Vaginal vs Systemic Estrogen, DHEA, and more!

In this video I go over indications for systemic as well as vaginal estrogen therapy, specific considerations, as well as how these medications can be used to treat recurrent urinary and vaginal infections. I also talk about vaginal DHEA, and its role in the treatment of postmenopausal vaginal disorders.

[@dianastoevelaar9548]

Thank you so much for your easy to understand explanations. I feel much more confident about using transdermal DHEA now. 😊

[@yorkeb6690]

Dr. Babb, I can’t tell you what a relief it is to finally hear from an American doctor who actually understands how to treat peri/menopause! Thank you so much for the education you provide through your social media channels. You have mentioned aspects of women’s health that I had never heard of before! 🤯 I suffered with symptoms for 4 years before I figured out for myself that I was perimenopausal. My obgyn never mentioned it despite seeing me for over a decade. When I raised it with her, her only solution was to put me on BCPs, so I left her practice. Since then, I’ve seen 3 other OBGYNs & called countless others and none of them have been properly educated on menopause. Unfortunately, not even a NAMS certification can be trusted. I had a NAMS-certified dr try to put me on BCPs instead of estradiol & progesterone. She totally blew off the risk for blood clots. According to the National Menopause Foundation, 73% of American women aren’t seeking menopause treatment. I’m not surprised based on how I’ve been brushed off by multiple OBGYNs. I recently learned about a GYN menopause expert based in DC. He doesn’t take insurance, but I don’t feel like I have any other options to receive competent treatment. I’m hopeful he will be as knowledgeable as you seem to be!

[@dr.coreybabb]

Thank you for the compliments! Are you going to see James Simon?

[@yorkeb6690]

@@dr.coreybabb Yes, he’s the one! I learned about him through Dr. Kelly Casperson’s podcast.

[@dr.coreybabb]

@@yorkeb6690 fantastic! Which one?

[@yorkeb6690]

@@dr.coreybabb You Are Not Broken: Menopause Whisperer - Dr. Jim Simon

[@djuanaberuk9908]

Thank you so much for covering this topic. I listened last year and again today. The info bears repeating because I learned something new today that seemed to have missed.

[@jenniewilliams1668]

Thanks -I've started on 13mg DHEA OTC Bezwecan (sp?) Vaginally for 1 week - really great effect on the tissues and sexual desire went from zero to normal. Shocking effect really - to be normal again. I also hesitate to use DHEA orally. I'd like to know more about what specifically rises with oral DHEA -as I understand it we don't really need more estrogen. Thanks again

[@ddibisnis3650]

Thanks for these videos very helpful. Can we please have a discussion on bleeding on HRT vs postmenopausal women.

[@gigijohn316]

Thank you! Very informative!!!❤

[@lwal2053]

Thank you for making this video. Question, what are your thoughts on transdermal dhea in postmenopausal women who cannot take estrogen systemically?

[@dellfinniam324]

So concise and clear I almost feel qualified to practice! SO helpful, Dr Babb, thank you for making everything to clear and comprehensible...couple of questions: you mention at 10 minutes in, '...in the urinary video we talked about...' can you help me locate that one with the date or title, as have gone to your page and wouldn't know which one! Also, '...can't have too much oestrogen - with some very obvious exceptions...' but what are the 'obvious exceptions'? Many thanks for the amazing resource you're providing.

[@dr.coreybabb]

Hi there! Thank you for bringing this to my attention. The video I was talking about was an Instagram story earlier in the week. My KZbin videos are a compilation of weekly Instagram stories, since Instagram deletes those after 24 hours. In the future I’ll make sure that I address that more clearly! The main issue in which we would want to avoid too much estrogen would be if a patient had a estrogen sensitive cancer, or, in the case of oral estrogens, if they had very high cholesterol. Oral estrogen intake raise that cholesterol level, which could be very problematic! I see you’re using the non-American spelling of estrogen - where are you watching from?

[@dellfinniam324]

@@dr.coreybabb Thanks, Dr Babb, that makes sense, and much appreciated. I'm in the UK, where, I've just read in a health insurance magazine today, a GP admit that his training encompassed only one lecture on menopause in year 2, which was devoted entirely to HRT and how dangerous it is/was (he looks quite youthful). Very scary, not to say irresponsible.

[@annettewilford7568]

Needed this 😊

[@joannepigliavento7930]

Would you consider Vaginal DHEA safer than Estrogen? I’m a 62 year old minimalist when it comes to meds. Thanks!

[@tammywheeler7463]

Awesome information. Does intravaginal DHEA metabolize moreso to testosterone or estriol, estradiol? My question is how does oral DHEA versus intravaginal DHEA metabolization differ?

[@dr.coreybabb]

The vaginal DHEA has an intracrine effect, meaning it breaks down into the hormones needed by the adjacent tissue. The mechanism isn’t fully understood, but that’s how it acts. Oral DHEA gets the shotgun breakdown - it splits into many hormones, and you never know what you’re going to get!

[@tammywheeler7463]

@@dr.coreybabb thank you. Your clinical experience is evident in this video.

[@msmith1821]

Thanks I have an appointment with a Dr. for Bioidenticals now I know what to ask about.

[@N17sd]

Hi Dr, am post menopausal 49y, low estrogen, testosterone, DHEA, low energy and focus. Niw if I take DHEA is it better pills or cream? Plus do I have to take pregnenolone too with DHEA? Thanks

[@LoveABun]

Dr. Babb, thank you for another highly-informative video! I have a question, please: Does Intrarosa have any benefits over vaginal estradiol when it comes to treatment for that chronic vaginal burning sensation that results from post-menopausal vaginal dryness? After reaching the 12-wk mark with Imvexxy, I’ve seen noticeable improvement in many GSM symptoms. But that AWFUL, internal burning-although a bit less frequent now-still seems to occur too often. Is there a point where under such circumstances a doctor should consider a switch to Intrarosa (thinking maybe the androgen component would be the difference maker)? Or do some post-menopausal women’s dryness just take longer than 3 mos to adequately respond to vaginal estradiol?

[@dr.coreybabb]

Great question! Honestly I like to use Intrarosa as my first line therapy, but I understand that a lot of patients have insurance plans that don’t cover it. In your case, I would agree that if you’re still having symptoms, you need to investigate other potential therapies - and causes - outside of straight GSM. Almost all of the studies for GSM medications demonstrate optimal efficacy by the three month mark.

[@denisedito3129]

Im having the same awful burning after applying the dhea vaginal estrogen. Im on day 15. I wanted to know if you were still burning or figured out why your still burning after 3 months. This is an old video I just wanted to know since I have the same problem if you figured it out. I also have Interstitial cystitis that causes burning from foods and drinks. If you didn't figure it out yet that might be the problem. I hope you respond to me I need your advice. Thank you

[@LindaLindaHoneyListen]

Please do a section on Resistant ovary syndrome previously known as savage syndrome. High fsh(99), normal amh and follicles present on scan. Recently diagnosed after 7 years of misdiagnosis. Was put on femoston 10/1, dhea 75mg p/d.

[@LindaLindaHoneyListen]

No period for 3 years, got my menses after 21 days

[@imme1972]

Can I use interosa and yuvafem together?

[@OZMAZZ12]

Can you use systemic estrogen cream for only 2 weeks of the month?

[@OZMAZZ12]

Why do I have a huge reaction to progesterone? It’s like I’ve had 5 cups of coffee at once.. why 😢

[@annettewilford7568]

Got no idea re lichen planus

[@user-dr4jo5ik6y]

What type of estrogen?

[@user-dr4jo5ik6y]

I was diagnosed with endometrial atypical hyperplasia and have a IUD Mirena. I am in my 50's experience severe dryness. Can I take an estrogen? It has been 7 years with this diagnoses. They did want me to have a hystectomy.

[@N17sd]

Will vaginal estrogen cream cause endometriosis?

[@healingwisdomarts]

it burns !!!!!!!!!!!!

[@MGSpecial2023]

If it or anything burns for you or anyone, most likely it is an allergy! Stop taking it immediately and check in with your dr and or pharmacists for other options. Other possibilities are interactions with other meds or sensitivity due to UTI etc, so definitely check it out right away.

[@dqzj565]

Sir, can you please keep up with research! Stop spewing the cholesterol scam!