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Episode 261:
Show Notes
This episode of The Real Health and Weight Loss Podcast, hosted by Dr Lucy Burns, features a deep dive into women's health topics that are often considered taboo, such as vulval and vaginal health, menopause, and related conditions. The special guest is Dr Gab Staniforth, a GP from Orange, Australia, with expertise in menopause, vulval health, and transgender care.
Introducing Dr Gab Staniforth:
- Dr Gabrielle Staniforth is a passionate women's health GP dedicated to empowering women for healthier, happier lives. With over two decades of healthcare experience, starting as a Registered Nurse and now as a doctor, Dr Gab has made a significant impact in rural healthcare in regional New South Wales. Her expertise includes perimenopause and menopause care, as well as transgender medicine.
- This passion led to the development of The Papillon Clinic in 2023. Dr Gab is driven by a desire to discuss the tricky aspects of health. She isn't afraid to dive into awkward topics and has a knack for putting her patients and audience at ease with her easy-going and friendly approach to healthcare and health education. Outside of medicine, Dr Gab enjoys the peace of the country living on her property outside of Orange, spending time with her family and dogs, as well as running and reading.
Breaking Taboos in Women’s Health:
- The conversation stresses the need for correct anatomical language (vulva, labia, clitoris) and the importance of overcoming societal discomfort and stigma around discussing female genitalia. This lack of open discussion can prevent women from recognising or communicating health issues.
Vulval Anatomy and Education:
- Dr Staniforth provides a clear, systematic overview of vulval anatomy, noting that many women are unfamiliar with these terms or their own bodies due to inadequate education and cultural shame.
Common Vulval and Vaginal Conditions:
The most frequent issues seen, especially around menopause, include:
- Genitourinary Syndrome of Menopause (GSM): Thinning and drying of vulval and vaginal tissues due to decreased estrogen, leading to pain, itching, discomfort, and urinary symptoms. GSM is highly treatable with local estrogen therapy, which is safe, effective, and can dramatically improve quality of life.
- Lichen Sclerosus: A chronic inflammatory skin condition of the vulva and perianal area, often presenting as persistent itch and white plaques. It can cause significant anatomical changes and increases the risk of vulval cancer if untreated. Many women and clinicians are unaware of the condition, leading to underdiagnosis.
- Chronic Vulvovaginal Candidiasis (CVVC): A hypersensitivity reaction to normal levels of candida, resulting in chronic cyclical itching, often worsening premenstrually. It requires prolonged antifungal treatment and is diagnosed clinically rather than by swab.
Empowering Women Through Self-Examination:
- Women are encouraged to become familiar with their own vulval anatomy through self-examination, as vulvas vary greatly and there is a wide range of normal. Understanding one’s own “normal” can help detect changes early and seek appropriate care.
Societal Pressures and Body Image:
- The podcast discusses the impact of pornography and cosmetic surgery on women’s perceptions of what is “normal.” Resources like illustrated books showing diverse vulvas can be reassuring, especially for younger women.
Treatment and Prevention:
- Most vulval and vaginal conditions discussed are easily treatable, especially GSM, where local estrogen can be life-changing and effective even years after menopause. Early recognition and treatment can prevent complications such as recurrent urinary tract infections and anatomical changes.
Healthcare Professional Education:
- Both hosts acknowledge gaps in medical training regarding vulval health and stress the importance of ongoing education for clinicians to better recognise, diagnose, and treat these conditions.
Access to Care:
- Dr Staniforth shares her clinic details and encourages women, especially in rural areas, to seek care and not be embarrassed about discussing or showing their vulval concerns to healthcare professionals.
Connect with Dr Gab:
📷 Instagram: @dr_gabstaniforth
📘 Facebook: Dr Gab Staniforth
🌐 Website: drgabriellestaniforth.com.au/
🏥 Clinic: The Papillon Clinic
Episode 261:
Transcript
Dr Mary Barson (0:04) Hello, my lovely friends. I am Dr Mary Barson.
Dr Lucy Burns (0:09) And I'm Dr Lucy Burns. We are doctors and weight management and metabolic health experts.
Both (0:12) And this is the Real Health and Weight Loss podcast!
Dr Lucy Burns (0:21) Good morning, lovely friend. Dr Lucy here this morning. How are you on this beautiful Tuesday morning? Unless it's Wednesday when you're listening to this—or even Friday. This morning, I am without Dr Mary because I have a fantastic guest you are going to love. She is a wealth of information, and we’re going to touch on some subjects that some people might consider a bit taboo. They may be a little uncomfortable, but they’re topics that need to become more comfortable. So, I am super happy to welcome to the podcast Dr Gab Staniforth. She is a GP in the lovely country town of Orange. Her special interests are menopause, vulval health—not to be confused with ice bulbs or bulbos—and transgender care. She has some really interesting things to talk to us about today, and I think you're going to love it. Gab, welcome to the podcast.
Dr Gab Staniforth (01:16) Thank you so much for having me, Lucy. I feel really humbled that you asked me to come and chat on a podcast that I’ve been listening to forever, it seems. So, thanks for having me.
Dr Lucy Burns (01:26) Ah, you are welcome. So, my lovely friends, Gab and I met in person at the So Hot Right Now conference, which was a menopause conference way back in March, organised by some fabulous medical doctors from Australia. We happened to just sit next to each other, which was wonderful. So good, yeah. Last year, we ran a big series on menopause. And I mean, this isn’t just about menopause—it’s really about women’s health. Our podcast is called Real Health and Weight Loss. Not everything we talk about is related to weight loss—a lot of it is—but not everything. And I think that when we’re talking about women’s health, we need to be using the right words to describe women’s bits and pieces.
Dr Gab Staniforth (02:15) 100%. If we don't have the right language around it, then we're just going to get it wrong—and women are just going to go under the radar and not get the help they need. So, we do have to get comfortable with the uncomfortable. And there's nothing like practicing to make it more comfortable.
Dr Lucy Burns (02:34) Exactly, exactly. It’s interesting because I think people do seem to be more comfortable with the word vagina—they use that a lot. I don’t know whether it just sort of rolls… it sounds nice, rolls off the tongue. But some of our other words—nobody’s using them.
Dr Gab Staniforth (02:29) Yeah, I think you're right. Even the word vagina is still quite taboo word. I mean, don’t we get a big red mark against our name if we even mention it on Instagram or Facebook? Which is absolutely ridiculous. But I think, you know, words like vulva or labia—it's probably twofold. There are a lot of people who haven't received proper education around what language to use for genitals, for example. But also, in the generation I was brought up in, there was more than just a bit of shame and stigma around genitals and sexual health. So anything referring to that was met with a giggle—or sometimes you got in trouble for it. So of course, there’s difficulty and a lack of education around using the correct terms. And that then leads to women not being able to adequately describe their own bodies or recognise when something is going wrong.
Dr Lucy Burns (03:52) Exactly, exactly. So I guess—well, this is tricky, because we're on a podcast and people can only hear us. But if you were to describe all the bits and pieces, what exactly is our anatomy?
Dr Gab Staniforth (04:04) I think some of the important things that need to be covered—and I like to take things systematically—so maybe I’ll go from the top down. It’s important to be able to name and talk about the clitoris and the clitoral hood, which it sits under. Then we've got all the external parts of our genitals, which are collectively referred to as the vulva. That includes the labia majora, which are the outer flaps, if you like, and the labia minora, which are the inner flaps. Lying within them, at the upper end, is the urethral opening, which is the opening from the bladder. Then we’ve got the vagina and the introitus, which is the opening to the vagina. And of course, part of the genitals also includes the perineum, the anus, and the perianal area as well—words we definitely don’t tend to use, do we?
Dr Lucy Burns (05:03) No. That was just considered naughty and dirty.
Dr Gab Staniforth (05:04) But it’s important—because,
Dr Lucy Burns (05:07) yeah, everyone just calls it your bottom.
Dr Gab Staniforth (05:08) Yeah—bottom, front bottom, back bottom. That’s how I was brought up. I didn’t even know I had three holes by the time I got my period. So is that, like, shocking?
Dr Lucy Burns (05:19) Yes, yes, I think it is. It’s hard—and I think it's because we’re not used to the words. We don’t like them. They’re all there, you know, and some of them do feel... it’s a bit like scrotum. Scrotum is another word that nobody likes to say. It’s sort of—I don’t know what it is. It’s like...
Dr Gab Staniforth (05:32): I think it’s—is it because it almost, I don’t know, makes you envisage it? I don’t know. I don’t know. And then you go back to being a child and you’re like, oh God—penis, bum, scrotum.
Dr Lucy Burns (05:46): Yeah, yeah. I don’t know—it’s funny. Whereas, you know, like humerus, which is your arm—we just say that. Humerus, no big deal. I don’t know—there’s no overlay to it.
Dr Gab Staniforth (05:55): No big deal. Yeah. No, no.
Dr Lucy Burns (05:57): Whereas, yes, you’re right. And even something like mons—most people wouldn’t know what their mons is. So if you’re listening and thinking, “Yeah, what is the mons?”—it’s that front bit, right at the front. I guess for, you know—and again, what do we call it? The map of Tassie. Yeah, yeah—exactly. A little, you know, euphemism for it.
Dr Gab Staniforth (06:20): Yeah, yeah. It’s the front bit, isn’t it? Right on top of your pubic bone. Where your pubic hair sits—or your map of Tassie, if that’s how you choose to curate your pubic hair.
Dr Lucy Burns (06:30) Yeah, absolutely, absolutely. And even pubic—that’s another word people don’t tend to say. Pubic hair, pubes—yeah, all of those. So I think getting comfortable with those words is really useful, because that leads us into the next part of our conversation, which is when things go a bit awry down there. And—hear that? I didn’t even mean to say it like that, it just sort of came out. Down south.
Dr Gab Staniforth (06:54) You’ve got to let the audience be comfortable too, and just ease them in. So I think down there is fine.
Dr Lucy Burns (06:59) Yes. So—yeah—there are things that do go amiss down there. And that’s your area—you know, you see a lot of vulval health. So perhaps, can you step us through some of the things you commonly see that women may not realise are either not normal, or that they’ve just put up with?
Dr Gab Staniforth (07:18) Yeah. So, I mean, there are quite a lot of things that commonly present—particularly now that I’ve started really focusing on menopausal health. Because, believe it or not, a lot of these dermatological conditions involve the vulva, which is skin—so we’re talking about dermatology. These conditions can actually be exacerbated by the hormonal changes that occur during perimenopause, and we see a big spike in the incidence of certain conditions around this time, including the genitourinary syndrome of menopause, previously referred to as vulvovaginal atrophy. This encompasses not only vulval and vaginal symptoms but also urinary symptoms as well. I think the biggest or most common issues I see coming through my doors are the genitourinary syndrome of menopause, lichen sclerosus, CVVC—which is chronic vulvovaginal candidiasis, not to be confused with acute candida infections or thrush—and, I guess, simple dermatitis as well as psoriasis. They’re not necessarily common in the general population, but they are the conditions I most often see when people come in with an issue.
Dr Lucy Burns (08:44): OK, so GCSM—or the genitourinary syndrome of menopause. Can you tell our audience what that is?
Dr Gab Staniforth (08:52): Yes. So when our hormones change and we lose estrogen, we have lots of receptors for estrogen and testosterone in our genital area, so that area is deeply affected around this time. We lose collagen, which makes the skin thinner and paler. And if it’s thinner, then it’s going to be more susceptible to trauma with any type of friction. And I’m not just talking about intercourse—I’m talking about walking around, sitting, riding a bike. If things are really frail, then they’re going to be disrupted down there, which is obviously going to cause symptoms of pain, itch, and discomfort. In addition to that, our glands produce less secretions, which means we’re not as lubricated, and that’s where the dryness comes in. And that’s a really uncomfortable state. I think everyone could probably think about a time when they had a really dry mouth, or even conjunctivitis, where it feels like you’ve got sand in your eyes. I’m sure that would feel really uncomfortable if that’s what you were walking around with in your pants. In addition to that, everything becomes smaller. The labia minora—the inner flaps—can actually get so small that they disappear. The clitoris can get smaller, which can obviously affect function—sexual function. The clitoral hood can shrink and tighten over the clitoris, which again can cause discomfort or a change in sexual function. These changes are true within the vagina as well. And within the urinary system—because the urethra is right there within the folds of the vulva—that can really alter urinary function. If the urethra kind of protrudes out, then that too is going to be more susceptible to microtrauma, which is an area where bacteria can get in. And that’s where we’re seeing women suddenly getting recurrent UTIs again, or experiencing symptoms like dysuria—which is pain on urination—or urinary frequency, which might happen during the day or cause them to get up more often overnight. I think with these particular symptoms—the urinary symptoms—a lot of women just put it down to, “I’m getting old,” or “I had a cup of tea at night.” They don’t actually link it to hormonal changes. And I think that’s why it’s important to have these conversations using these words, so women know, “Oh, this actually could be something to do with shifting gears in my hormones.” And that’s OK—because we’ve got really simple, effective treatment that can not only help women feel better, but also prevent progression to really sinister things like urosepsis.
[Dr Lucy Burns (11:42): Yeah, absolutely. So I must say, I think it is amazing that you can just use some vaginal cream, like an estrogen cream, so you're replacing the hormones locally. And all of a sudden, you're not getting up twice a night to wee.
Dr Gab Staniforth (11:57): It’s insane. I say this to women all the time. They come in and say, “Oh no, no, but I don’t have a dry vagina.” And I’m like, “You just told me that you’re getting up three times to go to the toilet overnight. You’re tired.” You know, what if I could improve that for you? “Oh no, no, that’s not going to work—with a little pessary or a cream.” And most of them come back within four to six weeks and say, “That is amazing.” That is amazing. And in addition to that, “I didn’t realise how uncomfortable I was until I became more comfortable with the treatment.” It’s so easy. It’s so effective. It’s safe. I don’t know anything that’s safer to prescribe. And in fact, I don’t even think we should have to prescribe it—I think it should be over the counter. It’s an absolute game changer. And I think everyone should at least know about it. All women should know about it—because all women will go through menopause—and make a choice as to whether they not only want to treat GSM but prevent things like architectural changes, prevent UTIs. You know, prevention is better than cure, right?
Dr Lucy Burns (13:00): Yeah, absolutely. And I just look back—I mean, I’ve been a GP for a very long time—and I think, gosh, so many women back in the ’90s, we would put them on low-dose antibiotics, like low-dose, long-term antibiotics, which we shouldn't have been doing, when probably, no—they just needed estrogen.
Dr Gab Staniforth (13:22): Yeah, with antibiotics now. And, you know, we don’t know what we don’t know. But I often think back to all the years I was practising medicine and nursing—examining women’s vulvas and vaginas, doing Pap smears, or delivering babies, or whatever it might have been. And I am horrified to say that there must have been so many women out there that I missed—simply because I didn’t know. I wasn’t taught. And I’m so sorry for that. I guess that’s part of what’s formed my mission in all of this—to correct the wrongs that I’ve done. Hopefully educate people, but also educate my colleagues. Say, “Make sure you know what’s normal—so that if it’s not normal, you can say, ‘That’s not normal.’” You don’t need to know what it is if it’s not normal, but you do need to know enough to refer to someone who may be able to help.
Dr Lucy Burns (14:18) Ah, absolutely. And knowing that women developing incontinence as they age isn't just normal.
Dr Gab Staniforth (14:24): It’s not just because you’ve had a baby. Everyone says, “Oh, you’ve had a baby.” But there are many women out there who have not delivered vaginally, who have not even carried a baby, who still develop these urinary symptoms, including incontinence. And of course, sometimes there are structural things going on—it is multifactorial. But one big contributor is a lack of estrogen and the changes in the tissue that happen with menopause.
Dr Lucy Burns (14:49): Yeah, absolutely. I’ve been talking about it like this: it’s a bit like you’ve got this old, dry, crusty autumn leaf. And then you give it some estrogen and whoof!—it’s back to being green and lush.
Dr Gab Staniforth (15:01): Do you know, I’ve got a really good analogy in my office. I have a water lily. And, you know, you can’t kill a water lily. But I tell you what—a couple of times I’ve walked in and it looks so sad, really droopy, hanging over the edges. And I liken that to a menopausal vulva. All you have to do is fill up the sink—which would be your estrogen—tuck it in for a couple of hours and whoosh! You’ve got a beautiful water lily again, with really vibrant, moist leaves and flowers.
Dr Lucy Burns (15:31) Oh, beautiful. That’s what we all want—a water lily.
Dr Gab Staniforth (15:34) Get yourself a water lily to remind you.
Dr Lucy Burns (15:36) Excellent. Now, one of the other conditions that you mentioned is something called lichen sclerosis. So talk us through that, because I reckon if you did a poll—top 100 women—who knows about lichen sclerosis? It wouldn’t be that many.
Dr Gab Staniforth (15:55) No, I would absolutely agree with you. And I know that when I went through medical training and GP training, and did a diploma with RANZCOG, it was sort of brushed on—but it was a very textbook thing that I just rote-learned. I never really got taught clinically what it looked like or what I should be looking for. It’s not particularly common, but it's probably more prevalent than what is stated, which is about 3% of the population. And that’s simply because people don’t know what it looks like—they don’t know what they’re looking for. And then, once again, women are not presenting with these things because of shame and embarrassment. It’s a chronic inflammatory dermatological condition of the vulva and the perianal area, and it usually presents with itch. That’s the predominant symptom—chronic itch that doesn’t go away, worse at night. Some people do come in with no symptoms—so 10 to 15% are asymptomatic. And I know now that, as soon as I started to really dive into this area, I began looking every time I did a pap smear or what have you, and I started diagnosing asymptomatic women just through the appearance of what was happening. So when it’s in an active process, there are skin changes—pallor, sort of white plaques around the vulval area and involving the perianal area and the perineum as well. A typical textbook picture would be a figure of eight, if you like. But over time, if it’s not treated—because it’s a chronic inflammatory condition—it can lead to architectural changes. The outside flaps can become sticky—this is how I explain it to my patients. So, in really simple terms, they can become sticky and start to fuse together. You can get fusion between the labia minora and majora, and clitoral hood adhesions. In extreme cases, it can join together so much that the vaginal introitus is virtually gone. I’ve seen a couple of older women with just pinholes, which obviously is going to affect sexual function—it’s impossible if you want to have penetrative sex. But it can also affect urinary function, because it’s covering up the urethral opening. So it can be quite devastating. And importantly, it can be a premalignant condition as well—it can progress to SCC, or squamous cell carcinoma, in about two to six percent of cases if not treated.
Dr Lucy Burns (18:33) So I’m imagining that women, though, could have both GSM and lichen sclerosus?
Dr Gab Staniforth (18:39) Yep, absolutely. And in fact, you know, one can sort of—not really trigger the other—but because those hormonal changes are really driving the GSM, the hormonal changes drive inflammation as well. We lose estrogen, and it's a potent anti-inflammatory everywhere in our body, including in our skin. So this is a time where a lot of dermatological conditions that were pre-existing become worse again—eczema, for example—or there are new diagnoses like lichen sclerosus.
Dr Lucy Burns (19:13) Yes. And then the third thing you mentioned is chronic candidiasis. Tell us a bit about that.
Dr Gab Staniforth (19:19) I think this is really interesting. I didn’t know about this until I started working with a dermatologist a couple of years ago. I didn’t even know it was a thing—didn’t know it existed. So, acute thrush is when you get an overgrowth of candida, which is a normal commensal of our vaginal tract. You get this dysbiosis, and that can be triggered by many different things—diet, a course of antibiotics, a stint of being unwell, what have you. So that’s an overgrowth of candida. CVVC, which is so much easier for me to say compared to chronic vulvovaginal candidiasis—it’s a tricky one—is, I guess, a genetically determined hypersensitivity to candida. So, really, the body recognises candida as an antigen, a foreign body, and then has a maladaptive immune or inflammatory response to that normal level of candida. It’s not that there’s a dysbiosis or an overgrowth; it’s just that the immune system is recognising it as foreign and is acting inappropriately, if you like. That presents as a chronic itch, but it has a particular pattern. Because candida is oestrogen-dependent—and that’s an interesting thing as well—it means that this sort of grumbles along throughout a cycle, peaking in the premenstrual week, because that’s when oestrogen is at its lowest. Then you actually get relief with menstruation, and it starts to build back up again. So, any woman that comes in with this cyclical pattern of chronic itch, which gets better with their period, that’s a telltale sign that you might be dealing with CVVC. Unlike acute thrush, it doesn’t have that typical cottage cheese-like discharge. It tends to have more of a watery discharge, maybe nothing at all, and it doesn’t necessarily matter if you get anything on a swab. It’s a clinical diagnosis, and it’s treated a little bit differently to acute thrush in that it’s going to require a prolonged course of oral antifungals. Another part of the history that’s important to hook into—many of these women will say, “Oh, I’ve got thrush,” and they’ll go over the counter and grab some treatment, which is absolutely appropriate, and they respond to it. But then, inevitably, it starts to build up again. So, if there’s that history of response to antifungals, then that’s also a clue that you’re probably dealing with that. Importantly, with any chronic itch, it’s important to have a look and see if there are any changes, because you might be putting it down to CVVC, for example, but there might be lichen sclerosus there—in isolation or in conjunction with it—or GSM, or what have you. So, examination is important.
Dr Lucy Burns (22:14) Yeah, yeah, which is tricky, because I know for lots of women, they're embarrassed and they don’t want to, you know, again, show their vulva to people.
Dr Gab Staniforth (22:23) Yeah, and I think one way to overcome that is to really encourage every woman to examine themselves. I think it’s really important to get familiar with your own anatomy and what you look like. Vulvas are so unique, and everyone is going to have their own. So it’s really important to understand what normal looks like for you, so that you can say, “Oh, that’s not normal for me.” And then that might, you know, prompt you to go and seek a practitioner that you’re comfortable with, who can have a look for you and appropriately treat you. But the biggest thing you can do—and it is really hard when you’ve been told, “Don’t look at your genitals,” or “Genitals are dirty”—is to actually get out a mirror and have a look. But it is the number one thing you can do that can really turn things around.
Dr Lucy Burns (23:11) Yeah, absolutely. And I think you're right, they are all different. And again, it's so tricky these days, particularly for younger people who have access to pornography. It's becoming much more commonplace, which gives a stylised version of what people think their bodies—especially their genital region—should look like but in particular the genital region.
Dr Gab Staniforth (23:39) Yeah. And we’ve got to remember that there are lots of women out there getting labiaplasties and trying to create the “perfect” vulva. But what on earth is that? Like, I see vulvas all day, and oh my gosh, they’re so varied and so different. My sister has that book—oh, you know the one I’m talking about? It’s a pocket guide... something like Look at My Flaps or just Flaps? Yeah, it’s a really clever book, but it’s beautiful. It’s so beautiful. It includes so many different women with their own vulvas—obviously from different cultural backgrounds, even some trans vulvas in there as well. I was looking at it with my niece, who’s 13 or 14 and going through puberty, and just talking about what normal is. And everyone’s normal. It’s just—everyone has their own normal.
Dr Lucy Burns (24:39) Yes, absolutely. And I think you're right. We’ll link that book in the show notes, because I think it is— Thank you. Good. Yes, I can't remember it either. But that’s fine—we can go and research it and have a little look. I think the author got—I can’t remember how many, maybe a few hundred—women to send in de-identified pictures.
Dr Gab Staniforth (24:58) I thought she actually—did she photograph them? Was she a photographer?
Dr Lucy Burns (25:03) She may have. Either way, what we want to do is be looking. So these are just pictures of just a bog-standard woman—nothing, you know. They're not models. They're not. They're just standard women of all shapes, sizes, ages, you know, as you said, different ethnicities—and realising that there is a huge variation of normal.
Dr Gab Staniforth (25:23) It could be really reassuring for lots of people. I'd love to get that book and have it accessible, you know, in my waiting room. In fact, I'm going to do that with no warning label, because it's just normal anatomy. But I think it's particularly for younger women as they're going through puberty—to be able to, you know, and they're wondering, I haven't seen anyone else's vulva. Is my vulva normal? You know, being able to look at a book and say, Oh God, I'm pretty sure, you know, mine's definitely within the realm of normal.
Dr Lucy Burns (25:54) Yeah, absolutely. Absolutely. And so I think this is it. I mean, what we've been discussing really is that, you know, we've got a wide range of what's normal—and that's good. We need to know what's normal. There are several things that can go on that are not normal, and that, you know, they need to be diagnosed and treated. And the treatments are pretty easy—like it's not big treatment for most of these things. And the treatment is accessible. It's low-risk, low side effects. And particularly with GCSM, you're never too late. Like people, if, you know, if you're listening to this and you're 75 and thinking, "Oh, well, yeah, it's too late for me"—it's not. It's not too late.
Dr Gab Staniforth (26:37) No. And Lucy, importantly around that, what we know about GCSM is it can lag. So there can be like a decade lag after menopause. So often, you know, as we go through menopause or perimenopause, a lot of the symptoms that are more predominant are the hot flashes, night sweats, the psychological changes, the sleep disturbance, musculoskeletal pain—my gosh, I could go on. There are so many symptoms. And yes, of course, the GSM symptoms can crop up at that time. But a lot of women find that they go through and over menopause and they’re sort of recalibrated, they’re sitting pretty happy. And then all of a sudden, they become really uncomfortable or they get urinary symptoms—that’s the big thing—a little bit later. And they’re like, “Oh, just getting old. And then they go down that pathway of urology referrals, and like you said, the long-term antibiotics, when in fact it could just be part of this picture of GSM. And adding in vaginal estrogen, with or without other treatment, is so simple, so safe, so affordable. It’s a beautiful treatment.
Dr Lucy Burns (27:41) Absolutely. Well, lovely. This has been a great talk with not a vulva mentioned in sight. So I’m happy about that. If people want to connect with you—so where do they follow you on social media? How can they find you?
Dr Gab Staniforth (27:55) Oh, that’s a good question. I think I am @dr_gabstaniforth by memory. Dr Gab Staniforth—and there’s an underscore in there.
Dr Lucy Burns (28:03) That's okay. I'm sure if they put you in.
Dr Gab Staniforth (28:06) Yeah, it'll come up.
Dr Lucy Burns (28:07) Yes. Yes. And we will, again, link these in the show notes. Thank you. And your website address?
Dr Gab Staniforth (28:12) drgabriellestaniforth.com.au and then if you're local and you want to come and connect with me as a patient in the Central West, my clinic is called the Papillon Clinic, and their website is thepapillonclinic.com.au
Dr Lucy Burns (28:26) Oh, I love that. So yes, if you're in Orange or surrounds, you can actually go and see Dr Gab in person, show her your bits. She'll sort you out. All right, my lovely friend. Well, time to head on with the rest of your day. I hope that you have a fabulous one, no matter where you are and how you're feeling. May your day be wonderful. Thanks for listening. And I will catch up with you next week. Bye for now.
Dr Lucy Burns (28:53) The information shared on the Real Health and Weight Loss Podcast, including show notes and links, provides general information only. It is not a substitute, nor is it intended to provide individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.
