Labia Logic

Vulvar cancer probably isn't topping anyone's list of fun conversation starters, but that's exactly why it needs one. What does vulvar cancer actually look like? Which changes are worth getting checked? And how do you know when a stubborn "yeast infection" might be something else entirely?
In this episode of Labia Logic, Dr. Ashley Fuller and Dr. Meredith McClure are talking about vulvar cancer, including the different types, the HPV-dependent and HPV-independent pathways, and why conditions like lichen sclerosus can increase risk. 
They go over warning signs like persistent itching, burning, sores, bumps, bleeding, and skin changes, plus when a vulvar biopsy may be needed. And yes, they are once again asking you to actually look at your vulva. Know your baseline. Your mirror is not the enemy.
You'll also hear what happens during a vulvar biopsy, how vulvar cancer is typically treated, and why sexual health, pelvic floor therapy, mental health, and quality of life all deserve attention during cancer recovery. 
Most importantly: persistent vulvar symptoms deserve an actual exam, not an endless parade of treatments that aren't working. Know your vulva, notice changes, and don't be afraid to advocate for someone to take a look.
 
Links:
lssupportnetwork.org
lostlabia.com
Labia Logic – The Clinical Course – Meredith McClure MD
 
More about the hosts of Labia Logic:
Dr. Ashley Fuller is a Sexual Medicine Gynecologist and Vulvar Specialist in Seattle, WA. 
www.ashleyfullermd.com
 
Dr. Meredith McClure is a Menopause Specialist, Sexual Medicine Gynecologist, and Vulvar Specialist in Dallas, TX.
www.meredithmccluremd.com
Follow the show on Instagram @labia_logic 
This episode was produced by Audiotocracy Podcast Production.

Perimenopause can feel like your body suddenly changed the rules without sending you the updated handbook. Mood swings, brain fog, sleep problems, weird bleeding, libido changes. And yes, you can still be having perfectly regular periods while all of this is happening. 
So… WTF is actually going on?
In this episode of Labia Logic, Dr. Ashley Fuller and Dr. Meredith McClure are joined by Women's Health Nurse Practitioner Dr. Jaclyn Piasta to talk all about the hormonal chaos of perimenopause. They talk about why perimenopause cannot always be confirmed with a single hormone test but is still a clinical diagnosis. They also cover why symptoms can change from month to month, and how treatment may include birth control pills, IUDs, menopausal hormone therapy, vaginal estrogen, or a mix-and-match approach depending on what your body is doing.
The topics of painful sex, vaginal and urinary symptoms, libido, testosterone, mood changes, bleeding, and the very real mental load of midlife all come up too. 
Here's the hot take: perimenopause is not one-size-fits-all, treatment may need to evolve as your hormones do, and "normal labs" or regular periods do not automatically mean your symptoms should be dismissed. 
Consider this your permission slip to ask better questions, explore your options, and expect care that actually listens to what your body is telling you.
Links:
mymonarchhealthco.com
@jackiep_gynnp on IG
https://ww@monarchhealthclinicianacademy on IG
 
About Our Guest:
Dr. Jackie Piasta is a Doctor of Nursing Practice, Women's Health Nurse Practitioner and a nationally recognized expert in perimenopause and menopause care, with a career spanning 16 years in women's health. She is the founder of Monarch Health, a specialty midlife women's health practice, and Monarch Health Clinician Academy, a CME-accredited training program that has educated hundreds of clinicians in evidence-based midlife and menopause care.
She serves on the Medical Advisory Committee for the National Menopause Foundation
and contributes to national professional organizations, including The Menopause Society, the National Association of Nurse Practitioners in Women's Health, and the International Society for the Study of Women's Sexual Health. She speaks nationally on women's health topics and most recently chaired NPWH's annual Virtual Menopause Summit. She is also adjunct faculty at Vanderbilt University School of Nursing, where she lectures on menopause care for women's health nurse practitioner students.
Dr. Piasta was awarded the Excellence in Leadership and Innovation Award from Frontier Nursing University in recognition of her contributions to menopause education and clinical leadership. In 2025, she was inducted into the inaugural Fellow class of the National Association of Nurse Practitioners in Women's Health. Her work bridges advanced clinical practice, clinician education, and national advocacy.

More about the hosts of Labia Logic:
Dr. Ashley Fuller is a Sexual Medicine Gynecologist and Vulvar Specialist in Seattle, WA. 
www.ashleyfullermd.com
https://www.ashleyfullermd.com/labia-logic-podcast
Dr. Meredith McClure is a Menopause Specialist, Sexual Medicine Gynecologist, and Vulvar Specialist in Dallas, TX.
www.meredithmccluremd.com
Follow the show on Instagram @labia_logic 
 
This episode was produced by Audiotocracy Podcast Production.

Water? Green light. Vaginal steaming? Hard red. Boric acid? Well… that depends. The internet has no shortage of products promising to clean, balance, freshen, moisturize, tighten, detox, or otherwise "fix" your vulva and vagina. 
But which ones are actually helpful? And which ones would your vulva very much like to be excluded from?
In this episode of Labia Logic, Dr. Ashley Fuller and Dr. Meredith McClure play a round of Red Light, Green Light: Vulvar Edition, sorting common vulvar and vaginal products and habits into the good, the questionable, and the please-don't. They cover everything from gentle cleansing, lube, moisturizers, vaginal estrogen, and bidets to boric acid, probiotics, period products, wipes, shaving, tight workout clothes, douching, fragranced products, vaginal steaming, Vagisil, and the dreaded one-day Monistat.
These docs want you to remember: your vagina is self-cleaning, your vulva doesn't need to smell like a spa, and more products definitely doesn't mean better care. No matter what TikTok tells you.
Labia Logic – The Clinical Course – Meredith McClure MD
 
More about the hosts of Labia Logic:
Dr. Ashley Fuller is a Sexual Medicine Gynecologist and Vulvar Specialist in Seattle, WA. 
www.ashleyfullermd.com
 Dr. Meredith McClure is a Menopause Specialist, Sexual Medicine Gynecologist, and Vulvar Specialist in Dallas, TX.
www.meredithmccluremd.com
 
Follow the show on Instagram @labia_logic 
 
This episode was produced by Audiotocracy Podcast Production.

What actually happens to the vulva and vagina after giving birth? How long does it take for swelling, bleeding, dryness, and soreness to improve? And when are postpartum symptoms a normal part of healing versus a reason to call your doctor?
In Labia Logic Gets Knocked Up: Postpartum Edition, Dr. Ashley Fuller and Dr. Meredith McClure get candid about what recovery really looks like after a vaginal delivery or C-section. They explain postpartum hormone changes, vaginal tearing and stitches, urinary leakage, pelvic floor trauma, painful sex, breastfeeding-related vaginal dryness, and the many pads, ice packs, and sitz baths involved in welcoming both a baby and a temporarily unfamiliar vulva.
Listeners will learn what to expect during the first six weeks postpartum, why vaginal estrogen may help with dryness and discomfort, and how pelvic floor physical therapy can support healing from incontinence, pelvic pain, prolapse, and pubic bone separation. 
The doctors also discuss granulation tissue, resuming sex, postpartum contraception, mood changes, anxiety, depression, and why asking for help is an essential part of recovery—not a sign that your body has failed.
Labia Logic – The Clinical Course – Meredith McClure MD
More about the hosts of Labia Logic:
Dr. Ashley Fuller is a Sexual Medicine Gynecologist and Vulvar Specialist in Seattle, WA. 
www.ashleyfullermd.com
 
Dr. Meredith McClure is a Menopause Specialist, Sexual Medicine Gynecologist, and Vulvar Specialist in Dallas, TX.
www.meredithmccluremd.com
 
Follow the show on Instagram @labia_logic 
 
This episode was produced by Audiotocracy Podcast Production.

swelling, discharge, pressure, and occasional "lightning crotch"? Is all that extra sensitivity normal? And when should a change actually earn a call to your OB?
In the Pregnancy Edition of Labia Logic Gets Knocked Up, Dr. Ashley Fuller and Dr. Meredith McClure explain how pregnancy hormones, increased blood flow, pelvic pressure, and a rapidly changing body can affect the vulva and vagina. From darker or swollen labia and vulvar varicose veins to yeast infections, hemorrhoids, pelvic floor changes, and pregnancy discharge, the hosts share candid answers with their usual mix of medical expertise, reassurance, and zero shame.
Ashley and Meredith cover which vulvar and vaginal changes are common during pregnancy, why estrogen and progesterone deserve some of the blame, and what can help ease throbbing, pressure, constipation, and discomfort. 
They also cover sex during pregnancy, safe treatment options for vaginal infections, herpes management before delivery, and warning signs that should be evaluated by a medical provider.
 
Labia Logic – The Clinical Course – Meredith McClure MD
More about the hosts of Labia Logic:
Dr. Ashley Fuller is a Sexual Medicine Gynecologist and Vulvar Specialist in Seattle, WA. 
www.ashleyfullermd.com
Dr. Meredith McClure is a Menopause Specialist, Sexual Medicine Gynecologist, and Vulvar Specialist in Dallas, TX.
www.meredithmccluremd.com
Follow the show on Instagram @labia_logic 
This episode was produced by Audiotocracy Podcast Production.