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Speaker 1: Yea. Welcome to the Therapy for Black Girls podcast, a

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Speaker 1: weekly conversation about mental health, personal development, and all the

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Speaker 1: small decisions we can make to become the best possible

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Speaker 1: versions of ourselves. I'm your host, Dr Joy hard and Bradford,

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Speaker 1: a licensed psychologist in Atlanta, Georgia. For more information or

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Speaker 1: to find a therapist in your area, visit our website

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Speaker 1: at Therapy for Black Girls dot com. While I hope

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Speaker 1: you love listening to and learning from the podcast, it

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Speaker 1: is not meant to be a substitute for a relationship

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Speaker 1: with a licensed mental health professional. Hey y'all, thanks so

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Speaker 1: much for joining me. Prossession to thirty two of the

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Speaker 1: Therapy from Black Girls Podcast. We'll get right into the

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Speaker 1: episode after a word from our sponsors. Concerns like pcos, fibroids,

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Speaker 1: and endometriosis are often very painful and complicated, but are

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Speaker 1: also often misdiagnosed. Joining us today to chat about these

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Speaker 1: gynecologic concerns that impact our health and sometimes fertility, is

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Speaker 1: Dr Ashley Davis. Dr Davis is a gynecologic specialist at

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Speaker 1: the fibroid In Pelvic Wellness Center in Peachtree Corners, Georgia.

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Speaker 1: She received her Bachelor of Science at Peri View A

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Speaker 1: and M University and went on to attend medical school

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Speaker 1: at the University of Tennessee. Upon graduating, Dr Davis entered

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Speaker 1: the residency program in Obstetrics and Gynecology and Mount Sinai

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Speaker 1: Hospital in New York. She completed a post doctoral fellow

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Speaker 1: at M. D Anderson's Ovarian Cancer Research Lab. She is

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Speaker 1: not only Board certified and obstetrics and gynecology, but has

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Speaker 1: also received a Focused Practice designation in Pediatric and Adolescent

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Speaker 1: Gynecology from the American Board of Obstetrics and Gynecology. During

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Speaker 1: our conversation, Dr Davis shared about the symptoms of pcos,

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Speaker 1: endometriosis and fibroids, what some common treatment plans might include,

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Speaker 1: and things you might want to consider related to fertility.

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Speaker 1: If something resonates with you while enjoying our conversation, please

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Speaker 1: share it with us on social media using the hashtag

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Speaker 1: TVG in Session. Here's our conversation. We are very excited

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Speaker 1: to dig into lots of like women's health kinds of topics,

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Speaker 1: and there have been lots of conversations and questions from

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Speaker 1: our community about like fertility and things that lead to infertility,

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Speaker 1: and so we really wanted to have an expert on

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Speaker 1: to talk about some of these things. And so one

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Speaker 1: of the things that has come up a lot within

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Speaker 1: the community is PCOS, and so I would love for

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Speaker 1: you to maybe start by telling us a little bit

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Speaker 1: about what PCOS is and how it can show up

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Speaker 1: in our bodies. So PCOS is basically a disorder. It's

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Speaker 1: a syndrome or polycystic ovarian syndrome, and it's and it's

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Speaker 1: basically a disorder of anovulation. So every month you're supposed

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Speaker 1: to ovulate and that's what triggers your period. But in

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Speaker 1: women with PCOS, they don't ovulate and so you cannot

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Speaker 1: have a period. It's also tied to a syndrome. It

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Speaker 1: can be associated with pre diabetes, elevated cholesterol, and sometimes obesity.

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Speaker 1: The main symptom that you're gonna have is one of

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Speaker 1: three things. You're going to not have your cycle every month.

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Speaker 1: You may have signs of excess testosterone like acne, or

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Speaker 1: maybe you notice some growth on your chin or your chest,

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Speaker 1: you know, excessive hair growth, you feel like you're really hairy,

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Speaker 1: or having polycystic ovaries on ultrasound, got it, Yeah, And

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Speaker 1: you know, we often hear about PCOS as it's related

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Speaker 1: it's a fertility but my understanding is that it can

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Speaker 1: predispose us to all sorts of health problems. Can you

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Speaker 1: say more about how it impacts us in ways not

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Speaker 1: connected to fertility, So it can predispose you to in

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Speaker 1: some resistance or predispose you to pre diabetes. And really

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Speaker 1: the main thing with PCOS that I try to explain

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Speaker 1: to my patients is when you are not on any

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Speaker 1: hormonal therapy and not having a cycle, it's very unhealthy

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Speaker 1: for your uterus because every month, when your body doesn't

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Speaker 1: get that signal to have a cycle, the lining can

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Speaker 1: continue to build up, and that can put you at

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Speaker 1: higher risk of cancer or pre cancer of the lining

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Speaker 1: of the uterus. When we're treating PTOs, that's really the

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Speaker 1: main thing we're trying to prevent is making sure you

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Speaker 1: have a cycle so you're not predisposed to that. And

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Speaker 1: so when you have patients that come to you who

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Speaker 1: think they may have PCOS is having a miscycle typically

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Speaker 1: the first symptom they have or how might we know

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Speaker 1: this might be something we're struggling with if you don't

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Speaker 1: have a cycle every month, So if you're not having

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Speaker 1: a cycle at least every one to thirty five days,

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Speaker 1: you definitely need to be evaluated for PCOS. There's other

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Speaker 1: things that can cause miss periods as well, like thyroid vs. Prolactin,

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Speaker 1: but PCOS is very common and so you definitely need

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Speaker 1: to be worked up for that. Got it? What are

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Speaker 1: some treatment options for somebody who has been diagnosed with

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Speaker 1: PCO is So first I said, like, the main thing

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Speaker 1: is we want to get your period back to protect

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Speaker 1: the lining of your uterus so you're not predisposed to

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Speaker 1: cancer the line of the uterus. So that looks like

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Speaker 1: some form of usually hormonal therapy like birth control pills

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Speaker 1: or um A merina i e D. It's an io

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Speaker 1: D that has some progesterone in it that keeps the

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Speaker 1: lining of the uterus. Then it also involves lifestyle changes

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Speaker 1: because you are at higher risk of developing high cholesterol

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Speaker 1: and and resistance or pre diabetes. I like to send

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Speaker 1: my patients to a PCOS nutritionist that can help them

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Speaker 1: with the lifestyle changes. Sometimes that includes weight loss, sometimes

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Speaker 1: it doesn't because not all PCOS patients are overweight, so

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Speaker 1: they can optimize their diet for that lifestyle and then

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Speaker 1: hormones are not the only medications available. Sometimes we can

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Speaker 1: use things like mac Foreman, which is a diabetes medication.

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Speaker 1: And then sometimes the therapy is just targeted at some

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Speaker 1: of the other symptoms of the hydro sastone, like the

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Speaker 1: acne and the excessive hair growth, and you can use

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Speaker 1: other medications like pronolactone for that, and so Dr Davis,

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Speaker 1: might you be on maybe a couple of those medications

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Speaker 1: depending on which you're symptoms exactly exactly, okay, okay, Yeah,

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Speaker 1: And I would imagine that may be difficult, especially for

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Speaker 1: people who maybe don't like to take a bunch of medicine. Yeah,

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Speaker 1: can you talk a little bit about, like maybe how

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Speaker 1: you talk to patients about this and what their treatment

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Speaker 1: plan looks like. I find that a lot of people

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Speaker 1: they've been told the a PCOS and they're given a

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Speaker 1: birth control pill and they're not told why they need it,

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Speaker 1: and they're like, well, I don't want to take this,

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Speaker 1: you know, it makes me feel crazy or might you're

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Speaker 1: worried about weight gain. And when I really explained to

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Speaker 1: them why we're giving you hormone therapy, were really trying

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Speaker 1: to protect the lining of your uters, keep your uterus

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Speaker 1: healthy so you can you know, conceive one day. They're

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Speaker 1: usually more accepting. There's a lot of different forms of

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Speaker 1: birth control and hormonal therapy, some that you don't even

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Speaker 1: have to take every day of the month. And so

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Speaker 1: just finding a doctor that's open to having that conversation

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Speaker 1: that's not just giving you a pack of pills and

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Speaker 1: say hey, take this, but giving you all the alternatives.

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Speaker 1: Got it? Got it? And so is this something that Okay,

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Speaker 1: maybe you're on this medication for like six months to

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Speaker 1: a year and then we see it like subside or

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Speaker 1: is this something that they typically have to be on

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Speaker 1: for like the rest of their lives. It depends. I've

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Speaker 1: definitely had patients that noticed that some lifestyle changes, either

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Speaker 1: if you are overweight, sometimes losing weight, or even if

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Speaker 1: they're not overweight, doing the lifestyle changes like I talked

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Speaker 1: about speaking to a nutritionists exercising, they're able to get

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Speaker 1: their period back and you can have pcos and reach

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Speaker 1: a stage where you are having a regular cycle. In

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Speaker 1: that case, you don't need to be on hormonal therapy.

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Speaker 1: Got it, Okay, So really we are trying to do

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Speaker 1: whatever we need to do to make sure that we

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Speaker 1: do have the regular cycle exactly, because that's your main

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Speaker 1: concern is that we don't want the uterine lining too

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Speaker 1: to thick in so that it predisposes you to a cancer.

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Speaker 1: Listen to me talking like that's excellent. Thank you. I

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Speaker 1: appreciate you breaking that down because you know, sometimes like

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Speaker 1: there's all these big words, and you know it can

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Speaker 1: be sometimes difficult to understand. So I appreciate you sharing

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Speaker 1: in a way that makes it really understandable for people,

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Speaker 1: like why this is a concern. Yes, I think that's

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Speaker 1: super important. You need to speak to patients like which

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Speaker 1: you have to be able to communicate with your doctor. Yeah,

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Speaker 1: thank you for that. You know something else that when

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Speaker 1: we told people we were having an expert to come

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Speaker 1: on and talk about some of these women's health concerns,

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Speaker 1: it seems like there's a little bit of a misconception.

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Speaker 1: Or you can tell me whether this is a myth

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Speaker 1: or a fact our Black women more prone to PCO

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Speaker 1: as compared to other ethnicities. I think that is a myth.

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Speaker 1: Hold on, I'm gonna fact check it. We love a

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Speaker 1: fact check. No, I think that is a myth. I mean,

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Speaker 1: it's a very very common condition and it can affect

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Speaker 1: a lot of women, m but there's nothing that that

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Speaker 1: you've read or study that would indicate that black women

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Speaker 1: to have a higher risk for pcos and other people

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Speaker 1: got it. Okay, Okay. So something else that comes up

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Speaker 1: as a part of this conversation is endometriosis. And I

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Speaker 1: know that there are some similarities between endometriosis and PTOs.

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Speaker 1: Can you talk about the differences and is it possible

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Speaker 1: for somebody to have both. It's definitely possible for someone

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Speaker 1: to have both. So endometriosis, the definition of that is

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Speaker 1: when you have the tissue that's supposed to be inside

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Speaker 1: the lining of the uterus is actually outside the uterus

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Speaker 1: and can be in the pelvis, it can be anywhere

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Speaker 1: in the body, most commonly found in the pelvis, and

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Speaker 1: those implants of endometriotic or endometrio like tissue cause inflammation

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Speaker 1: that can cause pain and a host of other problems.

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Speaker 1: It can cause infertility, pain with sex, bloating, gash or

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Speaker 1: intestinal symptoms, and it can also cause you know, irregular bleeding.

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Speaker 1: And I definitely have patients who have endometriosis and pcos

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Speaker 1: and it can really cloud the pitch it because they're

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Speaker 1: not getting a period every month, but when they do

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Speaker 1: get their period, it's really really painful. I have some

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Speaker 1: of the other like you know, elevated cholesterol, pre diabetes

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Speaker 1: that associated with the PCOS, and you know, on top

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Speaker 1: of dealing with the pain, the main symptom of endometriosis,

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Speaker 1: patients are gonna present with pain and that's going to

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Speaker 1: be in the main sense symptom, whereas with PCOS, their

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Speaker 1: main symptom is going to be I'm not having my

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Speaker 1: period every month. And so is the pain with endometriosis

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Speaker 1: typically when you get your cycle or is it like

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Speaker 1: pelvic pain like all the time. So it's typically presents

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Speaker 1: as being worse with your cycle, having a cycle that

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Speaker 1: is so painful that you're not able to go about

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Speaker 1: your daily activities, like if they're staying doc you know,

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Speaker 1: I have to miss work when I have my period,

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Speaker 1: or I have this history of I had to stay

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Speaker 1: home from school every month, I throw up, I pass out.

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Speaker 1: That is not normal, and that really clues us in

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Speaker 1: that this may be endometriosis. The longer that it goes

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Speaker 1: untreated and undiagnosed, it can progress to you having pain

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Speaker 1: with sex. You can progress to you having pain all

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Speaker 1: the time, or pain, you know, the week before your

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Speaker 1: period and not just on your period, so it can

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Speaker 1: presented a lot of different ways. And so you know

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Speaker 1: when you said like pain before your period, it made

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Speaker 1: me think of pmd D. Right, So some women talk

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Speaker 1: about having PMDD experiences. Can you talk about like what's

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Speaker 1: the difference between that and endometriosis. Well, pmd D is

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Speaker 1: really a mood disorder, does that make sense? Whereas endometriosis

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Speaker 1: is a pathology like in the pelvis, it is associated

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Speaker 1: with the hormonal changes that happened leading up to your cycle.

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Speaker 1: And where there's PMDD kind of describes the symptoms that

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Speaker 1: affect you know, their mood. When we can have severe

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Speaker 1: depression anxiety, it becomes suicidal because of that. However, you

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Speaker 1: know if you have anometriosis in your severe pain and

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Speaker 1: you're vomiting and you can't go to work, of course

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Speaker 1: you're going to be more likely to be depressed. So

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Speaker 1: those symptoms commingle and people may think they have PMDD,

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Speaker 1: but it really is, Oh, you're just in a lot

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Speaker 1: of chronic pain and that can definitely affect your mood.

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Speaker 1: More from my conversation with Dr Davis after the break,

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Speaker 1: So as you're talking, Dr Davis. I mean it definitely

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Speaker 1: sounds like so much of this can sound like the

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Speaker 1: other things, right, and so I'd love for you to

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Speaker 1: be able to share at least a little bit or

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Speaker 1: whatever you can around like how you make decisions depending

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Speaker 1: on what your clients come into you saying they're concerned about.

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Speaker 1: The main difference is going to be pelvic pain d

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Speaker 1: D versus when patients maybe come with a presenting symptom,

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Speaker 1: if they have anxiety or depression around their period, and

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Speaker 1: I'll ask them, how are your periods? How long are

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Speaker 1: your periods? If they're the lasting ten days? Of course

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Speaker 1: that's gonna affect you. Do you have pain with your periods?

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Speaker 1: And anybody that has pain with their cycles, I'm going

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Speaker 1: to be very suspicious severe pain with their cycles that

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Speaker 1: keeps them from doing their day to day activities. It's

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Speaker 1: not relieved by ibuprofen or mind all. I'm gonna be

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Speaker 1: concerned about endometriosis. Got it okay? And what might a

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Speaker 1: treatment plan for endometriosis look like? So initially it can

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Speaker 1: start with again hormonal therapy, especially for women who their

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Speaker 1: pain is just with their cycles, giving them medication or

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Speaker 1: hormonal therapy or like the I E. D. Where you

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Speaker 1: don't have a cycle at all, it can definitely help

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Speaker 1: with those symptoms. If you don't have a period, they

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Speaker 1: don't have the pain, and that it can really change

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Speaker 1: their life. What's important and where a lot of physicians

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Speaker 1: go wrong is we're kind of taught that birth control

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Speaker 1: pills are the first line therapy for endometriosis, but they

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Speaker 1: don't work for everyone, and so it's really important that

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Speaker 1: you have a good relationship with your physician and are

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Speaker 1: able to advocate for yourself and say, hey, try this treatment,

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Speaker 1: but it's not working. I'm still in pain, I'm still

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Speaker 1: not able to function, I still have pain in between

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Speaker 1: my cycles, and we need more evaluation. No one should

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Speaker 1: be diagnosed without at least getting a public ultrasound. You

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Speaker 1: can't see endometriosis on a public ulture sound, but it

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Speaker 1: can rule out other things. Okay, So yeah, so you're

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Speaker 1: trying to not necessarily see endometriosis, but you're trying to

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Speaker 1: rule out whether there's something else, got it. Okay. So

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Speaker 1: you mentioned that a lot of people are trained to

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Speaker 1: use birth control as the first line for a lot

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Speaker 1: of things, and when you talked about like the pain

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Speaker 1: that comes with endometrios is. And we know how often

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Speaker 1: black women talk about like how doctors don't believe their pain.

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Speaker 1: I'm wondering if you can talk a little bit about

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Speaker 1: maybe some of the medical biases that might make it

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Speaker 1: difficult when black women go in for treatment for some

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Speaker 1: of these concerns. Well, of course, this a history of

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Speaker 1: racism in medicine, where medicine was established in slavery. A

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Speaker 1: lot of our gynecological procedures were developed and discovered by

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Speaker 1: practicing on enslaved women without their consent. So there's a

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Speaker 1: history there and actually being an over gun that used

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Speaker 1: to be a very male dominated field because of the

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Speaker 1: surgical field, and so there's a long history of them

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Speaker 1: kind of being paternalistic and thinking they know what's best

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Speaker 1: for a woman rather than a woman giving her complaints

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Speaker 1: and us working together and trying to find a treatment plan.

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Speaker 1: And so people will find that when they come with

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Speaker 1: their complaints, as soon as they open their mouth, their

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Speaker 1: doctor already had an idea of what's wrong with them. Oh,

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Speaker 1: this could just be fixed with birth control pills. And

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Speaker 1: so when you go to the doctor, one thing that

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Speaker 1: you need to look for is when somebody that takes

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Speaker 1: your concerns seriously and that offers you some type of

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Speaker 1: like diagnostic testing, and you are also allowed to request

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Speaker 1: that if that's not what's offered. Can you say more

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Speaker 1: about like asking for some of these tests that are

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Speaker 1: not offered anybody with any type of period complaint, If

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Speaker 1: you're in pain, if your period is too long, you

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Speaker 1: need a public ulture sound. And I think that that

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Speaker 1: step is often missed, that's kind of looked over and say, well,

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Speaker 1: we'll try medication first and see if it gets better,

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Speaker 1: whereas I always I think we should always start with

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Speaker 1: the public ulture sound so we can actually make an

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Speaker 1: effort to diagnose what's going on. And if the doctor says, oh,

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Speaker 1: you know, let's start to a medication first and see

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Speaker 1: how you do you you ask it, you know, I

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Speaker 1: would actually think I should get a public ulture sound.

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Speaker 1: What do you think about that? Do you think that

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Speaker 1: would be a good idea? And most of the time,

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Speaker 1: you know, physicians do care. They will you know, acquiesce

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Speaker 1: and though if your patient is asked for a test

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Speaker 1: and it is indicated, they will give it to you.

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Speaker 1: If not, there's other doctors, right, So I mean so

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Speaker 1: that I think you bring up a good point, right,

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Speaker 1: Like if you are going to a doctor and you

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Speaker 1: ask for a test that you think could help to

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Speaker 1: rule out some things or give more information, and the

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Speaker 1: doctor isn't willing to do that, that may be a

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Speaker 1: sign that you might need a new provide exactly or explain.

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Speaker 1: If they're not able to articulate to you why you

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Speaker 1: don't need it and it doesn't make sense to you,

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Speaker 1: you can always get a second opinion that's never gonna

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Speaker 1: be harmful at all. So I would encourage people you

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Speaker 1: get to get a second opinion because you need to

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Speaker 1: be sure about your treatment planning. You need to know

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Speaker 1: what's going on with your body. Are there any like

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Speaker 1: specific diets, are lifestyle changes that somebody can make that

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Speaker 1: helps to curb the symptoms of either PCOS or endometriosis

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Speaker 1: you talked about, like maybe you know something related to

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Speaker 1: nutrition to try to get like you know, diet under control,

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Speaker 1: But are there other things you suggest? So there's no

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Speaker 1: like discrete evidence that this lifestyle intervention affects your pain

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Speaker 1: or can affect endometriosis pain. So for PCOS, it's different

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Speaker 1: because sometimes the weight loss avoiding carbs obviously avoiding cholesterol

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Speaker 1: and fat. If you have elevated cholesterol will affect PCOS

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Speaker 1: both endometriosis. I typically tell people to try to just

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Speaker 1: have a um anti inflammation diet, have a healthy diet,

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Speaker 1: lots of fruit and vegetables, avoiding what's called exogenous estrogen,

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Speaker 1: so any foods with a lot of estrogen. There's things

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Speaker 1: that we put in our lotions that we use and

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Speaker 1: just trying to basically use I don't like to say

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Speaker 1: clean ingredients, but trying to avoid extra hormones and even

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Speaker 1: that sometimes it's in birth control pills. I say that

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Speaker 1: from my fibroid and enometriosis patients, and I think you

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Speaker 1: have to figure out what works for you. I wish

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Speaker 1: there was a diet I could prescribe that I do

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Speaker 1: would help everybody. I think it's about researching, you know,

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Speaker 1: about the lifestyle changes and seeing if you notice that

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Speaker 1: if you're exercising more, that your periods are not as bad,

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Speaker 1: or your pain is it as bad if you're avoiding

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Speaker 1: certain things. Some people cut out meat and that helps them,

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Speaker 1: some people cut out dairy and that helps them. Just

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Speaker 1: see how it goes m hm. So it really is

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Speaker 1: just trial in error, Yes, exactly, for a lot of it,

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Speaker 1: got it, got it, So something else. Dr Davis that

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Speaker 1: has come up a lot. Most recently, Tiffany Cross had

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Speaker 1: a segment on her Saturday morning show, The Cross Connection

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Speaker 1: where she talked about like having surgery for her fibroids,

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Speaker 1: and so many people, it seems like, have these stories

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Speaker 1: about these orange size, lime size, like different size fib

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Speaker 1: broids that they end up having to have surgery for.

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Speaker 1: Can you talk a little bit about what fibroids are

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Speaker 1: and like how they develop? So, fibroids are benign or

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Speaker 1: noncancerous tumors or growths of the muscle tissue of the uterus.

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Speaker 1: They typically develop in the muscle ligning of the uterus.

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Speaker 1: They can be anywhere on the uterus. We don't know

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Speaker 1: exactly what causes them or why they start, but they

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Speaker 1: can grow and they usually cause heavy bleeding. They can

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Speaker 1: also cause pain, pulvic pressure and in some cases about

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Speaker 1: timbers and the cases in fertility and so do they

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Speaker 1: always require surgery or do they like go away by themselves?

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Speaker 1: Sometimes because they don't go away by themselves, they're always

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Speaker 1: going to be there. Everyone's different. So some way, when

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Speaker 1: may have one centimeter or a grape size fibroid and

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Speaker 1: it stays that way for years. Other people have that

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Speaker 1: size fibroid and it grows to the size of alime

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Speaker 1: in two or three years. And there's people that will

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Speaker 1: grow to the side of candle open one year, so

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Speaker 1: it's different in everybody. We know that those tumors are

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Speaker 1: sensitive to estrogen, and estrogen is what your body makes

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Speaker 1: every day. That's what makes you a woman, that social

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Speaker 1: ovaries make, and so they're very common that they will grow.

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Speaker 1: The majority of fibroids are not symptomatic, like women don't

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Speaker 1: have symptoms of heavy bleeding. They may find them incidentally

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Speaker 1: on an ultrasound or some other form of imaging, and

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Speaker 1: in those cases you don't need to do anything if

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Speaker 1: you don't have any symptoms of heavy bleeding or pain.

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Speaker 1: But we should always keep an eye on them to

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Speaker 1: make sure they're not growing rapidly. So that means an

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Speaker 1: ultrasound at least every couple of years or every year,

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Speaker 1: or your doctor examining you to make sure they're not progressing.

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Speaker 1: If they are symptomatic, we could again use medications, some

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Speaker 1: hormonal therapy, some non hormonal therapies that can slow down

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Speaker 1: the bleeding. That can be associated with the fibroids. And

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Speaker 1: then there's surgical options and not all those options are hysterectomy.

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Speaker 1: That's super important to to say. Yeah, and is that

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Speaker 1: one of those things too where a lot of physicians

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Speaker 1: will kind of rush to a hysterectomy as opposed to

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Speaker 1: drying some of it. And historically, especially for black women,

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Speaker 1: because there's a history of for sterilization and black women

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Speaker 1: in this country where they're sterilized against their will and

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Speaker 1: one it hystoriccts me is one of the ways of

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Speaker 1: doing that. Yes, some doctors if they offer you the

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Speaker 1: first thing, especially if you're young and you haven't had children,

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Speaker 1: and they say, the first thing you need is a

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Speaker 1: hystoricct to me, and they don't talk to you about

395
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Speaker 1: every single option you need to get another opinion. Yeah,

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Speaker 1: it definitely seems like it would be that kind of thing,

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Speaker 1: especially maybe physicians who have been trained for a long time, right,

398
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Speaker 1: the maybe their first line of defense. Yeah, it should

399
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Speaker 1: not be the first thing that's talked about at all. Right, right,

400
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Speaker 1: got it? And so how can fibroids impact your fertility

401
00:21:14,760 --> 00:21:17,280
Speaker 1: so fibrous in fact fertility if they're in the lining

402
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Speaker 1: of the uterus, So the baby needs to implant on

403
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Speaker 1: the inside of the uterus, in the uterine cavity, and

404
00:21:22,000 --> 00:21:25,080
Speaker 1: if the fibroid is either pressing in on that cavity

405
00:21:25,240 --> 00:21:28,960
Speaker 1: or actually inside the cavity, it can interfere with implantation.

406
00:21:29,119 --> 00:21:32,600
Speaker 1: Or if it's blocking the fallopian tube that's the tube

407
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Speaker 1: where the egg needs to get from the ovary into

408
00:21:34,840 --> 00:21:37,760
Speaker 1: the uterus. But it's rare that they're in that location.

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Speaker 1: So again it's about ten percent of the time that

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Speaker 1: it's affecting fertility. Got it, Okay? Yeah, And Tiffany mentioned

411
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Speaker 1: when she was talking about it, like one of her

412
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Speaker 1: symptoms was that her hair was falling out and she

413
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Speaker 1: knew because it also happens there a mom and I

414
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Speaker 1: had not heard of like hair lass as being related

415
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Speaker 1: to fire broids. Can you talk about that, Well, that's

416
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Speaker 1: because of the anemia. So the women and I've seen

417
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Speaker 1: this coming their first co plate, maybe that their hair

418
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Speaker 1: is falling out or they feel tired, and they find

419
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Speaker 1: it that they're anemic. And you'd be surprised how many

420
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Speaker 1: times and physicians don't look closely at Okay, what is

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Speaker 1: causing this anemia? And women may not tied to their

422
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Speaker 1: period because their periods have always been seven to ten

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Speaker 1: days and really heavy, and they think that's normal for them.

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Speaker 1: They don't recognize it. They're losing so much blood it's

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Speaker 1: making them sick. Yeah, because I could imagine if hair

426
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Speaker 1: loss was your first symptom, you probably would start with

427
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Speaker 1: like your primary care doctor, maybe a dermatologize, and if

428
00:22:38,119 --> 00:22:40,440
Speaker 1: they found that you were anemic, they would put you

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Speaker 1: on some kind of iron templement. I'm guessing right. And

430
00:22:43,920 --> 00:22:47,920
Speaker 1: so how would you then connect that to maybe a

431
00:22:48,000 --> 00:22:50,080
Speaker 1: fire broard or something like? Who would ever know to

432
00:22:50,359 --> 00:22:52,760
Speaker 1: to think of? They should know, they should know, that's

433
00:22:52,800 --> 00:22:56,520
Speaker 1: the point. So my non physician training would not let

434
00:22:56,600 --> 00:23:01,520
Speaker 1: me know. But a position position a physician, God, you have, Ama,

435
00:23:01,600 --> 00:23:03,520
Speaker 1: we need to figure out, Okay, why are you anemic?

436
00:23:04,680 --> 00:23:07,359
Speaker 1: Got it okay? And there's some blood what we can

437
00:23:07,400 --> 00:23:09,760
Speaker 1: do to see if it's iron deficiency anemia which is

438
00:23:09,840 --> 00:23:12,680
Speaker 1: usually associated with blood loss. But we have seen patients

439
00:23:12,720 --> 00:23:15,679
Speaker 1: you haven't been gone to a hematologist and getting ivy

440
00:23:15,800 --> 00:23:20,119
Speaker 1: iron and no one's talked about Okay, why are they bleeding? Okay?

441
00:23:20,200 --> 00:23:23,880
Speaker 1: So it is sometimes, yes, it is, unfortunately, So it's

442
00:23:23,960 --> 00:23:26,480
Speaker 1: important to have these type of podcasts where patients know

443
00:23:26,720 --> 00:23:28,720
Speaker 1: what to look for, how to look for the science

444
00:23:28,760 --> 00:23:30,879
Speaker 1: and symptoms. And I can tell you that if you

445
00:23:31,040 --> 00:23:33,440
Speaker 1: are bleeding so heavily that you're bleeding for your clothes,

446
00:23:34,080 --> 00:23:36,240
Speaker 1: that you feel, you know, weak and tired on your

447
00:23:36,280 --> 00:23:38,920
Speaker 1: cycle or your period last more than seven days, that

448
00:23:39,080 --> 00:23:42,840
Speaker 1: needs to be evaluated. More from my conversation with Dr

449
00:23:42,960 --> 00:23:55,960
Speaker 1: Davis after the break, are there other things that you've

450
00:23:55,960 --> 00:23:57,959
Speaker 1: seen like that, Dr Davis that you feel like, Oh,

451
00:23:58,040 --> 00:24:00,480
Speaker 1: I really wish more people knew about this. I would

452
00:24:00,520 --> 00:24:03,320
Speaker 1: love for them to know that there's an average of

453
00:24:03,680 --> 00:24:06,119
Speaker 1: three to five years before women get treated for their

454
00:24:06,160 --> 00:24:08,879
Speaker 1: fire broids, and it's usually because they're scared, you know,

455
00:24:08,920 --> 00:24:11,960
Speaker 1: they're scared of surgery, they're scared of the treatment options,

456
00:24:11,960 --> 00:24:14,280
Speaker 1: they're scared of gaining weight on birth control pills, or

457
00:24:14,720 --> 00:24:17,560
Speaker 1: because they've never tried them. And I would just say

458
00:24:17,640 --> 00:24:19,280
Speaker 1: that I really want them to try to find a

459
00:24:19,359 --> 00:24:21,199
Speaker 1: doctor that they can trust that will go over all

460
00:24:21,280 --> 00:24:24,040
Speaker 1: the options with them so they can feel comfortable making

461
00:24:24,040 --> 00:24:27,440
Speaker 1: a decision and not to just suffer so many women

462
00:24:27,480 --> 00:24:30,960
Speaker 1: they suffered for so long before they get help. And

463
00:24:31,160 --> 00:24:33,600
Speaker 1: as a personal story, like my mom had five broids

464
00:24:33,600 --> 00:24:37,600
Speaker 1: and nimetriosis and suffered for years that I saw growing up.

465
00:24:37,640 --> 00:24:39,840
Speaker 1: She would be in pain during her cycle, she would

466
00:24:39,920 --> 00:24:42,720
Speaker 1: kind of disappear. And it wasn't until like I wasn't O,

467
00:24:42,800 --> 00:24:44,520
Speaker 1: B G U A N and started learning about them

468
00:24:44,560 --> 00:24:46,080
Speaker 1: in medical school, and I was like, I don't think

469
00:24:46,080 --> 00:24:48,359
Speaker 1: what you're going through is normal. I think you may

470
00:24:48,400 --> 00:24:50,480
Speaker 1: have adometriosis. And she's like, when no one's ever told

471
00:24:50,520 --> 00:24:52,960
Speaker 1: me that. Yeah, And she ended up having a hysterect

472
00:24:53,040 --> 00:24:55,080
Speaker 1: me later when she was in her fifties and she's

473
00:24:55,240 --> 00:24:57,359
Speaker 1: you know, she's suffered for so many years. Yeah, you know,

474
00:24:57,480 --> 00:24:59,119
Speaker 1: you bring up a really good point. We had a

475
00:24:59,240 --> 00:25:02,760
Speaker 1: conversation in an earlier session with Dr Sarah Flowers. I

476
00:25:02,840 --> 00:25:06,159
Speaker 1: think her name is just about like socialization like related

477
00:25:06,200 --> 00:25:09,040
Speaker 1: to our cycles and so hearing you talk about like

478
00:25:09,160 --> 00:25:11,600
Speaker 1: your mom being in so much pain, Like I think

479
00:25:11,600 --> 00:25:13,800
Speaker 1: a lot of our moms and grandmother's like just talked

480
00:25:13,800 --> 00:25:16,399
Speaker 1: about like being in pain, and we then grow up

481
00:25:16,440 --> 00:25:18,679
Speaker 1: thinking like, Okay, well we're just supposed to like suffer

482
00:25:18,840 --> 00:25:21,280
Speaker 1: this pain for a couple of days out of a month,

483
00:25:21,320 --> 00:25:23,359
Speaker 1: But it actually could be something else going on. We

484
00:25:23,400 --> 00:25:25,640
Speaker 1: could be serious and it can be something that's treatable,

485
00:25:25,640 --> 00:25:27,480
Speaker 1: and it doesn't mean that you have to have a

486
00:25:27,560 --> 00:25:30,040
Speaker 1: hysterect to me and his correct me is the right

487
00:25:30,480 --> 00:25:33,639
Speaker 1: choice for some people and other circumstances, but you deserve

488
00:25:33,720 --> 00:25:36,200
Speaker 1: to just go through all the options. It's so funny

489
00:25:36,280 --> 00:25:38,280
Speaker 1: from my patients they come and knowing that they want

490
00:25:38,320 --> 00:25:40,480
Speaker 1: to his direct me because they've completed having their children,

491
00:25:40,520 --> 00:25:42,800
Speaker 1: and I still go through all of the options, all

492
00:25:42,880 --> 00:25:44,680
Speaker 1: the medications. They're like, can we just skip to the

493
00:25:44,800 --> 00:25:49,280
Speaker 1: last one. I'm like, everything, I just want to make

494
00:25:49,320 --> 00:25:54,080
Speaker 1: sure we explore all the options. So you've already talked

495
00:25:54,119 --> 00:25:57,720
Speaker 1: a lot about using hormonal things to kind of address

496
00:25:57,800 --> 00:26:00,200
Speaker 1: some of these other concerns. But I'm wondering for people

497
00:26:00,240 --> 00:26:02,760
Speaker 1: who maybe are thinking, like, Okay, I want to start

498
00:26:02,800 --> 00:26:04,639
Speaker 1: maybe some kind of birth control. Can you talk to

499
00:26:04,760 --> 00:26:07,680
Speaker 1: us about the different kinds of birth control that exists,

500
00:26:07,800 --> 00:26:10,359
Speaker 1: and then how you make decisions about maybe what is

501
00:26:10,440 --> 00:26:12,800
Speaker 1: the best one for your patients. So I let the

502
00:26:12,800 --> 00:26:15,800
Speaker 1: patients aside what's the best one for them. But there's

503
00:26:15,840 --> 00:26:18,080
Speaker 1: so many different types of The one that people know

504
00:26:18,200 --> 00:26:21,399
Speaker 1: about the most is pills, and that's something you have

505
00:26:21,480 --> 00:26:24,159
Speaker 1: to take every day. It's a combination of estrogen and

506
00:26:24,280 --> 00:26:29,080
Speaker 1: progesterone together that works similarly to your cycle, and you

507
00:26:29,119 --> 00:26:31,680
Speaker 1: can have a cycle every month. It's cycles similarly to

508
00:26:31,840 --> 00:26:36,520
Speaker 1: your normal hormones. That's one of the easiest um things

509
00:26:36,600 --> 00:26:39,600
Speaker 1: that estrogen progesterone combination comes in a pill form, a

510
00:26:39,720 --> 00:26:43,440
Speaker 1: patch form, and a ring form, and so the patch

511
00:26:43,560 --> 00:26:45,000
Speaker 1: you have to change once a week, the ring you

512
00:26:45,080 --> 00:26:47,920
Speaker 1: have to change once a month, and so it really

513
00:26:47,960 --> 00:26:51,080
Speaker 1: kind of just depends on how much effort daily effort

514
00:26:51,119 --> 00:26:53,760
Speaker 1: the patient wants to put in. Another favorite option is

515
00:26:54,040 --> 00:26:57,160
Speaker 1: the I E D intreator and device. There's two kinds.

516
00:26:57,280 --> 00:27:00,800
Speaker 1: One that has hormones and the hormones are very localized.

517
00:27:01,320 --> 00:27:03,960
Speaker 1: I think it's a great option for people that want

518
00:27:04,000 --> 00:27:06,920
Speaker 1: to minimize their exposure to hormones because most of the

519
00:27:06,920 --> 00:27:10,200
Speaker 1: action is local because it's inside the uterus. It keeps

520
00:27:10,240 --> 00:27:12,840
Speaker 1: the lining of the uterus stin and prevents pregnancy that way,

521
00:27:13,160 --> 00:27:15,960
Speaker 1: and it can last for five years and you have

522
00:27:16,080 --> 00:27:18,800
Speaker 1: a small amount of progestion only there's no estrogen in

523
00:27:18,880 --> 00:27:21,280
Speaker 1: it that's in your bloodstream, so the side effects are

524
00:27:21,440 --> 00:27:24,159
Speaker 1: very minimal. And there is a I U D that

525
00:27:24,320 --> 00:27:26,639
Speaker 1: has no hormones that last for ten years, but it

526
00:27:26,720 --> 00:27:29,720
Speaker 1: makes your periods heavier and longer and more painful, and

527
00:27:29,840 --> 00:27:31,760
Speaker 1: most of my patients are already suffering with that, So

528
00:27:32,240 --> 00:27:34,080
Speaker 1: it's not something that use that often, but it's still

529
00:27:34,160 --> 00:27:38,640
Speaker 1: there and a good option. There's other long acting ones

530
00:27:38,720 --> 00:27:41,479
Speaker 1: like the implants, the contracept of implant called the next

531
00:27:41,560 --> 00:27:45,000
Speaker 1: one on. It lasts for three years. It's another progesterone

532
00:27:45,080 --> 00:27:49,359
Speaker 1: only form. The main side effect with that one is

533
00:27:49,400 --> 00:27:51,679
Speaker 1: it can sometimes have a regular bleeding. But there's patients

534
00:27:51,720 --> 00:27:54,520
Speaker 1: to do great with it. I think that the most

535
00:27:54,680 --> 00:27:57,120
Speaker 1: important thing that people need to recognize. Like when they're

536
00:27:57,160 --> 00:28:00,560
Speaker 1: looking at birth control options, everyone's freaked out by potential

537
00:28:00,600 --> 00:28:02,920
Speaker 1: side effects. You know, try it and see, you know

538
00:28:03,040 --> 00:28:05,280
Speaker 1: what it does, and if you want to dis continue

539
00:28:05,400 --> 00:28:07,520
Speaker 1: or you want to try something else, we try something else.

540
00:28:07,680 --> 00:28:09,399
Speaker 1: Got it? Thank you for that. Yeah, I mean it

541
00:28:09,640 --> 00:28:11,959
Speaker 1: does seem like there are so many different choices now.

542
00:28:12,040 --> 00:28:13,879
Speaker 1: You know, back when like I was in college, like

543
00:28:14,000 --> 00:28:16,719
Speaker 1: thinking about birth control, like all of these options did

544
00:28:16,760 --> 00:28:19,200
Speaker 1: not exist. So it's good that there are so many

545
00:28:19,280 --> 00:28:21,480
Speaker 1: different options and you can pick, like you said, like Okay,

546
00:28:21,560 --> 00:28:23,639
Speaker 1: let me try something and see how it works and

547
00:28:23,680 --> 00:28:25,480
Speaker 1: maybe that is a good one, or maybe I try

548
00:28:25,560 --> 00:28:29,560
Speaker 1: something exactly You're not locked in and the pill is

549
00:28:29,600 --> 00:28:32,200
Speaker 1: not associated with weight gain in the studies. I know

550
00:28:32,359 --> 00:28:34,200
Speaker 1: that it happens to some people, So you just have

551
00:28:34,280 --> 00:28:37,840
Speaker 1: to see how it works for you. Yeah, So what

552
00:28:38,000 --> 00:28:40,120
Speaker 1: are some of the questions that young women should be

553
00:28:40,160 --> 00:28:43,640
Speaker 1: asking themselves regarding fertility? You know, we often hear about

554
00:28:44,040 --> 00:28:47,000
Speaker 1: this biological clock and you only have so many years.

555
00:28:47,360 --> 00:28:50,120
Speaker 1: First of all, is the biological clock real like and

556
00:28:50,240 --> 00:28:56,400
Speaker 1: we're working against Unfortunately it's got it okay. So some

557
00:28:56,520 --> 00:28:59,320
Speaker 1: people may know that they want children later, maybe people

558
00:28:59,360 --> 00:29:01,720
Speaker 1: on the side it. What kinds of thing should people

559
00:29:01,800 --> 00:29:04,680
Speaker 1: be thinking about in their youngest years, maybe you know,

560
00:29:05,160 --> 00:29:08,440
Speaker 1: eighteen over, about their fertility and like how to maybe

561
00:29:08,640 --> 00:29:10,880
Speaker 1: have some of those options open for later. So the

562
00:29:11,040 --> 00:29:13,600
Speaker 1: most important thing they can do is wrap it up.

563
00:29:13,920 --> 00:29:17,080
Speaker 1: So chlamydia is the number one cause of infertility because

564
00:29:17,120 --> 00:29:20,840
Speaker 1: it can scar your tubes. So just thinking about overall,

565
00:29:21,040 --> 00:29:24,560
Speaker 1: protecting your space, can protecting your organs, making sure that

566
00:29:24,680 --> 00:29:28,560
Speaker 1: you're having safe sex with a partner that's tested. I

567
00:29:28,640 --> 00:29:31,160
Speaker 1: think that is the number one thing. The second is

568
00:29:31,240 --> 00:29:33,600
Speaker 1: keep an eye on your periods. If your periods are

569
00:29:33,640 --> 00:29:37,000
Speaker 1: painful or they last longer in seven days to seek

570
00:29:37,520 --> 00:29:40,280
Speaker 1: you know, evaluation, to make sure that your unterse stays healthy.

571
00:29:40,720 --> 00:29:43,360
Speaker 1: You have pcos, you know, making sure that your unter

572
00:29:43,440 --> 00:29:46,720
Speaker 1: stays healthy, that you're taking the medications of the precautions

573
00:29:46,760 --> 00:29:49,240
Speaker 1: or lifestyle changes whatever you and your doctor decided to

574
00:29:49,360 --> 00:29:51,800
Speaker 1: make sure you're having your cycle. And unfortunately we have

575
00:29:51,920 --> 00:29:55,320
Speaker 1: to think about age. Your fertility does decline as you

576
00:29:55,440 --> 00:29:59,360
Speaker 1: get older. The perfect solution is to freeze your eggs

577
00:29:59,640 --> 00:30:02,360
Speaker 1: when in your early thirties or late twenties. Are those

578
00:30:02,400 --> 00:30:05,960
Speaker 1: conversations that you are frequently having with patients about freezing eggs.

579
00:30:06,040 --> 00:30:08,600
Speaker 1: It is it's not talked about enough, and unfortunately it's

580
00:30:08,640 --> 00:30:11,560
Speaker 1: not accessible to everyone because it is can be so expensive.

581
00:30:11,600 --> 00:30:14,680
Speaker 1: But it's like an insurance policy. You know, right, if

582
00:30:14,680 --> 00:30:18,240
Speaker 1: you don't meet Mr Wright until you're in your late

583
00:30:18,320 --> 00:30:20,880
Speaker 1: thirties or early forties, if you have your eggs frozen

584
00:30:20,920 --> 00:30:24,760
Speaker 1: and you don't have to worry about settling um. The

585
00:30:24,880 --> 00:30:28,640
Speaker 1: other thing, especially my patients with endometriosis, because endometriosis can't

586
00:30:28,680 --> 00:30:32,400
Speaker 1: affect fertility. I've had several young patients that are diagnosed

587
00:30:32,440 --> 00:30:34,960
Speaker 1: when they're twenty twenty three go ahead and freeze their

588
00:30:35,000 --> 00:30:38,320
Speaker 1: eggs so they keep their options open later. M hmm,

589
00:30:38,720 --> 00:30:41,400
Speaker 1: got it. Are there other things that impact fertility that

590
00:30:41,520 --> 00:30:44,760
Speaker 1: we haven't talked about, So a lot of infertilities unexplained.

591
00:30:44,840 --> 00:30:48,000
Speaker 1: About thirty percent of women that are unable to conceive,

592
00:30:48,400 --> 00:30:52,760
Speaker 1: we don't actually find a reason. But it can be

593
00:30:53,080 --> 00:30:56,440
Speaker 1: your ovarian reserve, how many eggs you have left, which

594
00:30:56,480 --> 00:30:59,400
Speaker 1: are affected by your age and sometimes are low, and

595
00:30:59,480 --> 00:31:02,760
Speaker 1: it could best by endometriosis. You have to make sure

596
00:31:02,800 --> 00:31:06,240
Speaker 1: your tubes are working, the connections between your uterus and

597
00:31:06,320 --> 00:31:09,720
Speaker 1: your ovary that can be affected by infection, by previous surgery,

598
00:31:10,280 --> 00:31:14,120
Speaker 1: by fibroids sometimes and then your uterus being healthy. So

599
00:31:14,240 --> 00:31:17,640
Speaker 1: making sure you're endometrium is normal if you have pcos,

600
00:31:17,960 --> 00:31:20,640
Speaker 1: making sure there's no fibroids in the way, and then

601
00:31:20,840 --> 00:31:24,120
Speaker 1: a male factor. So the man has responsibility in this too,

602
00:31:24,840 --> 00:31:27,080
Speaker 1: So in thirty of the time, it's because of the man.

603
00:31:27,440 --> 00:31:30,040
Speaker 1: Got it? Okay? You know we're thinking about like our

604
00:31:30,080 --> 00:31:32,400
Speaker 1: fertility options. Are there any test we can ask for

605
00:31:32,520 --> 00:31:35,720
Speaker 1: from a doctor about like testing fertility and those kinds

606
00:31:35,760 --> 00:31:37,280
Speaker 1: of things, So it depends on where you are. So

607
00:31:37,920 --> 00:31:40,440
Speaker 1: the diagnosis of infertility is when you're not able to

608
00:31:40,480 --> 00:31:42,959
Speaker 1: get pregnant for a year, So when you haven't been

609
00:31:43,000 --> 00:31:45,760
Speaker 1: trying to get pregnant. It's harder to predict, like am

610
00:31:45,800 --> 00:31:48,160
Speaker 1: I going to be able to get pregnant? If you're

611
00:31:48,200 --> 00:31:51,040
Speaker 1: having normal cycles, is likely that you're ovulating every month

612
00:31:51,520 --> 00:31:53,640
Speaker 1: and you're not having pain with your cycles or cycles

613
00:31:53,640 --> 00:31:57,920
Speaker 1: are long, it's reasonable assume that everything is healthy. Another

614
00:31:58,040 --> 00:32:00,560
Speaker 1: test you know everyone asked about is the MH or

615
00:32:00,560 --> 00:32:04,520
Speaker 1: antimalarian hormone, and that gives us an idea of your

616
00:32:04,560 --> 00:32:08,200
Speaker 1: ovarian reserve. That test was actually developed to see how

617
00:32:08,280 --> 00:32:12,720
Speaker 1: well people would respond to infertility medications. We kind of

618
00:32:12,920 --> 00:32:15,880
Speaker 1: use it to determine how many eggs a women has left,

619
00:32:15,920 --> 00:32:18,880
Speaker 1: but it really wasn't developed for that, and it doesn't

620
00:32:19,000 --> 00:32:21,200
Speaker 1: affect your ability even if you're a m H is

621
00:32:21,240 --> 00:32:23,760
Speaker 1: low to be able to get pregnant naturally. So that

622
00:32:24,480 --> 00:32:26,200
Speaker 1: you know test. I know there's a lot of over

623
00:32:26,240 --> 00:32:28,280
Speaker 1: the counter testing available for the a m H, but

624
00:32:28,360 --> 00:32:30,080
Speaker 1: just make sure that you have a conversation with your

625
00:32:30,120 --> 00:32:32,920
Speaker 1: doctor about those results so you don't freak out and

626
00:32:33,000 --> 00:32:37,280
Speaker 1: think that you're infertile just because you have a lower number. Okay,

627
00:32:37,400 --> 00:32:39,400
Speaker 1: So is that like testing like you can do on

628
00:32:39,480 --> 00:32:41,040
Speaker 1: your own. Yeah, there's I know there's a lot of

629
00:32:41,560 --> 00:32:43,240
Speaker 1: and if they have, you know, doing it on your own.

630
00:32:43,280 --> 00:32:44,840
Speaker 1: But I suggest going and you know, and having a

631
00:32:44,880 --> 00:32:46,840
Speaker 1: conversation with your doctor about those tests. You know how

632
00:32:46,880 --> 00:32:49,800
Speaker 1: to interpret it, and we can ask you those questions

633
00:32:49,840 --> 00:32:54,280
Speaker 1: about your uterus, about your periods, about your symptoms. And

634
00:32:54,480 --> 00:32:57,120
Speaker 1: I always ask about everybody's timeline. Are you dating anyone

635
00:32:57,280 --> 00:32:59,120
Speaker 1: or like what you're planning, because some people are like,

636
00:32:59,160 --> 00:33:00,680
Speaker 1: I know, I want to get preven the next year.

637
00:33:00,760 --> 00:33:02,480
Speaker 1: Some people are like, I don't know if I even

638
00:33:02,480 --> 00:33:05,000
Speaker 1: want to get pregnant, or there's not in the you know,

639
00:33:05,080 --> 00:33:08,560
Speaker 1: and all of that is important in this discussion. M hmmm.

640
00:33:09,080 --> 00:33:10,720
Speaker 1: And so is there a certain age of which you

641
00:33:10,800 --> 00:33:13,400
Speaker 1: start having this conversation and maybe about a freezing with

642
00:33:13,480 --> 00:33:16,080
Speaker 1: your patient. I have it early because the younger you

643
00:33:16,200 --> 00:33:19,320
Speaker 1: are the better, especially my patients that they have endometriosis.

644
00:33:19,440 --> 00:33:21,760
Speaker 1: So I offer it to everyone to talk to everyone

645
00:33:21,800 --> 00:33:24,000
Speaker 1: about it, and let's that make the decision. It's such

646
00:33:24,040 --> 00:33:28,280
Speaker 1: a personal decision. Yeah, you know, it really is, and

647
00:33:28,360 --> 00:33:30,520
Speaker 1: it's not something that you do with them in office.

648
00:33:30,560 --> 00:33:32,840
Speaker 1: They would need to go to a to go to

649
00:33:33,000 --> 00:33:35,840
Speaker 1: a yes, infertility physician, and I have a lot of

650
00:33:35,880 --> 00:33:39,640
Speaker 1: pratice fertility positions I can refer them to Perfect Perfect.

651
00:33:40,120 --> 00:33:43,040
Speaker 1: So are there any resources that you find yourself suggesting

652
00:33:43,160 --> 00:33:45,480
Speaker 1: to patients often, you know, related to some of the

653
00:33:45,560 --> 00:33:48,280
Speaker 1: topics that we've talked about. I think it's important to

654
00:33:48,880 --> 00:33:51,680
Speaker 1: have a support group. There's a lot of great endometriosis

655
00:33:52,320 --> 00:33:56,000
Speaker 1: support groups that they can find and fiber support groups,

656
00:33:56,040 --> 00:33:58,160
Speaker 1: so they just know that they're not alone. And women

657
00:33:58,200 --> 00:34:01,960
Speaker 1: are great at sharing resources so they can just get information.

658
00:34:02,080 --> 00:34:04,240
Speaker 1: I tell everyone too, they should do their Internet research

659
00:34:04,320 --> 00:34:06,640
Speaker 1: on the things that I'm suggesting, so you can come

660
00:34:06,720 --> 00:34:08,319
Speaker 1: up with questions and you can come back and ask

661
00:34:08,440 --> 00:34:11,320
Speaker 1: or message me questions. So do your own research, but

662
00:34:11,600 --> 00:34:14,919
Speaker 1: kind of with the guidance of a doctor that you trust. Yeah,

663
00:34:14,960 --> 00:34:18,359
Speaker 1: I think that that's important. Right. We are especially hearing

664
00:34:18,400 --> 00:34:20,640
Speaker 1: a lot about people doing their own research right now,

665
00:34:20,840 --> 00:34:23,520
Speaker 1: but we also want to check in on the research

666
00:34:23,600 --> 00:34:26,239
Speaker 1: with somebody, you know, with the appropriate credentials, because if

667
00:34:26,239 --> 00:34:28,439
Speaker 1: you google everything, they'll they'll tell you that you're about

668
00:34:28,440 --> 00:34:32,759
Speaker 1: to die. Don't Yeah, don't scare yourself on web m

669
00:34:32,800 --> 00:34:35,680
Speaker 1: d and stuff. So Dr Davis tell us where we

670
00:34:35,760 --> 00:34:38,520
Speaker 1: can find you. Please share your website as well as

671
00:34:38,560 --> 00:34:41,080
Speaker 1: any social media handles you'd like to share. So you

672
00:34:41,160 --> 00:34:44,800
Speaker 1: can find me on Instagram at Ashley Davis Underscore m

673
00:34:44,920 --> 00:34:49,840
Speaker 1: D and I practice in Atlanta, Georgia at the Fibrine

674
00:34:49,880 --> 00:34:53,680
Speaker 1: and Public Wellness Center with Dr Sewene Hawkins. I'm sure

675
00:34:53,719 --> 00:34:55,719
Speaker 1: many of you have heard of her. Her website is

676
00:34:55,760 --> 00:34:58,880
Speaker 1: fiber Publicum on this center dot com. Perfect. Thank you

677
00:34:58,960 --> 00:35:01,680
Speaker 1: so much, Dr Davis really appreciate you sharing with us today.

678
00:35:05,600 --> 00:35:07,680
Speaker 1: I'm so glad Dr Davis was able to share her

679
00:35:07,719 --> 00:35:10,919
Speaker 1: expertise with us today. To learn more about her work,

680
00:35:11,360 --> 00:35:13,719
Speaker 1: visit the show notes at Therapy for Black Girls dot

681
00:35:13,760 --> 00:35:17,080
Speaker 1: com slash session to thirty two and don't forget to

682
00:35:17,200 --> 00:35:19,160
Speaker 1: text two of your girls and tell them to check

683
00:35:19,200 --> 00:35:21,640
Speaker 1: out this episode as well. If you're looking for a

684
00:35:21,719 --> 00:35:24,359
Speaker 1: therapist in your area, be sure to check out our

685
00:35:24,440 --> 00:35:28,200
Speaker 1: therapist directory at Therapy for Black Girls dot com slash directory.

686
00:35:28,680 --> 00:35:30,920
Speaker 1: And if you want to continue digging into this topic

687
00:35:31,360 --> 00:35:34,080
Speaker 1: or just be in community with other sisters, come on

688
00:35:34,200 --> 00:35:36,719
Speaker 1: over and join us in the Sister Circle. It's our

689
00:35:36,800 --> 00:35:39,600
Speaker 1: cozy corner of the Internet design just for black women.

690
00:35:39,960 --> 00:35:42,479
Speaker 1: You can join us at community dot Therapy for Black

691
00:35:42,520 --> 00:35:45,080
Speaker 1: Girls dot com. Thank you all so much for joining

692
00:35:45,160 --> 00:35:47,719
Speaker 1: me again this week. I look forward to continue in

693
00:35:47,760 --> 00:35:50,879
Speaker 1: this conversation with you all real soon take get care,