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Speaker 1: What would you say is important for women to be

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Speaker 1: mindful of around that time in.

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Speaker 2: Our twenties, that's sometimes one of the first times that

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Speaker 2: we could be seen by Obi Juan More women are

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Speaker 2: thinking about babies in their thirties, going in for like

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Speaker 2: a preconceptual counseling visit, pre natal vitamins. That's really really key.

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Speaker 2: Forties is when you want to go get your hormones check,

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Speaker 2: keep paying attention to what your cycles are doing. You

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Speaker 2: want to make sure that you're doing your mammograms every year.

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Speaker 1: Happy Monday, everyone, Welcome to my podcast. I'm Cheeky's your host,

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Speaker 1: and I cannot wait to get into today's episode. It's

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Speaker 1: going to be a really great and informative one, so

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Speaker 1: I hope you guys walk away learning a lot about

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Speaker 1: a topic. Our culture doesn't really talk too much about

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Speaker 1: women's health. We have a really great guest joining us,

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Speaker 1: so stay tuned. This is Cheeky's and Chill. So today

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Speaker 1: we're going to talk about women's health and what we

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Speaker 1: should be looking for in our twenties, thirties, and forties.

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Speaker 1: I'm personally curious to learn about screenings and tests that

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Speaker 1: we should be taking, and about any diseases or conditions

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Speaker 1: Latinas are more prone to. And here to tell us

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Speaker 1: all about it is doctor Erica Montees. She's a board

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Speaker 1: certified OBGYN based in Arizona. She's also the creator of

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Speaker 1: the bilingual health blog The Modern Mohaed. Welcome to the podcast,

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Speaker 1: doctor Montees. How are you?

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Speaker 2: Thank you so much? Cheekye's I'm excited to be here.

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Speaker 1: This is gonna be fun. Okay, So let's just jump

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Speaker 1: into real quick.

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Speaker 2: Our twenties, Yeah, for sure. So I think in our

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Speaker 2: twenties that's kind of sometimes one of the first times

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Speaker 2: that we could be seen by obijuan. And so it's

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Speaker 2: important to know that pap smears do start at age

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Speaker 2: twenty one, so regardless of sexual activity prior to age

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Speaker 2: twenty one, they start at twenty one. And remember, pap

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Speaker 2: smear screen for cervical cancer doesn't test for ovarian cancer,

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Speaker 2: doesn't test for endometriosis, it doesn't test for ovariances. It's

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Speaker 2: just cervical cancer or abnormal cells of the cervix. This

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Speaker 2: is kind of around the age where even maybe a

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Speaker 2: little younger, but kind of also around twenty is when

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Speaker 2: you know women are going off to college or thinking

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Speaker 2: about birth control things like that, or how can they

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Speaker 2: prevent pregnancy. So there's so many options. It's important to

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Speaker 2: really review the options and the risk versus benefits and

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Speaker 2: ask those questions about misinformation so that way you can

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Speaker 2: make sure you're making the best decision for yourself. And

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Speaker 2: then I think just in general, like kind of getting

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Speaker 2: into the habit and the routine of like, this is

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Speaker 2: what it is, this is what we need to do

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Speaker 2: to protect our health and to make sure that we're healthy.

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Speaker 2: And so I think those are kind of three things

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Speaker 2: to look at in your twenties.

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Speaker 1: And I was going to say something here because I

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Speaker 1: didn't know that it was at twenty one. I thought

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Speaker 1: once you were sexually activing, if you're like twenty seven,

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Speaker 1: then that's when PAPS starts. But you're saying regardless whether

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Speaker 1: you're sexually active or not, pastmes started twenty one.

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Speaker 2: Yeah, And the reason the reason why is because we

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Speaker 2: know that in as teens and in the early twenties

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Speaker 2: there there is a higher incidence of acquiring HPV or

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Speaker 2: the human human papalomavirus, which which so you're like, well,

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Speaker 2: then you should do the path but I understand that,

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Speaker 2: but The thing is is if you're at a higher

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Speaker 2: risk of acquiring it during that time. We also know

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Speaker 2: that that age group actually can can decrease the time

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Speaker 2: that they have it or it becomes it's more of

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Speaker 2: a transient infection during that time. So if we start

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Speaker 2: doing paps on everyone, we're gonna we are going to

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Speaker 2: see the higher incidents of HPV, but then we're going

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Speaker 2: to be more prone to having them come back for

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Speaker 2: testing and procedures and taking you know, doing biopsies on

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Speaker 2: their cervix and things which can lead to other problems

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Speaker 2: down the road. So that's kind of why the society said,

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Speaker 2: let's just do twenty one, and that seems to be

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Speaker 2: a reasonable age timeframe.

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Speaker 1: That is great to know anyone that's listening. I mean,

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Speaker 1: because I told my friend, you know, she was already

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Speaker 1: twenty seven, she had just lost her virginity and she

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Speaker 1: had never gotten to papsmear So I thought, okay, well

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Speaker 1: now you have to because you're having sex. But this

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Speaker 1: is this is why we have doctor monthis on right now.

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Speaker 1: So she's gonna tell us all these things. Okay, is

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Speaker 1: there like a birth control doctor month? Is that you

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Speaker 1: like or you prefer or is it just every birth

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Speaker 1: control is different, you know for the woman.

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Speaker 2: Yeah, you know, I like I really like larks Or

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Speaker 2: And what that means is long acting reversible contraceptive methods,

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Speaker 2: which are the implants in the arm and the introuter

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Speaker 2: and devices or the iud's. And the reason why I

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Speaker 2: like them is because their user friendly, you know, error friendly.

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Speaker 2: You don't have to think about it, like they're there,

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Speaker 2: they're in, they're you know. They they work very well,

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Speaker 2: they're very effective to prevent pregnancy. And because the implant

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Speaker 2: in the arm and some of the iud's actually contain progesterone,

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Speaker 2: they can be used for other treatments for other female

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Speaker 2: health conditions such as endometriosis. One of them is approved

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Speaker 2: for heavy menstrual bleeding, and so like it's one of

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Speaker 2: those things where like taking into consideration, like everything that's

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Speaker 2: going on with that particular patient, then that's kind of

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Speaker 2: how I tailor what I would recommend for them.

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Speaker 1: Okay, perfect, Because now that you mentioned the IUD, I

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Speaker 1: was on the IUD for quite some time, but it

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Speaker 1: was the copper one, the tenure one, and I didn't

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Speaker 1: know that the other one, which is the only other

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Speaker 1: one I know is I think the.

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Speaker 2: Maderra, the Marina, Yeah, the Marina. There you go, right,

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Speaker 2: it's actually approved for eight years now.

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Speaker 1: Oh wow, so it can actually help with endometriosis as well,

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Speaker 1: that one.

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Speaker 2: Yeah, so, I mean remember these IUDs, there's actually four

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Speaker 2: progesterone containing IUDs. Those are those not saying like the

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Speaker 2: patient may not need resection surgery, which means where we

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Speaker 2: go in and we cut out the endometriotic implants or anything,

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Speaker 2: not saying that it may not be that that like,

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Speaker 2: we don't have to do that, because there is a

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Speaker 2: potential that we have to. But I mean possibly as

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Speaker 2: like a maintenance therapy or treatment. Maybe those progesterone containing

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Speaker 2: IUDs can be a treatment for that. We know it

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Speaker 2: also helps your heavy menstrum bleeding, so that's also a

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Speaker 2: treatment if a patient doesn't want to do like surgery

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Speaker 2: or something like that.

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Speaker 1: Okay, this is all great stuff. Okay already, and we're

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Speaker 1: just in our twenties. Okay, so now let's transition to

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Speaker 1: our thirties. What is important to like start thinking about

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Speaker 1: when you know, we're in our thirties.

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Speaker 2: Yeah, so, I mean in our thirties. I feel like

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Speaker 2: this is kind of the decade where because we are

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Speaker 2: focusing more on like careers and kind of like what

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Speaker 2: we want to do as a human being, I find

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Speaker 2: that more women are kind of getting pregnant or thinking

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Speaker 2: about babies, like in their thirties, right, So that's like,

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Speaker 2: that's really really key. I think going in for like

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Speaker 2: a preconceptual counseling visit where we like look at your history,

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Speaker 2: we see what's what's been going on with you, what's happening,

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Speaker 2: we start prenatal vitamins. Folic acid is so important to

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Speaker 2: decrease the risk of neural tube defects, which is a

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Speaker 2: birth defect. And unfortunately that that condition is very high

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Speaker 2: in Latinas because they don't know this or they don't

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Speaker 2: take us either folical or they don't take the recommended amount.

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Speaker 2: There was a push where they actually tried to they

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Speaker 2: actually have put some folic acid in thrtias because of

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Speaker 2: the diet that we have in Latin in our Latino

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Speaker 2: community is more mayise and thirtias and things like that

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Speaker 2: versus like bond bread, which has can have more folic

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Speaker 2: acid or cereals. You know, we really didn't necessarily eat

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Speaker 2: like cheerios or cereals growing up it was more like

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Speaker 2: thirdias and eggs and things like that. So they have

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Speaker 2: tried to mitigate for that difference for our community, but

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Speaker 2: it's still not ending up being enough. So that's so important.

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Speaker 1: Oh wow, actually just reminded me. I haven't been taking

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Speaker 1: my folic acid like at all. I have to because

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Speaker 1: see I'm thirty seven. So now we've I've tried the

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Speaker 1: whole like maybe we should do the IVF and and

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Speaker 1: you know, I'm having issues I have in demetriosis, so

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Speaker 1: I've always had like I've had ovariansis and the whole thing,

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Speaker 1: and all this started in my thirties. So that's why

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Speaker 1: I'm like, it's so important that we have these conversations guys,

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Speaker 1: and that we take this very serious. And you come,

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Speaker 1: I completely forgot about the folic acid until like this

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Speaker 1: very moment, So thank you. I'm going to get myself some.

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Speaker 1: And what age do you think is because I've heard

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Speaker 1: different like in your twenties you should start like maybe

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Speaker 1: freezing your eggs if that's something you're thinking about, want

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Speaker 1: to wait till having children, But you can still do

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Speaker 1: it in your early thirties, right, so you're still fine?

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Speaker 2: Yeah, I would agree I mean, under thirty five, we

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Speaker 2: know that your egg quality for the most part, is

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Speaker 2: still going to be pretty good. So I think if

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Speaker 2: you consider that, and if you are kind of keeping

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Speaker 2: your time for starting your family and everything later in

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Speaker 2: life because you have you know, you're getting your career going,

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Speaker 2: you have all these other things happening. That's the beauty

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Speaker 2: of technology, right that we actually can take We can

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Speaker 2: take the power in our hands and decide what we

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Speaker 2: want to do and how we want to do it.

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Speaker 2: I'm not saying that it always works, but at least

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Speaker 2: we have that technology to be able to do that.

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Speaker 2: So I think that, yes, egg freezing is very important.

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Speaker 2: I'm pretty sure in every major city there's a few

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Speaker 2: fertility specialists that do it. So it's just a matter

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Speaker 2: of going out and kind of seeking that treatment out.

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Speaker 1: Yes, I definitely have to told myself, I'm giving myself

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Speaker 1: into the end of this year to figure that out. Okay,

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Speaker 1: so what about breast exams and pelvic exams. Is this

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Speaker 1: something that we should start definitely doing in our thirties.

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Speaker 2: Yeah, for sure, And like you mentioned, you know that's

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Speaker 2: when you kind of started getting diagnosed with these different conditions.

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Speaker 2: It kind of tends to be our thirties where we

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Speaker 2: kind of diagnose more like PCOS or polycystical variant syndrome, indometriosis,

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Speaker 2: and you know, these different conditions that affect us. Not

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Speaker 2: saying that we're not going to find it in our twenties,

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Speaker 2: because of course we will, especially if you have a

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Speaker 2: doctor who's very diligent in a student and they listen

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Speaker 2: to what you say and they're trying to figure out

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Speaker 2: what's going on. But I would say most of these

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Speaker 2: conditions are also going to pop up in your thirties,

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Speaker 2: So you want to make sure you're going every year

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Speaker 2: for your annual gynecological exam. You want to make sure

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Speaker 2: that you even can maybe even like towards the end

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Speaker 2: of your thirties established care with a primary care doctor

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Speaker 2: just so you have like a general doctor as well.

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Speaker 2: But yeah, I think that's that's an important key there.

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Speaker 1: Yeah, and doing your like self checkups right, like touching

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Speaker 1: your breast and under your armpits and things like that, right. Yeah,

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Speaker 1: there are very you guys on YouTube and stuff that

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Speaker 1: can teach you guys how to do it if you

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Speaker 1: don't know how to do it, like just to check

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Speaker 1: for lumps and you know, I'm always I have to

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Speaker 1: because my breast cancer runs in my family. So I'm

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Speaker 1: always like all about the little lumps and bumps and

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Speaker 1: all that stuff. And it just sucks because I feel

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Speaker 1: so young, but my body's like my internal stuff is

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Speaker 1: telling me something different, so I get it. I am like,

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Speaker 1: it's a little frustrating for me. I'm like, I feel young,

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Speaker 1: I feel fine, but my ovaries are like, girl, you

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Speaker 1: need to put a baby in here or something. I

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Speaker 1: don't know. My doctor told me, You're like you have

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Speaker 1: a very instance because your body is saying you need

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Speaker 1: to get pregnant. I'm like, oh my god, oh my god.

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Speaker 2: Okay, yeah, I'm sorry. So as far as pelvic exams

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Speaker 2: and breast exams, yes, I mean, like I said, annually,

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Speaker 2: learn how to do it, like like we were saying,

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Speaker 2: I mean, it's so important to just be in tune

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Speaker 2: with your body and kind of that way you can

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Speaker 2: tell like if something's going on.

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Speaker 1: Yes, don't ignore things, you guys.

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Speaker 2: Yes.

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Speaker 1: Okay, So now forties, what do we do in our forties?

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Speaker 2: So forties is kind of like, well is me because

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Speaker 2: I'm like getting there right, But when I see I'm

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Speaker 2: forty now, so I think forty, thank you, Henny. Forty

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Speaker 2: is when when you can start having some menopause symptoms

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Speaker 2: or perimenopausal. So perimenopausal means she hasn't gone the whole

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Speaker 2: year without a period. She's kind of in that little

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Speaker 2: time frame where it's like right before she's getting to

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Speaker 2: those period changes, but she's already starting to fill symptoms

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Speaker 2: like you know, potentially hot flashes, nights with change in sleep,

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Speaker 2: difficulty concentrating, decrease quality of live, vaginal dryness, painful intercourse,

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Speaker 2: like all these things potentially could start happening in your

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Speaker 2: in your forties, possibly more upper forties, but still some

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Speaker 2: patients have it in their early forties. And so that's

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Speaker 2: when you want to go get your hormones checked. You

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Speaker 2: want to be paying attention to what your cycles are doing.

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Speaker 2: You want to make sure that you're doing your mammograms

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Speaker 2: every year starting at age forty. And now the new

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Speaker 2: recommendation at age forty five is we want patients to

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Speaker 2: get screening for colon cancer because the incidence of colon

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Speaker 2: cancer in our country has increased so much that we

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Speaker 2: moved it from fifty to forty five.

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Speaker 1: Wow, you guys, Oh my god, That's that's amazing to

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Speaker 1: know because that's something that we just, I mean, we

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Speaker 1: don't even think about as women, you know, right, So wow, Okay,

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Speaker 1: And as far as like in our forties, like, is

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Speaker 1: that when our fertility window closes? Is there like a

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Speaker 1: certain age where you're just like, ugh, I wouldn't because

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Speaker 1: I've heard of I have a friend that got pregnant

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Speaker 1: at forty two and by herself, no ideaf.

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Speaker 2: Oh great, Yeah. I mean, look, I wouldn't say that

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Speaker 2: it closes because again, like I mentioned, I mean more

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Speaker 2: women are getting pregnant later in life. You know, forty

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Speaker 2: is almost like the new thirty in a way, to

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Speaker 2: depend on you know, how you look at it. So

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Speaker 2: I mean I think that you should be aware though

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Speaker 2: that after age thirty five the increased incidents. Even now

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Speaker 2: the studies are showing more after forty the increased incidence

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Speaker 2: of gestational diabetes, severe preaclamsia, which is a blood pressure

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Speaker 2: condition during pregnancy, and also an increased risk of down

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Speaker 2: syndrome or chromosome anomalies with pregnancies can increase. So I

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Speaker 2: think it's that's why it's important to start prenatal care early.

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Speaker 2: Take your folic acid. We do recommend to give patients

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Speaker 2: who are of advanced maternal age, especially over forty a

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Speaker 2: baby aspirin every day during their pregnancy because that decreases

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Speaker 2: inflammation around the placenta. That potentially can decrease your risk

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Speaker 2: of preoclamsia or high blood pressure during pregnancy. So there's

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Speaker 2: a lot of preventative measures. Because our populations age is

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Speaker 2: changing and advancing. So I would still say, if you're

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Speaker 2: over all very healthy, you are considering pregnancy, that's still

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Speaker 2: it's still gonna be okay, but make sure you're seeing

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Speaker 2: a doctor that is well known to be able to

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Speaker 2: take care of those types of pregnancies.

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Speaker 1: Yeah, that those are stuff basically, yeah for that type

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Speaker 1: of Yeah, well, what is it called the jerry?

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Speaker 2: Oh they call it. Yeah, they call it like a

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Speaker 2: geriatric pregnancy. But I never call that's a code on

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Speaker 2: in like the ICD ten, like the medical code building

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Speaker 2: and coding, like that's the name of it. But we

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Speaker 2: call it advanced maternal age.

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Speaker 1: Oh, advanced, Okay, I call it sexy. We're gonna call

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Speaker 1: it sexy pregnancy.

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Speaker 2: Let's call it sexy maternal age.

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Speaker 1: Yes, I love that. C Yes, that's what we're gonna

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Speaker 1: call it hysterectomies? Are those very common in our forties?

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Speaker 2: You know? I would say yes. I mean towards the end,

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Speaker 2: like we were saying, like you kind of get diagnosed

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Speaker 2: with things or potential juice gynecological conditions in your thirties,

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Speaker 2: and then you kind of get to the point where

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Speaker 2: like we've tried conservative options like medications, auds, different things,

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Speaker 2: and they don't work. So then yeah, kind of then

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Speaker 2: you get into your forties and it's like, Okay, well,

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Speaker 2: possibly the only treatment at this point could be a hysterectomy.

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Speaker 1: Okay.

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Speaker 2: Remember though, a lot of what I teach my community

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Speaker 2: how to be an advocate for themselves, how to not

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Speaker 2: accept that a hysterectomy is the only option, because there

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Speaker 2: are the technologies improving, there's a lot of different options

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Speaker 2: out there for different conditions, and ultimately, I think it

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Speaker 2: is very common to need a hysterectomy in your forties

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Speaker 2: for different conditions, but in your particular case, that may

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Speaker 2: not be the only option. So just keep that in mind.

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Speaker 1: Yes, before I let you go I healthcare. I know

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Speaker 1: there are like barriers for black and brown women due

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Speaker 1: to variety of reasons. Do you see this changing at all.

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Speaker 1: I mean, what are the biggest barriers? Do you see

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Speaker 1: any resources for women that you recommend.

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Speaker 2: I think the barriers ultimately end up being kind of

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Speaker 2: like our upbringing and kind of like what our community

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Speaker 2: has believed to be, like what's normal and what's not normal.

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Speaker 2: I think another barrier is a lack of Latinos and

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Speaker 2: African American physicians being like in that space where people

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Speaker 2: who are patients can see us and feel comfortable and

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Speaker 2: feel like they can actually we can understand where they're

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Speaker 2: coming from, and we can understand those kind of different

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Speaker 2: community beliefs. I think things are improving. I think we

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Speaker 2: are becoming more of a society of being proactive and

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Speaker 2: preventative and things along those lines. But it's great, you

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Speaker 2: know podcasts like this it help just kind of get

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Speaker 2: that information out there. I mean, the morbidity immortality of

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Speaker 2: conditions like breast cancer and cervical cancer, even still which

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Speaker 2: is like totally preventable, is still a lot higher. We

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Speaker 2: know in Latinas and and African American women. Some of

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Speaker 2: it may just be our food, our diet, or our stress,

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Speaker 2: our genetics, you know, things like that. But I think

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Speaker 2: the more we can be proactive and preventative. I think

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Speaker 2: all that's going to help, and I think eventually it

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Speaker 2: will improve over time.

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Speaker 1: I agree. And informing yourself all right, guys, well, I mean,

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Speaker 1: is there anything else you'd like to add doctor month?

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Speaker 1: Is that we maybe didn't talk about that you want

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Speaker 1: our listeners to know.

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Speaker 2: You know? I think I just think it's important to

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Speaker 2: make sure that anything that you see on the Internet

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Speaker 2: or social media, unfortunately a lot of it can be

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Speaker 2: misinformation or can be information that may not be all accurate.

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Speaker 2: So just make sure you take what you read with

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Speaker 2: a grant of salt, ask your doctors about it, ask

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Speaker 2: your female healthcare providers about it, and make sure you

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Speaker 2: do your due diligence before you consider anything.

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Speaker 1: And you know, and talking about that, you do have

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Speaker 1: your blog right which is Modern Ruer And where can

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Speaker 1: listeners find you online? Just so that we can put

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Speaker 1: that out there please?

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Speaker 2: Oh? Yeah, thank you. So my main website is the

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Speaker 2: modern mohead dot com and then I'm mainly just on

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Speaker 2: Instagram at the dot modern dot Mohead.

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Speaker 1: Thank you perfect, No, of course, and thank you so much.

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Speaker 1: I love that you're Latina. I love that you're just

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Speaker 1: so intelligent, and you're so open and you're so pleasant.

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Speaker 1: Thank you so much for taking your time to speak

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Speaker 1: to us and inform our community, because I think it

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Speaker 1: is something so important. I always say knowledge is power,

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Speaker 1: you guys, so we just have to inform ourselves and

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Speaker 1: ask questions. So that's what I'm here for. And before

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Speaker 1: I let you go, I do end every episode with

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Speaker 1: a quote, and the quote for today's episode will be

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Speaker 1: Caring for your body, mind, and spirit is your greatest

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Speaker 1: and grandest responsibility. It is about listening to the needs

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Speaker 1: of our soul and then honoring them. There I think

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Speaker 1: it was perfect for this episode. Thank you, doctor Montes.

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Speaker 1: It was amazing. And you guys, I hope that you

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Speaker 1: learn a few things all of us. I definitely did,

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Speaker 1: so catch you on the next one. Okay, Cheeky's and

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Speaker 1: Chill right here all the time. We love you. Do

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Speaker 1: you need advice on love, relationships, health emails? I'm so

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Speaker 1: excited to share with you that my Cheeky's and Chill

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Speaker 1: podcast will have an extra episode drop each week. I'll

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Speaker 1: be answering all your questions. Just leave me a voice message.

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Speaker 1: Better on midday, all you have to do is go

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Speaker 1: to speak pipe dot com, slash Cheekys and Chill podcast

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Speaker 1: and record your questions. I can't wait to hear from you.

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