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Today's podcast is sponsored by Midi Health. So many women tell me the same thing. They finally speak up about brain fog, exhaustion or anxiety and they're brushed off or told it's just stress or age. That kind of dismissal makes you question your own body. MIDI changes that by offering expert insurance covered virtual care that actually understands midlife and treats women like they matter. Ready to feel your best and write your second act script? Visit joinmitty.comtamsin today to book your personalized insurance covered virtual visit. That's joinmitty.com Tamsen Midi the care women deserve. Look at him eating whatever he wants, never gaining a pound, while I'm stuck with the boring special and can't lose an ounce. How's your lunch, man? Amazing. Yours? So good. Oh, I'm so happy for you. Cool, buddy. Weight loss isn't fair, but Mochi Health is the affordable GLP1 source that can fix your frustration with food.
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So same time next week?
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No, definitely. And your friends learn more@joinmochi.com Mochi members have access to licensed physicians and nutritionists. Results may vary. Welcome back to the Tamsen Show. Happy Monday. I am so excited you're here with us. So this is my how to Menopause series where I'm taking my book and going even deeper one subject at a time. We never had a chance to do this, so if you don't have the book yet, it's linked in the show notes, but you absolutely do not need it to follow along today. I designed the book so you could open to any chapter based on wherever you are and what you're dealing with in your life and find your answer. So leave it on your bedside table because I wanted it to be this kind of what to expect when you're not expecting and you're dealing with perimenopause, menopause, whatever it is. Today's subject came from you, specifically from a comment that literally stopped me in my tracks. And before I get into it, I want to say something right at the top that I think is going to be a relief for all people. This episode is not the should I go on hormones? Conversation. That's a whole separate conversation and we have covered it and we will keep on covering it for you. What we're talking about today is something different and honestly, simpler. A treatment that is local, that stays right where you put it and that the doctors I've spoken with say every woman should know about. And a lot of us don't. So whether you are on menopausal hormone therapy Hormone therapy, hrt, whatever you call it, whether you ever plan to be or not, this is its own thing. Now, let me get back to the person I'm talking about. A few weeks ago, I posted a clip from a previous episode where I'm talking about something that a lot of women don't know is happening to them. That your vulva and labia can actually shrink and, and kind of disappear from estrogen loss. And sza, yes, that Sza replied and said, quote, had a really hard day. And this was the absolute last thing I needed to hear. Listen, SZA, I get you. I so get you. Almost 50,000 people like that comment because that's what it felt like. The absolute last thing that any of us want to hear. But here's the thing. If Sza, with all her resources and access and people around her didn't know this could happen yet, you are in very good company. And this is exactly why I made this episode. Sza, this episode is for you and for every woman who just got a little sick to her stomach watching that clip. Before we go any further, you know, I always say this, but I have to. I am not a doctor. I'm a journalist and a woman who has been through it all. I've done a lot of research on this. I've talked to a lot of experts, and all I needed when I was in the middle of it was a big sister who already had figured some of this out. And that's exactly what I want to be for you. Everything I know came from top doctors and researchers in this space. I've had them on the show. I've interviewed them for my book and my documentaries. And today, I'm going to make it as real and digestible as I can. Take what I share here and bring it with you to your doctor, because your body and your history are yours. And please don't. Women have been dramatically understudied in medicine. I can't say it enough, but especially around perimenopause and menopause, when you hear the research is still building. It's true. And it's also because we were not prioritized. So keep that in mind. And finally, finally, we are stepping up saying, no, we're prioritizing this. So let me start with why this hit so many women so hard when they heard that comment. Because when we talk about perimenopause or menopause, we talk about hot flashes, we talk about night sweats, we talk about emotions, we talk about brain fog, but no one ever sat us down and Said, by the way, the tissue of your entire pelvic region, your vagina, your vulva, your labia, is completely dependent on estrogen to stay healthy. And when estrogen declines, that tissue starts to change. There's a name for it. It's called gsm, Genitourinary Syndrome of Menopause. And I want to take a second on the history of that name, because it tells you everything about how women's health has been handled. The old medical term before GSM was senile vagina. Then they updated it to atrophic vaginitis. And I barely want to say neither of which sounds like something a doctor should say to a living, breathing woman with a straight face. Eventually, they landed on gsm, which at least sounds clinical enough to get through a conversation without everyone dying inside. And because it's a really hard thing to say, we're just going to keep saying GSM. Here's what the research shows. 100% of women will experience GSM to some degree. Not some of us, all of us. The question is just how much and whether we do anything about it. And unlike hot flashes or brain fog, which can ease up over time, GSM doesn't get better on its own. It progresses. So if you're waiting it out, please hear that. Here's what happens with all of it. Just to make it a little bit easier, estrogen keeps all that tissue thick, elastic, lubricated. When it drops, that tissue starts to thin, it loses its stretch. It becomes fragile and dry in a way that makes things really uncomfortable. And I'm not just talking about sex, even just going about your day. And because this process is progressive, the longer estrogen stays low, the more it changes. And that can include the labia and the vulva. They can visibly shrink. And I know that sounds shocking because it shocked me when I first heard it. I was like, wait, is this 100% true? I've never heard of this. Oh, gosh, I love this time of year. There is something about this time of year where I just want to move. I want to walk, I want to get outside, I want to just get in motion. Long walks, workouts, being outside again, it makes me rethink the basics I'm wearing every day. I've been getting back into my lifting workouts and bomba. Sports socks have been such a game changer. They're cushioned where you need them. They stay in place. And I'm not distracted by, like, adjusting everything all the time. I can just focus, focus on moving. And, you know, I love my morning walks. And you know what happens when I put my boots back in the closet? Then I'm all about comfortable footwear. Bombas has warm weather footwear and it's back in rotation. It's lightweight, supportive and perfect for travel days or for just running out the door, especially when it comes to their sandals. Even their basics though, surprised me. Overall. The tees, the underwear, they're soft, they're breathable, and they just feel like an upgrade from what I was wearing before. This is also a part that really matters to me. For every item you purchase, an essential clothing item is donated to someone facing housing insecurity. One purchased, one donated with over 150 million donations and counting, that is pretty amazing to me. Head over to bombas.com tamsen and use code TAMSEN for 20% off your first purchase. That's B O-M-B-A-S.com TAMSEN code TAMSEN at checkout hey there. So I keep hearing about Magnesium Breakthrough bio optimizers from doctors, from friends, from people whose opinions I trust. And everyone's been saying the same thing. This one is different, so I tried it. Most magnesium supplements use one or two forms. This one combines seven different forms plus the co factors your body needs to actually absorb it and use it, which is so important. I found out people are talking about more restful sleep, feeling calmer, better recovery, even digestion. I don't recommend things that I haven't tried myself. So I have started Magnesium Breakthrough and I want you to do this with me. Pay attention to how you sleep. Notice how you feel in the morning. You've got nothing to lose. By the way, Buy Optimizers offers a full 365 day, no questions asked money back guarantee. Go to buyoptimizers.com tamsen and use my exclusive code TAMSEN to get 15% off of any order. Make 2026 a year. You finally start sleeping great again. It clearly shocks SZA too, but this is what's happening and no one is telling us what it means. Physically. Sex can become painful, not uncomfortable. Painful. Halle Berry was on the show and described what happened to her. One night with her partner. She woke up and it took her 10 minutes to empty her bladder because she was in so much pain. Her doctor told her it was herpes. It was not herpes, it was from estrogen loss and she said not one of her doctors had ever talked to her about this before. At 54 years old, she ended up completely blindsided. It also affects your urinary health in ways that most women have no idea about. Research shows us that vaginal estrogen can reduce UTI rates by up to 50%. And this is so important. Reoccurring UTIs in older women are not just annoying, but they can lead to serious infections and hospitalizations. Vaginal estrogen is actually the most effective treatment for recurrent UTIs and menopausal women. So if you are somebody that is dealing with that and you keep getting handed antibiotics, you need to ask your doctor about this. It is so important. And I had no idea about any of it. I want to repeat it one more time. Vaginal estrogen is actually the most effective treatment for recurrent UTIs in menopausal women. So you're probably saying like, okay, Tamsen, how do I know I need this? Because my doctor never said anything. Mine never said anything either. This is a part I want you to really sit with, because a lot of women are dealing with these symptoms and not connecting them to this estrogen loss at all. Dryness down there, not just during sex, but generally. Itching, irritation that doesn't have an obvious explanation. Sex that's become uncomfortable or painful when it wasn't before. Needing a pee more urgently or more frequently. Getting UTIs over and over again when that was not something you were dealing with before. Any of those things I just mentioned or a combo of those could be gsm. And the thing to understand is that these symptoms often come on gradually, which means a lot of women just quietly adapt and then assume this is what getting older feels like. But it does not have to be. You can also start to recognize changes and notice changes in how things look. And that's what that clip that I shared on social media was about on Instagram. The tissues that can visibly thin and the labia that can shrink. That is not vanity. That is your body telling you it needs something, like, in a big way. So I need to shift here because I don't want this to be a scary episode. Even though Sza was scared and a lot of women were like, what the hell is going on? I want this to be a useful episode because here's the thing. This is largely reversible and the treatment is actually really simple. Vaginal estrogen can grow the tissue back. That's not an exaggeration. With consistent use over time, that tissue can regenerate and the elasticity can return. The lubrication comes back, the pain can go away. Doctors I have interviewed on this subject say it should be in a vending machine in every bathroom. That is how universally needed and how Safe, they believe it is. And that brings me to the piece I need you to hear, especially if you've ever been told you cannot take hormones. Vaginal estrogen is local. It stays in the vagina. It's not absorbed into your bloodstream in any meaningful amount. It's not the same as taking hormone therapy, menopausal hormone therapy, hrt. It is treating the issue right where the tissue needs help, nothing more and nothing less. So essentially every woman can use it, including women who have had breast cancer, according to experts. And yet these women's quality of life is being ignored. They could be on it and they're not being offered this. So whether or not you're on systemic hormones, like the patch, the pill, this is different. Vaginal estrogen stands on its own. So you've asked me, a lot of you have asked in the notes and we had doctors talking about this. If you are taking estrogen or patch, pill gel, yes, you can still take vaginal estrogen. Those are very different from each other and you don't have to be doing anything else to use it. So if you're not taking estrogen, progesterone or testosterone, yes, you can still use vaginal estrogen separately. This show is sponsored by MIDI Health. I remember it sitting in the doctor's office, listing off everything I was feeling. Exhaustion, brain fog, mood swings, sleep, all of it. And getting nothing but a vague smile. And this is just part of getting older. No test, no plan, just a brush off. And I thought, is this really it? If you're in midlife and feeling dismissed or unheard of, I want you to know you're not imagining it and you're definitely not alone. 75% of women who seek care for perimenopause or menopause symptoms, they walk away untreated. That is outrageous to me and it's why I'm so grateful MITI exists. MIDI is a virtual clinic built specifically for women in midlife by experts who actually get it. They're the only women's telehealth platform covered by major insurance. So it's not just high quality, it's accessible. What I love most, their clinicians listen one on one, face to face. They take the time to understand what you need and create a plan that works. This is the care we have been waiting for. Go to joinmini.com tamsen and finally feel seen. Ready to feel your best and write your second act script. Visit joinmitty.comtamsentoday to book your personalized insurance covered visit. That's joinmitte.com Tamson Midi the care women deserve let's talk a little bit about what spring means. Spring means more photos, more events, more moments where your glasses are front and center. Yeah, I realize I've been wearing the same frames for way too long. Warby Parker completely changed how I think about buying glasses. The virtual try on. Oh my gosh, it's so easy. It lets you see exactly how frames look on your face from your phone. And it actually works, which is more than I can say for every brand that has tried it. I got my current pair before Ira and I went away. And the compliments haven't stopped. Prescription glasses starting at $95. Contacts, sunglasses, online eye exams, over 300 stores nationwide. Quality and price. It's not even close. It is a perfect time to upgrade your glasses for spring. Buy one prescription pair and get 20% off any additional prescription pairs@warbyparker.com Tamsen that's 20% off additional prescription pairs or when you go to W A r b y. Parker.com Tamsen so what does it actually look like? Well, vaginal estrogen comes in a few forms and your doctor can walk you through what's right for you. But here's what I've learned. So you can walk in at least knowing some of your options. And then I have the entire list for you too. On my website and in the book, there is a cream, an estradiol cream that you can apply with a small applicator a few times a week. There are also vaginal tablets or inserts like vagifem, same idea, small insert that you can use a few times a week and then taper down to maintenance. If you're listening to this episode, I also show this over on YouTube so you can see it. And if you're watching on YouTube, you can see that this is the applicator and there's a little tablet inside here. And you insert this, you press this little button and the tablet just goes inside you. And this is super, super duper easy. These are one applicator per day when you use them, and this one's called vagifm. But again, there are a bunch of different options out there. There's a ring called estring that goes in like a diaphragm and releases a low steady dose over 90 days. So you can put it in and essentially forget it. I like this applicator that I have here, but to each his own. There's also a newer version called Intrarosa, which, which is a vaginal DHEA insert DHEA sounds complicated, but here's a simple version of it. It's basically a building block hormone that your body converts into smaller amounts of estrogen and testosterone directly in your vaginal tissue. Never again goes into your bloodstream. The conversion happens right there locally. So if you've been told estrogen is off the table for you, this is one to specifically ask about. Because technically it's not estrogen going in. It's a precursor that becomes estrogen once it's already in the tissue. To talk to your doctor to weigh in on what the best options are for you. There's also an oral option out there for women who can't or don't want to use it vaginally. It also specifically works on vaginal tissue, even though you take it by mouth before you go looking for them at the drugstore. These are all prescription. None of them are systemic hrt, and you do not need to be on anything else for them to work. One thing, lubricant is not the same thing. It helps in the moment, but it does not treat the tissue. If the tissue is thin and fragile, lubricant is a band aid for that vaginal estrogen is fixing the actual problem. You can and should use both. But don't let anybody tell you lubricant is the answer to this. If anything that I have described sounds at least a little bit familiar, here's how to bring it up. If you're like, how do I. What am I telling my doctor about this? Now? Be specific. Don't just say you've been having a little bit of dryness. Say, I want to talk about vaginal estrogen for gsm. I want to understand my options for. For vaginal estrogen or local treatment. And using the term GSM actually tells your doctor that you've done your homework, that you're a partner in all this and that you know this is a real clinical thing with real treatment options out there. I also think it signals that you're not asking about full hormone therapy. You're asking about a local treatment, which is different and maybe a simpler, easier, faster conversation. And maybe you want to have that hormone conversation when you've got more time with your doctor. If your doctor says you can't take hormones and shuts that down and says like, nope, sorry, please push back gently and say, I'm asking about local vaginal estrogen, which is not absorbed systemically, is that still off the table for me? In a lot of cases, including for women with a history of breast cancer, the answer to that question is actually different from the answer can I take hormone therapy? And you deserve to have that conversation. If your regular doctor isn't the right person for this, a menopause certified clinician can be a great, great option. And I have a provider search that's linked in show notes to make it easier for you. So I hope that this makes it feel a little less like the last thing that you needed to hear, more like information that makes sense and information that a lot of women don't have. What I want every woman who listened to this to know is that this is not about vanity. This is not about being embarrassed or something to whisper about. This is your health. This is the same way we talk about bone density or heart health or brain health, things to pay attention to so you're okay. Later on the tissue changes that starts to happen in perimenopause and that does not improve on its own. But you absolutely can do something about it. So please go talk to your doctor after listening to this and ask specifically about vaginal estrogen. There's also a transcript to this episode if that makes it easier. Ask about gsm. And if your doctor tells you you can't take hormones and closes the conversation there, I want you to come back and say I'm asking about local vaginal estrogen, which is different because it is everything I talked about today, the research, all of it that's in the show notes. So I hope this helped. I'm so glad you're here. Please share this if it was helpful. Please leave a review or a comment or a question down below and we'll talk next time. This is a Monday.com ad the same Monday.com designed for every team. The same Monday.com with built in AI scaling your work from day one the same Monday.com with an easy and intuitive setup. Go to Monday.com and try it for free.
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