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126 - Prolapse Warning: The Unspoken Role of Estrogen in Female Health, Part 2

W.O.W. MD - Your Wellness Optimizing Warrior

Release Date: 02/13/2026

134 - Rethinking Breast Cancer Screening on Hormone Therapy: A Fresh Perspective, Part 4 show art 134 - Rethinking Breast Cancer Screening on Hormone Therapy: A Fresh Perspective, Part 4

W.O.W. MD - Your Wellness Optimizing Warrior

In this episode we’re concluding our conversation about breast cancer screening. This part discusses the importance of breast exams and what an ideal breast surveillance process could look like (versus how it looks today for most women). Many women today are bypassing a breast exam by believing that a mammogram is sufficient. Here’s the truth: 10% of breast cancers are not picked up by a mammogram. You should have a breast exam performed at the doctor’s office annually. You can also perform your own regular breast exams at home. Regardless of whether or not you need a pap smear, you...

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133 - Rethinking Breast Cancer Screening on Hormone Therapy: A Fresh Perspective, Part 3 show art 133 - Rethinking Breast Cancer Screening on Hormone Therapy: A Fresh Perspective, Part 3

W.O.W. MD - Your Wellness Optimizing Warrior

We’re moving on to part 3 of our conversation about breast cancer screening in this episode. Previously, we’ve covered breast health surveillance in general. Today, we’re going to dive into breast cancer screening when a woman is on hormone therapy, as this therapy often brings up concerns for breast cancer risk. So, is there an association between hormone therapy and breast cancer? Although hormone therapy doesn’t cause breast cancer, this kind of therapy can act as a catalyst for existing cancerous tissues—if they’re already growing, estrogen-sensitive cancers can respond....

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132 - Rethinking Breast Cancer Screening on Hormone Therapy: A Fresh Perspective, Part 2 show art 132 - Rethinking Breast Cancer Screening on Hormone Therapy: A Fresh Perspective, Part 2

W.O.W. MD - Your Wellness Optimizing Warrior

In today’s episode we’re continuing our conversation about breast cancer surveillance, focusing on the risks of getting a regular mammogram. Last week, we discussed the cumulative risk of radiation damage that women are subjected to over decades of annual mammogram screenings. Mammograms also have shortcomings: they don’t detect pre-cancer changes. Many women aren’t aware of the unintended harm a regular mammogram can cause. One of those issues is overdiagnosis. This doesn’t refer to a false-positive diagnosis, but rather when a mammogram finds a cancer that grows slowly or not at...

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131 - Rethinking Breast Cancer Screening on Hormone Therapy: A Fresh Perspective, Part 1 show art 131 - Rethinking Breast Cancer Screening on Hormone Therapy: A Fresh Perspective, Part 1

W.O.W. MD - Your Wellness Optimizing Warrior

Today we’re beginning our conversation about breast cancer screening when on hormone therapy. There are biological markers and overall wellness indicators that need to be assessed every time a woman has an annual checkup when on hormone replacement therapy. Regardless of what therapies she is taking, every woman should have their breast wellbeing monitored, especially as she ages. Is an annual mammogram done over decades actually safe? Some medical experts say that the benefits of identifying cancer early outweighs the risk of yearly exposure to radiation. But the reality is that radiation...

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130 - The Future of Aging: Embracing Hormone Optimization, Part 3 show art 130 - The Future of Aging: Embracing Hormone Optimization, Part 3

W.O.W. MD - Your Wellness Optimizing Warrior

In this episode I’m concluding our conversation about hormone optimization. Previously, we’ve discussed the difference between hormone therapy and hormone optimization, as well as the myths and benefits about hormone use for health optimization. Today, we’re looking at the bigger picture of overall health and how the rest of your body plays a role in hormone balance. How well our bodies function as we age is highly dependent on how balanced our hormones are. For women, that’s not just about estrogen. It’s also about how all the other major hormones in your body are balanced...

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129 - The Future of Aging: Embracing Hormone Optimization, Part 2 show art 129 - The Future of Aging: Embracing Hormone Optimization, Part 2

W.O.W. MD - Your Wellness Optimizing Warrior

Last week, I introduced the concept of what hormone optimization is and how it differs from hormone therapy. In this episode, let’s focus on exploring the myths about using hormones and how you can use hormone optimization to age on your own terms. Going through menopause means experiencing significant changes in hormone levels, including estrogen, testosterone, and progesterone. These hormone shifts will have an impact on how you feel (both mentally and physically) and may even lead you to feel a loss of control over things you had a handle on before. Hormone therapy, especially hormone...

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128 - The Future of Aging: Embracing Hormone Optimization, Part 1 show art 128 - The Future of Aging: Embracing Hormone Optimization, Part 1

W.O.W. MD - Your Wellness Optimizing Warrior

Hormone optimization is a new and complicated topic, and we’re going to begin covering it in today’s episode. As women enter menopause and seek hormone replacement therapy as a solution, it’s important to have an understanding of how aging impacts the body and how hormone optimization can help. I recently listened to a podcast which compared hormone therapy to home renovation. The host, a retired doctor, discussed using the estradiol patch with oral progesterone (a common pair used in hormone therapy today). Taking into account the doses available for these products, there are only 10...

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127 - Prolapse Warning: The Unspoken Role of Estrogen in Female Health, Part 3 show art 127 - Prolapse Warning: The Unspoken Role of Estrogen in Female Health, Part 3

W.O.W. MD - Your Wellness Optimizing Warrior

On today’s episode we’re concluding our conversation about prolapse, specifically focusing on pelvic prolapse. These pelvic floor muscles are a small yet crucial aspect of your overall muscle structure. Women who have given birth vaginally are more susceptible to experience pelvic floor prolapse, making this area of muscles even more important to know about. Menopause can also cause various changes in the pelvic area, and the farther ahead a woman when she started menopause, the more likely she is to experience pelvic prolapse. Yes, this is in large part due to hormonal changes, however...

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126 - Prolapse Warning: The Unspoken Role of Estrogen in Female Health, Part 2 show art 126 - Prolapse Warning: The Unspoken Role of Estrogen in Female Health, Part 2

W.O.W. MD - Your Wellness Optimizing Warrior

Let’s continue on with our conversation about prolapse. A great number of women experience prolapse after childbirth trauma, but this can also come up many years after menopause when the loss of estrogen starts to impact a woman’s pelvic floor muscles and tissues. Women on some form of hormone therapy can still experience issues with prolapse, especially since the replacement dose is nowhere near the level a woman has when she is younger. Even a relief of symptoms, like hot flashes for instance, doesn’t necessarily mean that her estrogen is back to the same level it was pre-menopause. A...

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125 - Prolapse Warning: The Unspoken Role of Estrogen in Female Health, Part 1 show art 125 - Prolapse Warning: The Unspoken Role of Estrogen in Female Health, Part 1

W.O.W. MD - Your Wellness Optimizing Warrior

In this episode we’re talking about something I haven’t yet approached on this show: prolapse, specifically as it relates to a very specific female condition. Many women aren’t aware of the vital connection between estrogen and the health of the tissues of their pelvic floor, but you’ll learn about it today. A prolapse is caused by a weakening of the pelvic floor that supports the female organs, and this displacement can lead those female organs to descend towards the vaginal opening. There is no pill or cream that can correct this condition, especially if it’s more advanced....

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Let’s continue on with our conversation about prolapse. A great number of women experience prolapse after childbirth trauma, but this can also come up many years after menopause when the loss of estrogen starts to impact a woman’s pelvic floor muscles and tissues.

Women on some form of hormone therapy can still experience issues with prolapse, especially since the replacement dose is nowhere near the level a woman has when she is younger. Even a relief of symptoms, like hot flashes for instance, doesn’t necessarily mean that her estrogen is back to the same level it was pre-menopause.

A woman’s pelvic organs are held up by muscles, ligaments, tendons, and bones. These muscles also play a crucial role in bodily functions related to bladder control, bowel control, sexual function, and stabilizing organs during physical activity. When this is compromised, the uterus can descend into the vaginal canal to the point where you may even be able to feel it. This is called uterine prolapse.

Something similar can happen with the bladder, which is called bladder prolapse. It can lead to significant urinary incontinence and discomfort. The rectum can also prolapse into the posterior wall of the vagina. This can cause difficulty passing stool. Generally speaking, women can usually recall the event that triggered their prolapse. Before this, they have likely already experienced a gradual weakening of the pelvic floor.

Childbirth greatly increases the risk for pelvic floor prolapse. Delivering a baby through the vaginal opening results in great pressure and stress on the pelvic organs and tissues. The bigger the baby’s head, the greater the risk is for prolapse. Increased abdominal fat (obesity) can also weaken pelvic floor muscles. Some individuals may also have genetic disorders that impact muscle groups, including the pelvic floor.

 

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