Dr Angela Wright is a GP, Menopause Specialist and Clinical Sexologist. She is particularly interested in improving sexual function and menopausal symptoms in women who have undergone cancer treatment. We started by talking about the impact of localised (vaginal) oestrogen vs what systemic HRT does – both for GSM (genitourinary syndrome of menopause) and for sexual dysfunction. She goes on to explain that there is no increase in recurrence risk for oestrogen receptor positive breast cancers when using localized oestrogen to treat symptoms (and that it can be used alongside letrozole and tamoxifen). We discuss the need for patients to be able to make an informed choice about risks vs benefits, which can be challenging when healthcare professionals are not taught to understand the impact that GSM and sexual dysfunction can have on quality of life – certainly male sexual dysfunction gets a lot more attention and usually pretty rapid treatment!

Angela gives an overview of what self-care practices can be helpful for someone struggling with GSM. She also explains that a range of prescription medicines (in particular antidepressants, but also antihistamines, and blood pressure medication) can mess with our sexual responsiveness, so could be something to discuss with our healthcare provider.

Clare Bourne is a specialist pelvic health physiotherapist and the author of ‘Strong Foundations: Why pelvic health matters, an empowering guide to your body.’ In this episode we cover: why our full life story – from childhood onwards – is critical in getting a full picture of our pelvic floor health; constipation in childhood and later in life and why this is so important to address; the importance of oestrogen for our pelvic floor health; why kegels are just one tool in the toolkit and what is the bare minimum she recommends we do daily; and prolapse – it’s more common than you think, and how to advocate for yourself with your GP