Act Two Women's Wellness LLC

Act Two Women's Wellness LLC Providing comprehensive care for women in perimenopause and early menopause.

08/30/2026

PCOS or PMOS has a complicated history; we believe that 1 in 8 women worldwide have this condition, but due to changing and unclear diagnostic criteria, it’s possible that it has gone underdiagnosed for many years.

If you have or suspect you have this condition, follow along for more info.

Part 1: historical definitions and pathophysiology of PCOS

NIH then Rotterdam criteria provided us with the 3 features that ultimate became the core understanding of PCOS:
1. Oligomenorrhea or anovulation with

08/28/2026

Alcohol is contributing to your fatigue, weight gain, brain fog, and possibly even making your hot flashes worse.

It’s true.

Even mild alcohol consumption can worsen the symptoms of perimenopause and menopause. And many women entering their 30s and 40s become more sensitive to the effects of alcohol and are more prone to histamine reactions as well.

so if you are starting to see changes in your energy level, your brain fog is getting worse, yes, it’s good to talk to a professional about your symptoms of hormonal changes, but just like with any other lifestyle modification, we have to consider that even mild alcohol consumption can contribute to these symptoms. Just like we aim to improve our diet and exercise routine, we also need to look at our alcohol consumption as part of that.

And we aren’t talking about alcohol addiction or alcohol abuse, we are talking even casual alcohol consumption can contribute to the symptoms.

If you are someone who struggles with anxiety or social anxiety and you use alcohol to help you relax, it might be worth it to talk to your medical provider about other potential options that don’t come with as many side effects or different side effects.

OK that’s it, I’ve said what I needed to say and now it’s out there. I can’t wait to see how popular this makes me!

08/28/2026

Sometimes the answer isn’t that complicated, you just have to look at the whole puzzle instead of just the one piece that’s in your hand.

Specialists and sub-specialists are amazing resources and are important to quality healthcare. But sometimes we really miss out on seeing the big picture.

Also the goal of healthcare should be to prevent, not treat. In this case if we treat the heavy periods, we prevent multiple other medical conditions, instead of treating multiple medical problems without addressing the underlying issue.

08/26/2026

If you’re new here, Hi! And Welcome!
And if you’re not new, Hi also.

I’m Katie Rubin and I’m a nurse practitioner with my own practice providing care for women in perimenopause and early menopause, Act Two Women’s Wellness, located in Louisville, KY and serving the states of KY and IN.

I attended the University of Rochester in Rochester, New York (Go Yellowjackets?) where I completed a BS in nursing, a BA in political science, and a Masters in Nursing in 2009 with board certification as a Family Nurse Practitioner, meaning I was educated and trained to treat patients of all ages.

I currently work some days in hematology/oncology and breast health, other days I see patients in my practice. I do this because I love what I do. I love helping people, especially women, and I saw a huge gap in care in our community in this area of women’s health. I also saw that women need more time with their provider, and more than just a prescription but education and counseling too.

There is no better feeling for me than when a woman comes to a follow up appointment in my clinic reporting that she is sleeping better, has more energy, and feels more like herself.

So this page is just me, posting very amateurly filmed educational videos, case studies, or rants about the challenges of the modern healthcare machine. I’m ALWAYS open to your feedback, questions, or topic requests.

I won’t be at the top of the algorithm.
I won’t be posting every day.
I won’t be using AI, at least for 95% of what I put on here.
I won’t be selling you things you don’t need.
I won’t be advising you to use products you don’t need (based on evidence.)
And if it’s something you DO need, I will be the one helping you find the cheapest way to get it.

So if you DO want to see my videos, you’ll probably have to like and follow. And if you have friends who might want to see some content about Women’s health issues, feel free to share with them.

And lastly, disclaimer: I am A medical provider, but I am not YOUR medical provider (unless I actually am); this page is general information, not medical advice directed to you. Always ask your own provider.

08/24/2026

It ain’t easy being a woman.

08/22/2026

A recurrent issue with recurrent UTI: under treatment or improper treatment.

What should have happened for this woman was after her 2nd or 3rd UTI, she should have been started on va**nal estrogen and monitored. It is less invasive, lower risk, and lower cost than a surgical procedure to install a bladder sling. The procedure requires sedation, and implants a small mesh to support the urethra or the neck of the bladder. Typically recovery takes 6 weeks before you can resume regular activity. Women can lose muscle and mobility much faster than that. There is no such issue with va**nal estrogen.

She may have ultimately still benefitted from a bladder sling down the line, even if she had tried va**nal estrogen first, but now we’ll never know.

Like and follow for more women’s health educational content.

**na

08/22/2026

“Are you smarter than AI?” could be a great idea for a new game show. Instead of “Are you smarter than a 3rd grader?” Ken Jennings went up against a computer once on Jeopardy in 2011, IBM’s Watson, but it’s even more relevant nowadays. I would watch…

But anyway… How did you do??? Did you know the answer?

This is just a reminder to not trust everything on the internet, whether it’s AI or a human, no one is infallible, and the best use of AI is not to replace humans, but to be used as a tool by humans, in collaboration with their experience and expertise.

08/22/2026

Stay tuned for my next educational series. The topic is PMOS, Polyendocrine Metabolic Ovarian Syndrome. Formerly known as PCOS, polycystic ovarian syndrome.

i’ll be focusing on basic pathophysiology, diagnosis and treatment, and how this affects women through different stages of life, with focus on what we know about women with PMOS/PCOS in the late reproductive years.

Like, comment, and follow to be sure you get updates when those videos post!

08/21/2026

A patient with Anthem BCBS insurance learned from her pharmacy that the Slynd (drosperinone- a synthetic progestin only pill) I ordered for her is not on Anthem’s formulary. I was not notified by the pharmacy or the insurance, only she was, so while awaiting more info, I took to the internet to see what is on their formulary or in what instances they will cover Slynd.

I didn’t ask for its opinion but it gave it to me anyway and I’m embarrassed for it. I’m also kinda shocked by the lack of BASIC information the AI has.

Read the highlighted portion and let me know if you can figure out what AI got so wrong.

08/20/2026

Important Reminder:
Perimenopause and Menopause are VERY different.
Not just in their presentation, but in their treatment.

Yes they involve the same hormones, but what those hormones are doing and how those hormones respond to treatment are completely different.

menopause is typically a lot easier to treat because the primary determinant of your symptoms will typically be estrogen deficiency and it’s relatively simple to increase your estrogen level with replacement.

Perimenopause is a progressive and ever-changing process, from monthly cycle to cycle and year upon year the hormones continuously change and fluctuate. Your a very in function will be imperfect and unreliable and sometimes so will the treatment.

Some women in perimenopause might find what works for them within a few weeks to months, but most are going to require multiple adjustments and regular follow up. It’s really important to not expect your medications to work the day you start taking them. It’s also important to know that you might try some thing that works for your friend, but when you’re taking it it makes you feel worse and not better. There are so many options out there and it can be hard to predict how your body is going to respond, for better or worse.

Be patient, be persistent.
And of course if you ever experience any urgent or emergent symptoms physically or mentally you should always know how to reach an emergency provider or when in doubt call 911 or go to the emergency room.

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3924 S Dupont Square, Ste D
Louisville, KY
40207

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