
Hosted by Dr. Sameena Rahman · EN

Women's health is a team sport. That's something we've all learned the hard way—not in residency, but years later when we realized how much we weren't taught about vulvovaginal health.In this episode, I sit down with Dr. Meredith McClure from Dallas and Dr. Ashley Fuller from Seattle. They co-host the Labialogic podcast and both specialize in treating the conditions that most doctors either miss or dismiss—lichen sclerosus, desquamative inflammatory vaginitis, recurrent BV and yeast infections that won't go away.All three of us left obstetrics years ago and now run gynecology-only practices. And we've all come to the same conclusion: what we learned in training wasn't enough. We were taught not to examine the clitoris. We weren't taught proper vulvar anatomy. We weren't taught how to diagnose or treat the complex cases that show up in our offices every single day.We talk about why there's no one-size-fits-all approach to recurrent infections. We discuss the tests that doctors over-rely on for BV diagnosis that aren't actually accurate. And we share some of the worst medical gaslighting stories we've heard—like telling a PGAD patient "you've been through childbirth, how bad could this be?"We also discuss AI in medicine, why private equity is a problem, and how teaching women proper anatomical language changes outcomes.Highlights:We were all trained in residency not to examine the clitoris, which means many vulvar conditions get missed.Recurrent BV has no one-size-fits-all approach. Some DNA tests only check for Gardnerella and lead to false positives and overtreatment when what works depends on each person's unique microbiome.Don't use one-dose Monistat. It can cause severe inflammatory reactions in the vulva.Some vaginal inflammation doesn't show up on swabs and requires a microscope exam to diagnose properly.Teaching women proper anatomical language (knowing vulva vs. vagina, labia minora vs. majora) actually improves treatment outcomes.Lichen sclerosus is one of the most commonly missed diagnoses because doctors aren't examining the vulva properly.We hope that this episode gave you information that can help you understand that there are clinicians out there that want to help and find answers to your vulvovaginal health concerns.I appreciate everyone who is part of this community, and if you haven't already done so, I would appreciate you subscribing as it helps more women find the show so that they can get the information that they are looking for.Connect with Dr. Fuller:Website PodcastInstagramFacebookConnect with Dr. McIntireWebsiteInstagramGet in Touch with Me:WebsiteInstagramYoutubeSubstack

Endometriosis is often talked about as a pelvic disease, but it's actually a systemic inflammatory condition that affects the entire body. And the way we diagnose and treat it is still failing too many patients.In this episode, I sit down with Jandra Mueller, a pelvic floor physical therapist in San Diego and the incoming educational chair for the International Society for the Study of Women's Sexual Health. Jandra specializes in treating patients with endometriosis and has a unique perspective both as a clinician and as someone who went through the diagnostic odyssey herself.Her own experience getting diagnosed drove her to focus on this work. She spent years dealing with symptoms that kept getting dismissed and saw multiple specialists who couldn't figure out what was wrong. Even as a pelvic floor PT working in a hospital-based women's health center with access to specialists, it took years to get the right diagnosis.We discuss why the new guidelines for diagnosing endometriosis are a step forward but still fall short. We talk about the pelvic pentad the association between endometriosis, hypermobility, mast cell activation syndrome, pelvic floor dysfunction, and vestibulodynia. And we get into why fibrotic endometriosis is often overlooked during surgery and what that means for patients who continue to have symptoms after excision.HighlightsDoctors can now start treating endometriosis based on your symptoms without requiring surgery first.Scar tissue from endometriosis is often missed during surgery because it doesn't always show up on the biopsy.Endometriosis often shows up alongside other conditions like hypermobility, mast cell issues, and pelvic pain with sex.Not all surgeons who say they specialize in endometriosis actually have the advanced training needed.If you still have symptoms after surgery, keep pushing for answers—it doesn't mean the pain is in your head.Treating endometriosis with pelvic floor PT means looking at your whole body, not just your pelvis.Pain before bowel movements is a classic endometriosis symptom that often gets overlooked.If you're experiencing symptoms that aren't improving with treatment, don't stop advocating. Finding the right endometriosis specialist matters not all surgeons have the same level of training.Consider working with a pelvic floor physical therapist who understands endometriosis and can look at your whole body, not just your pelvis.Make sure to subscribe to the podcast so you don't miss upcoming episodes.Get in Touch with Dr. Mueller:WebsiteInstagramGet in Touch with Me:WebsiteInstagramYoutubeSubstack

This week we welcome Beth Crosby, aka Garbage Mom, to the show. Beth is an actress, comedian, and content creator.She started creating content during the pandemic as an outlet to connect with other women and share in the perimenopause transition. She now has over 250k subscribers and is the creator of Perimenapalooza™.We talk about her symptoms of perimenopause and how anxiety was one of the worst. We also chat about being in an industry that works last minute and isn't conducive to women being mothers.She shares how she had undiagnosed celiac disease that was causing a lot of issues and dealt with medical gaslighting from doctors until she finally got the right tests to discover what was going on.She also shares why, even though she knew how raw and honest she wanted to be, it's scary to really put everything out there online.And she shares some amazing attention she's getting from her idols—Alanis Morissette commented on her post about Perimenapalooza.She's hilarious, vulnerable, and completely unfiltered about what it's really like navigating perimenopause while trying to keep your career, marriage, and sanity intact.HighlightsGen X is the first generation refusing to accept the status quo whether it's breaking generational trauma or demanding better healthcare.If something feels off, keep going until you find the help you need.Motherhood is a gift but also hard.Vaginal estrogen can make a real difference when sex drive disappears.Freeze your eggs if you're young and unsure about timing.Couples therapy helps navigate the changes perimenopause brings to relationships.Don't accept "it's just your period" as an answer push for help.If you're experiencing symptoms that don't feel right, don't accept "it's just your period" or "this is normal" as an answer. Keep pushing until you find the help you need.Talk to your provider about what's actually happening. If they dismiss you, find someone who will listen.Subscribe to the podcast so you don't miss upcoming episodes.Connect with Beth:WebsiteInstagramGet in Touch with Me:WebsiteInstagramYoutubeSubstack

We start with a frustrating reality: 70% of OB-GYNs never ask patients about orgasm. And when women finally get the courage to bring it up themselves, the answer is usually "I'm so sorry, this just happens when you age."I ask Dr. Streicher to break down what an orgasm actually is and why arousal has to happen first. We discuss the different types of orgasms clitoral, cervical, and the controversial G-spot. Dr. Streicher shares the fascinating Maria Bonaparte research from the 1920s that discovered the 2.5 centimeter rule and why anatomical distance matters for orgasm during intercourse.We dive into primary versus acquired orgasmic dysfunction. For women who've never had an orgasm, nine out of ten times they just need education and a map to their clitoris. For women who used to have orgasms and can't anymore, SSRIs are often the culprit not hormones. We discuss solutions including Viagra, topical sildenafil, CBD, and why local estrogen on the clitoris matters.Dr. Streicher walks me through the history of vibrators and why they become necessary as women age and nerve endings become less sensitive. We talk about how to bring up using a vibrator with a partner and why it's a tool to make something possible, not just a toy for fun.We also discuss the FDA's removal of the box warning from local vaginal estrogen and what that means for women who were told they couldn't use it.HighlightsThe tiny nerve endings in the clitoris that respond to soft touch degenerate the most with age, while thicker ones that respond to vibration stay intact longer.The cervix has nerve endings that go to a different part of the spinal cord, which is why some women with spinal cord injuries can still have cervical orgasms.About 30% of women who develop orgasmic dysfunction from SSRIs will see improvement if they wait it out.There's no expiration date on local vaginal estrogen you can start using it at 99 years old,Only 7% of women consistently reach orgasm from intercourse alone without additional clitoral stimulation.If you're experiencing difficulty with orgasm or sexual function, don't accept "this just happens with age" as an answer. There are real solutions available, from addressing SSRI side effects to using local estrogen to exploring vibrators as medical tools.Talk to your provider about what's actually happening. If they don't have answers, find someone who specializes in sexual medicine.Connect with Dr. Streicher:WebsitePodcastInstagramGet in Touch with Me:WebsiteInstagramYoutubeSubstackMentioned in this episode:GSM CollectiveThe GSM Collective - Chicago Boutique concierge gynecology practice Led by Dr. Sameena Rahman, specialist in sexual medicine & menopause Unrushed appointments in a beautiful, private setting Personalized care for women's health, hormones, and pelvic floor issues Multiple membership options available Ready for personalized women's healthcare? Visit our Chicago office today. GSM Collective

Why do so many women with chronic pelvic pain get told "this is just motherhood" or "it'll get better when you go through menopause"? What if the heaviness, the aching, the constant discomfort isn't something you have to live with?In this episode, I sit down with Dr. Julie Baron, a pelvic floor physical therapist and director of Pelvic Health and Performance Center in Bellevue, Washington. Dr. Baron blew our minds at ISSWSH this year with her groundbreaking lecture on pelvic venous disorders a condition that's massively underdiagnosed and often dismissed as "just in your head."Dr. Baron shares her own lived experience with pelvic venous disease. For years, she couldn't sit or stand for more than 10 minutes without needing to lie down. She saw urologists, gynecologists, GI docs, colorectal specialists, and pelvic PTs and everyone told her she was normal. She was working as a pelvic floor PT herself, helping other people with pelvic pain while feeling like a fraud because she couldn't solve her own.She finally diagnosed herself, pushed her way into getting the imaging no one wanted to order, and finally felt validated after the report came back showing renal vein obstruction, iliac obstruction, gonadal vein reflux, and 12-millimeter varicose veins across her uterus. After gonadal vein embolization and sclerotherapy, her life changed completely.We discuss the classic presentation of pelvic venous disorderschronic non-cyclical ache or heaviness that gets worse throughout the day, urinary urgency, postcoital pain, and varicose veins. We talk about why pregnancy is one of the biggest risk factors and how hypermobility disorders, MCAS, and POTS all connect. Dr. Baron explains the imaging process and why a normal ultrasound doesn't always mean you're fine.She also explains the five functions of the pelvic floor and how pelvic venous disease impacts everything from bladder support to sexual function. We get into the sump pump concept, why belly breathing can actually make things worse for this patient population, and how compression shorts can be life-changing. Dr. Baron shares her protocol for helping patients optimize venous return through breathing, positioning, and nervous system regulation.If you're experiencing chronic pelvic pain and feel like you're being dismissed or told it's normal, talk to your provider about pelvic venous disease. While it's frustrating, don't stop advocating for yourself even if you're told everything is normal. You know your body, and if something feels off, keep pushing for answers.Make sure to subscribe so you never miss episodes like this one.Episode Mentioned:Dr. Alexis CutchinsGet in Touch with Dr. Baron:WebsiteInstagramGet in Touch with Me:WebsiteInstagramYoutubeSubstack

Why are women always apologizing for their bodies? Should you feel guilty about wanting plastic surgery in midlife? And what actually happens during a labiaplasty?In this Between Two Labia episode a subseries of the podcast filmed in my office I sit down with Dr. Dahlia Rice a board-certified plastic surgeon and owner of DMR Aesthetics Chicago.Dr. Rice started her career doing autopsies and teaching human anatomy before becoming one of only 1,400 female board-certified plastic surgeons in the United States.There's a misconception that labiaplasty is only cosmetic women trying to mimic unrealistic porn aesthetics.But the reality is that many are functional. Some women can't wear jeans or bike comfortably because of an elongated labia minora.Dr. Rice emphasizes finding a surgeon who does these procedures regularly and understands the anatomy. Being too aggressive can damage the clitoral arousal tissue that sits right behind the labia. Recovery sounds intimidating, but while there's significant swelling that Dr. Rice calls "Frankenpussy," the area heals quickly. You'll need to elevate your hips as much as possible during the first week and use lots of ice, but it's not as horrible as you might think.We also discuss medical tourism. A good deal on plastic surgery abroad sounds appealing, but Dr. Rice explains what happens when complications arise and you're back home with no one willing to help. The US has more expensive procedures because of stringent training and regulations, but when things go wrong overseas, you can fall through the cracks. Insurance won't cover it, and finding a surgeon to fix someone else's work becomes a challenge.Dr. Rice and I talk about why representation matters in plastic surgery. Only 20% of plastic surgeons in the US are female, even though over 90% of patients are women.We discuss how cultural understanding affects outcomes from knowing the right placement for eyelid creases in Asian patients to understanding how different cultures communicate about complications.Highlights50% of labia are naturally asymmetric, but social media and porn have created unrealistic expectations of what "normal" should look like.Plastic surgery as a board certification specialty has only existed since the 1940s, even though reconstructive procedures have been performed since ancient times.There's now cadaver fat available as an alternative to using your own fat for transfer, which eliminates issues with poor "take" in older patients.Korean skincare focuses on prevention and low inflammation from a young age, while Americans take a "guns blazing" approach when we suddenly panic about aging.Pigmentation naturally darkens during menopause regardless of your ethnicity or background.Plastic surgery has shifted from focusing on what men want to what women want for themselves and their own comfort.If you're considering any aesthetic procedures in midlife, take time to find a surgeon who understands the anatomy and does these procedures regularly. Ask to see their work, understand the recovery process, and set realistic expectations about outcomes.What other topics would you like to see from me? Who would you like me interview next? DM on Instagram.Get in Touch with Dr. Rice:WebsiteInstagramTikTokGet in Touch with Me:WebsiteInstagramYoutubeSubstack

Is age 35 really a fertility cliff? Should everyone freeze their eggs? And why does your doctor speak in such vague terms when you ask about your chances?In this episode, I sit down with Dr. Lucky Sekhon, a double board-certified reproductive endocrinologist in New York City and author of the bestselling book The Lucky Egg. Dr. Sekhon has spent years watching patients walk into her clinic overwhelmed by information that is not always true or grounded in science. This is what inspired her to write a book that could close the massive knowledge gap around fertility.Dr. Sekhon gives the actual numbers most fertility doctors won't commit to and explains why doctors who speak in absolutes are a red flag. How men have a biological clock too. Advanced paternal age can also bring on mutation risks and can affect pregnancy outcomes like preeclampsia.We talk about how many women end up with unwanted pregnancies due to thinking they are not able to get pregnant anymore because their cycles are no longer consistent.We also touch on vaginismus and how common it is in the South Asian community, where women often delay seeking help because of cultural stigma and family pressure. This is physical, not just psychological Dr. Sekhon will share something that confirms this is not in patients' heads.And the shocking fact that one in four female physicians will struggle with infertility, and it's an independent risk factor beyond just delayed childbearing.This is an episode you don't want to miss, especially if you're in the thick of making decisions around your fertility or you're a clinician in the field looking to better support your patients.HighlightsEgg freezing gives you a head start if you ever need IVF, not just an insurance policy.LGBTQ family building have more options than most people realize.Ovulation predictor can be helpful but aren't 100% accurate.Your fertility is individual you're not a statistic or an algorithm.How doctors can practice cultural humility. If you're making decisions about egg freezing or navigating fertility challenges, make sure to pick Dr. Sekhon's book The Lucky Egg for the evidence-based information you need. Visit theluckyegg.com to use the egg freezing calculator and access more resources.Make sure to subscribe to the podcast so you don't miss upcoming episodes.Get in Touch with Dr. Sekhon:Website BookInstagramTikTok YoutubeGet in Touch with Me: WebsiteInstagramYoutubeSubstack

Comprehensive sexual health care requires time and a team approach. I'm joined by two of my team members Karen Badley, my nurse practitioner, and Grace Prete, our pelvic floor physical therapist.We talk about why complex conditions like pelvic pain, painful sex, and hormonal changes don't fit into 10-minute appointments. You can't address someone's full picture when insurance only reimburses for quick visits. We discuss why multidisciplinary care matters, why pelvic floor therapy sessions need real time, and why treating hormonal health alongside aesthetics makes a difference.This conversation is about what patients deserve and why the traditional insurance model makes that impossible. We talk about treating the whole person, not just symptoms. Last year, I transitioned to a concierge model after over a decade of taking insurance because this is how medicine should be practiced.HighlightsGenitourinary syndrome of lactation is similar to GSM in menopause.Upper cross syndrome from breastfeeding and tech neck causes cervical spine issues.Visible light from phones and screens worsens hyperpigmentation (tinted mineral sunscreen helps).Tight pelvic floor muscles are actually the weakest, not the strongest.Insurance bundles entire pregnancy into one fee with no separate postpartum reimbursement.Patients can see multiple providers on the same day for coordinated care.f you're struggling with sexual health issues, pelvic pain, or hormonal changes and feel like your appointments are too rushed, consider seeking comprehensive care. Check out our practice at https://www.thegsmcollective.com/ to learn more about our concierge model. Subscribe to the podcast so you don't miss upcoming episodes.Connect with Dr. Rahman:Website - https://www.thegsmcollective.com/about-usInstagram - https://www.instagram.com/gynogirl/Youtube - https://www.youtube.com/@UCmFnlujKDsDE3uIUMrbcByQSubstack - https://gynogirl.substack.com/p/welcome-to-vagilante-nation?just_subscribed=true

Katalin Rodriguez Ogren is a certified badass. She's owned POW Gym in Chicago's West Loop for 25 years, she's a lifelong martial artist who played the female ninjas in Mortal Kombat 2, and she just wrote a book on nutrition for menopause after her GP handed her marriage counseling referrals instead of addressing her hormones.When Katalin started experiencing severe skin issues during menopause, her GP dismissed her concerns about hormones and instead gave her marriage counseling referrals. That experience led her to write a book about nutrition strategies for menopause.We discuss functional strength training and why it's different from typical gym workouts, how estrogen decline affects protein synthesis, and why most women aren't getting enough protein. Katalin explains why midlife is a reset rather than a decline, how to support strength training with proper nutrition, and why small wins compound into big wins.HighlightsEstrogen decline causes anabolic resistance, making it harder to synthesize protein as you age.Pairing protein with every carb helps stabilize blood sugar throughout the day."One plus one equals three" strategic meal combinations compound nutrition benefits.Digestion should be invisible; if you can hear it, your meal timing or choices need adjustment.Movement is longevity insurance for independence in later life.Midlife is a reset, not a decline. If you're feeling dismissed by doctors or struggling with where to start, consider prioritizing protein at your meals and finding movement that builds functional strength. Small changes compound over time.Katalin's book Nutrition for Women Navigating Menopause: The Power of Addition: An Anti-Diet Strategy is available on Amazon if you want practical strategies for reorganizing your nutrition.Subscribe to the podcast so you don't miss upcoming episodes.Get in Touch with Katalin:WebsiteInstagramBuy Katalin's BookGet in Touch with Me: WebsiteInstagramYoutubeSubstack

Welcome to Between Two Labia, a new series filmed in my office in front of my 8-foot vulva. When colleagues come to town, I sit down with them to talk about the things you want to ask but think you shouldn't. These are the conversations I have with friends and colleagues that you wouldn't normally get to listen to. Dr. Shieva Ghofrany is my first guest, and you'll see these episodes pop up from time to time between regular podcast episodes.We discuss the weird limbo between having a baby and hitting perimenopause, why bounce-back culture is toxic, why every vulva and labia looks different (and that's completely normal), and much more. Shieva talks about how going through her own health challenges made her a more empathetic doctor. And of course, we cover the basics: you NEVER and we mean never have to apologize for your body. We don't care how you come for your appointments. Get in Touch with Dr. Shieva GhofranyWebsiteInstagramGet in Touch with Me: WebsiteInstagramYoutubeSubstack