Oct 13, 2026 · 50 min · 15 segments
📩 Get Dr. Vonda's insights Want to understand what's happening in your body — and what to do next? Each week, Dr. Vonda shares science-backed guidance on strength, bone health, muscle, and…
I think that comes from a lack of curiosity, because the reality is, when a little old lady or anyone has a bladder infection, they can get dizzy and they fall down from the dizziness, not 'cause they're clumsy, not 'cause they broke a bone, until they fell.
And I want you to know, five times yesterday in my clinic, I wrote for vaginal estrogen.
It should be called ortho prevent- prevention, sepsis prevention cream, right? It should be called orthopedic sepsis prevention cream.
'Cause what surgeon wants to do a hip replacement or a shoulder replacement or a knee repair if their, if their patient has bacteria in their bladder and a risk of urinary...
Your, your work is worse, and their risk of returning to the hospital is high.
Well, because we put metal in bones, and metal attracts any bacteria floating through the blood.
So orthopedic surgeons, if you're listening, or wives of them, this is orthopedic prevention medicine.
But before we leave vaginal estrogen, when we talk about it preventing infection, altering the microbiome in those places, are we also talking about, okay, estrogen receptors are on every tissue, all the mucal- mucosal tissue, the muscle of the pelvic floor, the bladder, I don't know, my dear, intima.
Is it skin care? Is it structural? What is the mechanism when estrogen sits in the receptors that provides all this protection?
protection?Yeah, it's a couple things, um, because again, just the health of the tissue improves, the quality of the tissue improves, the lubrication.
I would say hormones are like nature's lubrication, so they help your joints, right? Like, hormones help joints, which you published on, right? The musculoskeletal symptoms.
There's a reason we get dry eyes and itchy ears and, and dry vaginas in menopause is 'cause you lose the lubrication.
And so adding hormones back improve the lubrication, which is, again, your brakes, when they have fluid, work a lot better when there's fluid around.
... of the tissue, but it also helps recruit sort of lactobacillus, which is the healthy bacteria that create that as- acidic environment.
I think that comes from a lack of curiosity, because the reality is, when a little old lady or anyone has a bladder infection, they can get dizzy and they fall down from the dizziness, not 'cause they're clumsy, not 'cause they broke a bone, until they fell.
And I want you to know, five times yesterday in my clinic, I wrote for vaginal estrogen.
It should be called ortho prevent- prevention, sepsis prevention cream, right? It should be called orthopedic sepsis prevention cream.
'Cause what surgeon wants to do a hip replacement or a shoulder replacement or a knee repair if their, if their patient has bacteria in their bladder and a risk of urinary...
Your, your work is worse, and their risk of returning to the hospital is high.
Well, because we put metal in bones, and metal attracts any bacteria floating through the blood.
So orthopedic surgeons, if you're listening, or wives of them, this is orthopedic prevention medicine.
But before we leave vaginal estrogen, when we talk about it preventing infection, altering the microbiome in those places, are we also talking about, okay, estrogen receptors are on every tissue, all the mucal- mucosal tissue, the muscle of the pelvic floor, the bladder, I don't know, my dear, intima.
Is it skin care? Is it structural? What is the mechanism when estrogen sits in the receptors that provides all this protection?
protection?Yeah, it's a couple things, um, because again, just the health of the tissue improves, the quality of the tissue improves, the lubrication.
I would say hormones are like nature's lubrication, so they help your joints, right? Like, hormones help joints, which you published on, right? The musculoskeletal symptoms.
There's a reason we get dry eyes and itchy ears and, and dry vaginas in menopause is 'cause you lose the lubrication.
And so adding hormones back improve the lubrication, which is, again, your brakes, when they have fluid, work a lot better when there's fluid around.
... of the tissue, but it also helps recruit sort of lactobacillus, which is the healthy bacteria that create that as- acidic environment.
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