The Menopause Hour Episode -7
Podcast

The Menopause Hour with Winona: HRT & Sexual Wellness: Reclaiming Pleasure in Menopause - Episode #7

Published: February, 2025

Dr. Cathleen Brown

Featured Physician

Cathleen M. Brown

Host

Madi Baldwin

Episode #7 of The Menopause Hour with Winona is a replay of a live Ask the Experts Q&A, hosted by Madi Baldwin and featuring Winona Chief Medical Officer Dr. Michael Green and Medical Director Dr. Cathleen Brown.

Originally released on Valentine's Day, the episode covered how HRT and DHEA can help restore libido and sexual comfort. The doctors also answered listener questions on progesterone dosing, testosterone safety, and vaginal estrogen. This episode offers practical support for anyone navigating changes in intimacy during menopause.


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Episode Details

  • Podcast: The Menopause Hour with Winona

  • Episode Number: 7

  • Episode Title: Episode #7: HRT & Sexual Wellness: Reclaiming Pleasure in Menopause

  • Host: Madi Baldwin

  • Featured Physicians: Dr. Cathleen Brown & Dr. Michael Green

  • Published Date: February 14, 2025

  • Episode Duration: 57 min 31 sec

  • Format: Menopause Q&A

  • Main Topics: Sexual wellness & libido, DHEA & testosterone, Vaginal estrogen

About The Menopause Hour with Winona Podcast

The Menopause Hour with Winona is a health and wellness podcast featuring Winona Chief Medical Officer Dr. Michael Green and Medical Director Dr. Cathleen Brown. Each episode brings listeners candid, expert-led conversations that answer the menopause questions women may not feel comfortable asking their own physicians.

The show blends live Q&A sessions, doctor-to-doctor dialogues, and real patient stories to cover the full range of the menopause transition. By discussing symptoms, treatment options, and the underlying science, the podcast aims to help women feel informed and confident rather than confused or dismissed during these transitional years.

Visit The Menopause Hour on Buzzsprout.

About This Episode

This episode revisits a Valentine's Day Ask the Experts session, where Dr. Green and Dr. Brown answered listener questions about the effects of hormone therapy on libido, intimacy, and overall sexual wellness. They also introduced Winona's new arousal cream for supporting sexual health during menopause.

Beyond libido, the conversation covered when estrogen therapy can be started even without the presence of classic vasomotor symptoms and how DHEA supports women’s natural testosterone levels. The doctors also answered safety questions about progesterone dosing, testosterone use after age 60, and vaginal estrogen for women with a history of cancer. This episode is an essential listen for anyone wanting a clear, judgment-free picture of how HRT intersects with intimacy.

RSVP here to join our next Menopause Q&A.

Topics Covered

  • Why estrogen may be recommended even without classic symptoms like hot flashes

  • Winona's new arousal cream and how it supports sexual wellness

  • The role of DHEA in libido, energy, and testosterone support

  • HRT and endometriosis, fibroids, and other benign conditions

  • Progesterone cream vs. pills and dosing considerations

  • Testosterone, heart health, and starting HRT after age 60

  • "Estrogen dominance": why it isn't a real medical diagnosis

  • Migraines, joint pain, and frozen shoulder as hormone-related symptoms

  • Vaginal estrogen safety, even for women with a history of cancer

  • Managing supplement routines when starting HRT

  • Hair shedding after starting hormone therapy

  • Preventive health screenings recommended alongside HRT

Key Takeaways

Estrogen may help even without classic vasomotor symptoms

Estrogen naturally declines with age regardless of whether someone experiences hot flashes or night sweats. Dr. Cat shared that many women only realize how much subtle symptoms like brain fog or joint pain were affecting them once they start treatment.

Vaginal estrogen is safe for nearly everyone, including many cancer survivors

Unlike systemic HRT, low-dose localized vaginal estrogen carries a different safety profile and can be used by women who otherwise wouldn’t be eligible for systemic hormone therapy. Dr. Cat explained that localized treatment safely addresses vaginal dryness and discomfort that can affect intimacy and daily comfort.

"Estrogen dominance" isn't a recognized medical diagnosis

Dr. Cat clarified that "estrogen dominance" does not exist as a diagnosable condition. She explained that every woman's estrogen production declines with age, and that many women navigating menopause can benefit from individualized estrogen therapy.

Endometrial protection requires proper progesterone formulation and dosing

Dr. Green explained that progesterone must be micronized and dosed carefully to protect the uterine lining, which is why over-the-counter topical creams sold without a prescription often don't contain enough progesterone to be effective.

Starting hormone therapy after 60 carries more risk than continuing existing treatment

Both doctors noted that starting HRT for the first time after age 60 carries higher cardiovascular risks than continuing a treatment regimen that was initiated earlier in the menopause transition. They emphasized that timing matters more than age alone once someone is already established on therapy.


Cathleen M. Brown

Dr. Cathleen M. Brown

Obstetrics & Gynecology

Dr. Cathleen Brown is a menopause specialist and physician with Winona. She brings a physician’s perspective to menopause, perimenopause, hormone changes, symptom care, and treatment options during midlife.

At Winona, Dr. Brown helps women better understand symptoms, health history, hormone changes, and when physician-reviewed care may be appropriate.

Meet Dr. Cathleen M. Brown

Watch or Listen to the Episode

Watch the full conversation with Dr. Cathleen M. Brown on
The Menopause Hour with Winona with Madi Baldwin.

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About Winona

Winona is a physician-led telehealth company focused on menopause and perimenopause care. Its board-certified physicians help women understand symptoms such as hot flashes, night sweats, sleep disruption, mood changes, brain fog, vaginal dryness, intimacy issues, weight changes, hair thinning, and joint discomfort.

When appropriate, Winona offers personalized treatment plans that may include hormone replacement therapy, bioidentical HRT, estrogen, progesterone, vaginal estrogen, and non-hormonal options. Winona also provides education and community support for women navigating hormone changes, menopause symptoms, perimenopause, and postmenopause.

To learn more, get started with Winona.

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Winona helps women access menopause and perimenopause care from home. Start with a short health questionnaire, and a board-certified physician will review your symptoms, health history, and treatment options.

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