In this episode of Women Mastering Midlife, I welcome back Nurse Practitioner Vanessa Weiland for a candid and much-needed conversation about vaginal estrogen, genitourinary syndrome of menopause (GSM), and sexual wellness for women in perimenopause and beyond.Too many midlife women suffer in silence from vaginal dryness, recurrent UTIs, painful sex, and bladder issues—often unaware that safe, effective treatments exist. Vanessa and I unpack the myths, explore the latest research and guidelines, and explain why vaginal estrogen is not only safe but also life-changing for many women.We also dive into alternatives like vaginal DHEA, the role of pelvic floor therapy, how to advocate for yourself with your provider, and why the FDA’s outdated black box warning continues to create unnecessary fear.What You’ll Learn in This Episode:What Genitourinary Syndrome of Menopause (GSM) is and how it affects sexual and urinary healthWhy vaginal estrogen is different from systemic hormone therapy—and why it’s considered safe, even with a history of breast cancer or blood clotsThe pros and cons of creams, tablets, and rings for vaginal estrogenHow vaginal estrogen can improve blood flow, sensation, lubrication, and overall sexual experienceThe growing evidence for pelvic floor physical therapy, yoga, and lifestyle strategies as part of GSM careHow to confidently start the conversation with your provider, even if they don’t bring it upMyths and misconceptions that prevent women from getting the care they needResources & Links Mentioned in the Episode:Menopause Rating Scale (Self-Assessment Tool)ACOG guidelines on vaginal estrogen safetyGSM Clinical Guidelines (latest recommendations)Connect with Nurse Practitioner Vanessa Weiland on Instagram: @phases.clinic If you’ve been struggling with vaginal dryness, painful sex, or recurrent UTIs, this episode is for you. You’ll walk away with knowledge, confidence, and practical steps to reclaim your comfort and sexual wellness in midlife.Join the Women Mastering Midlife Community and let’s grow stronger together. Listen & subscribe on Apple Podcasts, Spotify, or your favorite podcast app.Join the ConversationGet your FREE guides HERE: www.msvictoriabyrd.com/free-guides Share your thoughts and stories on our social channels and tag us @WomenMasteringMidlife  and @misvictoriabyrd Let’s rewrite the narrative together!  Find more information on our website: www.womenmasteringmidlife.com Book a FREE 1:1 discovery call to learn more about coaching programs and coursesDisclaimer  This podcast is for entertainment, educational, and informational purposes only. The hosts, guests, and experts featured are not your personal healthcare providers or advisors. The content should not be considered as professional, personalized medical, psychological, or prescriptive advice.  Always consult qualified professionals such as your physician, therapist, pharmacist, or coach for specific concerns and decisions related to your health or lifestyle. *Women Mastering Midlife* is not responsible for any undesired outcomes resulting from actions taken based on the content of this podcast.

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