Vaginal Estrogen, Menopause & Hormones: What Your Doctor May Not Be Telling You

Vaginal and urinary symptoms are common during perimenopause and menopause—but understanding why they happen and how different forms of estrogen work can be confusing.

In Episode 8 of this hormone series, Dr. Brendan McCarthy breaks down the relationship between systemic estrogen, vaginal estrogen, estradiol, estriol, testosterone, and the genitourinary symptoms many women experience during menopause.

He discusses:

Why oral estrogen doesn't necessarily reach every tissue in the body the way you might expect

The difference between systemic and vaginal estrogen

Why vaginal estrogen can be an important medical intervention—not simply a "cream"

How estrogen can affect vaginal tissue, pH, and urinary health

The role of androgens like testosterone in vaginal and genitourinary health

What we know—and still don't know—about vaginal estrogen transfer to a partner

Why informed consent means truly understanding your treatment

Questions you can ask your provider about your hormone therapy and monitoring

Dr. McCarthy's goal is simple: to give women unbiased information so they can feel more informed, curious, and confident when making decisions about their health.