In this episode, I'm back with Dr. Sameena Rahman for Part 2 — and we go places most medical appointments never do. We open with PCOS, GLP-1s, peptides, and ketamine, then shift into what may be the most important hormone conversation I've had on this show: is hormone therapy actually safe for women over 60?
Dr. Rahman breaks down why the original Women's Health Initiative study was mismarketed, not flawed — and how that bad marketing set back women's health by two decades. She explains how to think about the risk-benefit calculation for starting hormones later in life, and what screenings actually matter before making that call.
We then get into the reality of concierge medicine — why so many doctors are leaving insurance-based practices, and what women who can't afford private care can actually do. And we close on a myth that genuinely alarmed me: the idea that women over 65 no longer need pelvic exams. Dr. Rahman sets the record straight — and explains why genitourinary syndrome menopau
In This Episode:
00:00 - Welcome Back & Recap of Part 1
01:20 - PCOS Explained: What It Is and Who It Affects
02:50 - GLP-1s, Peptides & Ketamine: What the Evidence Actually Says
05:10 - Hormone Therapy After 60: Is It Safe?
07:30 - The WHI Study: Bad Marketing, Not Bad Science
09:20 - Heart Health, Bone Health & Who Should Consider Starting Late
11:45 - Why Doctors Are Moving to Concierge Medicine
14:00 - The Insurance System Is Rigged Against Women
16:05 - What to Do If You Can't Afford a Specialist
17:45 - The Pelvic Exam Myth Putting Women at Risk
19:15 - Genitourinary Syndrome, Vaginal Estrogen & UTI Prevention
20:50 - Final Thoughts & Where to Find Dr. Rahman
Want a deeper look? Watch the full episode on YouTube for a more visual experience of today’s discussion. This episode is best enjoyed on video—don’t miss out!
Karen Bigman, a Sexual Health Alliance Certified Sex Educator, Life, and Menopause Coach, tackles the often-taboo subject of sexuality with a straightforward and candid approach. We explore the intricacies of sex during perimenopause, post-menopause, and andropause, offering insights and support for all those experiencing these transformative phases.
This podcast is not intended to give medical advice. Karen Bigman is not a medical professional. For any medical questions or issues, please visit your licensed medical provider.
Looking for some fresh perspective on sex in midlife? You can find me here:
Email: karen@taboototruth.com
Website: https://www.taboototruth.com/
Instagram: https://www.instagram.com/taboototruth
YouTube: https://www.youtube.com/@taboototruthpodcast
About the Guest:
Dr. Sameena Rahman is a board-certified OB/GYN and certified Menopause Practitioner with over a decade of expertise in midlife care, sexual medicine, and concierge gynecology. After training and practicing at leading institutions including USC, the University of Chicago, and Northwestern, she founded The GSM Collective in downtown Chicago to deliver a more personalized, patient-first model of women’s healthcare.
Nationally recognized for her leadership in sexual and menopausal health, Dr. Rahman serves on the Board of Directors and as Scientific Committee Chair for the International Society for the Study of Women’s Sexual Health (ISSWSH), where she is also a Fellow (IF). She is a Menopause Certified Practitioner and active member of The Menopause Society’s Education Committee, frequently speaking at national and international conferences on culturally informed care and sexual health.
Connect with Dr. Sameena Rahman:
Website: https://www.thegsmcollective.com/
Instagram: https://www.instagram.com/gynogirl/
Karen Bigman, a Sexual Health Alliance Certified Sex Educator, Life, and Menopause Coach, tackles the often-taboo subject of sexuality with a straightforward and candid approach. We explore the intricacies of sex during perimenopause, post-menopause, and andropause, offering insights and support for all those experiencing these transformative phases.
This podcast is not intended to give medical advice. Karen Bigman is not a medical professional. For any medical questions or issues, please visit your licensed medical provider.
Looking for some fresh perspective on sex in midlife? You can find me here:
Email: karen@taboototruth.com
Website: https://www.taboototruth.com/
Instagram: https://www.instagram.com/taboototruth
YouTube: https://www.youtube.com/@taboototruthpodcast
Substack: https://karenbigman.substack.com
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