Dr. Shawna Ruple

Dr. Shawna Ruple OBGYN. Mother. Advocate. Educator. Friend.

Vaginal Estrogen: One of the Most Underutilized Tools in Women’s HealthVaginal estrogen is safe for the vast majority of...
06/22/2026

Vaginal Estrogen: One of the Most Underutilized Tools in Women’s Health

Vaginal estrogen is safe for the vast majority of women.

Studies have not shown an increased risk of blood clots, stroke, breast cancer, or heart disease with low-dose va**nal estrogen because very little is absorbed into the bloodstream.

And it’s about much more than intimacy or va**nal dryness.

Vaginal estrogen can help support:
✔️ Vaginal tissue health
✔️ Urinary health
✔️ Prevention of recurrent UTIs
✔️ Burning, irritation, and itching
✔️ Urinary urgency and frequency
✔️ Comfort with exercise and daily activities

As estrogen declines during menopause, the tissues of the v***a, va**na, and urinary tract change. These symptoms are common—but they are not something women have to simply “live with.”

Every menopausal woman should at least have a conversation with her healthcare provider about whether va**nal estrogen is right for her.

05/22/2026

Hormone replacement therapy shouldn’t be based on lab 🧪numbers alone. Symptoms, quality of life, medical history, and individual goals matter most.

That said, labs can still be helpful in certain situations to personalize and optimize a treatment plan — especially when symptoms don’t match expectations, absorption may be an issue, or adjustments are needed.

Good hormone care is individualized medicine, not one-size-fits-all medicine❗️

05/19/2026

Women naturally produce testosterone too — yet there are still no FDA-approved testosterone products specifically designed for women in the U.S.

➡️➡️➡️That means many prescriptions are written ‘off-label,’ which often leads to extra scrutiny, insurance denials, inconsistent dosing concerns, and pharmacists questioning perfectly valid prescriptions.

HOWEVER, there are tons of medications that are prescribed for an “off-label” usage daily, and I don’t get phone calls about those…

Meanwhile, men have multiple approved testosterone options. Women are left trying to navigate barriers, stigma, and outdated assumptions about hormone health.

Women deserve evidence-based care, informed conversations, and access to treatment options that improve quality of life — not shame and unnecessary fear 🙄

05/14/2026

Perimenopause treatment should NOT be based on labs alone. Hormones fluctuate constantly during this stage, and many women with “normal” labs are still struggling with very real symptoms.

Treatment should focus on the whole picture — symptoms, quality of life, history, and goals — not just a number on a lab report. 💛

05/05/2026

If you’re prescribed testosterone gel packets but need more precise dosing, transferring it into a syringe can make things much easier 👇

A few tips:
✔️ Use a new or thoroughly cleaned syringe each time

✔️ Carefully open the packet and squeeze the contents into a clean, dry container (like a small medicine cup). From there, use an oral syringe (no needle!) to draw up the exact amount you need. This allows for more consistent, accurate dosing instead of guessing from the packet.

✔️This small adjustment can make a big difference in consistency and symptom management 💡

*As always, check with your healthcare provider before changing how you measure or apply your testosterone

04/28/2026

Why do women so often have to prove their suffering to receive care?

So many women are asked to justify, quantify, and defend what they’re experiencing before being offered hormone replacement therapy.

We don’t require this level of proof in most other areas of medicine. So why here?

Women deserve to be heard the first time. They deserve evidence-based care without having to jump through hoops or minimize their own experience to be taken seriously.

It’s time to shift from skepticism to support. From gatekeeping to guidance. From “prove it” to “how can we help?”

04/27/2026

Hormone replacement therapy (HRT) has been misunderstood for decades.

In July 2002, widespread misreporting of medical studies led to a dramatic drop in HRT use—creating fear that still lingers today.

What we now know is far more nuanced:
✔️ The route of administration plays a major role in risk
✔️ For many women, appropriately prescribed HRT can actually reduce certain health risks
✔️ Avoiding therapy altogether isn’t always the safer choice

It’s time to move beyond outdated headlines and focus on individualized, evidence-based care.

Women deserve accurate information—not fear-driven decisions.

04/24/2026

🚨 Estrogen Patch Shortage — What You Need to Know

If you’ve been told your estrogen patch is “on backorder”… you’re not alone.

There’s a nationwide surge in demand for estradiol patches, and supply hasn’t kept up. The result? Frustrated patients, pharmacy runarounds, and missed doses.

💡 Here’s what matters:
• This is a supply issue — not a safety issue
• You still have options
• You do NOT have to suffer through symptoms

👉 Talk to your clinician about alternatives:
• Estradiol gels or sprays
• Oral estrogen
• Different patch brands/doses (if available)

Your care shouldn’t depend on what’s in stock.

If your prescription can’t be filled — advocate for yourself, ask questions, and don’t settle for “just wait.”

04/23/2026

Women used to be told “use it or lose it” when dealing with va**nal dryness or pain.

That advice = Not good medicine.

Pain isn’t something to push through. Dryness isn’t a personal failure. And intimacy shouldn’t hurt.

These symptoms are common—especially in perimenopause and menopause—but they’re also treatable. Hormonal changes are real, and so are the solutions.

You deserve better than outdated advice.

If something feels off, it’s worth talking about. You don’t have to suffer in silence.

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