Interview, Fireside Chat
Dr Rachel Rubin: "I'm Filled With Rage!" Your Doctor Was Never Taught About Women's Bodies!
- Vaginal estrogen cream used twice weekly is predicted to prevent death from urinary tract infections (UTIs), improve sexual pleasure by reducing pain and dryness, and enhance arousal and orgasm, described as "literally better than Viagra" for these specific outcomes.
- It is expected that the primary barrier to women achieving orgasm is educational, stemming from the misconception that orgasm results from penetration rather than clitoral stimulation, despite the clitoris being the primary source.
- By 2026, the speaker predicts the word "clitoris" will still be absent from OBGYN training checklists, perpetuating a lack of medical knowledge regarding sexual health treatment.
- More than 75% of individuals in large database collections are not receiving prescriptions for generic medications that could improve quality of life, with only 1.7% of eligible women currently prescribed hormone therapy.
- Testosterone levels in women are expected to drop precipitously in their 30s, causing issues like lower libido, delayed orgasm, and reduced engorgement, yet medical literature historically focuses on estrogen and progesterone.
- Birth control pills are predicted to lower testosterone in a subset of users, with studies indicating up to 27% of users report decreased sex drive, which can lead to low libido and pain during sex.
- While no published papers on sexual health side effects for GLP-1 weight loss drugs exist, a preliminary survey of 1,000 women suggests 25% report sexual side effects, with 50% of those reporting lowered function and 25% reporting improvement.
- Perimenopause generally occurs between ages 35 and 45, menopause between 45 and 55 (average age 52), with symptoms like temperature changes, fatigue, and low libido identified as hormonal in nature.
- Vaginal hormones are predicted to be safe for women of any age and medical history, including those with cancer, blood clots, or stroke, and can prevent UTIs by more than half by maintaining an acidic vaginal microbiome.
- Advice such as "pee after sex" is characterized as folklore, whereas vaginal hormones are predicted to be more effective than cranberry pills or increased water intake for preventing UTIs and urinary symptoms.
- A vaginal ring used locally, replacing creams or tablets, is suggested as a preferable alternative for individuals with dementia or poor dexterity, staying in place for three months.
- The speaker expects that 23% of women have clitoral adhesions that restrict the hood from the glans, and that removing these adhesions can improve orgasm, arousal, and satisfaction by up to 60 to 70%.
- Up to 75% of women are expected to experience painful sex at some point in their lives, with 10-20% suffering from chronic pain, a figure that rises to between 20 and nearly 50% during menopause.
- It is predicted that 20% of women report an inability to orgasm, largely due to the misconception that penetration alone is sufficient, while vibration and clitoral stimulation are expected to be highly effective.
- The speaker anticipates that by 2026, culture must break down barriers regarding sex education and communication to foster stronger partnerships and address a predicted "sex recession" characterized by reduced human connection.
- Hormone therapy is expected to be more effective if initiated during perimenopause rather than waiting for menopause, with the current "wait 12 months" protocol described as "insanity."
- The Women's Health Initiative study is predicted to be reinterpreted by 2025, clarifying that hormone therapy poses no increased risk of cardiovascular disease or breast cancer for women below age 70, contrary to late 1990s interpretations.
- Scheduling sex is expected to improve relationship satisfaction and counteract the "spontaneous myth," provided it is treated as a "partner day" to avoid performance pressure.
- Body image issues are identified as a major barrier, with a prediction that education can shift the narrative from desiring to be skinny to desiring to be strong and worthy of sex.
- The speaker predicts that solo pornography consumption has a consistent link to lower relationship and sexual satisfaction due to deception, whereas watching porn together may be positive if it meets couple needs.
- A specific patient case is noted where vaginal hormones restored orgasm, arousal, sleep, and prevented UTIs, enabling the individual to complete law school, though this is presented as a specific outcome rather than a universal guarantee.
- The medical system is expected to continue providing limited care time (10 minutes), leading to blanket denials of treatment rather than nuanced, data-driven shared decision-making.
- Less than 9% of Medicare patients are receiving hormone therapy prescriptions, despite many presenting with "Not Feeling Like Myself" symptoms attributed to hormonal changes.
- The speaker anticipates that testosterone is a natural hormone in the female body that supports bone, brain, and heart health, and that its absence is a key factor in sexual dysfunction, yet it is not recognized as a menopausal hormone.
- It is expected that research data must be manually disseminated to clinicians because it does not automatically integrate into medical practice, and that doctors currently lack training on hormone types, safety, and risks due to historical fear and misinformation.
- The speaker plans to continue increasing the frequency and intensity of advocacy efforts weekly and monthly to provide requested content and maintain promises regarding audience conversations.
- Women are expected to be encouraged to advocate for themselves by learning their body parts and hormones through mirror use during exams, and to seek different providers if current ones fail to provide adequate care or agreement.
- The three most common questions predicted for women involve hormones, pain during sex, and libido, which are often neglected in standard medical conversations.
- It is predicted that relationships require "conflict resolution" and communication to survive, as couples who stop discussing sensitive subjects often drift apart and face unexpected breakdowns years later.
- The speaker predicts the YouTube algorithm will recommend content based on viewer preferences, and expects that if people share this information, the community will benefit from improved medical care and communication skills.