PodcastsHealth & WellnessEmpowering Midlife Wellness with Dr. Susan

Empowering Midlife Wellness with Dr. Susan

Dr. Susan Hardwick-Smith
Empowering Midlife Wellness with Dr. Susan
Latest episode

253 episodes

  • Empowering Midlife Wellness with Dr. Susan

    Testosterone Gel vs. Pellets for Women: What New Research Says

    2026/07/08 | 22 mins.
    Testosterone therapy for women is one of the most debated topics in modern menopause medicine—and one of the areas where misinformation is most common.Over the past year, I have been collaborating with Baylor College of Medicine's world-renowned urologist and sexual medicine specialist Dr. Mohit Khera, to better understand how testosterone can be prescribed safely and effectively for women.One of the key questions we set out to answer is surprisingly simple: What testosterone blood levels do women actually achieve when using testosterone gel at the recommended female dose, and how do those levels compare with appropriately dosed pellet therapy?In this video, I discuss:Our research comparing blood levels with testosterone gel vs. pellet therapy in women. Why optimal testosterone therapy depends on appropriate dosing and careful monitoring, not simply the method of delivery. When to draw testosterone blood tests, which laboratory tests to order, and the differences between LC-MS and ELISA testing.I also discuss the following publications:Global Consensus Position Statement on the Use of Testosterone Therapy for Women (2019) Efficacy of Changing Testosterone Gel Preparations (AndroGel® or Testim®) Among Suboptimally Responsive Hypogonadal Men The 50-Year Amsterdam Transgender Cohort Study (long-term safety data)At Complete Midlife Wellness Center, we believe testosterone therapy should never follow a one-size-fits-all approach. Every woman deserves an individualized treatment plan, expert monitoring, and dose adjustments based on her unique needs and goals.Whether you choose to work with us or another provider, make sure your testosterone therapy is managed by clinicians with specialized expertise in women's hormone health. Testosterone affects much more than sexual function—it also plays an important role in cognition, bone density, muscle health, energy, mood, and overall quality of life.Learn more about Complete Midlife Wellness Center:www.completemidlifewellness.comSchedule a consultation:https://completemidlifewellnesscenter.com/book-your-appointment/
  • Empowering Midlife Wellness with Dr. Susan

    Vagina-Maxxing: Science or Social Media Nonsense?

    2026/06/25 | 24 mins.
    The internet is buzzing about a new trend called "vagina-maxxing"—the idea that women should optimize their vaginal microbiome to achieve the "perfect" vaginal health profile.
    But how much of this trend is actually supported by science?
    In this video, I break down what we currently know about the vaginal microbiome, why certain Lactobacillus species are associated with vaginal health, and whether genetic testing, probiotics, supplements, and various vaginal wellness products truly deliver on their promises.
    We'll discuss:
    What "vagina-maxxing" actually means The role of the vaginal microbiome in women's health Why Lactobacillus crispatus gets so much attention The different vaginal community state types (CSTs) What the research says about vaginal probiotics The difference between evidence-based treatments and marketing claims Whether you really need microbiome testing Vaginal wellness treatments including the O-Shot®, PRP, Emsella®, vaginal laser therapies, labiaplasty, and vaginoplasty When these treatments may be appropriate—and when they may not What women should focus on instead of chasing the "perfect" vaginal microbiome
    The truth is that vaginal health is far more complex than a single test result or social media trend. While the vaginal microbiome is an important part of women's health, there is no such thing as a perfect vagina, and many of the claims circulating online deserve a closer look.
    If you are experiencing vaginal dryness, recurrent infections, discomfort, sexual concerns, pelvic floor symptoms, or simply have questions about your vaginal health, there are evidence-based options available. The right approach depends on your symptoms, goals, and stage of life.
    As always, my goal is to help you separate science from hype so you can make informed decisions about your health.
    If you'd like personalized guidance, we'd be happy to help. Schedule a consultation with our team at Complete Midlife Wellness Center to discuss your concerns and explore the options that may be right for you.

    https://completemidlifewellnesscenter.com
    RESOURCES:Live Vaginal Laser Therapy & O-Shot Procedurehttps://youtu.be/_ZZYgWAgUYI
    Urinary Incontinence? Here are your optionshttps://youtu.be/BvN2-Z3SIdQ
    Labiaplasty 101https://youtu.be/jRAsEXTPU9A
    Amazon - VagiBiomhttp://bit.ly/4oTuzHX
    Amazon - Genetic testinghttps://a.co/d/03BqtsZS
    ARTICLES:Randomized Trial of Lactin-V to Prevent Recurrence of Bacterial Vaginosishttps://www.nejm.org/doi/full/10.1056/NEJMoa1915254
    Vaginal Injection of Platelet-Rich Plasma for Sexual Function: A Randomized Controlled Trialhttps://pubmed.ncbi.nlm.nih.gov/41855531/
  • Empowering Midlife Wellness with Dr. Susan

    Progesterone Levels Explained: What Every Woman Should Know

    2026/06/19 | 12 mins.
    Progesterone is one of the most important reproductive hormones in a woman's body, yet there is often confusion about what progesterone levels actually mean and whether they should be measured.

    In this video, I explain what progesterone is, how it is produced, how levels change throughout a woman's reproductive life, and why interpreting a progesterone blood test is often more complex than many people realize.

    We'll discuss

    The role of progesterone in the menstrual cycle and reproductive health
    How progesterone levels change from the reproductive years through perimenopause and menopause
    The normal rise and fall of progesterone during a menstrual cycle
    Why progesterone levels can vary dramatically from day to day in perimenopause
    Common signs and symptoms associated with declining or fluctuating progesterone
    When progesterone testing may provide useful information—and when it may not
    Why symptoms and clinical context are often more informative than a single laboratory value

    One of the most important concepts to understand is that progesterone is not a static hormone. Its levels change throughout the cycle and can fluctuate significantly during perimenopause, making a single blood test difficult to interpret in many situations.

    My goal is to help you better understand the physiology of progesterone so you can make more informed decisions about your health and have more productive conversations with your healthcare provider.

    Interested in booking an appointment? Click here: https://completemidlifewellnesscenter.com
  • Empowering Midlife Wellness with Dr. Susan

    Hormone Therapy Timing: When to Start, When to Stop, and Is It Ever Too Late?

    2026/06/12 | 19 mins.
    Now that we understand much more about the potential health benefits of menopausal hormone therapy, I want to tackle one of the questions I hear most often: when should you start hormone therapy, when should you stop it, and is there ever a point when it's too late to begin?

    We know that starting estradiol close to menopause can help support healthy blood vessels and may reduce the risk of cardiovascular disease and other age-related conditions. But what if you weren't offered hormones when you first entered menopause and are now 10 or more years beyond it?

    In this video, I discuss what the research actually shows about starting estrogen later in life, who may benefit, who may not, and why some of the perceived risks have often been overstated or misunderstood.

    I'll also take a closer look at the Women's Health Initiative study that changed the course of hormone therapy conversations more than 20 years ago. We'll discuss what the study found, the limitations that were recognized over time, the lessons we learned from it, and why its conclusions do not apply equally to all women.

    I'll also discuss the ELITE trial and what it taught us about the timing of hormone therapy, including findings that suggest estrogen may help preserve vascular health when started closer to menopause.

    I'll explain what the researchers discovered, how these findings have influenced our understanding of hormone therapy today, and what they may mean for women who are considering treatment now or wondering whether they missed their opportunity to benefit from it.

    Whether you're considering hormone therapy for the first time, wondering if you should continue taking it, or questioning whether you've missed your opportunity to benefit from it, I'll walk you through what we know today.

    By the end of this video, you'll have a clearer understanding of the evidence behind starting, stopping, and starting hormone therapy later in life—and the questions you should be asking when making these decisions for yourself.

    If you'd like personalized guidance, you can schedule an appointment with me or one of our Menopause Society Certified Practitioners. We offer in-person care in Houston and Cypress, Texas, as well as virtual appointments for patients throughout Texas, California, and New Mexico.

    https://completemidlifewellnesscenter.comhttps://completemidlifewellnesscenter.com/on-hormone-
    consultations/info/https://completemidlifewellnesscenter.com/virtual-medical-care/
  • Empowering Midlife Wellness with Dr. Susan

    Do I Still Need a Pap Smear? Brand-New ACOG Cervical Cancer Screening Guidelines Just Released

    2026/06/03 | 20 mins.
    New cervical cancer screening recommendations have just been released and many women haven't heard about them yet. These brand-new ACOG guidelines are among the most important updates we've seen in years, and they may change how often you need screening, which tests are recommended, and when screening can safely stop.

    In this video, I'm breaking down these newly released recommendations and explaining what they mean for you.

    We'll talk about the differences between Pap tests and HPV tests, how often screening is recommended at different ages, and why the guidelines have evolved as our understanding of cervical cancer prevention continues to improve.

    My goal is to help you understand the science behind the guidelines so you can make informed decisions about your health with confidence.

    One important takeaway:
    even if you don't need a Pap smear every year, that doesn't mean you should skip your annual wellness visit. Cervical cancer screening is just one part of preventive care, and a comprehensive wellness exam should address many other aspects of your health as you move through midlife and beyond.

    Learn more about our Annual Wellness Experience:
    completemidlifewellnesscenter.com/annual-wellness/

    Interested in booking an annual wellness appointment?
    completemidlifewellnesscenter.com

    We offer in-person care in Houston and Cypress, Texas, as well as virtual medical care for patients throughout Texas, California, and New Mexico.

    As always, this information is intended for educational purposes and should not replace personalized medical advice from your healthcare provider.

    For more evidence-based information about women's health, menopause, hormone therapy, longevity, and thriving in midlife, be sure to subscribe to the channel.

    RESOURCES:
    New ACOG Cervical Cancer Screening Guidelines
    drive.google.com/file/d/1IMPnlA7b…view?usp=sharing

    Detailed recommendations and information on exceptions (such as previous hysterectomies or high-risk history) can be viewed directly on the ACOG Cervical Cancer Screening page.
    www.acog.org/womens-health/info…l-cancer-screeningWe'll talk about the differences between Pap tests and HPV tests, how often screening is recommended at different ages, and why the guidelines have evolved as our understanding of cervical cancer prevention continues to improve.My goal is to help you understand the science behind the guidelines so you can make informed decisions about your health with confidence.RESOURCES:New ACOG Cervical Cancer Screening Guidelineshttps://drive.google.com/file/d/1IMPnlA7blnGD2GsC-MHrj2OCfWAI3WSO/view?usp=sharing Detailed recommendations and information on exceptions (such as previous hysterectomies or high-risk history) can be viewed directly on the ACOG Cervical Cancer Screening page.https://www.acog.org/womens-health/infographics/cervical-cancer-screening
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About Empowering Midlife Wellness with Dr. Susan
Meet Dr. Susan, a renowned Board-Certified Gynecologist and Certified Menopause Practitioner through the Menopause Society (former NAMS), focused on hormone optimization, sexual wellness, and longevity. She's the pioneering force behind the Complete Midlife Wellness Center in Houston, TX, and the best-selling author of "Sexually Woke." Tune into her engaging podcast, "Empowering Midlife Wellness," for insightful conversations. Boasting numerous accolades, including the Texas Super Doctor award and being consistently rated among Houston's top gynecologists, Dr. Susan combines her medical expertise with her passion as an ICF-certified life and leadership coach. Outside the clinic, she's a fitness enthusiast, marathon runner, Ironman triathlete, and mother of three young adults. Join her YouTube channel for empowering wellness strategies designed for midlife and beyond. Content is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your health care provider with any questions you have regarding a medical or mental health condition, and before undertaking any diet, dietary supplement, exercise, or other health program.
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