Episode Details

Who controls what happens between women’s legs after menopause?

It’s a confronting question, but one that sits at the heart of this episode.

In this short, powerful conversation, I am joined by menopause specialist and sexologist Dr Angela Wright to explore why so many women — particularly those who have had cancer — are still being denied access to vaginal and vulval oestrogen treatments. And why we’re not routinely having the conversation about sexual health after cancer treatment.

Despite being widely recognised as one of the most effective and low-risk treatments for genitourinary symptoms of menopause (GSM), access remains incredibly low. Many women are left navigating pain, dryness, recurrent infections, loss of sexual function, and a deep impact on identity and relationships — often without being offered treatment. Or they’re told ‘no’.

This episode explores:

• Why are women not allowed to make an informed choice about their intimate health?
• The realities of genitourinary syndrome of menopause (GSM) — and why it’s more than “just dryness”
• The added complexity for women on treatments like aromatase inhibitors (e.g. Letrozole)
• The emotional and relational impact of untreated symptoms
• How history, culture, and medical caution continue to shape women’s access to care
• The growing body of guidance suggesting low-dose vaginal hormones may be appropriate for many women, including after breast cancer
• The balance between clinical responsibility and patient autonomy

This is not a black-and-white conversation. It’s not about right or wrong.

It’s an invitation — to think, to question, and to open up more honest, informed conversations between patients and healthcare professionals.

Because at its core, is it about choice?

Links mentioned in this episode:

You can find Dr Wright here: https://spicedpearhealth.co.uk/about/

Sweetness of Venus: A history of the clitoris book https://www.amazon.co.uk/Sweetness-Venus-History-Clitoris/dp/B08W3NZ1H9

Women’s Health Made Easy Book: for Healthcare Professionals, click here

More information about vaginal oestrogen after breast cancer: https://menopauseandcancer.org/navigating-vaginal-oestrogen-after-breast-cancer-what-every-woman-needs-to-know/

Episode Highlights:

00:00 Intro

05:36 Doctor's journey and women's health

08:17 Challenges of Menopause Treatment

10:32 Debating hormone prescription guidelines

14:25 Discussing medical trauma and autonomy

18:19 Discussing bodily agency and benefits

21:18 Reclaiming life after trauma

24:31 Understanding compliance with endocrine therapies

26:42 Valuing women's opinions in healthcare

29:48 Discussing erectile dysfunction post-cancer

34:39 Opening conversations on sexual health

Connect with us:

For more information and resources visit our website: