Dr. Ramirez Zamudio, English-Speaking Gynecologist in Paris

Dr. Ramirez Zamudio, English-Speaking Gynecologist in Paris American 🇺🇸 Colombian 🇨🇴 Gynecologic Surgeon in Paris
💡 Evidence-based GYN education
🏳️‍⚧️ Gynecologist for all 🌈

27/07/2026

🏳️‍⚧️ Are you a transgender woman living in Paris and wondering if you still need gynecological care?

The answer is often: yes.

After vaginoplasty, many people are followed closely by their surgeon during the first months after surgery — but long-term vaginal and gynecologic health still matters.
The type of tissue used during vaginoplasty can influence what conditions may occur.

Depending on the surgical technique, care may include monitoring for:
✨ vaginal irritation or skin conditions
✨ infections or changes in discharge
✨ s*xually transmitted infections (when relevant)
✨ dermatologic conditions
✨ other concerns specific to the type of tissue used

A provider experienced in transgender gynecologic care can help determine what exams or screenings are appropriate for you.

A wellness visit can also be a chance to discuss:
🩺 hormone therapy
🩺 dilation practices
🩺 s*xual health
🩺 breast cancer screening (depending on age and hormone exposure)
🩺 bone health and density testing when indicated

Gender-affirming care does not stop after surgery.
Your health deserves ongoing, respectful, and knowledgeable follow-up.

20/07/2026

🏳️‍⚧️ Do you avoid cervical cancer screening because Pap smears feel uncomfortable or dysphoric?

You’re not alone.

For many trans masculine, non-binary, and gender-diverse people, a speculum exam can be physically uncomfortable or emotionally difficult. It can also be challenging for trauma survivors.
The good news? There are now more options.

🩺 If you have a cervix, cervical cancer screening is still important—regardless of your gender identity.
In France, primary HPV testing is recommended from age 25 and, for many people, can be repeated every 5 years if the result is negative.

✨ Even better, HPV screening can be performed using a self-collected vaginal swab in many situations, allowing you to collect the sample yourself instead of having it taken during a speculum exam.
A self-swab may be a great option if your main goal is cervical cancer screening.

That said, a pelvic examination may still be recommended if you’re experiencing symptoms such as pain, bleeding, unusual discharge, or if your healthcare provider needs to evaluate your uterus, ovaries, or vaginal canal.

💙 The most important message?
If you have a cervix, it deserves appropriate screening—no matter your gender identity. And today, there are more comfortable, gender-affirming ways to do it than ever before.

If you’re looking for information about cervical cancer screening in France, HPV self-swabs, transgender healthcare, or finding an affirming gynecologist in Paris, follow for evidence-based gynecologic and LGBTQ+ health education.

06/07/2026

🏳️‍⚧️ Considering a gender-affirming hysterectomy in France and unsure what to do about your ovaries?

This is one of the most important conversations to have with your surgeon.
A hysterectomy removes the uterus — which can stop menstrual bleeding, eliminate uterine cramping, and may help relieve gender dysphoria related to this organ.

But an important distinction:
The uterus does not produce your s*x hormones.

Your ovaries produce hormones like:
✨ estradiol
✨ progesterone
So the decision to remove or keep your ovaries is a separate and personalized choice.
Things to consider:
1️⃣ If the ovaries are removed
Your body will become dependent on external hormones (such as testosterone or estradiol) for important functions including:
🦴 bone health
❤️ cardiovascular health
🧠 mental wellbeing
This is why lifelong hormone access and follow-up are important parts of the discussion.

2️⃣ If the ovaries are kept
They are usually suppressed while taking testosterone, but they may become active again if testosterone is stopped.
This may be an important consideration for people with:
• ovarian cysts
• endometriosis
• certain family histories or risk factors
• future hormone goals

3️⃣ Fertility considerations
The ovaries contain your “eggs”, so fertility preservation should also be discussed before surgery if this is something you may want in the future.
There is no single “correct” choice.
The right decision depends on your health, your goals, your relationship with your body, your access to hormones, and your future plans.

22/06/2026

🏳️‍⚧️ Recently moved to France and wondering how to start gender-affirming hormone therapy?

The good news is that France offers multiple options for gender-affirming hormonal treatment, and most are covered by the French healthcare system.

✨ Here’s what you should know:

To start treatment, the initial prescription is typically written by:
• an endocrinologist
• a gynecologist
• or a urologist

These specialists can initiate treatment, monitor bloodwork, and help adjust doses during the first months of therapy.

🩺 Once you’re stable on treatment, follow-up care and prescription renewals can often be managed by your primary care physician.

For testosterone, options available in France include:
💉 Long-acting injections
💉 Shorter-acting injections
🧴 Daily testosterone gel

For estradiol, options include:
✨ Daily transdermal gel
🩹 Weekly or twice-weekly patches
💊 Oral tablets

Injectable estradiol is not currently available on the French market. If you obtain injections abroad, make sure your healthcare provider is aware so they can help monitor treatment safely.

Progesterone is also available, and additional medications such as androgen blockers may be used depending on your individual goals and treatment plan.

💶 Another reassuring point: many hormone therapies are covered through the French Social Security system, and even without coverage, generic formulations are often very affordable.

The most important thing to remember is that there is no single “right” hormone regimen.

Your treatment should be individualized based on your goals, medical history, and preferences.

If you’re looking for information about transgender healthcare in France, gender-affirming care in Paris, HRT, testosterone, estradiol, or navigating the French healthcare system as an expat, follow for evidence-based gynecologic and transgender health education.

04/06/2026

🤔 Are you in perimenopause and confused about your treatment options in France?

You’re not alone.

As an American gynecologist practicing in Paris, one of the biggest differences I’ve noticed between France and countries like the US is how perimenopause has traditionally been managed.

📅 Menopause is officially defined as 12 consecutive months without a menstrual period.

But perimenopause can begin 10–15 years before that final period.

During this transition, hormone levels don’t gradually decline, they fluctuate dramatically, which can cause symptoms such as:

✨ Brain fog
😴 Sleep disturbances
😟 Anxiety
💔 Palpitations
🦴 Joint and muscle pain
🎢 Mood swings
🔥 Hot flashes and night sweats (sometimes—but not always)

Many women assume that because they’re still having periods, their hormones must be stable.
They aren’t.

For years, some French guidelines recommended waiting until menopause was officially reached before prescribing hormone replacement therapy (HRT). In contrast, North American, British, and Australian guidelines have recognized that hormonal treatment can be safe and effective during perimenopause in appropriately selected patients.

This obviously leads to changes in clinical practice.
💡 The most important takeaway:
You do NOT need to wait until your periods stop completely to start a conversation about treatment options.

Every patient is different, and decisions about HRT should be individualized based on symptoms, medical history, and personal preferences.

If you’re an expat living in Paris and trying to navigate perimenopause, menopause, or HRT in France, follow for evidence-based health information explained clearly.

26/05/2026

✉️ Did you receive a letter from the Assurance Maladie about menopause and wondered what this is all about?

France has introduced a dedicated menopause consultation to improve care during perimenopause and menopause, and to encourage conversations around symptoms that can go unexplained.

Menopause is not just hot flashes !
Symptoms can include:
 • sleep problems
 • anxiety or low mood
 • brain fog
 • attention difficulties
 • vaginal dryness
 • recurrent UTIs
 • irregular periods
 • joint pain
 • fatigue

Many women don’t realize these symptoms can begin YEARS before periods stop completely.

This consultation is also important for prevention, since hormonal changes can increase risks of: high cholesterol, weight gain, diabetes, heart disease and osteoporosis. 

Who can you see in France?

Midwives can help guide menopausal care, but hormonal treatment may require a gynecologist or GP trained in menopause medicine.

If you’re an expat living in Paris and trying to understand menopause, HRT, or the French healthcare system, follow for evidence-based gynecologic information explained clearly.

11/05/2026

You’re not living like the French 🇫🇷… until you have your own kiné 😉

If all your French friends talk about their kinésithérapeute (physiotherapist) — there’s a reason 👇

💡 In France:� ✔️ There are many physiotherapists available� ✔️ Appointments are easy to get � ✔️ Visits are reimbursed by the national healthcare system

➡️ Which means: people actually USE them regularly
🩺 And in gynecology, this is a game changer.
We often prescribe pelvic floor therapy for:� • Urinary incontinence� • Pelvic organ prolapse� • Pelvic pain conditions such as endometriosis� • Vulvodynia� • Vaginismus

🤰 Plus — postpartum patients are systematically referred for pelvic floor & perineal rehabilitation.

✨ This is part of a more holistic, multidisciplinary approach to gynecologic care in France.

⚠️ Important:� You’ll need a doctor’s prescription to see a kiné — so start with a consultation.

💾 Save this & follow for more tips on navigating gynecologic health in France as an expat

*xpat

04/05/2026

Left your doctor’s appointment in France with a stack of paper prescriptions and no idea how to schedule your imaging test, bloodwork, or referrals ? 😅🇫🇷

You’re not alone.

If you’re used to the U.S. system 🇺🇸 Where everything is done before you leave the office, the French system can feel… confusing 😅

💡 But here’s the thing:
This system actually gives you flexibility, you choose when and where to do everything.

Here’s how it works 👇

💊 Medications
Take your prescription to ANY pharmacy (look for the green cross ✳️)
Bring:
✔️ Carte Vitale
✔️ Mutuelle
✔️ Your paper prescription
➡️ They’ll give you your medications (or order for next day)
⚠️ Don’t lose the prescription — you need it for refills!

🧪 Bloodwork & lab tests
Go to any medical lab (search laboratoire medical on google maps!) — usually no appointment needed
📧 Results are sent to YOU (not always your doctor!)
👉 Your job: make sure your doctor receives them (usually email or next appointment)

🩻 Imaging (ultrasound, MRI, etc.)
Choose any radiology center
✔️ Often same-day results
✔️ You may speak directly with the radiologist
➡️ But you still need to follow up with your doctor for next steps

✨ Bottom line:
📄 Don’t lose your paper scripts
📩 Make sure your results get back to your doctor
💾 Save this — Once you understand this system, it becomes much easier to navigate.
👯‍♀️ Share with an expat friend

*xpat

27/04/2026

Did you know you don’t always have to pay upfront with international insurance in France? 🤯🇫🇷

If you have international health insurance (through your employer or privately), you might be used to:� 💸 Paying first� 📄 Then submitting for reimbursement

That’s manageable for a consultation… but what about surgery or hospitalization? 🏥
� Costs can reach thousands of euros — and reimbursement delays can make this a real barrier to care.

✅ Here’s what many expats don’t know:� Some hospitals in France have direct agreements with international insurers. These hospitals have teams dedicated to working with many global insurance providers and can:� ✔️ Request a guarantee of payment (guarantee of benefits)� ✔️ Coordinate directly with your insurance� ✔️ Help you avoid paying upfront

💡 This can also apply to:� • Pre-operative visits� • Post-operative care� • Planned procedures

✨ A small trick that can make a HUGE difference when navigating healthcare abroad

💾 Save this for later — you never know when you might need it� 👯‍♀️ Share with another expat in France!

*xpat

The best thing about being a clinician-researcher is the variety of activities I can have in a single week: patient cons...
23/04/2026

The best thing about being a clinician-researcher is the variety of activities I can have in a single week: patient consults, surgery, field work, research meetings... I never get bored, I balance my work, and I enjoy every minute of it 😍

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