35 - How vaginal hormones can transform the health of women

The Dr Louise Newson Podcast

Dr Louise Newson

Health & Fitness, Mental Health, Medicine

4.8 • 798 Ratings

🗓️ 25 November 2025

⏱️ 30 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this episode, Dr Louise Newson is joined by urologist and sexual medicine specialist Dr Rachel Rubin for a clear look at how hormonal changes can often worsen both urinary and vaginal health. The conversation examines why recurrent urinary tract infections are so common in women, how prevention with vaginal hormones is often overlooked and what current evidence shows about the safety and effectiveness of vaginal hormone treatments.

They also explore the impact of inaccurate hormone labelling, the role of androgens in genitourinary tissues, and the growing push for updated regulatory guidance. Grounded in clinical experience and research, this discussion offers practical insight for anyone seeking to understand menopause care, hormone therapy and the broader health implications that follow when symptoms are dismissed or untreated.

Note: This podcast was recorded before the FDA's announcement that it is removing the black box warnings on estrogen products.

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Transcript

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0:00.0	Today it's a great podcast because I'm talking to Rachel Rubin.
0:04.0	She's a urologist and a sexual health specialist in US.
0:07.9	She's also a great friend and a really big ambassador for the health of women.
0:13.0	We talk a lot about how so many women are neglected when they have urinary tract infections,
0:17.9	how we're not thinking about reducing the incidence of them and the harms
0:21.5	that can have. We're talking about the inaccurate labelling of vaginal hormones and how the FDA
0:27.7	are going to change that and we should change that over here. It's quite a meaty, bit political
0:33.0	conversation, but I hope you enjoy it. So Rachel Rubin, I want you in my studio. You're nearly here,
0:41.2	you're remote, you're in US, and you are just brilliant because you understand probably as
0:48.9	much more than me about how hard it is for women to be listened to, to be treated properly, the safety and the
0:56.8	efficacy of hormones, especially when it comes to even just vagina hormones, right? They're really
1:02.7	very safe and people can't access them. Yeah, I mean, holy mother of God. And I'm a neurologist.
1:10.8	I know you're married to urologist. We curse a lot.
1:13.2	So I'm going to try to be appropriate here because I know on the other side of the pond, you guys are much more proper than we are.
1:18.9	But I have a lot of bad words to say about this. And I think it really comes from my frustration on the men's health side because we do not do what we do to women we
1:29.6	don't do to men we don't have the same level of you can't do this you can't have this um i saw a woman
1:37.2	this week uh in my busy clinic i have one day a week of a busy clinic and she was a picture perfect
1:43.0	candidate for hormone therapy picture perfect she had all the symptoms she was a picture perfect candidate for hormone therapy. Picture perfect.
1:45.8	She had all the symptoms. She was very healthy. She had no medical problems, no family history.
1:51.4	I mean, it was a home run as if I were to give a lecture on the perfect patient to give easy
1:58.0	hormone therapy to. And she said to me, she said, but Dr. Ribbon, my,
2:01.7	my doctor said, I wasn't a good candidate for hormones. And I said, what are you talking about?
	...

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