← You Are Not Broken
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- [00:04]
A
Welcome to the youe Are Not Broken podcast. I'm your host, Dr. Kelly Casperson, a board certified urologist, thought leader, and conversation starter on midlife living, hormones and sexuality. Enjoy the show. Hey, everybody. Welcome back to the youe're Not Broken podcast. I'm having so much fun with Dr. A and Mary Alice Haney today. They are the co founder, creators of the SheMD podcast. And I was just podcasting with them and this last hour over on their podcast. So now we're all warmed up and we're friends. So welcome to my podcast.
- [00:36]
B
Thank you for having us. We, first of all, we're big fans of your podcast. We just talked about that on our podcast. What big fans we are of you on your podcast. So it's a big love fest over here.
- [00:46]
A
I love it. And I ran into your sister at the Menopause Society meeting in fall 2024, and she was like, my sister just started GMD podcast. And I was like, obviously we need to. Obviously our Venn diagrams are intersecting. So.
- [01:00]
B
Exactly.
- [01:01]
A
So how old is your podcast and how did you guys team up to want to do this?
- [01:05]
B
Well, we love this story. It's not a year old. So in March, it becomes a year old. And I. And I have to say congratulations.
- [01:12]
A
It's.
- [01:12]
B
I know, it's like we birthed a baby. We birthed two babies this year. One is ov, which is our PCOS platform, and then the other one is she OND podcast. But I actually met her on my friend Molly Sims's podcast because I was co hosting. It was right after Covid and my father had gotten really sick with Parkinson's and there was a lot of brain disease in my family. So I was bringing a lot of medical doctors that I wanted to meet and talk to. Dr. Richard Isaacson, you kind of name it. And then she came on as a guest and we started talking before. And I can't believe we had never met in Los Angeles because I lived here for 30 years. She lived here for a long time. But she started talking about her breast cancer journey, her pcos. And I'd never heard of pcos. That was the first time in my life I'd actually ever heard of pcos. And then menopause. And we just came on the podcast and we interviewed her. And I left saying, okay, that's my next. This is my next chapter. Like, I need to get this woman and her knowledge, her expertise and try to help women out there that live in medical wastelands or who don't have access to the kind of medical care that we have in LA or in places like New York. And so we met and I said, okay, let's do this. And she said, what? It's funny because she has all these celebrity clients that come and see her, but she doesn't know who anybody is. And all of them said, you know, we want to come on the Shamd podcast because we want to do what Dr. A wants to do, which is to help other women. And to incredible women that had never talk about anything publicly, and they're talking about this very vulnerable conditions that they have in medicine. So it's just went. It blew up like a rocket ship. The week that we launched, Olivia Munn came out saying that Dr. Ali Body had saved her life with breast cancer. And it just. When some things are right, they just happen or, you know, organically, it's not. And I say this, I always tell. I say the same thing in relationships. Like, if you have to work so hard at it, it's probably not right. And that's kind of how I felt with our. Our.
- [03:12]
C
I worked really hard for medicine.
- [03:16]
B
Now I bring her over and she's like. I'm like, okay, you've got. You can only do two surgeries today, and at 4 o' clock you're going to go do the podcast. She's like, what?
- [03:24]
C
No, it's. I mean, I have to say I wanted to help women and educate them, but, you know, as a physician, you know, in a private practice, you just go to work, see your patients and come home. And I really. You don't have a voice. Right. Like other people do. So this. And I always try to educate and be a women's health advocate and be a PCOS advocate and be an endometriosis advocate and have everyone calculate their lifetime risk of breast cancer. But I couldn't really do it until I met this woman because she really brought my messaging to the world. And it's been the biggest blessing in my life. You know, you were saying in our podcast that, you know, someone told you that it takes seven years in medicine to get to that reset button, to
- [04:10]
A
get the science out into the clinic.
- [04:12]
C
Right, right.
- [04:13]
A
Oh, you mean the seven year itch.
- [04:14]
C
The seven year.
- [04:15]
A
Yeah. Itch. Yeah, yeah, yeah.
- [04:17]
C
So I didn't have that at seven years, but I think I had that at 23 years because I was so focused on making myself better, becoming a better surge, learning more about different conditions and becoming really an expert in the conditions that I was passionate in. But it's been amazing, an amazing journey, and I just Absolutely love gmd. And I don't know if you know, but now we have a PCOS platform called OVI to help, hopefully to bring awareness to PCOS and help these patients at least not self diagnose, but be self aware of their symptoms because majority of them go undiagnosed.
- [04:59]
A
Yeah, well, that's the truth with endometriosis too.
- [05:02]
C
Right? Right.
- [05:03]
A
The average woman, I just read this the other day. The Average woman goes 10 years before endometriosis is that 9 to 11 years.
- [05:10]
C
Average age of diagnosis is 32. Having said that, majority of them go undiagnosed. A lot of these unexplained infertility patients, chronic pelvic pain patients, painful periods, and they're told painful periods are normal. I mean, as a urolog, just. I'm sure you see a lot of endometriosis patients end up at a urology office because of recurrent UTI symptoms. And their urine cultures are, you know, they come back negative. But these patients keep getting treated with antibiotics from one doctor to the other. And, you know, even though these cultures are negative, they still get a prescription for antibiotics from their gynecologist. Primary care, and a lot of times end up in a urology office. And unfortunately, even when they get to a urologist's office, they get diagnosed with interstitial cystitis. And I always say, when you have a young girl and the number one cause of her chronic pelvic pain is up here, and it's endometriosis, why are we looking for zebras down there? But that's. That's women's health. And that's why I so much appreciate having you as a female urologist. Because if we had more female urologists, maybe we wouldn't have been in this situation. But then again, we have a lot of female gynecologists and we're still in this.
- [06:26]
A
Touche. Yeah, I was just podcasting with somebody this morning and talking about, like, they're like, okay, well, a woman with interstitial cystitis comes in and I was like, I take more interstitial cystitis diagnoses away from women.
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C
Bravo.
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B
What is interstitial like, again, that's what
- [06:41]
A
I do on this podcast.
- [06:42]
B
I'm like, what are you talking about?
- [06:44]
A
You're, like, taking notes for our next episode over on gmd. So interstitial cystitis is a. This is how I describe it to people. It's a chronic incurable condition that is a diagnosis of exclusion, meaning it's not cancer, it's not an infection, it's not something else.
- [06:59]
C
Endometriosis.
- [07:01]
A
Endometriosis, exactly. And it is. We don't know how to manage it. It's basically kind of chronic pelvic pain of the bladder, of the bladder lining. But it's kind of this throw, throw it at a woman. And I think of it like bricks in a backpack. Like, a woman comes in, she's got this heavy bricks in her backpack of this chronic incurable disease. And I'm like, you've had two urinary tract infections. That's not interstitial cystitis. Or like, you have really tender pelvic floor muscles on palp. You can find it on exam. That's not interstitial cystitis. So it's like, to me, I'm like, you actually listen to a woman, do a proper physical exam. The good urologist on this will know we take more interstitial cystitis away from people. And then some people think you just have a sensitive bladder, like your bladder doesn't like tomatoes. So to me, I'm like, should we call it a chronic incurable disease or should we just say, like, your bladder is sensitive to citrus.
- [07:55]
B
Your bladder didn't like tomatoes.
- [07:56]
C
But I will tell you as a gynecologist, a lot, a lot of these patients diagnosed with interstitial cystitis have endometriosis because endometriosis does affect the bladder and it gives very similar symptoms with that pelvic pain, urinary frequency, urgency, UTI symptoms, but it's not really bladder related. It's endometriosis related. And that chronic inflammation and those implants are affecting the bladder. I do so many. Every Friday I do a ton of laparoscopy on endometriosis patients. And you see these implants on the bladder and these are patients with all the bladder symptoms that for years they go dismissed undiagnosed. And unfortunately they either get the wrong treatment or they don't even get treated. Endometriosis patients end up seeing urology, GI doctors for colonoscopy. They see psychiatrists, they see primary care doctors, they see functional doctors. They go through, through the list of physicians until they end up average age 30 to 9 to 11 years later, someone a good gynecologist or chronic pelvic pain physicians or fertility doctors finally diagnosed them. But majority of them go undiagnosed still throughout their lives.
- [09:16]
A
How common is it?
- [09:17]
C
It affects 10% of women on the planet. Close your eyes and think of 10. I always say, if men had a condition that would Put them down one week per month, they would bleed, they would have painful cramps, they couldn't have sex because of painful sex. They had bloating, infertility, they would lose their sperm. Do you think majority of them would go undiagnosed. No doctors would get sued left and right. But here I have patients who walk into my office with a Percocet prescription. Had a 23 year old few years ago. She walked into my office, she's like, I just came from the fifth floor and I was diagnosed. You know, they told me I have chronic pelvic pain and they gave me Percocet. Percocet for endometriosis.
- [10:06]
A
Yeah.
- [10:07]
B
Well, and what I've learned from you is that 15% of all women have PCOS. And it's one of the leading causes of infertility. And so it's the same. And thank God we're talking about them more in the same way. Menopause, I think a few years ago now with people like you and Dr. Mary Claire Haver and you know, all of these amazing women that are out there saying like, let's talk about this, the same thing's happening with PCOS and endometriosis. I hope, I mean, I hope that we're making a dent in it.
- [10:36]
A
Do we know why endometriosis happens? Because when I was in med school, it was like the rogue uterine lining escaped and decided to implant in the body. But then that theory's changed. Is that right?
- [10:48]
C
It's changed and we really don't know why it happens. You can have endometriosis tissue in the lungs, you can find it anywhere in the body. The most, you know, there is a hypothesis that menstrual blood cells basically go through the tube into the pelvis. But then you also have adenomyosis, which is when you have endometrial, like tissue in the wall of the uterus, also causing heavy periods, painful periods and miscarriages. So you just have to listen to the patient. You have do an ultrasound. But majority of endometriosis you cannot diagnose on any imaging. Mri, ultrasound. And the best way, the most accurate way of diagnosing endometriosis is by listening to the patient. I was talking to a scientist who has come up with a blood test for endometriosis. And he said it's 90 some percent accurate. And I was at breakfast with him and I told him, I'm like, you know, my accuracy is about 99% and all I do is listen to the patient. So we really don't need these fancy tests, but you do need to take a good history. You need to. As a physician, you need to be knowledgeable about endometriosis, which really breaks my heart, because as one of the top causes of infertility affecting 10% of women, how could we dismiss these patients as a gynecologist, how is this happening?
- [12:11]
A
Gynecology residency is four years after med school. How much is devoted to endometriosis and pcos?
- [12:17]
C
So for me, it was a little bit different because I trained at county usc, and when I was doing my residency, county USC was the second best program in the nation. And we had OB rotations, but then we had a GYN clinic with hundreds of patients in the waiting room. And because we didn't have attendings, we had one supervising attending, and we had to see those patients. So county trained residents know enw of PCOs really well. Having said that, I still didn't get as much exposure to it until I started my practice. And I had these patients who would come dismissed from other clinics with chronic pelvic pain. And that's when I was telling you it took me even longer than seven years because I just. I knew this was the problem. But then I eventually I got better at taking them to surgery, operating on it. It's. I learned a lot after my residency and not necessarily during the residency. The problem is I see the residents right now. At my hospital, there's a huge focus on OB and pregnancy because you're dealing with a mom and a child, and things can go wrong really fast. And if you miss something, you can have devastating outcomes. And so there's more focus on ob. Number one, in training a lot of these programs. Number two, I always say this. They need to divide OB GYN into an OB residency and a GYN residency.
- [13:46]
A
Yeah, you read my mind.
- [13:48]
C
Majority of doctors are really good at delivering babies, taking care of pregnancy. But you know, when you're up all night delivering baby, you're in the clinic, you have three laboring patients, the nurse is constantly calling you. You have a clinic with 40 people who are coming for an annual pap smear. Do you think you have time to talk to an endometriosis patient? No way. I spent like 45 minutes to an hour with a new endometriosis patients. 40% of endo patients end up having PCOS. Then I have to talk about PCOS. Then endometriosis patients can also have SIBO. Then I have to talk about SIBO, and then I have to tell them why I'm prescribing all this, because if you don't do that, majority of doctors, you go in, you're like, I have acne, here's birth control. I have painful periods, here's birth control. I'm losing hair, here's birth control. My periods are irregular, here's birth control. And these patients go home and they're gradually, Grandma's like, why are you taking birth control? Birth control will make you infertile. There's so much misinformation. And because they didn't get that information from their doctor, they will not be compliant with that treatment. I'm not saying birth control is the answer, but that's as if patient, as a female patient, when you go to the gynecologist four out of five times, you leave with a birth control prescription. That's not always the solution. And these patients don't know why these things are happening to them. PCOS patients don't know why they're gaining weight, why they have an eating disorder disorder, why they're having hair loss, acne, facial hair, body hair, irregular period, miscarriages, they're having fertility issues because they've been dismissed for so many years. And all you have to do is really listen. But until we separate these residencies and really train gynecologists on GYN surgery, I don't want to talk about myself. But less than 1% of gynecologists know how to do GYN surgery. You know, I take a uterus the size of a watermelon out of three tiny little incisions, outpatient. I don't even take them to a hospital, and they go home. But still, at major hospitals in this country, these patients are getting a vertical incisions from their belly button all the way down to have this hysterectomy. So why are we not training these doctors? Because the doctor who's delivering OB and delivering pregnant patients does not have time to get really good at laparoscopic surgery. I was able to do it, but I also, I think I've misdiagnosed ADHD. I can work 15, 16, 18 hours hour days, right? And that's what I've been doing for 30 years.
- [16:19]
B
And, and I make her do a
- [16:20]
C
podcast and she makes me do a podcast. But for me, I just did so much. And when people, even my children, come and tell me, mommy, you're so smart. I was not smart at all. Smart didn't get me where I am. My effort got me where I am. Today. If someone did 2000 deliveries, I did 8000 and when you do 8000 deliveries, you get really, really good. If someone has done 30 hysterectomy, I've done hundreds of them. That's how you get good. And it's the same thing with endometriosis. It's the same thing with pcos. It's the same thing with menopause. It's the same thing with breast cancer. You just have to spend a lot of time and it takes a lot of effort, a lot of hard work to become a competent physician. And I'm sure you know this, Kelly, but that effort is not there. And I think doctors are burned out. So going back to that topic. Sorry to be long winded.
- [17:13]
B
Well, and I know when we first started, she talked about this, she said if I could get every 18 year old into my office, I would shut fertility clinics down. Because all of these pcos, endometriosis, these leading causes of infertility, we would figure that out at this age so that they're.
- [17:32]
A
They're like stage. At age 35, when they want to start a family. Yeah.
- [17:37]
B
Because by then sometimes it's too late. I mean, it's, you know, that's, you know, the female body is such a beautiful, magical thing, but it's required to do so many things. You know, it's like we have this, the gift of life, and we go through all of these stages. And I'm not saying men don't do that, but.
- [17:54]
C
No, they don't.
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B
Well, they don't.
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A
They don't. Somebody gave me the. This is not my metaphor, but I think it applies, is like, men are like Hondas, like, sturdy, reliable, functional. They do the job. They'll get, get. They'll get around the last for a while. And women's bodies are Ferraris of, like, highly specialized.
- [18:13]
B
Yeah.
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A
You gotta maintain it. Like it's a beautiful, powerful, amazing thing. And it requires different care than the Honda does.
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B
Yeah.
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A
And I was like, that's pretty badass that we get to be the Ferraris.
- [18:27]
B
I love being the Ferrari.
- [18:29]
A
Yeah, I think, I think it's a badass.
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B
I don't want to be a Honda.
- [18:32]
A
No. It's like, Hondas are fine. Yeah, Ferraris are.
- [18:36]
B
Yeah.
- [18:36]
A
Ferraris are very, very shiny and special. So let's talk about the treatment for endometriosis. And I think, you know, this is. I love this because I can kind of share what I think, which is probably more than even what the layperson does, and then I get to bounce it off of you. So horrifically underfunded surgeries are horrifically. Underfunded reimbursement for physicians. Horrifically underfunded. But a common treatment is, excuse me for the word castration, by giving Lupron to suppress hormones. Urologists give Lupron for advanced prostate cancer. And so for me, I'm like, I know what that drug does. And we're giving it to like young 28 year olds. And I'm like, oh my God, we shudder when we give it to 70 year old men. So, so explain why Lupron's used. And if you don't like me using that word, well, we can pick another word.
- [19:26]
C
No, no, it's true. And that's how I started and that's how we treated patients in my residency program have changed. I mean, maybe the way I treat endometriosis is the ALIA body way of treating it, but I've had years of experience and I know what works and what doesn't work. And it's, I can tell you in the past 10 years, I've written two prescriptions for Lupron. So it's extremely rare. I don't use it. So endometriosis for your listeners, I don't know if they know what it is. It's the top cause of pelvic pain in a young woman. And basically this is when endometrial like tissue. So from the day we get our period to the day we're menopausal, our ovaries are trying to get us pregnant. They secrete a hormone, estrogen, where the lining inside the uterus gets thick and juicy, ready for pregnancy. And when we don't get pregnant, the lining breaks down and comes out as a form of period. 10% of women have similar tissue to this endometrial lining in the wall of the uterus that can be called adenomyosis, but most commonly outside of the uterus, around the tubes and ovaries, called endometriosis. And if these cells inside the ovary, then we call it endometrioma, all of it falls into the umbrella of endometriosis. It affects 10% of women. So once a month, when the ovaries are secreting estrogen, and this is the easiest way for me to explain it to patients so they can understand it. So once a month, when the ovaries are secreting their estrogen to get the lining of the uterus ready, these little cells outside of the uterus also get stimulated thinking they're in the uterus. And when we don't get pregnant and we shed the lining of the uterus, these endometriosis cells in the pelvis also break down and bleed, but in reality they're bleeding outside of the uterus. Blood is an irritant. It causes pain. We're not supposed to have blood in our pelvis, so our body sends in, it starts an inflammatory process. These inflammatory cells come to clean up the blood and they start an inflammatory process in the pelvis that can cause scarring of the tubes and, and blockage of the fallopian tubes. It can cause scarring and adhesions in the pelvis. Eventually it can affect the egg count and quality. It starts with painful periods, painful sex with deep penetration, bloating, leg pain, back pain, all sorts of pain, bladder pain, recurrent bladder infections with negative urine cultures. And these patients start bouncing from doctor to doctor. They end up having a colonoscopy because they're bloated. They end up having going to the urologist because they have bladder symptoms. They end up going to pain specialists because they have back pain. They end up going to psychiatrist because someone's telling them, we can't find anything and you're crazy and you need to be on anti anxiety medication. And let me tell you, chronic pelvic pain causes depression. There's not a single human on this planet earth who can constantly be in pain and not become depressed. I've never met such a person. And it starts with painful periods, but then it gets worse, worse. Eventually these patients can't go to work, they have to cancel their social activities, they can't have sex because it's too painful, they're bloated from their leaky gut. Then they gain weight. I mean, it's just a cascade of symptoms that happen one after the other. And then they start bouncing from doctor to doctor and everyone gaslights them, telling them, there's nothing wrong with you. And at some point after 7, 8, 10, 15 years, they start thinking and believing that they're really crazy. And it's so exhausting.
- [23:08]
B
You see it all the time.
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C
I see it all the time. I cry with these patients. I had a 34 year old in my office with zero eggs. She had gone to doctors since she was 20 years old. 20. And when I told her, you have no more eggs, I wanted to vomit in the room. When she was sitting across from me, I started crying with her. She said, the only thing I've ever wanted was a family. And now that I'm married, I can't have a child. How do you answer these patients? Does this ever happen to men? Does anyone talk about it? It's Heartbreaking. And until you spend a day in my office, you don't understand the heartache of these patients. Enough is enough. I'm sick and tired of it.
- [23:50]
B
Well, and that's why we started the podcast. That is why we started the podcast, so that we could, each of our episodes have, you know, we'll have an endometriosis episode, we'll have a menopause episode, we'll have a sex health episode. You know, but really giving all the information that she would give her patients so that they can go and tell this to their doctor, hey, give me this test. Do this, do this. And if the doctor won't do it, then you find another doctor because you're not going to be dismissed anymore. And I think that if we can, and you do that with your podcast, it's like once you educate women, once you give them the right information, then they can be their own health advocate and they can go and say, screw you. I'm not going to be talked down to, and I'm not crazy. And either you fix me or help me get through this, or I'm going to find somebody that will.
- [24:36]
C
And, you know, you were asking me about the treatment for endometriosis. So now all you have to do is sit down and listen to that patient, have medical assistance outside the door before taking history. That before I walk in, they're like, you have a new endo patient. And how do they know? Just by listening to the patient. Now, how do you treat it? So these endometriosis implants, and in simple terms, they grow with estrogen, but their growth slows down by either lowering the estrogen or giving the patients progesterone. What I do in my office for young patients, I start them on either a progesterone only, birth control pill, I give them a progesterone only iud. Any young girls who haven't been sexually active, I give them a small Kyleena iud. If they're older, I use a Mirena iud. And if they don't respond to that, you can go on other medications that help lower that estrogen, like Oralisa or Myfembri. Unfortunately, these pills have the side effects of hot flashes, mood changes, nausea, and they're tolerated well, but they do have side effects. The gold standard treatment for endometriosis is laparoscopic resection of endometriosis. You don't want to go burn it. You want to go in and cut it up. Here's the problem. I'm sure you understand this, Kelly, and you'll appreciate it. If you give 100 laparoscopes, 200 gynecologists, half of them will wake the patient up and say, you didn't have endometriosis. How about that? Talk about gaslighting. These are patients, they listen to your podcast, they go to the doctor and they say, I want a laparoscopy. The doctor puts them to sleep, wakes them up, and say, you didn't have it.
- [26:14]
B
And just because they're not, they just so.
- [26:17]
C
Because endometriosis. Typical endometriosis implants look like black purplish spots in the pelvis. But patients can have stromal endometriosis. It sometimes takes me 15 to 20 minutes to find it. If you have to zoom your camera centimeter by centimeter in the pelvis, behind the uterus, above the uterus, on the bladder, under the ovaries, in the pelvic side wall, abdominal wall, under the diaphragm. You look everywhere and you just see streaks of white lines. Those are stromal endometriosis. And these are patients who get dismissed. I mean, these are patients. I have patients who get 10 out of 10 pain, end up in the emergency room on their period. They have laparoscopy, and the doctor says, you don't have it. I take him back to have, like, stage three endometriosis. I can't even begin. What happens to these poor patients? Yeah, I mean, I get emotional talking about it because I'm upset for them. I've done a bowel resection on a patient of mine who's coming on our podcast. This is an actress with great access. She went to so many doctors in Los Angeles, and they told her there was nothing wrong with you. They told her she was anxious. When I did her surgery, we had to resect a part of her bowel because she had so much scarring from the endometriosis food couldn't pass through.
- [27:42]
B
She was young, and she was young.
- [27:44]
C
She was 34 years old. And when I was operating, I told my partner, I never forget that day. It was years ago, maybe, I don't know, six, seven years ago. I looked at my partner and I said, if this was my daughter, I would have turned this town upside down to have a bowel resection at 34. Because doctors dismiss you. And this happens. Imagine if this is happening in Beverly Hills. What do you think is happening to people in Middle east, in Thailand, and in all these other countries around the
- [28:13]
B
world, the United States, that we call these medical wastelands.
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C
So we need, need. We need. We need help in women's health.
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A
To me, I'm going to ask you to try to dig us out of the pit of despair. But I'm going to make it worse first and then we're going to have to dig out of it.
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B
Well, then talk about pcos, right?
- [28:29]
A
Yeah, yeah, let's add that on. So to me, I'm like, with my podcast, you know, my podcast has been going for five years now. And like, I know because I've had that much time, I know that the world is changing for better because of it. Like, women are going in, they're getting their vaginal estrogen, they're starting on their hormones, they're talking to their partners about sex, they're having better sex. Like, I can see that getting better because of the education we're providing. And I'm like, now you are providing it with the GMD podcast, but you can't make reimbursement for gyne surgery go up. You can't make better gyne surgeons.
- [29:05]
B
You can't.
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A
Like, there's so much that you can't because, like, that's just such the bigger barrier of like, what do you do with all of these educated women you're creating? Because in my, like, where I am in Washington state, women are already waiting one to two to three years to get in with a good endometriosis surgeon. I'm not saying don't educate the women, but I'm like, with me, I'm like, unless we run out of estrogen patches, like, right. It's a simple fix. To me, I'm like, what the hell are you going to do? Medicare, they're not going to start paying for appropriate reimbursement for 7 hour endometriosis surgery. Like, what are we going to do?
- [29:45]
C
So first of all, it's not seven hours, it's outpatient in the hands of a good surgeon with even with the stage four, we can get that patient out under two hours.
- [29:53]
A
That's I've heard, like, if it's brutal, it can take a long time again.
- [29:58]
C
But if you're good at license of adhesions, and usually I can have a gut feeling when someone has a stage 4 endometriosis because sometimes on ultrasound they have endometriomas. We call it kissing ovaries. The ovaries are touching posterior to the uterus, so you know you're going to deal with adhesions. I usually calm the uterus down with oralista or my fembre and then six months later I go in and operate. So there are ways around that. But to answer your question, I think the only hope left is. I know people hate this one.
- [30:31]
B
I love it.
- [30:32]
C
We need robotic doctors. My daughters are at Stanford. They're in biotech. I beg them, and they're like, mommy, what do we do? I'm like, make a GYN robot. That's. I need a doctor, a robot. I need, like, you need to have your robot. If they let us train our own robots and we let our robots go, imagine if we had your robot for menopause. Look how many people we could have saved. You know, there are these amazing medications for endometriosis. And the reps would come to my office, bring me lunch and do this. And one day I got so frustrated with them, and I'm like, don't come to my office. I don't need you to bring me lunch. I'm already writing this prescription, the problem with your medication. And the drug rep said, well, no one's writing for it. They're not writing for it because they need to diagnose it first. If the patient is not being diagnosed with endometriosis, your prescription medication is not going to be filled at the pharmacy. So instead of coming to my office and this other office and that other office and trying to convince doctors to diagnose it, educate women, empower them at home to become their own health advocate. So if you have someone who's doubled over in pain, who's not going to school, who gets bloating, painful sex, recurrent UTIs and all these random symptoms, and different people can have different symptoms or chronic pelvic pain and they're getting dismissed, at least they know to Google endometriosis specialist near me, you know, or someday a robotic. And the chatgpt right now will diagnose these patients.
- [32:03]
A
Yeah, well, I know it's coming because I have friends working on it. On it, because this is the, this is the problem with healthcare is like, how do you clone the experts, right? And like you said earlier, you know what it takes for you to become you and for me to become me, it takes that obsessive. I won't stop personality. And then it's true. And then clone that you AI that is coming. Yeah.
- [32:32]
B
And one of the things when we met, we, you know, I sat down and I said, okay, I'm just gonna. I need to take you and you in the hands of. In the ears and eyes and give all your information to all women. And one of the things she said, we were talking about endometriosis and pcos and she said, you get PCOS when you have your period and you have it for the rest of your life. And she said, there are questions that I give every single patient that comes to my office and I can diagnose it and my nurse practitioners diagnose it. And so we talked about that. I was like, okay, let's create a place where a woman can go on and take, take all the questions that you have. And then they get, you know, you can't diagnose online. You have to say you have the likelihood or whatever. And that's what we did. We created that for ovi. For pcos, it's free. You go, you get the same questions. Unfortunately, with endometriosis, it's harder.
- [33:21]
C
It's harder because it affects so many different systems and they have so many different way of presenting. But eventually, again, you can put your symptoms for pcos. Pcos. I mean, let's talk about that. Let's talk about that. You know, PCOS and endometriosis go hand in hand. Half of PCOS patients have endometriosis. So when you see pcos, you better not dismiss the endometriosis and the pelvic pain and the heavy period and the miscarriage and everything else that comes with it. So it's very important to diagnose all of it, because if you diagnose and treat PCO as enudismous endometriosis, your patient's still not better. If you diagnose and treat the endo, but you completely dismiss the PCOS part of it, your patient's not going to feel better. But generally speaking, PCOS is even a bigger disaster than endometriosis.
- [34:10]
B
But we're getting, we're going to. This is hope. We're going to give you some hope.
- [34:14]
C
So polycystic ovarian syndrome. And I'm so happy. I get, honestly, I want to fly when someone gives me the mic and I can bring awareness to at least the people who listen to you or the moms who have daughters at home suffering from this. So polycystic ovarian syndrome affects 15% of women in this country. If you go to Middle Eastern countries, that number can go north of 20%.
- [34:34]
A
And incidence is going up.
- [34:36]
B
Yes, diagnosis is going up.
- [34:38]
A
Diagnosis is going up.
- [34:39]
B
And 75% don't know that they have it.
- [34:42]
C
So literature says 75% of patients are never diagnosed. I think that number is 90%. Because you'd be shocked how many people have it and don't know that they have it. And they bounce from doctor to Doctor and they start thinking they're crazy, too. So these are patients they usually. You need two out of three of the following criteria to get diagnosed. Number one is irregular history of irregular periods. Number two is PCOS looking ovaries on ultrasound. Polycystic ovarian syndrome does not mean you have cysts. It means that it's a specific look to the ovary with multiple follicles. We call it string of pearls. That is a specific finding on ultrasound. Now, by itself, that's not a diagnosis. But if you have two out of three criteria, you can diagnose the patient. The second one, PCOS looking ovaries on ultrasound. And number three is elevated testosterone symptoms or elevated testosterone in the blood. So you do not have to have a high testosterone in the blood to get the diagnosis. But what is high testosterone symptom? Acne, hair loss, facial hair and body hair being the most common symptom of pcos. These patients. So how many people do you know, like, at 35, they still are dealing with acne. That's PCOS until proven otherwise. You're not supposed to have acne at 35. You're not supposed to have hair loss when you're 25 years old. You're not supposed to have three periods a year or five periods a year when you're young. You're not supposed to have a lot of facial hair, body hair. Some Middle Eastern Mediterraneans have that. But if you have it with other associated symptoms, then you can't dismiss it. PCOS patients have, have mood disorders. They're moody people. They suffer from anxiety and depression. I don't know if they have, you know, was it the chicken or the egg? Is it because they lose their confidence because of all these symptoms and all the issues they deal with that they become depressed? But generally speaking, they do have mood disorders and they usually have family history of diabetes, insulin resistance, overweight family members. 75% of them deal with weight issues. These are patients you see on the streets. They're overweight, they have acne, they have some hair thinning pattern, baldness or hair.
- [37:01]
B
But you don't have to have all of them. You could just be insulin resistant and you don't have to have acne or you don't have to, I mean, like. So it's not that you have to have all of these things, Right?
- [37:10]
C
Right, Absolutely. That's a very good point. Queen Carvania stood haloed by the morning sun an army hung on her every word.
- [37:21]
A
My champions, I have sold my chariot on Carvana Twas a Lovely suv.
- [37:28]
C
An inexplicably queenly offer.
- [37:31]
A
They're even coming to the castle to collect it. Tonight we feast. An offer you can feast on. Sell your car today on Carvana.
- [37:42]
B
Pick up.
- [37:42]
A
These may apply. My understanding of it now is it's really like a metabolic disorder of the ovary, and it's tied in with metabolic syndrome and insulin resistance. Can you kind of enlighten us on that? And the big question is, like, why is it happening?
- [37:57]
C
So a lot of us, you know, like, insulin resistance is very common, and 75% of PCOS patients gain weight. And the one thing before we go into insulin resistance that I want to bring up is a lot of teenagers with weight issues who are eating what their friends are eating, exercising, just like their friends, but they're gaining a lot of weight, end up going down the path of an eating disorder. And my mission in life is to, if I could, go into every eating disorder center and educate the clinicians there to make sure they rule out PCOS in their patients before they start diagnosing them with bulimia and this and that eating disorder.
- [38:43]
A
The eating disorder is a response to the.
- [38:45]
B
It's a result of. Correct.
- [38:48]
C
And because these patients are not diagnosed and dismissed, they get so frustrated with their weight that they start going down the wrong path. If you diagnose them, treat them, get their hormones imbalance, fix their insulin resistance. They're not crazy. They don't. Nobody wants to go to the bathroom and make themselves throw up after lunch if they don't gain the weight. They just do it because they're so
- [39:08]
B
frustrated and their body isn't working properly anymore.
- [39:12]
C
So insulin resistance, the way I describe it to my patients is in simple terms, when we eat carbohydrates and our body breaks it down into glucose, glucose stimulates our pancreas to release a hormone called insulin. The job of insulin is it opens up the receptors on the surface of the cells to grab the sugar, put it into the cell, where it turns into energy. This is what's supposed to happen. PCOS patients genetically have insulin resistance. No one caused this. They're just born with it. So at a young age, this insulin resistance, when they eat sugar and their body is releasing this insulin, their receptors don't respond right. So the glucose in the blood needs to be cleared. And I'm simplifying this again so for listeners to understand. So as the sugar stays in the blood, it pushes our insulin up as insulin goes up. Insulin is fat storage hormone. It's the last hormone in your body that you want it to go up. As insulin goes up, it does two bad things to the body. Number one, it tells your body, take this sugar, clear it, and store it as fat. So these are patients who have, have maybe a couple of slices of pizza. They gain weight, and their skinny friend sits across from them and eats the whole pizza and shows up the next day in her skinny gene. That's where the frustration comes. And they're eating, eating less, doing the same amount of exercise, but she's gaining weight and her skinny friend isn't. So weight gain is one issue. But high insulin in PCOS patients stimulates the ovaries to release testosterone, normal amounts of insulin that is required for us to function. However, PCOS patients either have androgen sensitivity, so their body is sensitive to the amount of testosterone that their ovaries are secreting, or they have higher levels of testosterone. Again, you don't need to have a high testosterone to get the diagnosis. But the combination of either androgen sensitivity or high testosterone gives them symptoms of irregular period because it blocks their ovulation. Facial hair, body hair, male powder hair thinning acne, body acne, facial acne. And these are the most common symptoms. So everything is related. So when it comes to pcos, you want to treat the symptoms of pcos, because PCOS doesn't have a cure, you have to regulate their symptoms. Now, one of the ways to do it, obviously a low carbohydrate diet is a must. Exercise is a must. I tell my PCOS patients, just like you would to diabetic patients, go for a walk after you eat, open up these receptors, clear that sugar out of your blood. But the problem is diet and exercise doesn't always cut it for these patients. And that's when the frustration comes and they start going down the path of an eating disorder or disordered eating. Almost all of them either have a disordered eating or an eating disorder. You combine that with anxiety and mood change that they're predisposed to easy weight gain, anxiety, depression, what do you get? An eating disorder. And they get dismissed and dismissed and dismissed, missed one after the other, until every single time I diagnose a PCOS patient, they start crying in my office, Every single one of them. The first thing they tell me is, I feel validated. I'm not crazy. I knew there was something wrong with me. So I want these patients to know that it's not like they have an irregular period and they have acne and they have facial hair and they're gaining weight and they have an eating, you
- [42:38]
A
don't have seven things wrong with you.
- [42:39]
C
You have one thing, one thing.
- [42:41]
B
Bravo.
- [42:42]
C
And that's why when I met Mary Alice, I was so frustrated. You know, my passion in life is endo, PCOS and breast cancer awareness. And when I met her, I'm like, if we're going to do cmd, we have to do something for pcos. Because I'm so frustrated and usually I would have these patients, I would diagnose them and I had to give them like 12 supplements plus prescription medication. In 2014 I started giving them the GLP1s which, which you people found out few years ago. But I was using this for PCOS literally in 2014. I was giving them Trulicity Kelly. And back then that's how I was using it to drop their weight. But I would give them all these supplements. And when I met Mary Alice, I'm like, the biggest gift we can do for women, especially younger women, is to have a platform where they go, obviously I can't diagnose them on a platform, but at least I can can tell them whether or not they have the likelihood of having PCOS or not. So I basically started this calculator and I use all the questions that I ask in my office and we have these patients for free, go on the platform, answer these questions and we'll tell you whether or not you have the likelihood of having pcos. And we're doing all these podcasts aren't available, I'm talking about it, so at least they know know how to deal with it. But the best thing I've done in my life, besides marrying my husband and having children and adopting my little daughter, the littlest daughter, is this OVI platform because we partnered up with the smartest scientists on the planet and with 20 some years of PCOS experience, basically we created this supplement that has 16 ingredients. And it's honestly, and I'm not for people who know me, they know I don't advertise, I'm actually shy about these things. But this is a game changer for PCOS patients. It really truly is. It regulates their hormones, it balances their weight, it has a lot of anti inflammatory supplements in it because PCOS patients have a chronic inflammation and it has a lot of antioxidants. And let's not forget that 40% of PCOS patients also have endometriosis. So imagine how much I talked right now, double that. That's my counseling for pcos. And after I finish this and I tell them what we need to do for pcos, then I start talking about endometriosis and add, what we talked about earlier. I do that. And if they're bloated, then I start talking about sibo, small intestinal bacterial overgrowth, which is a result of endometriosis in these patients. Chronic inflammation in the pelvis, caus, leaky gut. Leaky gut makes you more insulin resistant. So this vicious cycle just, it gets worse. So you have to treat the pcos, you have to treat the endometriosis, you have to deal with the sibo and on top of all of this, and I'm going to finish with that. PCOS and endometriosis affect egg quality, not count. Two things. PCOS patients, generally speaking, polycystic, it's polyfollicular. They have a lot of follicles, so
- [45:59]
B
they have a lot of eggs.
- [46:00]
C
They have a lot of eggs, so their egg count is high, goes down after 30. Endometriosis lowers quality and count. So you cannot sit here and say, oh, I have good eggs, I'm 24, I'm fine. You don't know, I have 18 year old, I send for egg freezing. Unfortunately, you have to be 18 in this country to do egg freezing. I have 14 year olds who have the egg count of a 40 year old with endometriosis. So I try to operate on that, suppress them until I get them to 18 and I freeze their eggs. So it's so important for patients a, to know their egg count. It's a simple blood test. Anti mullerian AMH or anti mullerian hormone test, covered by insurance. You can do it at any time in your cycle. It's a simple test. If your egg count is good, follow it every year. But just know that if you have endometriosis or PCOS or both, I usually start having that conversation with a normal egg count at about 25 and I tell them, and 30, I want you to freeze eggs. And that's because of quality, not quantity for a lot of these patients. And the last point, Sorry, I keep talking because I have opportunity to educate, but when you freeze eggs, you don't know the quality of it. So numbers make a difference. You want to have at least 20 eggs. So if you do one cycle of egg freezing and you get 10 eggs, then guess what you have to do one more time. If you're my daughter, I would have you do 30 eggs. The problem is it's so exp. You can't afford it, right? When you're young and you have good eggs, you can't afford it when you're older. And you have no eggs, then you can afford eggs. So it's so true. And it's not covered by insects.
- [47:43]
B
You try your whole life not to get pregnant. You know, from the moment you have sex, you're really trying not to get pregnant. And then when you want to get pregnant, it's like, no, too late.
- [47:54]
C
But the quality of it comes when you make an embryo. So if you have a partner and you don't want to have kids and you have endometriosis and pcos, freeze em. Because we can tell you you made five embryos. Three of them are good. You made six embryos or you made no embryos. But if you're only freezing eggs because you don't have a partner, then you just want to freeze eggs, but you want to have a minimum of 20. I hope this is a quick and fast explanation for all this, but I
- [48:25]
B
will say we launched this platform. It hasn't even been three months. And the people that have written in. We've had had so many women tell us they're pregnant. I mean, we've had so many. I know, it's crazy. We had so many young girls say, I've got my period. Oh, my God.
- [48:43]
A
Yeah, I'm, like, bloated.
- [48:44]
B
I've lost weight. I've. You know, and I'm. I don't know if I'm even allowed to say that, but I'm just telling you. But it's the truth.
- [48:49]
C
I'm just telling you.
- [48:50]
B
Which means I'm telling everybody.
- [48:51]
A
You're allowed. Yeah, I'm just telling you. Recording.
- [48:55]
B
No, but it's. No, but it's. Honestly, and I think you understand this more than anybody else when you're doing something like this, and you really are changing the world for women. God, we get to wake up every day and do that.
- [49:08]
A
It's the best job in the world.
- [49:09]
B
It's a gift.
- [49:10]
A
It's a gift.
- [49:11]
B
It's. And I. I mean, I wish.
- [49:13]
A
I wish the world was different so I didn't have this amazing job.
- [49:16]
C
Right.
- [49:16]
A
Like, that's the dream is like, put yourself out of business. But do you know, because of the need, you. You will never be out of a job. And, you know, I think the themes between. Between you being on my podcast right now, me doing your episode, is like the power of listening to the patient, helping them feel seen, giving them information. People are smart. They'll make the right decisions.
- [49:43]
C
Evening. Buyer's remorse. Buy a new car.
- [49:46]
A
I'll be moving in.
- [49:48]
C
Let's get started. Sorry, I think there's been A mistake. I bought it from Carvana. You what? Yeah, great price. I even have seven days to love it or return it. So there's no, no, no buy remorse.
- [49:59]
A
More like buyers rejoice.
- [50:01]
C
I guess I'll let myself out. Congratulations.
- [50:05]
A
I mean it. Buyers rejoice.
- [50:07]
C
Buy your car today on Carvana. Limitations and exclusions may apply.
- [50:10]
A
See our seven day return policy@carvana.com and the other theme that I think came up between the two podcasts is like, we all think we're doing a good job. And then you start this platform. I mean you, you clearly know, Dr. A, you know that you're not, we're not doing a good job for endometriosis and pcos, but by and large, doctors think they're doing a good job.
- [50:27]
C
Good job.
- [50:27]
A
Then you start this platform three months ago and they come out of the frickin woodwork.
- [50:32]
B
It's crazy, right? I mean, and then you're like, oh God, it's big, it's unbelievable. And, and I think that that was, you know, when, when you said if I could get every young girl in my office, I would shut down fertility
- [50:46]
C
and I would shut them down, but I would them go bankrupt. Yeah, so many people go into it.
- [50:52]
B
But I think another theme from both of our podcasts that we talked about today is prevention. Like, nobody's talking about prevention. And it's whether it's hormone therapy or whether it's OV or the, or the medicine that you give for ptcos. Like, we've got to get to the root cause of all this before it becomes a disease, before you are in a mental hospital because you think you're crazy and everybody tells you that you are. I think that that's it. And I think what you guys are doing, I'm the person sitting here that doesn't have a medical degree. So my job is literally to ask you, when you say something, what is that really? But you two on your podcast are educating women to be their own health advocate, but you're also educating doctors. And I think, you know, every day we have our podcast, she is a masterclass. Like these are the questions that I ask my patients. So yes, she's arming the patients, but you're also arming the doctors. So I think that there's, you know, having more of y' all out there doing the work that you're doing is going to change, change the world for women health.
- [51:53]
A
Thank you. Yeah, I mean, the role of trans being medical translators. Right?
- [51:57]
B
And like, I love that medical translator.
- [51:59]
A
Before we wrap up I have to tell you, my issue with pcos, that annoys me. We were talking about that.
- [52:04]
B
Yeah.
- [52:04]
A
So what annoys me about PCOS is that everybody always is like, well, testosterone's bad for women because in PCOS they have X, Y and Z. And I'm like, that is so annoying. Because testosterone doesn't cause pcos.
- [52:20]
B
Right.
- [52:20]
A
And it's an abnormal level of testosterone. Not physiologic, but all of the, like, air quotes. Testosterone research on women is looking at PCOS people and then extrapolating. And I'm like, that's an abnormal condition for multiple reasons. Don't use that as the reason why women shouldn't take testosterone.
- [52:40]
C
Bravo.
- [52:40]
A
So to me, like, that's my most irritating thing is like, people like, oh, testosterone, pcos, testosterone bad. And I'm like, no, everything too much
- [52:50]
B
or everything too little is bad. You want to get into this place of It's Goldilocks.
- [52:55]
C
But I wanted to say, and that's a great point, if you've been diagnosed with PCOS and now you're premenopausal, you're menopausal, postmenopausal, and you have decreased libido, you should use a testosterone cream. That's not a contraindication. We can sit here and talk all night and all day. There's just so much misinformation. And that's why I always tell patients, if in doubt, maybe go on ChatGPT, at least get diagnosis. And you get. You'll hope that, you know, it's been trained correctly, it will eventually be trained
- [53:27]
B
perfectly, or go on CMD where you are not broken.
- [53:31]
C
But in reality, you know, dealing with postmenopausal decreased libido and testosterone issues has nothing to do with polycystic ovarian syndrome, which is a condition of reproductive age and the insulin resistance and stays with these patients. So the weight gain, the risk of diabetes, all of that can stay. But hormone replacement therapies, hormone replacement therapy, and anyone on this planet can use it.
- [53:57]
B
So I actually have a question about that for you about that. So if you have PCOS and you have high testosterone, so you get all the symptoms, the androgen issues, you hit perimenopause and menopause, it's quite possible and probable that your testosterone now will do what it does with everybody else. So this is. This high testosterone is really helpful happening around reproductive age. Reproductive age. So you never get cured from pcos. So the insulin resistance and all of that stays, but the testosterone gets your ovarian function.
- [54:28]
A
Yeah, the ovarian function terminates just like every other menopausal woman.
- [54:33]
B
Great.
- [54:33]
A
So let's bust that mist now. You're perimenopause or postmenopause. So many women will say, I'm worried my endometriosis is going to flare, so I don't want to go on hormones. Or I've been told by my doctor I can't go on hormones because of history of PCOS and history of endometriosis. Can you clear that up for us?
- [54:50]
C
So, yes, let's talk about that. So patients with advanced stage endometriosis, they are in general at a increased, higher, increased risk of ovarian cancer in their life. So for patients who've had multiple. And these patients are the ones who get multiple cycles of IVF because they don't get pregnant. So one of the options for these patients at very high risk advanced disease, pelvic pain, is at menopause to just take their ovaries out. But doing hormone replacement is not a contraindication indication. In patients with history of pcos, it's like talking about apples and oranges. I don't even want. Do you know what? There's no discussion. If you have pcos, you can absolutely do it. With endometriosis, I always do a pelvic ultrasound. You want to make sure if you have an endometrioma, I get it out. What's an endometrioma is endometriosis inside the ovary. It's a chocolate cyst. It's a very distinct finding on ultrasound. You cannot confuse it with anything else. But because of the higher risk of ovarian cancer, it's very, very easy at menopause. And definition of menopause, we say no period for a year. That means ovarian function goes down. There are studies that say the testosterone keeps treating for. For patients with any abnormal finding in the pelvis at menopause, I would recommend removing your ovaries. But hormone replacement is. So it's life changing for these patients.
- [56:12]
B
I mean, so do you have endometriosis for the rest of your life?
- [56:16]
C
No.
- [56:17]
B
Once your period stops, it stops.
- [56:19]
C
It stops. Okay. Yeah. But what she's saying is that if you go and hormone replacement, could you make these implants grow? There are some patients with advanced disease, when you give them hormone replacement, they start complaining of pelvic pain again. But that's very rare after menopause. After menopause, but those are usually the ones within some there's some kind of finding in their pelvis.
- [56:41]
B
So there's something Else in their pelvis.
- [56:42]
A
Yeah. Especially for the women who've been treated. Right. I've had my surgery. I'm pain free. I've been treated. Yeah, get on the. Get on the hormones.
- [56:50]
C
And we have to. I think people forget how low dose
- [56:52]
B
these hormones are, which is why I sometimes put seven.
- [56:58]
A
One on the left side of the body, one on the right side of the body.
- [57:00]
C
No, she had two and two. That's the truth. I wanted to kill her.
- [57:05]
A
But, oh, I told. Just like, to tell a quick story about how low dose they are. I had a woman who, like, I'm a urologist. I get to see all genders. Husband came to see me for a urology issue. He brings in his wife. He's like, nobody's been able to help her. Can you try to help her? And depressed, dressed in black, is an artist, doesn't do her art. And I'm like, listen, I don't have many tools in my toolbox, but I've got hormones. When did this all start? You know, fibromyalgia, chronic pain, depression, all the things, all the labels. And she's like, oh, around age 50. And I'm like, has anybody offered you hormones? And she's like, no, she's like 58 now or something. And so throw her on a very low dose estrogen patch. See her back, she's no longer wearing black. She started painting again. Now she's smiling and laughing. The husband says, I have my wife back, thank you. And I say, and so I check her labs and I say, congratulations, I've given you the estrogen level of your husband.
- [58:01]
B
I love that because it's like, it's.
- [58:03]
A
It's, you know, at 30, estrogen at 30, that's a male estrogen level.
- [58:08]
B
Right.
- [58:08]
A
And I think women don't understand, like, postmenopause, your estrogen is lower than a man's estrogen. And when you point to the husband and be like, he's got more than you, then they're like, oh, so it's really low.
- [58:22]
B
Well, we had talked earlier, I don't know if it was on our podcast or your podcast, that my sister had been at the menopause conference and had run into you. And we had to go to Tennessee, which is where we're from, right after that conference. And she was like, she had learned so much there, and she's so inspired by everything that y' all were doing. And she had probably all of her high school friends were there. They were all calling her. She's an mp. Like this. I'm having this, I'm having this, I'm having this. I'm just. All the symptoms of menopause, but my doctor won't give me hormones. None of the doctors would give her hormones. And my sister was like, fuck that. Like, I'm going to give you. She's like, when is enough enough? When do we have to suffer enough? Like, this is insane. So I think sometimes those of us out here in LA and New York and that have much better access to new information to. We, we've debunked the Women's Health Initiative. You know, like, we know that that was a bad study, but we forget, you know, you talk about Middle Eastern countries. I'm saying that this is happen country in more places than we could ever imagine. And women are suffering just like our moms did. And that has to change. And Kelly, that is why this podcast is so important, because you do scream it from the rafters. And we do it on our podcast, too. But to have an expert like you really being able to say, you know what? I got educated. I didn't know enough. And I spent the time to go out there and really understand what's going on at this stage in a woman's life. And I don't know, just bravo. Because I think that it might just be chipping it away way one, you know, now my sister, who's in Washington D.C. she's educated in the practice where she works, and we're just doing this one little baby step at a time. And eventually, like you said, these, maybe these robotic doctors that'll have all the information from AI.
- [60:09]
A
Yeah, yeah, no, it's. It's coming. It has to come. Like, it has to come. We can't all be. We can't change the entire ship, but we can change the water the ship's in by education, educating the women.
- [60:19]
B
Yeah, totally.
- [60:20]
A
Well, so I'll put all the links to. To your amazing PCOS platform and GMD in the show notes. Any place else you want people to find you. Where can they go for more? Because I don't. I don't do a lot of pcos and endo on this podcast. So I'm so glad this episode's talking about it. And if people want more, where else can they go?
- [60:37]
B
I mean, Honestly, it's both. Ovii.com for PCOS and then GMT podcast. We literally do break down everything a woman could possibly. We talk about parenting, we talk about, about, you know, menopause, pcos, anything that women are going through, all from, you know, the lens of a woman. And then this woman over here has like 500,000 Instagram followers and she gives a lot of good information on there. But I really think and by the way, for our younger audience, they probably only want to look at Instagram. So beyond me. I have no idea how to do social media. But you do such a good job of getting your information out there in such a really easy, tangible way that everybody can understand. So I think, yeah. GMDpodcast.com and OV OVI guide.com I love it.
- [61:20]
A
Thank you so much for coming on.
- [61:22]
B
Thank you for having us and thank you for all the work you do.
- [61:24]
C
Kelly, you're amazing.
- [61:25]
B
Yeah, you are.
- [61:28]
A
Thank you for listening to this week's episode of you Are Not Broken. If you want to dig deeper with me, sign up for my Adult Sex Education Masterclass where you learn adult things like communication skills, anatomy lessons and desire types and how to talk to your doctor about sexual health concerns. If you want the Adult Sex Education Masterclass for free, join my monthly membership for more in depth exclusive content, more time with yours truly. A private podcast, coaching and educational empowerment and you can watch my interviews live and get them immediately without advertising. Head over to www.kellycaspersonmd.com for the membership and adult Sex Ed Masterclass members. Get the masterclass for free. This podcast is presented solely for educational, entertainment and informational purposes. I am a doctor but not your doctor in this format and all of my platforms and guests including on this podcast are not giving individual medical advice or practicing medicine. See and consult with your own care team for your individual needs and concerns. This podcast is not intended as a substitute for the care and advice of a physician, therapist or other qualified professional. This podcast does not constitute the practice of medicine in case you are curious about serious about that and no doctor patient relationship is formed. But I still love you. Using the information on this podcast or any of my platforms is at your own risk. Until next time, remember you are not broken.