Dr. Rachel Rubin

Right.

What's happening or my libido is a little bit lower.

Your testosterone is dropping precipitously.

Right.

OK, and that causes genital and urinary changes.

Sometimes it can cause mood changes or libido changes.

Now, we don't study it to the level that we should.

Again, going back to we need more funding, we need more research in women's health.

But if you feel not like yourself, it's real.

I'm going to say it's real, right?

And that doesn't mean science is fully figured out with guidelines to give you a book answer and every doctor is going to give you the same answer, but it doesn't make it any less real.

And so when these genital and urinary symptoms are happening, it's because of hormone changes.

And so the terminology genital urinary syndrome of menopause is a little bit not good because it's not menopause.

It's perimenopause.

It's breastfeeding.

It's

It's postpartum.

It's birth control pills can cause these hormonal changes.

Even though birth control is hormones, it's adding back fake estrogen and fake progestin, but it's not adding back testosterone.

And so we do see women who on, many women on birth control do great, but there is a subset who start having pain with tampons, pain with sex, vaginal infections, urinary tract infections.