S4 Ep173: Two Clinicians- Twelve Questions

I get lots of questions on various platforms. But I never get to all of them. So, today is Q and A day. I asked my friend and colleague, Dr. Heidi Flagg to join me because it’s always good to get another point of view. Dr. Flagg is, above all, a clinician. She is in her office in NY city, day in and day out, helping women navigate peri menopause and menopause. And unlike many people out there who are new to the scene, Dr. Flagg brings decades of real-world experience to the table. QUESTIONS Do you need to be 12 months without a period to start hormone therapy? I am getting a period every 3-4 months, so I assume I am in perimenopause. I am having a lot of symptoms, so I went to my doctor, and she suggested I go on birth control pills. I’m not even having sex. I don’t need birth control. I am 48 years old. I had a hysterectomy 5 years ago because of fibroids. I am now having hot flashes, brain fog, and mood swings. What hormone levels should I check to see if I am ready for hormone therapy? I started using an estrogen patch around 3 months ago. I am still having hot flashes. Do I need to give it more time or do I need more estrogen? Is it OK to substitute a brand name patch with a generic patch? I am 62. My last period was 13 years ago. Is it too late for me to state hormone therapy? Since I started using local vaginal estrogen, I have an accumulation under my clitoral hood. How best to clean it? Is it OK to put vaginal lubricant inside the vagina? Will hormone therapy trigger the recurrence of endometriosis? I have high cholesterol and want to know if Duovee™ is a good product for someone with high cholesterol. Would it be better to use a transdermal estrogen? Is it safe to use systemic estrogen and local estrogen at the same time? I had a hysterectomy last year because of uterine cancer. Can I take estrogen? I am taking low doses of testosterone, and I am pretty sure my voice is getting lower. My doctor said my levels are fine. I thought that only happened with high doses. If I go off, will it go back to how it was? I am 45 years old and scheduled for a hysterectomy because of fibroids that bleed a lot. Is my sex life going to change? A menopause coach who wants to know how to help women getting conflicting information on social media. Heidi Flagg MD IG @m_pause Dr. Heidi Snyder Flagg is a founder and managing partner of Spring ObGyn, a private practice in NYC. Since completing her ObGyn residency at Brown’s Woman & Infant’s Hospital Dr. Flagg’s clinical interests have spanned the woman’s reproductive cycle with a current focus on peri menopausal and menopause.Dr. Flagg is a medical advisor to Flow Health and Let’s Talk Menopause. Information on COME AGAIN-Sexuality and Orgasm Ways to Ask a Question I am not able to answer individual questions directly, but if you submit a question, I will do my best to get it answered during a podcast episode, Ask Me Anything Webinar, or a future Substack Article. The least likely place for me to see a question is on social media. (Instagram/Facebook) I do not check regularly. 1. Record a Question- Use this link to record your question. 2. Ask Me Anything Webinars Paid Substack subscribers can attend or submit a question in advance. The replays are available on my Substack platform. For more information or to become a subscriber, DrStreicher.Substack.com/subscribe . 3. Substack Chat S ubscribers can submit a question on my Substack chat. Dr. Streicher is on SUBSTACK DrStreicher.Substack.com Articles Monthly newsletter All COME AGAIN podcast episodes Monthly News Flash Reports on recent research Monthly Zoom Ask Me Anything Webinar Lauren Streicher, MD is a clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine, the founding medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause, and a Senior Research Fellow of The Kinsey Institute, Indiana University. She is a certified menopause practitioner of The Menopause Society. She is the Medical Director of Community Education and Outreach for Midi Health. Dr. Streicher is the medical correspondent for Chicago’s top-rated news program, the WGN Morning News , and has been seen on The Today Show , Good Morning America , The Oprah Winfrey Show , CNN, NPR, Dr. Radio, Nightline, Fox and Friends, The Steve Harvey Show, CBS This Morning, ABC News Now, NBCNightlyNews,20/20 , and World News Tonight . She is an expert source for many magazines and serves on the medical advisory board of The Kinsey Institute, Self Magazine, and Prevention Magazine. She writes a regular column for The Ethel by AARP and Prevention Magazine. Links: To receive Dr. Streicher’s FREE Insider Newsletter Glossary Of Medical Terminology Subscribe To Dr. Streicher’s Substack Information About COME AGAIN Podcast Dr. Streicher’s CV and additional bio information Books by Lauren Streicher, MD Slip Sliding Away: Turning Back the Clock on Your Vagina -A gynecologist’s guide to eliminating post-menopause dryness and pain Hot Flash Hell: A Gynecologist's Guide to Turning Down the Heat Sex Rx- Hormones, Health, and Your Best Sex Ever The Essential Guide to Hysterectomy To Find a Menopause Clinician Midi Health www.Joinmidi.com Midi Health is a telehealth company that provides high-level menopause care and takes insurance in all 50 states. Dr. Streicher is Midi’s Medical Director of Education and Community Outreach and is familiar with their medical protocols, which are all regularly updated and set by the top academic menopause experts in the country. The Menopause Society - Certified Menopause Practitioner List Menopause.org To find a menopause practitioner: https://portal.menopause.org/NAMS/NAMS/Directory/Menopause-Practitioner.aspx Put in your zip code and designate NCMP or CMSP to get a certified menopause practitioner. While all people on this list have passed a competency examination, Dr. Streicher does not vouch for every one of these clinicians. Most are excellent. Major Medical Centers It also may be helpful to check with major medical centers in your area. Many have menopause clinics or lists of doctors who have an interest and expertise in menopause. Dr. Streicher’s Inside Information podcast is for education and information and is not intended to replace medical advice from your personal healthcare clinician. Dr. Streicher disclaims liability for any medical outcomes that may occur because of applying methods suggested or discussed in this podcast.