drmilhouse

03/10/2026

🗣️ New Superpower UNLOCKED post menopause!!

I love my freaking job!!!!


*xualhealthmatters
*xaftermenopause

03/09/2026

03/06/2026

I can’t teach you how to Dougie… but I can teach you how to care for v***as. 💁🏾‍♀️

So grab your 🖊️ and take 📝.

Because the truth is — v***ar health is still wildly under-taught in medicine. Too many providers were never properly trained on how to examine the v***a, recognize v***ar disease, or confidently manage these conditions.

And our patients deserve better.

That’s exactly why and I, in partnership with ***ai.co and .hirsch.academy - created an entire Vulvovaginal Masterclass designed for clinicians who want to actually learn how to do this well.

Inside the masterclass we cover:
• How to perform a proper v***ar exam
• How to recognize and diagnose v***ar conditions
• Evidence-based treatment strategies
• When and how to perform a v***ar biopsy

If you take care of humans with v***as, this is training you should have gotten in residency — but probably didn’t.

So we built it.
LINK IN BIO ☝🏾☝🏾☝🏾☝🏾☝🏾

***ahealth

03/05/2026

Doctor friends- Are you doing this when you prescribe vaginal estrogen?

03/03/2026

Lots of new faces round here 👋🏾

I’m Dr. Fenwa Milhouse — board-certified urologist, s*xual medicine specialist, pelvic floor reconstructive surgeon and unapologetic advocate for better conversations about what’s happening down there.

I treat both 🍆 and 🐱owners— from s*xual dysfunction, perimenopause, hormone therapy to urinary issues and cosmetic ge***al procedures. Yes, all of it. Nothing is too awkward here.

I cuss a little (ok- a lot 🫣🤷🏾‍♀️)

I don’t believe in whispering about v***as and pen*ses.

I don’t believe in tiptoeing around inequity.

I am unapologetically me.
I love what I do.
The people’s urologist

Welcome!!! 🤗

02/27/2026

Colleagues: PLEASE spend the extra 2 minutes it takes to show the patient how to use coochie cream (vaginal estrogen) properly. 🙏🏾

It greatly improves compliance. Learn from my mistake.

02/27/2026

02/26/2026

Menopause whilst differentially abled
Menopause whilst Muslim
Menopause with a chronic illness or autoimmune disease
Menopause whilst uninsured
Menopause in a rural setting

Let your voices be lifted up.

02/25/2026

BACK BY REQUEST because there’s a whole lot of new faces here and I want to make sure all of you know what you’re doing out there with your 🐱 cream.

Tell your mamas
Tell your sisters
Tell your friends
Tell your wives
Tell your daughters

02/24/2026

No one knows what to do with 🐱 in medicine… and it shows.

I’m a urologist.
I treat both men and women’s intimate health.

And let me tell you something:

We do not see the same systemic barriers in men’s health that we see in women’s health.

Men get:
✔️ Clear terminology
✔️ Structured exams
✔️ Standardized treatment algorithms
✔️ Direct-to-consumer marketing
✔️ Billion-dollar investment pipelines
✔️ Front-page headlines

When men struggle with erections, there are commercials during the Super Bowl.
When women struggle with pain, dryness, or**sm, or arousal?
They get dismissed.

But women are still fighting for decent medical attention for their 🐱 and basic clinical comfort around their bodies.

This isn’t about competition.
It’s about equity.

We can do better.
We must do better.

Because 🐱 is not mysterious.
It’s not inappropriate.
It’s not optional.
It’s medicine.

02/22/2026

WHAT ABOUT ESTRADIOL PATCHES AND VAGINAL ESTROGEN???

I get this question repeatedly and I totally understand the confusion.

There is SYSTEMIC estrogen replacement and there is VAGINAL estrogen replacement.

Let’s break each down a bit. Keep reading 👇🏾

Consider their roles as separate —>

Systemic estrogen replacement for perimenopause/menopause comes most commonly in the form of patches, topical gels or oral pills. These forms of HRT are for the “body” symptoms of menopause like hot flashes, night sweats, mood changes, brain fog, joint pain, etc. These forms increase estrogen levels in your blood to help alleviate most symptoms of menopause.
But are NOT THE TREATMENT FOR GENITOURINARY SYNDROME OF MENOPAUSE. They don’t specifically help your coochie.

Vaginal estrogen — is THE TREATMENT FOR GENITOURINARY SYNDROME OF MENOPAUSE. It specifically helps your coochie! It gets directly into the v***a and vaginal tissues to improve their health and appearance of your coochie. It can be used alone OR in combination with other forms of estrogen replacement like patches, gels, or pills —-> because it’s low dose enough that it doesn’t affect the levels of estrogen in your blood. You aren’t getting “over estrogenized” combining it with your patch.. If you’re already on the patch or pill but still struggling with recurrent UTIs, vaginal dryness, painful s*x, v***a pain, overactive bladder, etc —> vaginal estrogen SHOULD be added.

Likewise- Vaginal estrogen can’t treat hot flashes and the other menopause symptoms so YOU CAN USE BOTH YOUR ESTROGEN PATCH AND VAGINAL ESTROGEN YALL!

Majority of my own patients are on what I like to call “The Trifecta” - estrogen patch, progesterone, and vaginal estrogen.

I really hope this helps. Spread the knowledge to your friends, your family, your wives, your daughters,