Estrogen was once considered the grand elixir, the hormone replacement therapy (HRT) for sharp minds, strong bones, and healthy hearts. Pills, patches, creams, and inserts were given out like candy.
Then the Women’s Health Initiative Study (2002) found increased dementia, heart attacks, and strokes in the study population, and estrogen became The Killer.
Then the findings were gradually debunked, but women and their providers continued to have their guard up for decades. Just this year, the “black box” warning on estrogen was removed.
In San Diego, over the last two decades, bright providers continued prescribing individualized custom HRT to their female patients and even addressing female sexual function benefits and bladder health benefits for their patients.
Two decades ago, postpartum patients I treated who were nursing babies and had bladder leaks + pelvic pain were offered and used topical vaginal estrogen 2-3x a week, and their leakage stopped and dyspareunia (pain with sex) resolved.
Two decades ago, I worked with women post breast cancer/chemo who had…bladder leaks and dyspareunia, were offered topical vaginal estrogen 2-3x a week, and their leakage stopped and dyspareunia resolved. They stayed cancer-free and got their lives back.
There is a higher risk with oral HRT, synthetic progestins combined with oral estrogen intake, and a possible breast or endometrial cancer risk, or strokes, blood clots, or heart attacks with the oral dosing. Genetics and lifestyle matter as well.
Topical, surface vulvar and urethral/vaginal applied estrogen is the new savior for many women; estradiol, low dose. It helps prevent UTIs, supports immunity, strength, and comfort in the urogenital regions and the pelvic floor muscles. Its use can help re-boost intimate function and also reduce bladder urgency and frequency.
Women and their providers may still be in the dark on the new guidelines. Become informed and empowered for your health and ask your provider for testing and treatment.
(Find out about the Tres Amigas: how estrogen works with acidophilus and a low pH in the vaginal biome, promoting immunity and UTI prevention. WATCH THE HAPPY BLADDER MASTERCLASS ON YOUTUBE)
Prolonged cycles of estrogen depletion can make women prone to UTIs, bladder leaks, OAB, pelvic pain, and even muscle strength loss, low bone density, dementia, and blood sugar dysregulation. These are hidden dangers that can sneak up after surgical menopause (hysterectomy) or the perimenopause journey. Vanity concerns develop as well, with skin changes.
Pelvic PT, OT, urology screening, and general practice medical care can screen and target what you need to live with good function and even thrive. Such as feeling energetic and getting your bladder control, libido, and pleasure back. (For your info: Here’s a link to the guidelines.)
And I can’t leave out your Pillars of Health in Lifestyle Medicine in this topic, as all great things work together. Look to the next blog to consider your health foundations and what might need shifting, boosting, or even a re-do.
I once lived in a fog, with fatigue, poor sleep, peri-menopause pelvic floor dysfunction, and chronic pain. Silent suffering; I just thought it was the way I was. Through studies, memberships, and mentors, I found out what needed support, shifting and boosting, and I recharged.
Questions for Dr Maureen Mason? Schedule a telehealth or in-clinic consult. You may reach Dr Mason at mmasoncover@gmail.com or 619 786-0436.
