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Reclaiming Pelvic Floor Health and Vaginal Estrogen with Dr. Aleece Fosnight
Season 2 Episode 84
In this episode, Mary is joined by Dr. Aleece Fosnight, a board-certified physician assistant specializing in sexual medicine, women's health, and urology, who brings crucial insights about pelvic floor health and the safety of vaginal estrogen therapy.
Bottom Line Up Front: Urinary incontinence is common but not normal—it's treatable at any age. Vaginal estradiol is safe and effective, with virtually no contraindications, yet misinformation continues to prevent women from accessing this life-changing therapy that can reduce UTIs by over 50%.
The conversation tackles the widespread misconceptions surrounding pelvic floor health and vaginal estrogen therapy. Dr. Fosnight reveals how the healthcare system spends over a billion dollars annually on recurrent UTIs—many of which could be prevented with proper treatment. She emphasizes that systemic hormone therapy doesn't reach genital urinary tissues effectively, making local vaginal estrogen essential for optimal health during and after menopause.
Dr. Fosnight also demonstrates how proper pelvic floor assessment should be standard care, explaining her trauma-informed approach to examinations and why every postpartum woman should receive pelvic floor therapy—a practice already standard in Europe that dramatically reduces long-term complications.
Connect with Dr. Aleece Fosnight:
Resources:
- American Urology Association Guidelines on Genitourinary Syndrome of Menopause (April 2025)
- GSM Guidelines Summary Cheat Sheet
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Mary is a Licensed Menopause Champion, certified Menopause Doula, and Woman's Coaching Specialist supporting high-achieving women to embrace their transition from peri- to post-menopause.
Mary coaches individuals and guides organizations to create a menopause-friendly workplace, helping forward-thinking organizations design policies to accommodate employees at work and foster a positive and supportive culture.
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Disclaimer: Information shared is for educational and entertainment purposes only and does not replace medical advice. Always consult with a healthcare professional.
Published on 14 hours ago