Painful Urination, Morning Sickness & Osteoporosis Explained | Essential Women’s Health

When I launched Gyno Info Frank Talk in August 2025, I didn’t have a social media following. I just had a mission: give women clear, evidence‑based gynecologic information without shame, confusion, or fluff.

Less than six months later, we’ve reached 100,000+ YouTube views across nearly 50 countries, with listeners in India, Indonesia, Japan, the United States, Brazil, and beyond. That tells me something important: women everywhere are looking for honest conversations about their bodies.

Today I’m highlighting three essential women’s health episodes you may have missed — episodes that could genuinely change how you understand your symptoms.

1️⃣ “It Hurts to Pee, But It’s Not a Bladder Infection”

Painful urination doesn’t always mean a urinary tract infection (UTI).

In this episode, I break down:

• The difference between a bladder infection and vaginal or vulvar causes of burning
• When symptoms like pain with urination could signal something more urgent
• Why misdiagnosis happens — and how to advocate for yourself

If you’ve ever been treated repeatedly for a “UTI” that didn’t quite make sense, this episode is essential.

2️⃣ Morning Sickness, Nausea in Pregnancy & Hyperemesis Gravidarum (Episode 127)

Morning sickness is common. Severe, dangerous nausea and vomiting in pregnancy is not.

I explain:

• Why nausea happens during pregnancy
• What’s normal — and what’s not
• The warning signs of hyperemesis gravidarum
• When dehydration and weight loss become medical emergencies

Too many pregnant patients delay care because they think suffering is just part of the process. It isn’t.

3️⃣ Osteoporosis: “Why Is My Grandma Shrinking?” (Episodes 107 & 108)

Osteoporosis is not just about aging — and it’s not just about your grandmother.

In these episodes, I discuss:

• How bone loss begins
• Why menopause and estrogen decline dramatically increase fracture risk
• How osteoporosis leads to life‑threatening complications
• Why prevention starts in childhood and early adulthood

Hip fractures are not benign events. They change — and shorten — lives.

My goal with Gyno Info Frank Talk is simple: help you understand your body so fear or embarrassment never keeps you from getting care.

If something feels wrong, please don’t delay seeing a doctor - because gynecologic health education should be clear, compassionate, and accessible worldwide.

You can write to us at Questions@GynoInfo.net

And follow us on Instagram @gynoinfo

Transcript

SPEAKER_00 0:00

Welcome to Gyno Info, Frank Talk with Dr. Berkey, the podcast dedicated to teaching everyday women what they need to know about their body and how it works to successfully deal with the healthcare system and communicate with their doctors. Each week, I'll provide you with new information and practical tips about gynecology and women's health care. I want to prepare you for your doctor's appointments by teaching you what to expect, what information your doctor will need to know from you, and what questions you will need and should ask her so you can be confident and make the most out of every visit. Gyno Info will give you the knowledge you need to take charge of your health and do this in a clear and frank way that you can understand without having a medical degree, one episode at a time. So now let's begin. Welcome back to Gyno Info. I started this podcast series on women's health in August of 2025. My goal was to offer important and useful information to women about their bodies in normal everyday language that normal everyday women could understand. No complicated medical words and no chit-chat, just straightforward and frank medical information. Also, not too long, so that women could find time in their busy lives to listen and learn what I have to teach them about their bodies and how to take care of their bodies. I started the podcast from scratch, from absolute zero. No TikTok account, no Instagram, no Twitter, no X, no active Facebook account, no active LinkedIn account, no nothing. So I'm very grateful that despite starting without any prior social media following, so many women have discovered my podcast and found it useful, are now regularly listening to it or watching it on YouTube. More than 100,000 views in barely six months from almost 50 countries around the world and counting. This is truly amazing and is worth all the hard work Josh, my producer, and I are putting into it. You also might find it interesting to know that the top five of the countries in the world where the podcast is being watched on YouTube are India, Indonesia, Japan, the United States, I expected that one, and Brazil, but not necessarily the countries I had expected to be on the top five. Some of the podcasts have been viewed many thousands of times, some only a few hundred of times, and some even less. And why that is, I have no idea. But as a doctor who picked the topics, because I think that all women should know about them, I find them, of course, all very important and would like everyone to get their information. Today I'm going to highlight three of my podcasts on topics that I find particularly useful for women to know about, but that somehow the internet managed to hide from you. The first one that I want to call your attention to is the very first podcast I ever posted. It is called It Hurts to Pee, but it's not a bladder infection. It is about how you can tell if you have a bladder infection or a vaginal infection. Both of them can make it burn and stink when you urinate, but their causes, risks, and treatments are completely different. I find the information in this podcast so essential that I make every nurse and medical assistant who wants to work in my office listen to it. It's a must. So I think it should be a must for you too. Here's a sample to show you what I mean. I hope it makes you want to go back and listen to the whole episode. Today we're going to talk about what you should think of first when it hurts when you pee. We're going to help you try to figure out if something is a bladder infection or more likely a vaginal infection, because both can cause pain with urinating and peeing. And we're also gonna try to help you figure out if this is a real emergency, like a kidney infection, and you should go to a clinic right away. So when it hurts when you pee, the most important question to ask is where does it hurt and when does it hurt? If it stings on the outside, as soon as the urine comes into contact with your crotch, your outer genitals, your vulva, those are all the same words for the same thing, it's more likely to be a vaginal or a vulva infection than an actual bladder infection. We're used to thinking that pain was peeing is always a bladder infection. But when urine, which is basically salt water, comes into contact with open herpes source or a skin on the outside of your crotch that's irritated and red and inflamed by a major yeast infection or some other vaginal discharge that causes the skin on your crotch to be damaged. It burns, it stings, it hurts. And still it's not a bladder infection. It's because your vagina produces an irritating discharge, or you have a yeast infection, or even herposaurus, as I mentioned. There are also some STDs, sexually transmitted diseases that infest and grow in the urethra. The urethra is a tube that leads from the bladder to the outside and opens right above your vaginal opening, right below your cliteris. One such STD, sexually transmitted disease that typically can be found in the urethra is chlamydia. When chlamydia grows in the urethra, it causes an inflammation, a so-called urethritis, and it hurts when you pee. Chlamydia actually can cause similar symptoms in men, but it may also cause no symptoms at all in either men or women, especially early on, so people pass it on without knowing that they have chlamydia. So again, when it hurts on the outside, it's most likely not a bladder infection. An infected and inflamed bladder generally causes a more dull, constant, deep pain inside behind your pubic bone. The bladder is a hollow muscle, kind of like a balloon. When it empties, it does that by contracting the bladder wall and the muscles in the bladder wall, which then dials up the pain from adult to excruciating at the end of peeing. So with a vaginal infection, it hurts as soon as the urine touches the inflamed skin on the outside of your crotch. With a bladder infection, the pain is worse at the very end of peeing. And even though it hurts emptying the bladder, an infected inflamed bladder prefers to be empty rather than stretched out when it fills again with urine and expands, which makes the irritated bladder walls even more irritated when they stretch out. That is why a major symptom of bladder infection is that you have to pee all the time because your bladder wants to be empty, even if there are only a few drops to come out. Doctors will call that frequent urination. So that is another important term to use when communicating with office nurses and doctors. Painful urination and frequent urinating is in small amounts. Those are the key words. But you can also just say, I have to pee all the time, and not much comes out and it hurts peeing. That says exactly the same thing and is totally clear. But it's really important you tell what symptoms you have and when they occur. The next podcast I want to feature is the episode 127 about morning sickness, vomiting in pregnancy, and hyperemesis gravidarum, the problem that plagued Kate Middleton, the future queen of England. Hyperemesis gravidarum is a type of uncontrollable, life-threatening vomiting in pregnancy, throwing up so violently that it can kill both mother and baby. Here are a few minutes from that episode as well. Today we're going to talk about something that happens to many of us. Morning sickness, or NVP, nausea and vomiting in pregnancy in Dr. Speak. We'll talk about what may be causing it, what you can do about it, and how much may be uncomfortable but still counts as normal. And when morning sickness becomes dangerous for both you and your baby. Even though this nauseousness in pregnancy is called morning sickness, for many women it is really more like an all-day sickness, feeling at least queasy, but many times much more than that, all day long. For me, it was mostly exhaustion sickness. The more exhausted I was with my pregnancy during my medical training, the more nauseous I felt. Curiously enough, I never felt sick while I was doing surgery. But as soon as I was finished operating, I draced to the restroom and throw up, barely managing to rip off my surgical mask in time. First, just how common is this uncomfortable symptom of early pregnancy? Between about half of all women to almost four in five women suffer from it. It generally starts about a month after you got pregnant, though many women swear they felt morning sickness the moment they got pregnant. The good news is that it goes away in most women by their fourth month of pregnancy. But about one to two in ten women are unfortunate enough to feel sick for their whole pregnancy. The other bad news is that it tends to happen again in the next pregnancy if you had it in your first one. Now let's talk about what causes moaning sickness, the term I will be using for the rest of this podcast. Nobody really knows for sure what causes it. The best guess is that there are many things that can play a role in causing it, that it's not caused by any one factor, but by several different ones in different women. We do know that it's somehow related to the size of the placenta. The larger the placenta, the more likely a moment will feel sick to our stomach. For instance, if a woman is pregnant with twins and has a larger than usual placenta because the placenta has to feed two babies. Another reason for the placenta to be unusually large is a so-called molar pregnancy. Then only the placenta part of the pregnancy grows and the embryo part, the baby part, disappears. So those women with a larger placenta will feel more morning sickness. Newer research shows that a certain type of growth hormone, plus the hormone called human chorion gonadotropin, HCG, which is used in pregnancy tests, play a major role in morning sickness. Both these hormones are produced in the placenta, and so it makes sense that a bigger placenta makes more of these two hormones, and women who have a bigger placenta will have more nauseousness. But there are also certain inherited genetic factors that can influence whether a woman is more or less prone to experiencing morning sickness, which also explains why the women in some families are more likely to throw up in pregnancy than in other families. And some women just tend to feel sick whenever they are stressed and tired. And if there's one thing that makes you tired and stressed, then that is pregnancy for sure. Next, I'm going to tell you a few things you can do that may make you feel a little bit better and will definitely not hurt you or your baby. But that doesn't mean that you do not have to go and see a healthcare provider for regular prenatal checkups. Women without prenatal care are three times as likely to give birth to a baby that is too small, either because it did not grow well or because it was born too early, or both. The risk of complications for the mother, including death, are much higher without prenatal care, which can pick up problem pregnancy before they turn into disaster pregnancies. The most important factor for a baby to be born healthy is and always has been and probably always will be, a healthy mom. And the last podcast I want to call your attention to has to do with osteoporosis, the loss of bone as people age, that leads to broken bones, and a lot of incredible but completely avoidable pain and misery in older people, especially older women. It is episode 107 and is called Why Is My Grandma Shrinking? And should best be watched as a video, as it has a lot of interesting slides that explain this crippling disease. Most of you will think, well, I'm too young for this. This is about old people like Dr. Berkey and has nothing to do with me. But you're dead wrong, completely wrong. It's actually incredibly important to pay attention to your bones, starting already as a child. By the time you are 25, you're finished building bones. And how good your bones are will make all the difference about how you will feel and how much pain you will have when you get to be old. Even though you cannot even begin to imagine ever getting old, you actually will get old, hopefully, unless we destroy Mother Earth before that. Check out a few minutes about this podcast on osteoporosis. I hope you like at least the pictures enough to watch the whole episode. And also E108 that goes with it. This episode is called Osteoporosis Kills and talks about how to treat and even better how to prevent it, which starts with good nutrition and the right vitamins in childhood. So today's episode is about postmenopausal osteoporosis, about the loss of bone leading to lower amounts of bone, decreased bone mass, and lower bone strength, fragile thin bones, and ultimately bone fractures after the ovaries stop producing estrogen in the postmenopausal phase of a woman's life. Bone is a living tissue. Old bone gets broken down in the body and replaced with new bones. Because bones are on the inside of your body, you cannot really see that. It's not like skin, where you can see the dead old skin that was replaced with fresh new skin as a ring in your bathtub. There are specialized cells inside the bones that build new bone, the so-called osteoblasts. And then there are those that break down the bone, the old bone that needs to be replaced, the so-called osteoclasts. After the bones have stopped growing around age 20, for the next two or three decades, the building and breaking down of bone is in perfect balance. No more bone is being acquired, but the bone that you have is being well maintained, and old bone is replaced with new bones. As long as you provide your body with the right ingredients to make bone, that is, enough calcium, enough vitamin D so you can absorb the calcium and enough protein, healthy food, good nutrition. At the time of menopause, the time when a woman's ovaries stop producing eggs and in the process of that stop producing hormones, the most important one being estrogen, the body starts losing bone. In the first two or three years, that bone loss amounts to at least one to two, even three percent per year. Later it slows down to about 1% a year or maybe even less, but you are gonna keep losing bone for the rest of your life. And if you live long enough, as we do now, almost half of our lives after menopause, over the course of three, four, five decades, you will lose a lot of bone. That's because the osteoclasts, the cells that break down old bone, are working overtime. And the bone-building cells, the osteoblasts, cannot keep up anymore with building new bone, and so the net result is bone loss. The cells breaking down bones used to be held in check by estrogen produced by the ovaries, but after menopause, when the ovaries no longer produce estrogen, the bone resorbing cells are out of control and you lose bone. We call this process of breaking down bone bone resorption, as the material that made up the bones is reabsorbed, sucked up into the rest of the body, and carried away in the blood to be used elsewhere or discarded through the kidneys, in the urine, or the intestines in the poop. So no ring in the bathtub for bone. Depending on how much bone is lost, we either talk about osteopenia, or if even more bone has been absorbed, then we call it osteoporosis. But they're both really parts of the same process. And at a certain point we just switch the name from osteopenia, which means little bone, penia means little or few, to osteoporosis. Bone with lots of pores, lots of holes where parts of the bone are missing. So this combination of decreased quantity of bone plus the decreased quality of bone, that is the increased fragiless and decreased bone strength of the aging bone, which is no longer being replaced by new fresh bone, leads to osteoporotic bone fractures, the breaking of bones. If you fall out of a second-story window or you crash your bike, or you have a skiing accident and then break some bones, that is considered a normal and expected fracture. If on the other hand, you trip over a rug and fall and either break your hip or your wrist while trying to catch yourself or crack a vertebral bone in your back, that is a typical osteoporotic fracture, a fracture from a minimal trauma. When a younger person with healthy bones would just only had a bruise but not a fracture. Such a hip fracture is often the beginning of the end for an older person. At gynoinfo, we're talking about osteoporosis in women. But men too can get osteoporosis and break their hips or their backs. But it's just five times more frequent in women than in men. After a hip fracture, an older person has only a 25% chance of returning to their own home. About half of them end up in a nursing home or some other assisted care facility, and a quarter end up dying from the complications of the hip fracture and the surgery needed to repair it. They might get a blood clot, they might get infection, or just putting an older person in bed for, let's say, the time it takes to heal and recover can make it so they never walk again right. Then not being able to move leads to social isolation and depression, and people give up and die. It's very, very common. So a hip fracture often is the beginning of the end. Sometimes you don't even need to fall if your bones are really weak and fragile. I hope that listening to these portions of some of my favorite podcasts made you curious enough to check them out some more and watch the whole episode. I say watch because three of them have slides. A good picture is usually worth a thousand words. All of the podcasts have very important, in my opinion, essential information that every woman in the whole world should know. This brings me to the end of this episode. Please share this information about these super important podcasts with all your friends, family, and coworkers. And again, please also make sure that you click the subscribe button wherever you listen to or watch GynoInfo. So you can get back to it easily whenever you want. And the more people subscribe, the easier it will be for others to find us. Remember, you can send any questions you might have or suggestions for future episode topics to questions at gynoinfo.net. Again, that's questions at gyneoinfo.net. Goodbye and have a really safe week. Until next time, thank you for listening. And remember that you and your health are super important and deserve your full attention. Don't ever put off contacting your doctor because you're scared or embarrassed when something feels wrong about your body. Doctors are here to help you, not to judge you. And also, regular well-woman visits are always a good idea that you should make time for. You deserve it, and you owe it to yourself, and you owe it to your body and your health. This podcast is part of Pride House Media, hosted by me, Dr. Burke, produced and edited by Josh Rosenzweig, original music composed by Nell Balaban. If you enjoyed this episode, please subscribe wherever you listen to podcasts. And while you're there, leave us a rating and a review. It really helps others discover the show. Stay connected and join the conversation by following me on Instagram and Facebook at gynoinfo and on LinkedIn at gynoinfopodcast. Remember, any questions that I answer or information that I give you on this podcast are to Be understood as information only, not treatment of your medical problems. While I'm a very knowledgeable gynecologist, I'm not your gynecologist who has talked to you and examined you personally and is therefore actually able to treat you. So please consult your own healthcare professional with any medical questions or concerns.