginal dryness, here's some moisturizers. Here's some lubricants. Here you go. If you're really bothered, really bothered, you got to be really bothered. Then there's this thing called vaginal estrogen that we could give you. Now, here's the crazy part of this.

This is the thing we just call the vulvovaginal atrophy. And we said, well, if you have pain with sex or a little vaginal dryness, here's some moisturizers. Here's some lubricants. Here you go. If you're really bothered, really bothered, you got to be really bothered. Then there's this thing called vaginal estrogen that we could give you. Now, here's the crazy part of this.

It's not just a little vaginal dryness. The vagina and the bladder need hormones. Babies don't have hormones, and that's why you see it's red. It's irritated. There are these small little labia minora. Diaper cream was invented because it looks so painful. They pee their diapers all the time. The genitals morph and change with hormones.

It's not just a little vaginal dryness. The vagina and the bladder need hormones. Babies don't have hormones, and that's why you see it's red. It's irritated. There are these small little labia minora. Diaper cream was invented because it looks so painful. They pee their diapers all the time. The genitals morph and change with hormones.

Puberty happens, and you have a change of the genital and urinary system. What happens is as you lose hormones, it goes in reverse. It changes the microbiome. The hormones keep the tissue acidic. It grows the healthy lactobacilli. The vagina is supposed to be acidic. It's supposed to be able to fight infection. And without proper hormones, you lose that ability to fight infection.

Puberty happens, and you have a change of the genital and urinary system. What happens is as you lose hormones, it goes in reverse. It changes the microbiome. The hormones keep the tissue acidic. It grows the healthy lactobacilli. The vagina is supposed to be acidic. It's supposed to be able to fight infection. And without proper hormones, you lose that ability to fight infection.

So you see urinary frequency, urinary urgency, vaginal dryness, increase in leakage, increase in urge incontinence, and recurrent urinary tract infections, which can and do kill people. We've known this since the 90s in the New England Journal of Medicine. Actually, this was on estriol. You could reduce the risk of urinary tract infections by well over 50%. We have known this all along.

So you see urinary frequency, urinary urgency, vaginal dryness, increase in leakage, increase in urge incontinence, and recurrent urinary tract infections, which can and do kill people. We've known this since the 90s in the New England Journal of Medicine. Actually, this was on estriol. You could reduce the risk of urinary tract infections by well over 50%. We have known this all along.

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Yeah. Correct. I think it's available in Europe. So the name got changed in 2014. 2014, a bunch of people got in a room and they said, you know what, this vulvovaginal atrophy thing, that's kind of a bad name because it doesn't describe what's really happening to people. So they changed the name to genitourinary syndrome of menopause, GSM.

Yeah. Correct. I think it's available in Europe. So the name got changed in 2014. 2014, a bunch of people got in a room and they said, you know what, this vulvovaginal atrophy thing, that's kind of a bad name because it doesn't describe what's really happening to people. So they changed the name to genitourinary syndrome of menopause, GSM.

Now there was one urologist, my mentor was in the room, and they almost didn't put the word urinary in it. And he fought and he yelled and he screamed, this is the power of one person to be able to change the whole world. And they said, okay, we'll listen to you. We'll put the word urinary. in it. And I'm so glad they did because the urinary problems are the things that kill people.

Now there was one urologist, my mentor was in the room, and they almost didn't put the word urinary in it. And he fought and he yelled and he screamed, this is the power of one person to be able to change the whole world. And they said, okay, we'll listen to you. We'll put the word urinary. in it. And I'm so glad they did because the urinary problems are the things that kill people.

People are dying of urinary tract infection. In fact, a large amount of money goes to Medicare expenditures when it comes to urinary tract infections. And we published last year that if Medicare patients used vaginal estrogen, which is safe for everybody, and $13 a tube, we would save Medicare between $6 and $22 billion a year. Billion.

People are dying of urinary tract infection. In fact, a large amount of money goes to Medicare expenditures when it comes to urinary tract infections. And we published last year that if Medicare patients used vaginal estrogen, which is safe for everybody, and $13 a tube, we would save Medicare between $6 and $22 billion a year. Billion.

When you do a low-dose local vaginal estrogen or DHEA product, you can reduce your risk of urinary tract infections by more than half. They are safe to use if you've had a history of blood clots, breast cancer, whatever medical problem you can come at me, I can tell you that it's safe. It will not only help with lubrication, help with pain with sex, help with urinary frequency urgency leakage,

When you do a low-dose local vaginal estrogen or DHEA product, you can reduce your risk of urinary tract infections by more than half. They are safe to use if you've had a history of blood clots, breast cancer, whatever medical problem you can come at me, I can tell you that it's safe. It will not only help with lubrication, help with pain with sex, help with urinary frequency urgency leakage,