Episodes

Is a GLP-1 Microdose Right for You? Sophie, a nurse practitioner at Turner Medical Arts, explains GLP-1 microdosing as using the same medication at a very small dose—about 25% or less of a traditional starting dose. She says microdosing may be appropriate for people who are highly sensitive to medications, those with less weight to lose, and those who experience stronger GLP-1 side effects related to slowed digestion, such as constipation or nausea. It can also help patients who already eat ver...

Postpartum Leaks and Vaginal Laxity: VTone and Morpheus8 V OptionsSophie Mengele, nurse practitioner and women’s health lead at Turner Medical Arts on The Vagina Doctor Podcast, discusses common postpartum concerns for women in their 30s and 40s, including urinary leaking when laughing or sneezing, pelvic floor looseness, and reduced sexual sensation despite being told by an OBGYN that everything looks fine. She explains two in-office technologies for vaginal rejuvenation and pelvic floor streng...

Statins, ApoB & Heart Disease Risk: Debunking Myths (Vitamin K2, Muscle Pain, Diabetes & Dementia) | Dennis Hughes, MDOn The Vagina Doctor Podcast, Duncan Turner, MD, interviews internist Dennis Hughes about cardiovascular disease risk assessment and misconceptions about statins. Hughes explains why vitamin K7 claims about preventing vascular calcification are misguided, noting calcification can stabilize plaques and a small study showed no event reduction. They discuss coronary artery calcium s...

The Three Horsemen of Women’s Health: Sermorelin, HRT, and GLP-1s | The Vagina Doctor Podcast/The Women's Health Edit with Sophie Mengele Nurse practitioner Sophie shares her “three horsemen” of women’s health: Sermorelin, hormone replacement therapy (HRT), and GLP-1s, and explains how they fit together. She describes Sermorelin as a synthetic analog of the body’s natural growth hormone that declines with age and may help maintain muscle and prevent wasting associated with sarcopenia; she notes...

The Mystery of the Missing Estrogen Patches: FDA Label Changes, Demand, and HRT Alternatives Duncan Turner, MD and Karen Spaulding discuss the recent shortage of estrogen patches, explaining that it stems from an FDA change in the wording of warnings on prescription estrogen products, which corrected messaging influenced by misinterpretations of the 2002 Women’s Health Initiative study. Although the safety of estrogen hasn’t changed, updated FDA verbiage prompted renewed demand that manufacture...

Is Vaginal Estrogen Safe? What It Treats, How It Works, and Why It Doesn’t Raise Cancer Risk Nurse practitioner Sophie explains why vaginal estrogen is commonly used in pre- and postmenopausal patients to treat vaginal atrophy caused by low estrogen, which leads to dryness, irritation, discomfort, burning, and increased risk of UTIs and vaginal infections. She addresses a common fear that vaginal estrogen raises blood estrogen levels, stating it is applied locally and does not affect blood leve...

Vaginal Rejuvenation After Baby: Non-Surgical Options for Pelvic Floor Support Sophie, Women's Health Lead at Turner Medical Arts, introduces her women’s health channel and explains vaginal rejuvenation, focusing on younger women after their first baby whose anatomy changes can lead to urinary urgency, pressure sensations, and leaking when sneezing. She reviews traditional prolapse approaches like pessaries and surgical mesh, then highlights newer non-surgical devices designed to contract pelvi...

Evidence-Based Hair Loss Treatment Plans: Hormones, Labs, Microneedling, PRF & Growth Factors Dr. Duncan Turner and Sophie Mengele discuss how their practice developed an evidence-based, individualized approach to hair loss after frequent patient requests, focusing on identifying root causes through extensive lab testing and health assessments. They emphasize hormone optimization (especially estrogen in women and awareness that testosterone can accelerate loss), family history, and checking vit...

Peptides in Practice: Safety, Regulation, and Easier Delivery with Pens Dr. Duncan Turner and nurse practitioner Sophie Melli discuss how their practice’s use of peptides has evolved, from early interest in longevity and growth-hormone-related benefits before COVID to increased restrictions during the Biden administration that made many peptides impossible to obtain legally, then a return through weight management with GLP-1 peptides treating metabolic disease and supporting weight loss and red...

Sarcopenia Wake-Up Call: DEXA Results, Protein Goals, and Lifting Heavy for Longevity Duncan Turner and Karen Spaulding reunite on The Vagina Doctor Podcast to discuss Karen’s recent full-body DEXA and body composition scan at HealthSpan, which revealed sarcopenia despite her lifelong activity with running, walking, Pilates, bands, and calisthenics. Reviewing the color-coded report with a physician, she learned she has strong bones, no visceral fat, but low muscle mass, and was advised to treat...

Perimenopause or “Am I Going Crazy?” Understanding Complex Symptoms and Hormone Fluctuations Duncan Turner, MD discusses how perimenopause symptoms can be complex, obscure, and easily confused with other conditions, leading some patients to be prescribed medications like Xanax or antidepressants that may not address the underlying hormonal changes. He explains that perimenopause is marked by unreliable, inconsistent shifts as the ovaries “misfire,” with intermittent ovulation and fluctuating es...

Non-Hormonal Options for Menopausal Symptoms On the Vagina Doctor Podcast, nurse practitioner Sophie Mengele discuss non-hormonal options for managing menopausal symptoms such as hot flashes, night sweats, and mood irregularities. Sophie reviews several medication choices used when hormone therapy isn’t desired or isn’t an option, including SSRIs (noting Lexapro as a preferred option) and SNRIs for anxiety and mood stabilization. She highlights Veozah, which works on brain pathways involved in ...

Perimenopause, Sleep Disruption, and Hormone Therapy Options (Estrogen vs Progesterone) | The Vagina Doctor Podcast Duncan Turner MD and Sophie Mengele NP role-play a gynecologist visit with a 45-year-old patient who suspects perimenopause due to irregular heavier periods, mood changes, hot flashes, and especially disrupted sleep. The clinician explains that perimenopause is challenging because ovarian hormone output becomes unpredictable, with fluctuating estrogen and inconsistent progesterone...

Pap Smears Don’t Screen for Ovarian Cancer—So What Does? This episode explains that Pap smears do not screen for ovarian cancer and that there is no particularly good routine screening test, which contributes to ovarian cancer often being diagnosed at an advanced stage. The ovaries are best evaluated with ultrasound, which the office performs annually to assess appearance. A blood test can sometimes detect very early ovarian cancer, but it has not been found to be tremendously effective. A newe...

Body Composition Scans: What They Show, Who Should Get One, and Why It Matters on GLP-1s Nurse Practitioner Sophie at TMA explains how body composition scans provide more useful information than a scale by showing where weight loss is coming from, including lean muscle mass, visceral fat around the organs, and total body fat. She describes using scans to track changes over time, especially for patients on GLP-1 medications, with the goal of losing fat without losing muscle. Sophie shares a pati...

Dr. Naz on Foot Pain Misdiagnoses, Orthotics, and Building a Concierge Podiatry Practice in Santa Barbara Nurse Sophie Mengele interviews her friend Dr. Naz, a board-certified podiatrist with surgical residency training in Kansas City and a minimally invasive surgery and limb reconstruction fellowship at Emory, now running a small concierge podiatry practice in Santa Barbara and working for a local nonprofit. Dr. Naz explains she is currently nonsurgical and often provides second opinions, post...

Avoiding Contaminated Hormone Lab Results: Timing, Application Sites, and Common Mistakes Nurse Sophie Mengele and Duncan Turner, MD discuss how topical hormone replacement therapy can contaminate blood test results, leading to unrealistically high lab values that don’t match other markers like FSH. Using a recent patient example, they explain that contamination can occur when hormone cream is applied too close to a blood draw or transfers to the draw site, making results hard to interpret and ...

Why Your Labs Look “Normal” but You Still Feel Awful in Perimenopause & Menopause Nurse Sophie Mengele and Duncan Turner, MD discuss why patients—especially those in perimenopause or menopause—can have debilitating symptoms despite being told their lab work is “normal.” They emphasize that many “full panels” may not include hormone testing at all, and that when hormones are tested (progesterone, testosterone, estrogen, FSH), results must be interpreted in context, including timing within a 28‑d...

Nurse Practitioner Sophie Mengele at TMA discusses Lexapro (escitalopram) for women’s health, explaining it as an SSRI that increases serotonin to help stabilize mood and reduce anxiety. She describes using Lexapro for younger patients and for premenopausal/menopausal patients, either continuously through the menstrual cycle or only during the luteal phase (after ovulation, about 12–14 days before a period) for recurring premenstrual symptoms like mood fluctuations, anxiety, depression, and slee...

Oculoplastic Surgeon Lyndon Doss on PDRN, Microneedling, Lasers, Exosomes, and the Future of Surgery Duncan Turner, MD interviews Santa Barbara oculoplastic surgeon Dr. Lyndon Doss about modern shifts from traditional cutting-and-lifting surgery toward regenerative approaches, including injectable PDRN (“salmon sperm”), placenta extract, microneedling, and selective laser resurfacing. Doss explains causes and treatment differences for under-eye dark circles, emphasizing thin skin and the roles ...

Painful Intercourse Across the Lifespan: Estrogen, Vaginal Atrophy, and Rejuvenation Options Dr. Duncan Turner and nurse practitioner Sophie Mengele discuss painful intercourse across life stages and how low estrogen affects vaginal tissues. They note symptoms can be multifaceted and occur in teens through geriatrics, including patients on oral birth control who may have suppressed estrogen peaks and benefit from vaginal estrogen or vaginal rejuvenation treatments, which may also help reduce re...

The Vagina Doctor Podcast with Duncan Turner MD Should Ovaries Be Removed During Gynecologic Surgery? Menopause, Risks, and Hormone Therapy This episode explains how the decision to remove ovaries during gynecologic surgery depends on whether a patient is premenopausal, perimenopausal, or postmenopausal. Postmenopausally, ovaries produce little measurable estrogen or progesterone, so removal during pelvic surgery can reduce future risks like cysts or malignancy, regardless of hormone replaceme...

Sleep Specialist Explains Sleep Apnea, Wearables, Ferritin, REM Behavior Disorder & Why Pills Aren’t Real Sleep A sleep-medicine and neurology specialist joins the podcast to discuss his path from art school to medicine, his own sleep apnea diagnosis, and how sleep medicine overlaps with neurology. He explains common sleep disorders he treats, why women are often underdiagnosed for sleep apnea, and the limitations and risks of over-relying on wearables, emphasizing trend tracking and age-approp...

GLP-1 Weight Loss, Muscle Loss & Bone Health in Menopause: What Women Need to Know Dr. Duncan Turner and nurse practitioner Sophie Mengele discuss the impact of GLP-1 weight loss medications on muscle mass and bone health, especially for women undergoing hormonal changes and menopause. They note that while weight management and exercise are proven to support longevity, weight loss commonly leads to reduced muscle strength, and diminished appetite on medication may worsen inadequate protein inta...