What if everything you thought you understood regarding the sex hormones of women is either wrong or somehow not conveyed properly? In this episode of the Balls Deep podcast, Dr. Dent Williams, an experienced OB/GYN with over four decades of practice, sits down with Dr. Joe Pazona to share stories from his career. From the myths of menopause and misunderstandings about hormone therapy, Dr. Williams delivers pearls of wisdom gathered over decades of caring for women. Here’s what you should know about sex hormones and women’s health:
Women Talk. Doctors Listen (Sometimes).
One of the most important observations that Dr. Williams shared was that women simply wanted someone to give an ear and not speak. A doctor at times had to take the role of a therapist during very sensitive situations like labor and menopause. The burden of hormonal changes can cause women to suffer physically and mentally. Most women do not feel safe discussing these issues with their partners or even their doctors.
“Menopause isn’t just hot flashes. It’s brain fog, mood swings, vaginal dryness, and relationship stress. And yes—these are treatable," Dr. Williams said.
Understanding Menopause: Not Only Aging, But Hormonal Decline
Menopause marks the shutdown of ovarian function, meaning a woman produces less sex hormones (estrogen and progesterone) and will run out of eggs. This will manifest itself in:
- Hot flashes & night sweats
- Vaginal dryness
- Cognitive & emotional decline
- Urinary symptoms primarily urgency and leakage
Dr. Williams mentions that an overwhelming amount of women seem to suffer in silence, because they think it’s a normal consequence of growing older. More often than not, menopause symptoms are indeed treatable—often with something as simple as topical estrogen.
The Hormone Study That Misled Millions
A 2002 Women’s Health Initiative study, claimed that HRT (Hormone Replacement Therapy) for menopause could lead to heart disease and breast cancer. It caused millions of women to come off hormone therapy overnight.
Dr. Williams explained how the media—and medicine—got it wrong:
- The risk of breast cancer only increased in 1 in 1,000 women.
- The increased heart risk was only in older women well past menopause.
- The estrogen-only group of the study actually had less breast cancer.
- The origin of concern was primarily associated with the use of synthetic progestins, not estrogen.
“Timing Matters. Starting hormone therapy close to the onset of menopause is safer and more beneficial.” – Dr. Williams
Pelvic Floor Truths: Leaks, Laughs & The Mesh Myth
Dr. Williams and Dr. Pazona also addressed the most controversial issue of all: bladder leakage. From coughing to running, a lot of women suffer from stress incontinence because of weakened pelvic tissues and low estrogen levels.
The good news? Innovation has improved treatment options:
- The use of mid-urethral mesh slings is safe, effective, and minimally invasive.
- Office-based bulking devices, such as Bulkamid, aid in restoring bladder control.
- Vaginal estrogen helps maintain tissue health, preventing mesh exposure or atrophy.
Forget what you saw on lawyer commercials—done properly, mesh should be viewed as a paradigm of innovation, not the devil it is often depicted as.
Lessons from a Lifetime of Listening
When reflecting on what women have taught him, Dr. Williams says: “Listen to your patients long enough and they’ll tell you what’s wrong.”
In today’s fragmented health care world, we often disregard the timeless truth that, “Patients want to be heard." That's undoubtedly why he has had the pleasure of his obstetrical patients delivering three generations of babies—and still gets hugs in the grocery store.
Final Advice for Women: Don’t Suffer in Silence
Dr. Williams’s primary advice is: Take the initiative. Don't wait for 'sensitive' issues to be discussed. Don’t be scared to speak out. Get checked.
Painful sex and urinary incontinence—these are just a few symptoms that women suffer from and are treated as ‘just normal’ or a ‘part of aging.’ But there are solutions. Women deserve to feel empowered, informed, and listened to when talking about their health.
We hope these secrets from an OB/GYN will bring you comfort and help you address any issues caused by sex hormones you may be experiencing. To gain a better understanding, feel free to check out everything you should know about menopause and women’s health.
Disclaimer: This blog is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for personalized guidance.
