Dr. Selk interviews Dr. Martha Goetsch who is a long-term researcher and clinician specializing in vulvar conditions at the Oregan Health and Sciences Unit. In this week's episode they discuss some of her recent research on estrogen in vulvar pain. Topics covered include the background and reasons for exploring this area, theories behind the cause of vulvar pain, methods studied to reduce vulvar pain, and results after implementing these methods in post-menopausal women. They also discuss estrogen regimens in post-menopausal patients, differentiating between atrophy/dryness and pain, systemic absorption of topical estrogens, how long to treat with estrogen post-menopause, reassuring patients about estrogen use, the utility and importance of using lidocaine in these patients and what concentration of lidocaine to use.