Vanishing Vulvas & Menopause: What's Really Happening with Dr. Karen Tang

**Mary Claire Haver** (0:00)
Menopause hormone therapy is a microdose compared to what your body was making in your premenopausal years. It is unreasonable to think that for the next 30 years, this microdose is going to be enough to penetrate that general urinary system. You are better off treating both areas at the same time, and maybe we can prevent any of these problems.

**Karen Tang** (0:18)
The prevention is so huge because, again, so much of the menopause and women's health in general is you're sort of like reacting. You're like waiting until you can't tolerate it anymore, until you're just like I can't deal with this anymore, and then you finally treat it. That was definitely the way that we thought of women's health for so long.

**Mary Claire Haver** (0:46)
The views and opinions expressed on unPAUSED are those of the talent and guests alone and are provided for informational and entertainment purposes only. No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis or treatment.
In part one of my conversation with Dr. Karen Tang, she walked us through what happens when common gynecologic conditions like endometriosis and fibroids collide with the menopause transition. But there's another category of symptoms that affects millions of women and is still surrounded by confusion, stigma, and far too much suffering and silence. In this episode, we turn our attention to one of the most common complaints women bring into midlife—pain in the vulva and vagina. Dr. Tang, a board-certified gynecologist, minimally invasive gynecologic surgeon, and the author of It's Not Hysteria, explains why itching, burning, dryness, and painful sex are so often dismissed or misdiagnosed, and what women should know about the conditions that might be causing these symptoms. We also tackle the persistent myth that that painful sex is simply something women should expect as they age. And because so much of women's health care still requires self-advocacy, we close with a practical conversation about treatment options, vaginal estrogen, surgical decision-making, and how to find the right specialist when you're not getting answers. Because we both firmly believe that while suffering may be common, it is never something women should have to accept. I'm Dr. Mary Claire Haver, a board-certified obstetrician and gynecologist and certified menopause practitioner. I'm also an adjunct professor of obstetrics and gynecology at the University of Texas Medical Branch. Welcome to UnPAUSED, the podcast where we cut through the silence and talk about what it really takes for women to thrive in the second half of life.
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**SPEAKER_4** (3:51)
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**SPEAKER_5** (4:53)
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