117 - Painful Sex: The Story of Lichen Sclerosus, a Shockingly Under-Diagnosed Post-Menopause Skin Condition, Part 2
W.O.W. MD - Your Wellness Optimizing Warrior
Release Date: 12/05/2025
124 - Managing Your Health Expenses: Beyond the Monthly Insurance Premiums
W.O.W. MD - Your Wellness Optimizing Warrior
Today we’re continuing our conversation about health insurance, health expenses, and what to consider when you’re budgeting for your health. We often forget that health insurance is a business. And just like any other business, there’s a lot to know, and it takes a few extra intentional steps to truly understand it. Last episode, we discussed how your health insurance plan is not designed to maintain your health, but rather to treat diagnosed conditions and illnesses. Many people find it difficult to save for their health expenses while also paying for their insurance. So what can...
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123 - The Real Cost of Staying Healthy (Beyond Having an Insurance Plan)
W.O.W. MD - Your Wellness Optimizing Warrior
In this episode we’re diving deeper into health expenses to help you gain insight into where your money is best allocated. In the last episode, we explored how your health insurance is designed to treat illness, not to keep you healthy. Often, saving for your health treatments is the best option if you want to stay healthy. Unfortunately, that’s not an option for everybody, especially those who are already paying for expensive health plans. Be aware that most physicians, especially those working for corporations, are removed from the process of healthcare expenses. Their schedule is full...
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122 - 2026 Health Outlook: The Intersection of Insurance and Self-Care
W.O.W. MD - Your Wellness Optimizing Warrior
Let’s talk about your health goals for this year and beyond. The truth is that basic self-care practices don’t always restore us to the level we desire. That’s where seeking additional support comes in, but in order to use that, we first have to understand insurance plans. The first basic question you can ask yourself is this: What kind of expense can actually bring the greatest value to your health? This can help you uncover where your money is best spent. Dedicating more time, effort, and money to your self-care now is the key to avoiding many of the health issues that some people...
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121 - Why Self-Care is the Key to Achieving Your Health Goals in 2026
W.O.W. MD - Your Wellness Optimizing Warrior
How you can achieve your health goals in 2026 and in all the years to come? Life can (and does) get busy, and time can move by quickly. Self-care doesn’t always feel easy, but prioritizing self-care is so important if you want to achieve a truly optimal state of health Many people struggle to intentionally dedicate time to their selfcare. Why? It’s often due to putting other people's health and wellness before our own, and this is especially true for women. For me, rest is going to be at the top of my priority list this year. I have a lot of obligations, responsibilities, and goals, and...
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120 - Estrogen’s Role in Urinary Health for Aging Women: An Eye-Opening Discussion, Part 2
W.O.W. MD - Your Wellness Optimizing Warrior
Today we are continuing our conversation on women’s urinary health and the issues that arise during and after menopause such as loss of elasticity, vaginal discomfort, and urinary incontinence. These changes are all related to the loss of estrogen over time. Other conditions can impact estrogen production too, for example PCOS, certain medications, and eating disorders. Understanding the core issue of estrogen loss, regardless of the woman’s age, is extremely important. Estrogen therapy can make a significant difference for women struggling with urinary issues. Estrogen promotes healthy...
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119 - Estrogen’s Role in Urinary Health for Aging Women: An Eye-Opening Discussion, Part 1
W.O.W. MD - Your Wellness Optimizing Warrior
In today’s episode I’m talking about urinary health and the problems that can arise during and after menopause. These urinary problems can become an ongoing or worsening problem as time goes on. So what’s happening to the urinary tract as we age? The problems start in perimenopause, primarily beginning with an increase in urgency. Sometimes this change is subtle; an increase in getting up during the night to empty your bladder. It’s disturbing to your sleep, but it may not necessarily stand out at first. Increased urgency, frequency, and discomfort can also be a typical presentation...
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118 - Painful Sex: The Story of Lichen Sclerosus, a Shockingly Under-Diagnosed Post-Menopause Skin Condition, Part 3
W.O.W. MD - Your Wellness Optimizing Warrior
This week, let’s wrap up our series on lichen sclerosus by discussing more of the therapies available for treatment. If diagnosed and treated early, the condition can be greatly improved—especially if you’re using a hormone replacement therapy approach that’s been optimized. Aside from steroid medication, tacrolimus, estrogen therapy, and testosterone therapy (which were all options discussed in a previous episode), there are other treatment options like platelet-rich plasma, which can be injected to improve vaginal and sexual wellness. PRP is gaining in popularity because it’s...
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117 - Painful Sex: The Story of Lichen Sclerosus, a Shockingly Under-Diagnosed Post-Menopause Skin Condition, Part 2
W.O.W. MD - Your Wellness Optimizing Warrior
Let’s continue our conversation about lichen sclerosus, specifically focusing on treatment options this time. The treatments and therapies I’m discussing in this episode can actually be quite useful for many vaginal conditions and are something all women should know about. The first line of approved care for lichen sclerosus is a local application of a steroid medication, usually in an ointment form. Prolonged use of a steroid medication can lead to thinning of the skin, but it is particularly useful for women dealing with significant itching and plaque formation. Keep in mind that...
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116 - Painful Sex: The Story of Lichen Sclerosus, a Shockingly Under-Diagnosed Post-Menopause Skin Condition, Part 1
W.O.W. MD - Your Wellness Optimizing Warrior
Let’s talk about a surprisingly common skin condition that impacts women after menopause: Lichen sclerosus. It’s a chronic inflammation of the skin which creates a pathological change at the vaginal entrance. These skin changes are often underdiagnosed and even misdiagnosed, sometimes even for years. This debilitating skin condition can cause persistent and uncomfortable itching, white patches on the skin, and may also result in thinning of the skin. It can cause a disappearance of sensitive skin areas where certain tissue areas fuse. The skin can also crack, resulting in irritation and...
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115 - Holistic Non-Hormonal Approaches to Menopausal Urinary and Vaginal Health, Part 2
W.O.W. MD - Your Wellness Optimizing Warrior
Today we’re continuing our conversation about natural solutions for vaginal wellness after menopause. There are various issues that can arise after menopause due to a drop in estrogen, and vaginal lubrication is one of the main ones that women seek to address. The tissues in the vaginal canal and opening are very sensitive, and after menopause, the area can be dry and the skin begins thinning. One of my favorite solutions is DHEA (dehydroepiandrosterone)—a hormone typically made by the adrenal gland but that can also be obtained through supplementation. For purposes of vaginal wellness,...
info_outlineLet’s continue our conversation about lichen sclerosus, specifically focusing on treatment options this time. The treatments and therapies I’m discussing in this episode can actually be quite useful for many vaginal conditions and are something all women should know about.
The first line of approved care for lichen sclerosus is a local application of a steroid medication, usually in an ointment form. Prolonged use of a steroid medication can lead to thinning of the skin, but it is particularly useful for women dealing with significant itching and plaque formation. Keep in mind that treatment does not mean reversing the course of the disease.
Another treatment option—one I rarely use due to side effects and cost—is a topical tacrolimus. Tacrolimus is a potent immune system suppressant, and it can decrease the inflammation associated with this skin condition (as well as some others). It is only intended for short-term use, and can be compounded for application.
There are also some unconventional options for care, including topical estrogen. It can improve dryness, reduce pain during sex, and support elasticity. Estrogen can also be used as treatment in the form of pellet therapy. This treatment option can help women return to more comfortable intimacy in as little as 4-6 weeks. Nothing is perfect, but estrogen pellets offer more consistent exposure than other options.
Testosterone is another hormone that can be used in the treatment of lichen sclerosus. This hormone plays an important role in skin quality, and it has been demonstrated in improving skin elasticity and strength. Side effects and an adjustment of dose can reduce the risk of unwanted side effects.
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