Are you experiencing symptoms like burning and itching around your vulva and vagina, or painful sex? Or perhaps you have the urge to wee more often or are plagued by recurrent urinary tract infections? Joining Dr Louise this week is trailblazing US urologist and sexual health doctor Dr Rachel Rubin, to address these common menopause symptoms and the relief vaginal hormones – often used alongside systemic HRT – can bring. Dr Rachel explains why we need to stop using terms like vaginal dryness and vaginal atrophy, which hugely downplay the impact of declining hormones on your whole genitourinary system. ‘When we say women have vaginal dryness, we minimise their symptoms, we minimise that it's no big deal, that you can just use a little lubricant, a little moisturiser,’ says Dr Rachel. Plus, Dr Rachel and Dr Louise also discuss DHEA – a hormone treatment which converts to estrogen and testosterone in the vagina – and the benefits this can bring to women struggling with genitourinary syndrome of the menopause (GSM), again often alongside systemic HRT. Dr Rachel’s three tips if you are struggling with GSM: Know that if you have any symptoms that affect your vagina, vulva or urinary system and you’re over the age of 45, you deserve a vaginal hormone product. Talk to your healthcare professional about access to this treatment that can prevent urinary tract infections, decrease your frequency and urgency of needing to urinate, decrease your pain in intercourse and lead to better lubrication, arousal and orgasm. Keep using your localised hormone replacement: it is a safe product, so can be used long term to sustain the benefits. Click here to visit Dr Rachel’s website, and follow her on Instagram @drrachelrubin.

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“What did the council decide on item 42?” — answered with the speaker and the moment.