31 Comments
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Art, Food & Life's avatar

You are one of the first doctors that I have seen who has said “how can hormones cause cancer?”. I would love to know your opinion on whether Menopause Hormone Therapy is a risk for somebody who had breast cancer?

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Lou Hudson's avatar

Launch menopause symptoms into space with the rise in hysterectomies. From what I’ve been told, that’s INSTANT menopause. Like here today, gone tomorrow estrogen.

Fellas, there is NO WAY we could manage that. After 40, testosterone levels drop. But TO ZERO?

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Neil Salmon's avatar

But what does a CD submissive sissy do at 69 ? Purges never lasted..Female Supremacy is always on my mind . Sissy neil

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Missouri Boy's avatar

You forgot ANGER! Menopause makes some women ANGRY!

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Jason M. O'Toole's avatar

I'm currently an investigator for elder abuse and neglect (and more often than not, self neglect) and UTIs are the culprit in a high percentage of my cases where a woman, or sometimes a man, gets disoriented, has hallucinations, winds up at the Walgreens in tennis whites in the middle of January asking for a haircut. Gotta take care of down there...

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Adrian's avatar

Thank you for writing this article with the clarity you have

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Gary E.'s avatar

We have found wearing a condom to be a surefire way to avoid UTI.

Of course, in my house, not having sex also works.

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Dr R's avatar

Preach it! I did some studying on HRT and was able to convince my wife that it was worth the minimal risk to sleep better at night. HRT changed her life profoundly for the better!

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Dr. Amber Hull's avatar

Poor sleep is at the root of a lot of health problems. And it significantly affects mood and quality of life. I’m glad to hear that you did that research in order to advocate for your partner!

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Keith Martin's avatar

Hyaluronic acid.

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Jessey Anthony's avatar

I do believe lack of exercise contibutes to menopausal symptoms. I mean take for instance arthritis is severe for older people, hence other issue arise when tissues and muscles contract or an inflammation occur.

I have noticed that aged women with active lifestyle do have less problems with their sexual life.

Although that doesn't mean men should disregard their partner's feelings when they speak up about body changes with age.

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Dr. Amber Hull's avatar

I agree that lack of exercise contributes significantly to metabolic disease and overall frailty. But there are hormonal reasons for the decline in exercise tolerance during and after menopause.

Hormone therapy isn’t a universal solution but I think it’s important that clinicians learn how to educate and treat patients who are interested in the therapeutic benefits of hormones.

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Jim Ryser's avatar

I so appreciate your clarity. I have L5/S1 myelomeningocele. Wasn’t supposed to live, let alone thrive as I have (I just turned 60!). I am just fortunate that after 62 major surgeries (mostly ortho and kidney for urostomy and subsequent revisions). You might just have inspired me to write about my experiences with sex as a “disabled” person - and I can do it in a non morbid curiosity way. 99% would never know I have any issue but I do still struggle with the mirror without clothes. But according to my bride that is MY problem…💜

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Jim Ryser's avatar

I’ll get on that today. Thanks for the inspiration.

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Dr. Amber Hull's avatar

My pleasure!

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Dr. Amber Hull's avatar

Write your story. Disability affects so many people but being disabled doesn’t eliminate the human need for intimacy.

Helen Hunt starred in a movie called The Sessions that was all about a surrogate partner relationship. The other lead character in the movie had CP.

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Andy's avatar

As a middle aged dad, it’s important that guys (dads) accept scars from child birth. Body confidence is sexy, stretch marks and the possible lack of a flat tummy should be celebrated - you (we) were responsible for those scars and we reap the joy of being a father, at the expense of someone else’s sacrifice. Intimacy and acceptance that bond creates means more than getting your veiny bang stick wet…

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Dr. Amber Hull's avatar

Natural bodies are beautiful! And you’re absolutely right about the embodiment of love through the scars of childbirth.

At the same time, I’m a huge advocate for pelvic floor physiotherapy after childbirth. It can make a world of difference in quality of life.

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Laura T RN BSN's avatar

I use Evamist and progesterone

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Elizabeth Behnke's avatar

Right on Dr Amber. Men, please be kind to women around you going through this - it has been such a cultural leper for so long. I went through menopause ten years ago, and I have to say, first my (now ex) husband and then my sex partners were not at all nice or understanding.

And women of a certain age should definitely use the topical estrogen to keep the vulva, and, importantly, the area around the urethra, flexible and in good shape - my young woman doc and Dr Amber made me a fan - so much more comfortable just generally.

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Dr. Amber Hull's avatar

Thank you for your kind words!

I’m absolutely delighted that this essay has been so widely read, shared and commented on.

I think that many men actually do care about the physical changes their partners experience but the topic, as you mention, has historically been shrouded in shame and ignorance. It’s heartening to see so many guys engaging with this piece.

And I absolutely agree with you about the game-changing value of topical vaginal estrogen. UTI related sepsis results in a LOT of hospitalizations in post-menopausal women. And costs Medicare millions of dollars annually. This needs to be taught in medical school.

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P. J. Paoletti, PhD's avatar

The husband can have his own set of medical issues that can put a damper on things. See my comment here. https://ladydrummond.substack.com/p/marriage-without-sex-is-not-marriage/comment/90321527

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Dr. Amber Hull's avatar

It’s true. I’ve written a bit about creativity, toys and kink as elements in healthy sexuality as we age. Making one’s intimate life contingent on the functionality of such a fickle appendage is very limiting.

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P. J. Paoletti, PhD's avatar

I’m talking about more than just broken plumbing. The urge is completely gone. Zero. Zilch. Nada. I’ve adjusted to it though. In some ways it has been, strangely enough, liberating to not have to deal with an emotion that was previously there for over fifty years.

I adore woman. But I look at and act differently toward them now. It’s been an interesting experiment so far.

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John's avatar

I love that you wrote this for your male readers. Brilliantly informative! My thanks to you.

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Dr. Amber Hull's avatar

Thank you! When I started on Substack, I thought that my audience would primarily be women. It’s been a pleasant surprise to see that men are interested in and learning from my work.

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