Why is lichen sclerosus so commonly missed?

Lichen sclerosus is frequently missed because many clinicians are not examining the vulva properly — or at all. Physicians trained in standard residency programs were often taught not to examine the clitoris, leaving vulvar conditions undetected during routine exams. Without a thorough visual and physical assessment of the entire vulva, lichen sclerosus can go undiagnosed for years while symptoms are attributed to other causes.

Why do some BV DNA tests produce false positives?

Some DNA tests used for bacterial vaginosis only check for Gardnerella, which is naturally present in many healthy vaginal microbiomes. Testing for a single organism without evaluating the broader microbiome can produce false positives and lead to overtreatment that further disrupts vaginal flora. A more complete picture requires broader testing and clinical evaluation.

Can one-dose Monistat cause a reaction?

Yes. One-dose Monistat is not recommended by some vulvovaginal specialists because its concentrated formulation can cause severe inflammatory reactions in the vulva. Multi-day formulations are generally better tolerated. Women with recurrent yeast infections or unusual reactions to over-the-counter treatments should see a clinician with specialized vulvovaginal health training.

Why does anatomical language matter in women's healthcare?

Teaching women accurate anatomical language — the difference between the vulva and vagina, labia minora and labia majora — improves clinical outcomes. Precise language allows patients to describe symptoms accurately, which helps providers identify what is actually wrong. Imprecise or absent anatomical vocabulary contributes to missed diagnoses and significant delays in appropriate treatment.

Why did three OB-GYNs stop delivering babies to focus on gynecology?

Dr. Sameena Rahman, Dr. Meredith McClure, and Dr. Ashley Fuller all transitioned out of obstetrics to focus on gynecology-only practices after recognizing significant gaps in their training around vulvovaginal health. Standard residency programs did not adequately cover vulvar anatomy, examination technique, or complex conditions like lichen sclerosus, desquamative inflammatory vaginitis, or recurrent infections — leaving them underprepared for the patients who needed them most.

What is the Labialogic podcast?

Labialogic is a podcast co-hosted by Dr. Meredith McClure and Dr. Ashley Fuller, two gynecologists who specialize in vulvovaginal health. The podcast focuses on the conditions most often missed or dismissed in standard gynecological care, including lichen sclerosus, recurrent bacterial vaginosis, desquamative inflammatory vaginitis, and complex vulvovaginal conditions.

Teaching Anatomical Language, AI, Private Equity, and Why Three OB-GYNs Stopped Delivering Babies

May 15

Written By Sameena Rahman, MD, FACOG, IF, MSCP

Women's health is a team sport. But it took us years after residency to realize how much we weren't taught about vulvovaginal health. In this episode, I sit down with Dr. Meredith McClure from Dallas and Dr. Ashley Fuller from Seattle. They co-host the Labialogic podcast and specialize in treating conditions most doctors miss, such as lichen sclerosus, recurrent BV, and yeast infections that won't go away. All three of us left obstetrics years ago and now focus on gynecology. Our training had major gaps. Examining the clitoris was off-limits. Vulvar anatomy wasn't covered properly. The complex cases we see every day? Nobody prepared us for those. We discuss recurrent infections, why some BV tests aren't accurate, AI in medicine, private equity's impact on healthcare, and how teaching women proper anatomical language changes outcomes.

What You'll Learn:

Why did all three of us stop delivering babies and focus on gynecology-only practices?
How lichen sclerosus and other vulvar conditions get missed when doctors don't examine properly.
Why some DNA tests for BV lead to false positives, and there's no one-size-fits-all treatment approach.
Why one-dose Monistat can cause severe inflammatory reactions.
How teaching women proper anatomical language improves treatment outcomes.
The role of AI in medicine and why private equity is problematic for healthcare.

Every episode of Gyno Girl Presents is a conversation I wish more women could have with their doctors — without the 10-minute clock running. Subscribe wherever you listen, and if this episode helped you, share it with a woman who needs to hear it.

Lichen SclerosusRecurrent BVVulvovaginal HealthWomen's HealthMedical GaslightingVulvar AnatomyVaginal InfectionsAnatomical LanguageDesquamative Inflammatory VaginitisWomen's Sexual HealthPelvic HealthGynecology

Sameena Rahman, MD, FACOG, IF, MSCP

Dr. Sameena Rahman is a board-certified OB/GYN and founder of The GSM Collective in Chicago. She specializes in sexual medicine, menopause care, and complex gynecology, offering personalized, concierge-level care through an integrative lens.

Teaching Anatomical Language, AI, Private Equity, and Why Three OB-GYNs Stopped Delivering Babies

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Teaching Anatomical Language, AI, Private Equity, and Why Three OB-GYNs Stopped Delivering Babies

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