Are you in your 40s or 50s and wondering why sex suddenly feels different—less comfortable, less pleasurable, or even painful? You’re not alone, and it’s not just in your head. In this powerful episode, we sit down with Dr. Rachel Rubin—a board-certified urologist and sexual health expert—to uncover the real science behind libido, vaginal health, hormones, and desire during perimenopause and menopause.We explore how hormonal shifts affect libido, vaginal dryness, painful sex, arousal, and clitoral changes, plus the truth about vaginal estrogen, testosterone therapy, and why so many women suffer in silence. Dr. Rubin shares shocking insights into why menopause care is decades behind, the myths killing women's sexual health, and how we can reclaim pleasure and connection in midlife and beyond.Whether you're experiencing low libido, recurrent UTIs, discomfort with intimacy, or just don’t feel like yourself anymore—this episode is a must-listen.Topics covered:• What Genitourinary Syndrome of Menopause (GSM) really means• Why vaginal hormones are safe—even for breast cancer survivors• Clitoral shrinkage & labia resorption explained• The case for testosterone in women’s health• Why vaginal estrogen can save lives (not just improve sex)• The silent epidemic of untreated postpartum sexual dysfunction📌 If you’re a woman in midlife—or a partner, clinician, or advocate—this is the sexual health conversation you didn’t know you needed.Follow Dr Shauna and the podcast on social:Podcast Website: ⁠www.allaboutyoupod.com⁠.Instagram: https://www.instagram.com/allaboutyou_withdrshaunawattshttps://www.instagram.com/drshaunawattsgpLinkedIn: https://www.linkedin.com/in/shauna-watts-a903a5247Disclaimer: This podcast and any information, advice, opinions or statements within it do not constitute medical, health care or other professional advice. Information is provided for educational and entertainment purposes only.Discover the RATIONALE glow. Six Collections, each featuring a unique Complex of essential active ingredients for optimal skin health.Luxury Australian Skincare - Shop RATIONALE and enter the code ‘YOU’ at checkout.00:00 - Intro: What This Episode Covers 00:00:14 - Meet Our Hormone Health Expert 00:01:14 - Sexual Health Changes in Midlife 00:02:38 - Hormonal Shifts That Affect Libido 00:03:46 - Common Sexual Health Questions Answered 00:04:55 - Vaginal Discomfort After 40 Explained 00:06:56 - Myths About Vaginal Hormone Therapy 00:08:06 - Why Vaginal Hormones Are Often Needed 00:11:52 - The Cost of Recurrent UTIs 00:13:24 - Types of Vaginal Hormone Treatments 00:15:11 - Why Not to Stop Therapy Early 00:22:56 - Testosterone’s Role in Women’s Health 00:25:30 - The Research Gap on Testosterone 00:30:35 - What Is GUSL in Lactation? 00:34:19 - Sexual Health Advocacy and Research 00:35:22 - Menopause and Labia Minora Changes 00:39:44 - Understanding Clitoral Changes With Age 00:41:10 - Clitoral Adhesions: What Women Should Know 00:44:08 - Gaps in Sexual Wellbeing Education 00:46:27 - Sex and Midlife Relationship Dynamics 00:50:43 - Misconceptions About Hormone Therapies 00:57:20 - Best Vaginal Lubes and Devices 01:02:04 - Advice for My Younger Self menopause and libidovaginal estrogen safetyperimenopause sexual healthclitoral changes in menopausetestosterone for womenpainful sex midlifeGSM symptoms treatmentvaginal atrophy solutionsvaginal dryness in menopausehormone therapy for libidohow to fix low libido after 40estrogen cream for menopausewhy does sex hurt after menopausehormone replacement therapy 2025midlife marriage and intimacyvaginal health postpartumbest treatment for painful sexvaginal estrogen vs DHEAmenopause podcast episodesexual health after breast cancer

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