Dr. Selk interviews Dr. Michelle Jacobson, a menopause expert gynaecologist in Toronto, about treating vulvovaginal issues during and after menopause. Topics covered include changes in the vulva and vagina in menopause, counselling around local and systemic estrogen therapy (safety/when to use systemic therapy/combining therapies/choosing between vaginal estrogens/DHEA/combing estrogens and topical steroids), non-hormonal over-the-counter treatments for menopausal symptoms, and sexual counselling in post-menopausal patients.