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

LISTEN TO THE PODCAST – Also available on Spotify and Apple Podcasts

In this episode of the Thyroid Pharmacist Healing Conversations podcast, I spoke with Dr. Anna Cabeca, triple board-certified OB-GYN, functional medicine expert, and founder of The Girlfriend Doctor, about the questions so many women secretly want answered – but are often too embarrassed to ask.

We get into everything from libido changes during perimenopause and postpartum recovery to vaginal health, painful intercourse, HPV, hormones, fertility, and why many women feel dismissed when they bring these concerns to their doctors. Dr. Anna has such a warm, honest way of talking about women’s health, and I know so many listeners are going to feel seen and validated by this conversation.

One of the biggest takeaways from this episode is that so many symptoms women assume are just “part of aging” may actually be signs that the body needs more support. Whether it’s vaginal dryness, bladder issues, low libido, painful sex, or mood changes after pregnancy, there are often root causes and solutions worth exploring.

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.

Freebies

• Free trial of Julva® cream
• Dr. Anna’s Hormone Fix Quiz

Guest Resources / Connect with Dr. Anna Cabeca

• Visit Dr. Anna’s Website
• Listen to The Girlfriend Doctor Podcast
• Follow Dr. Anna on Instagram
• Sexual CPR Program: Dr. Anna’s holistic approach to supporting intimacy, libido, and sexual well-being.
• The Hormone Fix: Burn Fat Naturally, Boost Energy, Sleep Better, and Stop Hot Flashes, the Keto-Green Way by Dr. Anna Cabeca
• Keto-Green 16: The Fat-Burning Power of Ketogenic Eating + The Nourishing Strength of Alkaline Foods = Rapid Weight Loss and Hormone Balance by Dr. Anna Cabeca

Supplements We Discussed

• Mighty Maca Plus®: Dr. Anna’s signature adaptogenic blend of over 30 superfoods and botanicals to support adrenal health, hormone balance, and detoxification.
• Julva® Cream: Used to rejuvenate vulvar tissue, improve moisture, and support local hormone balance.
• Julva® Kiss: A DHEA-based lip renewal complex that can moisturize, plump, and reduce fine lines.
• Progesterone – Discussed for postpartum hormone support, mood balance, anxiety reduction, and sexual health.
• Omega-3 Fatty Acids (EPA/DHA) – Dr. Anna shares that omega-3 depletion is extremely common after pregnancy and may impact mood and inflammation. Consider Pure Encapsulations EPA/DHA Essentials.
• DHEA – Supports vaginal tissue health, elasticity, bladder function, and libido, especially during aging and menopause.
• Testosterone – Discussed as an important hormone for drive, muscle support, libido, and vaginal tissue integrity. Consider a formulation targeted for women like Hormone Fixxr.
• Vaginal Targeted Probiotics – Used to support the vaginal microbiome, bladder health, fertility, and vaginal comfort. Consider Seed’s VS-01 Vaginal Synbiotic.
• Adaptogenic Herbs – Used to support adrenal health and healthy stress responses.
• Vitamin C – Foundational for adrenal support.
• B Vitamins – Discussed for adrenal and hormone support.
• Maca – Adaptogenic root traditionally used to support hormone balance, adrenal function, energy, and libido. Used as part of Dr. Anna’s adaptogenic support blend.
• Polyphenol Blends – Discussed for hormone and adrenal support.
• Berberine – Mentioned for blood sugar balance and PCOS-related symptoms. Consider Rootoclogy Berberine.
• Myo-Inositol – Discussed as a supportive nutrient for women with PCOS tendencies. Consider Rootcology Myo-Inositol Powder.
• Zinc – Mentioned topically and orally to support hormonal balance and unwanted facial hair concerns. Consider Pure Encapsulations Zinc 30.

Other Tools and Resources

• Transvaginal Ultrasound – An important but underutilized tool for evaluating pelvic pain, ovarian cysts, fibroids, and other gynecological concerns.
• Pelvic Exams and Pap Smears – Dr. Anna emphasizes the importance of continuing pelvic health screenings during menopause and beyond.
• Vaginal Microbiome Testing – Used to assess bacterial balance and monitor improvements with probiotics and hormonal support. Companies like Evvy and Juno Bio offer at-home testing kits.
• Oxytocin Nasal Spray – May offer support for intimacy, calm, and vaginal dryness.
• Oxytocin Vaginal Suppositories – May support vaginal moisture and tissue health.
• Red Light Therapy Vaginal Wands – May help with pelvic floor strength and circulation. Consider Fringe Heals (get 10% off with this link) and Joylux.
• Non-Hormonal Birth Control Methods – Discussed as alternatives to hormonal birth control for women concerned about libido and hormonal suppression.
• Check out our previous podcast episode featuring Dr. Anna, Menopause is Mandatory, Suffering is Optional: Thriving in Your Second Spring.

Books and Articles About Women’s Hormones, Libido, and Menopause

• Did Your Thyroid Condition Start or Worsen During Perimenopause?
• Estrogen Dominance as a Trigger for Hashimoto’s
• Seed Cycling for Hormonal Health
• Are Your Adrenals Sabotaging Your Health?
• How Do Adaptogenic Herbs Benefit Hashimoto’s?
• 14 Ways Birth Control Pills Rob Us of Our Health
• Solutions to Increase Low Libido in Those with Hashimoto’s

Get the Full Episode Transcript

Let’s Connect!

• Follow me on Instagram: @izabellawentzpharmd
• Get my FREE weekly thyroid & gut health newsletter: Sign up here
• Subscribe & Review: If you loved this episode, please leave a review on Apple Podcasts or rate it on Spotify!

Got questions? Drop them in the comments! 🙂

About Our Host

Dr. Izabella Wentz 

Dr. Izabella Wentz is a compassionate, innovative, solution-focused integrative pharmacist dedicated to finding the root causes of chronic health conditions. Her passion stems from her own diagnosis of Hashimoto’s thyroiditis in 2009, following a decade of debilitating symptoms.

Dr. Izabella Wentz has written several best-selling books, including the New York Times bestseller Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause, the protocol-based #1 New York Times bestseller Hashimoto’s Protocol: A 90-Day Plan for Reversing Thyroid Symptoms and Getting Your Life Back, the Wall Street Journal bestseller Hashimoto’s Food Pharmacology: Nutrition Protocols and Healing Recipes to Take Charge of Your Thyroid Health, and Adrenal Transformation Protocol. Her latest book, IBS: Finding and Treating the Root Cause of Irritable Bowel Syndrome, is now out in the world, and available here!

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About Our Guest

Anna Cabeca, DO, OBGYN, FACOG, is the best selling author of The Hormone Fix, Keto-Green 16, and MenuPause. Dr. Anna is triple-board certified and a fellow of gynecology and obstetrics, integrative medicine, and anti-aging and regenerative medicine. She holds special certifications in functional medicine, sexual health, and bioidentical hormone replacement therapy.

She lectures frequently on those topics and shares the secret behind the ebb and flow of intimacy as she demystifies the fascinating hormonal changes over time. She will help you discover how the “love hormone,” oxytocin, can breathe life into your relationship, how cortisol can take it away, and how the delicate balancing act of those hormones can reignite your libido and support a healthy relationship – most importantly, the one you have with yourself.

She is sassy, blunt, speaks from the heart, and has a wonderful sense of humor, and this is why we call her The Girlfriend Doctor, because everyone needs a friend like her!

She has personally developed natural products to help women balance hormones and thrive through menopause, including the highly acclaimed Julva® cream for the vulva, and MightyMaca® Plus, a powerful superfood blend. She lives in Dallas with her daughters, horses, and dogs.

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