107: Ask Dr. Anna Anything: Libido, Vaginal Health, Hormones, and Menopause Unfiltered

In this episode of Thyroid Pharmacist Healing Conversations, Dr. Izabella Wentz interviews Dr. Anna Cabeca – triple board-certified OB-GYN, functional medicine practitioner, and women’s hormone expert – for an open and honest conversation about the topics many women are too embarrassed to ask about. They discuss libido, vaginal health, painful intercourse, hormones, fertility, postpartum recovery, perimenopause, and menopause. Dr. Cabeca explains how hormonal changes affect everything from mood and intimacy to the vaginal microbiome and bladder health, while also sharing practical strategies women can explore to support healthy aging, hormone balance, and sexual wellness. This episode helps normalize conversations around women’s health, and reminds listeners that many symptoms commonly dismissed as “just aging” deserve attention and support. What You’ll Learn in This Episode: Why libido is about so much more than testosterone. Dr. Anna explains why desire is influenced by hormones, stress, emotional connection, inflammation, adrenal health, and even whether your bedroom feels calming or chaotic. She also shares why many women experience “secondary desire” – meaning they don’t initiate intimacy but enjoy it once they get started. The surprising connection between vaginal health, bladder health, and the microbiome. As estrogen and hormone levels decline with age, the vaginal microbiome changes too, increasing the risk for bacterial vaginosis, urinary symptoms, HPV, and painful intercourse. Dr. Anna explains why Lactobacillus species are essential for maintaining a healthy vaginal environment. Why painful intercourse should never be dismissed as “normal aging.” Loss of collagen, elasticity, hormones, and healthy bacteria can all contribute to discomfort during sex, but Dr. Anna emphasizes that pelvic pain always deserves a full workup, including pelvic exams and transvaginal ultrasounds when appropriate. How pregnancy and postpartum recovery can affect hormones in your 40s. Dr. Anna discusses why women in perimenopause may feel postpartum hormonal shifts more intensely, including the role of progesterone withdrawal, low omega-3 levels, and declining testosterone after pregnancy. The overlooked ways birth control pills can affect libido and attraction. Dr. Anna explains how hormonal birth control suppresses ovulation, testosterone surges, and natural fertility signaling – potentially impacting sex drive, mood, and even who women are attracted to. Why vaginal probiotics may support fertility, urinary health, and intimacy. Dr. Anna discusses how the vaginal microbiome can influence sperm survival, conception, urinary symptoms, and vaginal comfort – and why targeted probiotics may be an important tool in women’s health. Tune in to learn more about hormones, intimacy, vaginal health, and how women can support their bodies through every stage of life. Sign up for the Thyroid Pharmacist Weekly Thyroid Solutions Newsletter here: https://thyroidpharmacist.com/gift/ For the full list of resources and products mentioned in this episode, and to get the full episode transcript, see complete show notes here: https://thyroidpharmacist.com/articles/podcast/ Learn more about your ad choices. Visit megaphone.fm/adchoices