Episode Details

You’ve increased estrogen.

You’ve supported the gut.

You’ve cleaned up the protocol.

And… she’s still dealing with dryness. recurrent UTIs., and discomfort that keeps coming back.

At some point, it stops being a hormone conversation.

When labs look “fine” and symptoms persist, adding more support doesn’t fix the problem. It just exposes it.

In this episode, Dr. Ritamarie sits down with Dr. Anna Cabeca to look at a pattern that gets missed in conventional and functional care: the vaginal microbiome.

This is NOT a side topic but a primary driver.

They walk through what happens when Lactobacillus balance is disrupted, why vaginal pH shifts matter more than most practitioners realize, and how these changes can create symptoms that look hormonal but don’t respond to hormone-based approaches.

You’ll start to see why some cases don’t resolve…

and what to look at next when they don’t.

What’s Inside This Episode?

• Normal estrogen… but persistent dryness
• Why UTIs keep coming back
• When pH—not hormones—is the issue
• The key Lactobacillus strains that matter
• How antibiotics and HRT disrupt the ecosystem
• Urgency and leakage that aren’t a bladder problem
• The link to fertility, aging, and tissue health
• Why systemic protocols fail when the issue is local

Resources and Links

• Download the Full Transcript
• Download our FREE Metabolic Health Guide here.
• Join the Next-Level Health Practitioner Facebook group here for free resources and community support
• Visit INEMethod.com for advanced health practitioner training and tools to elevate your clinical skills and grow your practice by getting life-changing results.
• Check out other podcast episodes here

Dr Anna’s Resources and Links

Dr Anna’s Website: https://drannacabeca.com

Check out Dr Anna’s products

Find her on Social Media

Facebook

YouTube: The Girlfriend Doctor:

TikTok

Podcast

Labs & Testing Mentioned in This Episode

These tools go beyond traditional testing (HPV, chlamydia, gonorrhea, trichomonas) and help assess overall vaginal microbiome balance, including beneficial Lactobacillus species.

• MDL (Medical Diagnostic Laboratories)