Urologist Reveals 75 Percent of Menopausal Women Denied Life-Saving Hormone Prescriptions
"More than 75% of people in large database collections are not getting prescriptions for this. And so women are not getting access to generic medications that could save their lives and also really improve quality of life."
About this episode
In this episode of The Diary of a CEO, host Steven Bartlett speaks with Dr. Rachel Rubin, a urologist and sexual health specialist, for an unflinching examination of systemic failures in women's healthcare. The conversation opens with Rubin's declaration that she is 'filled with rage' because women across all socioeconomic levels—from Halle Berry to Melinda Gates—are being denied access to life-saving information and treatments for hormonal health, sexual function, and menopause. Rubin reveals shocking gaps in medical education: the word 'clitoris' does not appear in mandatory OB-GYN training checklists, over 75% of menopausal women are denied prescriptions for vaginal hormones that prevent deadly UTIs, and only 1.7% of eligible women receive hormone replacement therapy despite updated safety evidence. She explains that testosterone in women peaks in their 30s—not at menopause—and that 23% of women have clitoral adhesions blocking orgasm, a condition easily fixed but almost never diagnosed because doctors don't examine the clitoris. The episode covers the biology of female arousal, the orgasm gap between men and women, how birth control affects libido, the safety and efficacy of vaginal estrogen creams available for as little as $14, and why penetrative sex is not how most women orgasm. Rubin dismantles myths around hormone therapy stemming from a misinterpreted 2002 study, advocates for men to understand female anatomy as a relational duty, and argues that education and communication—not just psychosocial factors—are essential to solving widespread sexual dysfunction. Bartlett shares personal stories of past relationship struggles caused by ignorance, underscoring Rubin's thesis that basic biological literacy could save countless partnerships.
Key takeaways
- Over 75% of menopausal women are denied vaginal hormone prescriptions that prevent UTI deaths and improve sexual function despite being safe and cheap.
- The word clitoris does not exist in mandatory OB-GYN training checklists in 2026, leaving gynecologists untrained in female sexual anatomy.
- Only 1.7% of women who should receive hormone replacement therapy are actually getting it due to medical education gaps stemming from a misinterpreted 2002 study.
- 23% of women have clitoral adhesions that block orgasm; a simple office procedure can improve sexual satisfaction by up to 70%.
- Female testosterone levels peak and decline in a woman's 30s, not at menopause, contributing to libido changes often dismissed by doctors.
- Halle Berry was misdiagnosed with genital herpes when she actually had genitourinary syndrome of menopause, illustrating failures even among affluent patients.
- Most women do not orgasm from penetration alone because the clitoris, not the vagina, is the primary site of female sexual pleasure.