What No One Tells Women About Hormones, Bladder Leaks & Sex After 40 with Dr. Peter Castillo

Women are often told that bladder leaks, changes in sexual function, stubborn weight gain, brain fog, and disrupted sleep are simply part of getting older. But which changes are common, which deserve a closer look, and what options are women rarely told about? Dr. Pamela Mehta sits down with Dr. Peter Castillo, a urogynecologist and reconstructive pelvic surgeon, to discuss how women’s bodies change after 40. They unpack perimenopause and hormone testing, pelvic organ prolapse, urinary incontinence, Kegels, sexual health, estrogen and testosterone therapy, GLP-1 medications, and how to advocate for better care when something does not feel right. IN THIS EPISODE: 00:00 Women’s Health After 40   01:22 What Should Women Expect From a Hormone Specialist?   03:08 Why Do Women Feel Dismissed by Their Doctors?   05:29 Can Hormone Tests Detect Perimenopause?    08:40 What Does a Urogynecologist Treat?   12:15 What Are the Symptoms of Pelvic Organ Prolapse?   14:13 Do Women Need Pelvic Floor Therapy After Childbirth?   17:00 Stress Incontinence vs. Urge Incontinence   18:40 What Are the Treatments for Overactive Bladder?   21:00 How Can Women Protect Their Pelvic Floor Before Pregnancy?   22:05Can Lifting Weights Cause Bladder Leaks or Prolapse?   23:30 Are You Doing Kegels Wrong?   24:50 Why Does Sex Feel Different After Childbirth or Menopause?   27:17 Can PRP Improve Female Sexual Health?   27:50 Why Do Orgasms Change After 40?   28:50 What Is Vaginal Rejuvenation?   30:05What Does Vaginal Estrogen Treat?   31:22 What Does Testosterone Therapy Do for Women?   32:55 What Are the Side Effects of Testosterone in Women?    38:37 Does Hormone Replacement Therapy Increase Cancer Risk?   41:30 Can Hormone Changes Cause Anxiety or Depression?   43:04 Why Is It Harder to Lose Weight After 40?   44:50 How Do GLP-1 Medications Work for Weight Loss?   47:15 What Are Peptides Used for in Women’s Health?   48:05 What Treatments Are Available for Low Libido in Women?   50:03 How Do Doctors Build Trust With Female Patients?   53:58 How Can Women Advocate for Better Health Care?   55:08 What Should a Doctor Do When They Don’t Know the Answer?   55:59 Where to Find Dr. Peter Castillo  GUEST RESOURCES: Website: https://swanmd.com/ Instagram: https://www.instagram.com/swanmed/?hl=en Dr. Peter Castillo Instagram: https://www.instagram.com/drpetercastillo/  THE RESILIENCE FACTOR WITH DR. PAMELA MEHTA: YouTube: https://youtube.com/playlist?list=PLiQ_AOy_Pd4mEXrsUN3hC6dEtSpmtQuDF&si=szS_5tqUV85kV1R9   Apple Podcasts: https://podcasts.apple.com/us/podcast/the-resilience-factor/id1822815775   Spotify: https://open.spotify.com/show/3D3mys5DJka3zrsdKEPVs3?si=c56539bea0174bbd   HOST RESOURCES: Instagram: https://www.instagram.com/dr.pamelamehta   TikTok: https://www.tiktok.com/@dr.pamelamehta   Become a Patient: https://www.resilienceorthopedics.com   Earn FREE CE Credits: https://learnatpinnacle.com  This episode is brought to you by ⁠The Pinnacle Podcast Network⁠!  ABOUT DR. PAMELA MEHTA: Pamela Mehta, MD, is a board-certified orthopedic surgeon, practice owner, chief medical officer of the Good Feet Store, and founder of the education platform Learn at Pinnacle. Dr. Mehta specializes in minimally invasive surgery, orthobiologics, and sports medicine. She helps people of all stages of life learn how to live a healthier life, longer.  Disclaimer: Pamela Mehta, MD, is a doctor, but she is not your doctor. This content is for general education and is not a substitute for individualized medical care. Learn more about your ad choices. Visit megaphone.fm/adchoices