Published: September, 2025
Published: September, 2025
Featured Physician
Cathleen M. BrownHost
Episode #25 of The Menopause Hour with Winona: "Real Answers about Hormones, Symptoms, and Sexual Health" was a live Q&A hosted by Madi Baldwin and featuring Winona Medical Director Dr. Cathleen Brown.
Dr. Brown addressed long-standing myths about the Women's Health Initiative (WHI) study, explained why hormone testing isn't useful for guiding HRT treatment decisions, and answered listener questions about DHEA, sexual wellness, and menopause care for women with a history of breast cancer.
Podcast: The Menopause Hour with Winona
Episode Number: 25
Episode Title: Episode #25: Real Answers about Hormones, Symptoms, and Sexual Health
Host: Madi Baldwin
Featured Physician: Dr. Cathleen Brown
Published Date: October 1, 2025
Episode Duration: 59 min 48 sec
Format: Menopause Q&A
Main Topics: WHI study & HRT myths, Genitourinary syndrome of menopause, Hormone testing myths
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. The show addresses common questions about perimenopause and menopause, combining medical expertise with straightforward discussions of symptoms, treatment options, and the science behind the menopause transition.
Episodes include live Q&A sessions, doctor-led conversations, and patient stories. In its live Q&A format, women from Winona's community submit questions directly to the hosts, creating practical discussions shaped by the concerns women commonly bring to their own doctors.
Dr. Brown opened the Q&A by revisiting the landmark early 2000s Women's Health Initiative (WHI) study, addressing persistent myths about HRT health risks that kept many women off hormone therapy unnecessarily. She explained that the original study used synthetic hormones and started participants on treatment well after menopause. She noted that starting HRT within 10 years of menopause is now understood to be both safe and heart-protective for appropriately screened patients.
From there, she talked about DHEA use during early perimenopause, why routine vaginal exams still matter after a hysterectomy, and why hormone or urine metabolite testing is not clinically recommended for guiding treatment decisions. Dr. Brown also responded to more personal questions from listeners, including those about HRT eligibility for women with a ductal carcinoma in situ (DCIS) breast cancer history, kidney function and estrogen, and overall sexual wellness.
The Women's Health Initiative (WHI) study and why its results were misinterpreted
Why starting HRT within 10 years of menopause carries a more favorable benefit-risk profile
DHEA as an option for early perimenopause symptoms
Genitourinary syndrome of menopause (GSM) and continued vaginal exams after hysterectomy
Why hormone and urine metabolite testing isn't recommended for HRT treatment
HRT eligibility after a DCIS (stage 0) breast cancer history
Estrogen's possible connection to kidney function
Combining vaginal estrogen with DHEA for testosterone support
Medication timing and lifestyle changes for managing night sweats
Using Winona’s arousal cream for sexual wellness
Caution around DIM supplements while on HRT
Navigating HRT discussions with a doctor who doesn't support hormone therapy
Dr. Brown explained that the original WHI study used synthetic hormones and started many participants on HRT well after menopause. These critical nuances were left out of the media headlines, creating a widespread misconception that treatment risks applied equally to all patients, hormone formulations, and delivery methods. Later analysis showed that starting HRT within 10 years of menopause is not only safe but can be cardioprotective in appropriate treatment candidates.
Dr. Brown explained that DHEA converts into estrogen and testosterone in the body. For women in the earlier stages of perimenopause, it can sometimes provide enough relief on its own before estrogen becomes necessary.
Dr. Brown emphasized that even without a cervix or uterus, regular gynecological exams are essential for detecting early signs of vaginal and vulvar cancers. Routine exams also allow physicians to screen for genitourinary syndrome of menopause (GSM), which can raise the risk of recurrent urinary tract infections (UTIs) if left untreated.
Dr. Brown highlighted that even a personal history of non-invasive, early-stage breast cancer like DCIS requires close, in-person monitoring that telehealth platforms can’t provide, since exams and imaging tests can’t be conducted virtually.
Dr. Brown reiterated that hormone levels fluctuate too much throughout the day to provide actionable lab metrics, while urine metabolite testing lacks the scientific backing to guide dosing decisions. She explained that a detailed symptom diary is a far more reliable tool for guiding individualized HRT treatment.
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.
Watch the full conversation with Dr. Cathleen M. Brown on
The Menopause Hour with Winona with Madi Baldwin.
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.
