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00:04Now, we shift into an essential conversation about women's health, mental, physical, and
00:11emotional well-being, joining the Global Black Economic Forum stage for a Declaration of
00:18Independence discussion.
00:20Please welcome Dr. Davida Hunter Cummings, founder, Aspire New Jersey Youth and Tri-Sage
00:28Method, Dr. Topeka Sam, founder, CEO, and visionary, Topeka K. Sam Ventures, and Dr.
00:39Jennifer Tropez, assistant professor of obstetrics and gynecology at Tulane University.
00:46Our moderator is Dr. Judith Joseph, board-certified psychiatrist and researcher, Manhattan Behavioral
00:55Medicine.
01:02Well, thank you all for joining.
01:05Women's health is so essential, and we know from the data around the world that when women
01:11thrive, children thrive, communities thrive, economies thrive.
01:16But unfortunately, black women struggle with really scary statistics.
01:21We have high rates of postpartum depression, maternal mortality rates, longer, worse symptoms
01:30of perimenopause and menopause, worsened symptoms and higher rates of fibroids, and yet we are
01:37the most likely to be underserved, although we have these high alarming rates.
01:41But there is hope.
01:43We have wonderful advocates and doctors and specialists here to dive into solutions.
01:49So thank you all for being here, and I'd like for you to share a little bit about your journey
02:00and why you decided to enter the women's health space.
02:04So we'll start with Dr. Tropez.
02:07Good morning.
02:08So I entered into women's health because I had the opportunity to spend a wonderful week with Dr. Gwyneth Latson
02:15at Meharry Medical College,
02:16watching her take care of women in all sorts of ways, and I knew immediately when I finished
02:22that time with her that there was no better calling than to become a women's health provider.
02:27And so I get to take care of women, young girls, throughout their entire lifespan, and it's very dear to
02:34me.
02:34You know, before I'm an OB-GYN and an educator, I'm also a woman and a mother and a sister
02:39and a daughter,
02:40and so this is very personal life work for me.
02:44And Dr. Sam, tell us about how you entered this space.
02:48Sure.
02:49So I started this work through my nonprofit, Ladies and Pope Ministries.
02:53We work to end poverty and incarceration of women and girls, and to date now, after nine years,
02:59we've been working with thousands of women across the country and in the Caribbean with helping with employment,
03:05housing, removing barriers, financial education, but there was one thing that seemed to be a major issue,
03:12and that was access to quality health care.
03:15And then through my own example, when I was incarcerated myself and I ended up having uterine fibroids,
03:21it was incredibly difficult to get the care that I needed.
03:23And so my husband and I decided to create a solution and remove the barriers for people who are justice
03:29-impacted,
03:30and that was how and why we created Epic Health.
03:32And so we're a telehealth platform, a telepharmacy,
03:36and we also provide mental health through our app, Epic Health PBC.
03:42And Dr. Hunter Cummins, tell us about your work and how you got into this space.
03:48Yeah, so my name is Davida Hunter Cummins, and I am a licensed clinical psychologist.
03:55I got into this area of work about 25 years ago, and I was working with youth,
04:01and that was my main theme just with youth, but their parents needed assistance.
04:07The mothers needed help as well.
04:10And I think that I started this journey just listening to them going through perimenopause and menopause
04:17and trying to help and trying to be there.
04:21But then when my own journey began through that stage of life, it became very real to me.
04:28And I looked for solutions and was unable to find them that really helped me,
04:35and that's why I came up with Tri-Sage Method.
04:40And it's been amazing the past two years, and when I've shared it with other women,
04:45they feel the same way.
04:47And so, you know, that's pretty much part of my journey
04:53and why I became a mental health provider for women in mental health.
05:00It was for youth, but it kind of transcended into this
05:05because of my own experiences in life and in perimenopause.
05:11Well, these stories are important because we know that the outcome for women's health,
05:17health for black women's health improves with black providers, black professionals,
05:22and having people that look like us is crucial.
05:26It's a key part of the solution.
05:29Now, I'm going to ask the audience a question.
05:31How many in here know someone or are you someone who lives with uterine fibroids?
05:36Raise your hand.
05:40And what about how many in here know someone or you're living with endometriosis?
05:46Raise your hand.
05:48Okay.
05:49I know someone, too.
05:50All right.
05:51So that leads me to you, Dr. Trapez.
05:52Why is it that black women get diagnosed later and have more severe symptoms?
06:00And what are some solutions to address that for these two conditions?
06:04So the reason why we are typically diagnosed later and with worse symptoms is,
06:10number one, we actually have worse symptoms.
06:11Okay.
06:12And they usually are misdiagnosed or missed over years.
06:16There's ACOG even showed in their recent guidance in 2026 because the pain is dismissed,
06:22normalized, or misattributed.
06:25Also contributing to that is I think we think that it's okay to have heavy periods.
06:31It's okay to bleed through clothes.
06:32It's okay to have pain with sex.
06:36And none of that is actually normal.
06:38And those are the signs that you need to seek professional help sooner than later.
06:42I think we also have mistrust with the medical system as well as, like, the options that are provided to
06:50us.
06:51Hormone therapy is essential, especially in both of those conditions.
06:56So I think it's also finding the right provider that you feel like you can trust that resembles you,
07:03that you can make a plan together.
07:07I recently came across two specific platforms, Health in Her Hue and Thee Manual,
07:14which help women of color to better understand their bodies in different conditions.
07:19And I absolutely recommend becoming your own agent and understanding your body more
07:23and seeking more information.
07:25There's also another organization, the White Dress Organization,
07:29named because a lot of women fear bleeding and not being able to wear white.
07:34And it's a community.
07:36So I think community care is really important.
07:38And let's talk about the mental health implications.
07:41I talked about how women are afraid to wear white dresses.
07:44Dr. Hunter Cummins, tell us about the mental health implications related to fibroids and endometriosis.
07:52Well, I will speak to perimenopause and mental health and how, you know, they're interchangeable, right?
08:02So, and they both should be treated, whether or not it's through menopause or perimenopause
08:08or you're having mental health or symptoms of issues in mental health.
08:13I know that in menopause, I can speak on my own, you know, experiences with having menopause
08:22and feeling and going out and reaching out to doctors and saying,
08:26okay, somebody's got to help me because I'm not feeling like myself.
08:31And then trying to prescribe maybe antidepressant, but I wasn't depressed.
08:37And so I feel like for a lot of women, that's what they get versus figuring out what the problem
08:45is,
08:46journaling what's happening to your body, sharing that information with the doctor.
08:53When you have informed, when you have this information to share with the doctor,
08:57I think that the doctor can possibly help a little bit better.
09:01But I also think it's super important that going through these stages of life,
09:05that you have a medical doctor, that you have a therapist to help you through it,
09:10because it can be very, very, it's a new experience.
09:14And there's, you know, our mothers went through it, but they were quiet.
09:18They were silent.
09:19They didn't share about what happened.
09:21And so I think that this generation of women are more forward in telling what's happening to their bodies
09:29and what's going on and asking for help.
09:32And so for me, I feel like I don't want my daughters to have to experience this without any assistance.
09:40It's super important that they're always informed, that they always share what's going on with their bodies and know that
09:48it's normal.
09:49It's a transition in life, and we all have to experience it if we get old enough, right?
09:53We all experience this.
09:56And I feel like mental health, and regardless to whether or not you're going through menopause,
10:02if you feel like something's going on, don't hold it, don't hide it, share it.
10:08Get a professional who can help you to go through it.
10:13That's it, yeah.
10:14So, yeah, Dr. Hunter Cummings was saying that a lot of the anxiety comes from the uncertainty.
10:21So if you, let's say, you don't expect to be having symptoms like bleeding or hot flashes or brain fog,
10:28that creates even more anxiety.
10:30But naming it and using tools to help you can actually help you to cope better.
10:36So it's not just medications, but there are different therapies and skills that you can use.
10:41But if you don't know about it, how can you prepare, right?
10:44So thank you for that.
10:46Dr. Sam, you work with a lot of people who are underserved and feel as if they're sometimes misdiagnosed,
10:53underdiagnosed, not given the correct supports.
10:56How can people advocate for themselves, especially with these women's health conditions that we talked about?
11:01Yeah, I mean, you know, it is, your voice is the one that matters.
11:06And like Dr. Cummings said, that it is important, you have to always, when you feel something's wrong with your
11:13body,
11:13it doesn't matter what situation that you're in, whether it is a prison, whether you're unsheltered,
11:20or whether you have quality health care, you have to let the professional know that something is going on,
11:25and you cannot wait.
11:26When I spoke earlier about my fibroids, for example, I had incredible medical insurance.
11:32I had incredible doctors.
11:34I went and saw my gynecologist regularly, so I knew going into prison that I had uterine fibroids,
11:40and I was actually scheduled before my arrest for a laparoscopic myomectomy.
11:46Yet when I got in, I was facing 10 years, and the doctor told me,
11:52well, you'll be in here 10 years, and you won't have children by that age, so you might as well
11:55get a hysterectomy.
11:57And it shocked me, because one, I knew I didn't need that.
12:02And so I was like, well, wait a minute.
12:03I need to get a second opinion.
12:06But they wouldn't let me.
12:07And I actually ended up going to the SHU, which is a special housing unit,
12:11because I made a call to my doctor to try to get additional help and additional support.
12:16And so another reason why we had created the platform for Epic Health is so that people have the ability
12:21to speak with other professionals that are culturally competent,
12:25that understand what a person is going through, and not treat them differently, irrespective of their circumstance.
12:31So I think it's critical that you understand that no matter where you are, your voice matters.
12:37And that if you don't take care of yourself and your body, no one else will.
12:42That's important.
12:43And if you didn't advocate for yourself, you wouldn't get the adequate treatment.
12:47And we're fortunate to have a doctor on stage who does provide adequate treatment.
12:53So if someone were to come to you and say, my doctor thinks I need a hysterectomy,
12:58or they think I need all these procedures for conditions like fibroids, et cetera, what should they do?
13:05So your first action plan should actually, like I said, do some of the research yourself.
13:11You know, explore some of your options.
13:13When you get physically in front of the doctor, you want them to explain their thought process,
13:19have them provide that differential diagnosis and what the plan of action will be at each step.
13:25Personally, I show this to patients on the computer real time,
13:29especially when we're talking about menopausal treatment.
13:31It has to be individualized.
13:33And so I say, this is what you're experiencing.
13:35You've given me this composite of symptoms.
13:38So this is what I think is happening.
13:40Now, the different treatment plans, it's vast.
13:42And so we're going to try this first.
13:44This is what's absolutely recommended first line.
13:46And then if that doesn't work, then we're going to switch to this.
13:49So we're going to see each other a lot until we get this right.
13:52So be it via in person or via telehealth, we're going to continue to work on this plan together.
13:58And I try to give them the algorithm of what we're going to do step by step
14:02so that they don't have anxiety about, well, what next?
14:04Is there no more action?
14:06Is this just not for me?
14:07Because there's always a treatment plan that's perfect for you.
14:10When it comes to treatment for fibroids and endometriosis,
14:14you definitely should obtain at least two or three opinions with various surgeons
14:18if you're down the path already of surgery.
14:21But there are many options, medically speaking, prior to getting there.
14:25We have hormone therapy.
14:26We have IUDs.
14:27We have GnRH agonists and antagonists to sort of help calm down fibroids
14:33as well as endometriosis.
14:35And so there's, like I said, there's an option for everybody,
14:37but it has to be a bidirectional relationship with you and your provider
14:41that comes up with a plan that works best for you.
14:44Now, in some instances, you know, a hysterectomy really is, it is the last resort, okay?
14:51And ultimately, we think of the uterus as a non-essential organ.
14:55You know, that's easy to say if it's not yours,
14:57but I consider everything that I have in my body essential.
15:01But at the end of the day, if you are having bleeds to the point
15:05where you need blood transfusions, you're in the hospital,
15:09you may have outcoursed all of the other options besides a hysterectomy.
15:15So that's why it's important that when you see these symptoms early on,
15:18you seek care early and often and either help delay the progression of the disease
15:25or condition and or even prevent it up front.
15:29So there are options, like the doctor laid out.
15:32And you mentioned hormonal health and the fact that women have options for support.
15:38Black women are more likely to have hot flashes.
15:41They're more likely to have longer symptoms of perimenopause and menopause,
15:46earlier symptoms, more severe symptoms.
15:49Yet many times we're taught, well, everybody goes through perimenopause and menopause.
15:53What makes you so special, right?
15:55Dr. Hunter Cummings, what are some of the mental health symptoms
15:59that we should look out for in terms of perimenopause and menopause,
16:03and how can we support them?
16:04So I think first and foremost is sleep.
16:07I think a lot of women come to me and say, I can't sleep or I'm up at 3 a
16:11.m.
16:11and I can't go back to sleep.
16:14And so my first thing that I recommend is, okay, so we need to journal this.
16:20Journal what time you're getting up.
16:23What are you doing during the day to help you, you know, feel better?
16:30And a lot of times they, because they can't sleep at night, it's hard for their days.
16:36Their days are difficult.
16:39So my suggestion is always to see your doctor to get a prescription for some sort of hormone
16:49that gets you balanced.
16:51Your diet should be really, you know, you can't eat all the junk food
16:56and things that make your body not feel good.
17:00Also, I think getting rest, getting exercise, doing all those things to help your mental health,
17:06I think makes a huge difference.
17:09I think journaling is super important.
17:12That's part of the process with Tri-Sage is we ask the ladies to journal their symptoms,
17:18everything that's going on so that they can be aware of things that are happening.
17:23So sleep, brain fog is another thing that they say, oh, my gosh, I can't remember this.
17:30I don't know what's going on.
17:31But when estrogen declines, you know, it's cognitive, right?
17:37And so you're not thinking the same as you would normally.
17:44That's another symptom.
17:45What else is it?
17:47But the two things that are most, you know, prevalent for many of the women that come to me is...
17:52And you were saying mood, too.
17:54You were saying earlier that a lot of people were getting prescribed antidepressants.
17:57And you were...
17:58Right.
17:58And they're like, I'm not...
18:00They're like, I'm angry, but I don't think I'm depressed.
18:03And it just comes and goes.
18:04But it's all symptoms of perimenopause and menopause.
18:07Those are those symptoms.
18:08And so I think that it's important that, like I said, you visit your doctor.
18:14You come up with a treatment plan that works best for you.
18:16And it's not one size fits all.
18:19Like, everybody is different and everybody needs something different.
18:22So it's important that, you know, you have that relationship with your doctor and make it work for you.
18:29And it's not...
18:31It's, you know, it doesn't last forever.
18:34And once you get on the right plan and you have that treatment and it works, give yourself a couple
18:41of weeks and then it works.
18:42And then you're like, oh, this really makes a difference.
18:45So, and I know that a lot of women are afraid of, and this is my mother's generation, they were
18:51afraid to use hormones because of, they were synthetic and they didn't, you know, they caused cancer.
19:00But things are different now.
19:01And so we're not using those same hormones that they once did back in the 70s.
19:06And so I think that the relief that comes from using it makes a huge difference.
19:12Yeah.
19:13You want to add to that, Dr. Sam?
19:14Yeah, I do want to add to that.
19:15So when I started perimenopause, I didn't know.
19:20And I was talking to Dr. Cummins about my symptoms.
19:23And she said, I think maybe you're going through perimenopause, you know.
19:27And so then that's when I started taking her product, Novara, and immediately it changed.
19:33I mean, my husband saw a difference.
19:34I was completely evil and mean, and then all of a sudden I was happy-go-lucky.
19:40And he was thankful for that.
19:42But I think, you know, part of it, we don't know, right?
19:47We are told, and I say we as in black women are told to, you know, if you're struggling with
19:52something, to pray it away, you know, which is why we don't talk about mental health, which is why we
19:57do not go to different professionals to seek help.
20:01People don't have access to quality health care, so they can't.
20:04People are embarrassed about having the conversations that they're going through.
20:08And so I think it's really, really important now today that these conversations are happening specifically within our community.
20:15And again, you know, when you are in these vulnerable situations, you, unfortunately, a lot of your choices are taken
20:22away from you.
20:23The only choice you do have is your voice.
20:25And so it is just critical that you're asking the right questions to even one person if they'll listen.
20:31Because that person can give you, like my friend did, advice to let me know what I was going through
20:36and put me on the plan that I needed to take the right product and do what I need to
20:42do.
20:43Yeah, it's really important to know what the symptoms are because you could get misdiagnosed.
20:48And that's why, you know, I developed a system called the TIES method.
20:52T is thinking.
20:53So if you're having memory problems, thinking problems, it could be due to hormones.
20:57The I is identity issues.
20:59Do you feel like you're not yourself anymore?
21:01The E is emotional issues.
21:03Are you moody, irritable, sad, anxious?
21:05And the S is sleep.
21:07T-I-E-S ties.
21:09So that way you know, possibly this is due to hormones and let me get the appropriate help.
21:14I'm going to ask each of you one thing you wish that all women knew.
21:18I know it's a big ask, but just, you know, down the line, I'll start with you.
21:22So I think one thing that I wish all women knew is that menopause is normal and it is a
21:28transition.
21:29And it happens over sometimes two decades.
21:33Okay.
21:33So, and it is the end of one era and the transition to another, but there's many stages to it
21:40and
21:40that they oftentimes miss all of the symptoms early on because you might begin them in your
21:45thirties and you're not even thinking about that's what's happening.
21:48So as Dr. Hunter Cummings stated, it's really important to create objective data for yourself
21:55and for the doctor.
21:56So if there was one thing is that have the data, write down your symptoms, track it, always
22:02know your period, track when your period starts, ends, and the quality of the symptoms when you
22:08have them.
22:09So just track that down in the journal.
22:11I love that.
22:12Write it down.
22:13You are the best historian of your own personal history.
22:17You come to the doctor with that list and you know what you're talking about.
22:20You're actually an active part of the treatment plan.
22:22Dr. Sam?
22:24Okay.
22:25Look, repeat the question for me one more time.
22:27What should all women know?
22:29If you could list one thing, every woman should know for their mental, for their, uh, for woman's
22:33health.
22:33For woman's health.
22:34Um, I think I want one.
22:37I think what I would like every woman to know about their, about their health.
22:42Um, again, underscoring that this is your body and no one knows your body better than
22:47you do.
22:48No one, not even your doctor.
22:50You can tell your doctor what you're going through, but your doctor can't look at you
22:53and say what's happening.
22:54So as long as you know, you can take that confidence because you know, it's my body.
23:00I own it.
23:01And so therefore I know when something feels wrong, a person cannot tell me that what I'm
23:06feeling is not so, um, and challenge it.
23:09And if you're not getting the answers that you're looking for from your particular professional,
23:14find another one.
23:15That is also your choice and your right.
23:19There's only one you, right?
23:21So you have to advocate for yourself.
23:22You have to look out for yourself.
23:24Dr. Hunter Cummings, what's one thing that you wish women would know?
23:27And I believe mine is on the same theme.
23:30You can't be quiet about what's happening to your body, right?
23:35Because when you're silent, you erase everything.
23:37And so you have to speak up, let every, let your doctors know what your body is going
23:43through and don't pay the price of, of silence because everyone, we can help, right?
23:51There, there, there's help out there.
23:52You don't have to live through this and be embarrassed by going through perimenopause.
23:59It's aging, but it's okay, you know, and it's, you can come out on the other side much better
24:05if you share and if you do the things that make you feel better.
24:09And that's, that's getting help.
24:12Yeah.
24:12I love that.
24:13Unfortunately, women often do things alone, right?
24:15We feel as if we don't want to burden others.
24:17Other people depend on us.
24:19Many of us, you know, in midlife, we're taking care of our kids.
24:23We're taking care of our parents.
24:24We're the rock.
24:25But if you don't take care of yourself, how are you going to take care of others?
24:29You know, and you're worthy of your own joy.
24:31And I see that there are some men in here as well.
24:34And I like to ask this question, you know, if we have time, but what are ways that men can
24:39support women's health issues?
24:41I'll start with you, Dr. Sam, because I heard you talk about your husband.
24:45My husband's not here right now, but I'm sure that he would laugh and just be like, you know,
24:49ignore her.
24:51But the way that men could help support us is just understand, give us grace.
24:57That's what I'll say.
24:58You know, those hot flashes are nothing to play with.
25:01One minute we're cold.
25:02The next minute we're hot.
25:03The mood swings.
25:04I know just, we love you.
25:06Just give us all the grace possible.
25:08But also, I think, in all fairness, just educate yourself also on what menopause is so that you
25:16have an understanding, because you may even notice symptoms and changes within your partner
25:21that they may not even realize what's going on.
25:24And also, you know, for men, not that this was the conversation, but also men, too, should
25:30check their own hormonal health as well.
25:32I love that.
25:34Dr. Travez?
25:35I mean, be an advocate for the women in your life, legally, through policy, through your
25:42voting capabilities.
25:44Speak up for women amongst other men.
25:48Raise young men to be more aware themselves.
25:53Understand women's bodies.
25:54Don't just dismiss it as, oh, they're on their cycle.
25:58They're hormones.
25:58Women's bodies are extremely complex, way more complex than men's bodies.
26:02Let's just say that.
26:02And so, we have these life cycle changes that do put us through some compromising situations
26:11sometimes with our relationship.
26:13And like they said, give us some grace, but also take the time to learn about it.
26:17But most importantly, I have to say, be our advocate, be our in policy, and when we're
26:23not around.
26:25That's right.
26:26Educate yourself.
26:27And Dr. Hunter Cummings?
26:28And I feel the same way.
26:30I think that men, it's, I mean, we run the house, right?
26:35We really take care of everybody.
26:37And so, to have men understand what menopause is about and how to support your significant
26:43other, I think it makes a huge difference.
26:45So, just, I think men should educate themselves on it and talk to your friends about it.
26:50You know?
26:51That's something that's super important, that they have those conversations with other men
26:55about what's going on and support each other, because it's difficult.
27:00You know?
27:00During menopause, there's a lot of, there's a such thing as men-o divorces, right?
27:05So, there's a high rate of divorces during menopause for a lot of couples.
27:11And so, I think that if they're educated about what's going on, they won't take it so personal.
27:17And they would help their significant others to get through this transition.
27:23And I met your daughter backstage.
27:25You know, how can we talk to our kids about it?
27:28Because they're going to go through it.
27:29Oh, yeah.
27:30For sure.
27:30You know, you can't outrun menopause.
27:32You can't outrun perimenopause.
27:34Yeah.
27:34My daughters know what it is.
27:36And there's no, it's no quiet, we don't keep any secrets.
27:40Everything is, you know, up front and personal, so that when they're making that transition
27:44in their life, they'll know how to handle it, and they'll be well-prepared.
27:47So, it's super important to share, even with your children, what you're going through.
27:52Yeah.
27:53I think secrets can really hurt us in the black community, because if we don't talk about
27:56it, so many of my patients say, my mother never talked about that.
28:01My grandmother never talked about that.
28:03So, when you're trying to get a family history, like, okay, when did your mom go through this?
28:07I don't know.
28:08They never talked about it.
28:09And there's also so much misinformation, and I think it's important to highlight that
28:13study, and I'll ask you, Dr. Tribas, to take us through the data that, you know, I think
28:18has led to women not getting the medical treatment that could actually improve their quality of
28:23life and also extend their lives.
28:26Do you mind if I speak on it just for a little bit?
28:28So, the study she's referring to is the Women's Health Initiative that came out in 2002.
28:33Prior to that, women were receiving hormone replacement therapy regularly.
28:38That data was wildly misinterpreted, just to be explicit with how we got here and what we're
28:45going to do about it now.
28:48There is a segment of time in which hormone replacement therapy is absolutely safe, and that is in the
28:54perimenopause transition as well as up to 10 years after menopause, the final menstrual period.
29:00Where the study, what the study highlighted, unfortunately, was that women in their 60s who were started on
29:06combined estrogen and progestin therapy had increased risk of, like, heart attacks and strokes.
29:12Well, that's not really the way we practice in treating menopause.
29:15We treat women in their 40s and 50s with hormone replacement therapy, and what that does long-term
29:20actually helps to prevent some of the things that those women who are receiving
29:25menopausal hormone replacement therapy late in their 60s to mitigate.
29:30So, for instance, over those 10 years, women catch up with cardiovascular disease risk that is the same as men.
29:38Over those 10 years, they increase their risk of colon cancer and breast cancer.
29:42But if they were started on the hormone treatment before, then all of these things are actually mitigated.
29:49Hormone replacement therapy has a ton of benefits, which I don't think are highlighted enough.
29:53They prevent osteoporosis.
29:54They prevent colon cancer.
29:56You know, so we don't talk about all of the good parts of it.
30:00They have not been able to prove that it specifically prevents dementia, but it does help with mood as well
30:07as, like, the brain fog.
30:08So, I just want to highlight one other quick thing that also came out of that time period was this
30:13term bioidenticals.
30:15So, bioidenticals is a branding terminology.
30:19Often, the FDA-approved hormone replacement therapies are bioidenticals also, and that's the first-line recommendation for treatment.
30:29What I don't recommend is that people get off-label products, things that are not, like, regulated at all, because
30:36what we don't want is you getting unopposed estrogen.
30:39This is my main point today.
30:41If you have your uterus, you need estrogen and progestin.
30:44You cannot go around obtaining unopposed estrogen, which can lead to you having breast cancer and uterine cancer.
30:50So, that's my main point today.
30:52Hormone replacement therapy is absolutely safe when starting the transition of menopause, and that if you have your uterus, you
30:59need both estrogen and progestin.
31:01If you don't have your uterus, you can just have estrogen.
31:03And you also mentioned the physical health benefits that can extend life.
31:10Osteoporosis.
31:11Women end up, you know, breaking their bones, breaking their hips.
31:14Things like urinary tract infections.
31:16I used to work on a geriatric unit, and a lot of times people would come in with these bacterial
31:21infections because had they gotten the hormone therapy, perhaps they could have prevented that.
31:26That's why one of the most common things that you see as you age is you have to go to
31:30the bathroom a lot, a lot frequently.
31:32Well, because hormones don't just impact your ovaries and your uterus, they impact every cell in your body.
31:38So, that creates these changes.
31:40And so, this could be life or death, but, you know, that's why we have to have these conversations so
31:45we have access to this information.
31:47The one thing that we really didn't touch on that much was the high rates of maternal mortality.
31:54And, you know, we talk about women's health as being essential.
31:58Well, this is essential for our livelihood, for our generations even existing.
32:03So, I'll start with you, Dr. Hunter Cummins.
32:05Tell us about some of the, you know, the rates that we're seeing and things that we can do to
32:11address this.
32:12I'm sorry.
32:13Could you repeat this?
32:14Oh, the maternal, the high maternal mortality rates.
32:17How can we advocate for ourselves?
32:20I think it's important that, like we talked about earlier, like just being present, sharing everything with your doctor.
32:31Um, I think that the mortality, the infant, you said infant mortality, right?
32:37Yeah, maternal.
32:37Maternal.
32:38Maternal.
32:39I'm sorry.
32:40Hold it up high.
32:41I'm not so well-versed on that, so maybe we pass that.
32:44I mean, what can we do to advocate for ourselves if we're feeling as if our doctor isn't listening to
32:48us, um, if we're concerned about that?
32:51Well, I think that that's super important, that if your doctor is not listening to you, maybe that's not the
32:55right doctor for you.
32:56And you need to find someone who does listen, who does, you know, connect with you on that level.
33:03And I think that even in my own experiences with gynecologists, they're, you know, I didn't connect with a few,
33:11and it didn't work.
33:12And they didn't tell me, and not that I, tell me what I wanted to hear, but I don't think
33:17that they were actually hearing me.
33:18And so I think that it's important that you connect with a doctor who hears you, who understands you, and
33:25who you can connect with in order to make a great treatment plan for you.
33:29So.
33:31I was going to say, we use this terminology called cuss.
33:34So if everyone learns how to cuss when they go to the doctor, and C stands for I'm concerned.
33:40Uh-huh.
33:41U is I'm uncomfortable.
33:43All right?
33:44And then S is like I'm worried about my safety, right?
33:47And then always bring an advocate with you.
33:49Always have someone there with you so that they're hearing this information also when you're in the presence, especially when
33:55it comes to, like, the maternal mortality.
33:57I love acronyms.
33:59That's a good one.
34:00Cuss.
34:00I'm going to remember that one.
34:01I got two to death.
34:03Dr. Sam.
34:04Yeah, I mean, again, I'll just speak from women who are incarcerated.
34:10And the maternal morbidity rates there.
34:12There are so many women, unfortunately, when incarcerated, they are shackled during child labor.
34:21We passed over 20 pieces of legislation nationally to end shackling during child labor for women who are incarcerated and
34:29made sure that it was put in the dignity provision in the Federal First Step Act.
34:33But that was because women were dying, right?
34:36People don't care about women who are in prison and then especially a pregnant woman in prison and a black
34:45woman in prison, right?
34:47So you have all these compound barriers in these different situations and circumstances, and we just don't get the proper
34:55care.
34:56And so while I don't have the exact rates and numbers, we know because we see it every single day
35:01that black women are dying during childbirth.
35:04And it isn't because it cannot be prevented.
35:06I would also, I would, I would err to say that a lot of it happens because they don't have
35:13the right professional, a person that looks like them, that cares about them, that understands their body, who they are,
35:21and respects it.
35:22Because when we're not respected, the doctor will not take care of us in the way that they should.
35:28And you don't have to do it alone.
35:30There are several groups out there.
35:32Sometimes we feel like we don't even know where to start.
35:34We go to our doctor, who's supposed to take care of us, and we feel rejected.
35:38We feel unheard.
35:40But there are so many groups of women and advocates out there.
35:45So, you know, just to share some of those resources so that you have those with you, I'll just go
35:49down the line.
35:50If you could share some women's health resources that people can utilize, both either nationally, locally.
35:55Dr. Yu, I'll start with you, Dr. Trapez.
35:57Oh, yeah, certainly.
35:58I'll say it again.
35:59It was health in her hue and then also fee manual.
36:03Those were the two.
36:05I would say Epic Health, PBC.
36:08If they go there, we have a host of resources, depending on the state that you're in.
36:13So you can find something local that can help you.
36:16And then TriSage.
36:17And I would definitely say TriSage Method.
36:21There's a host of products that you could use and information on perimenopause and menopause.
36:28I'll add something to that.
36:29Let's Talk Menopause.
36:30It's an advocacy group that I'm on the board of.
36:33And I think that everyone can get involved by writing to your local leaders, by getting involved with organizations that
36:40create positive change.
36:41Women were not included in clinical studies until the 90s.
36:46So a lot of the science out there isn't based on our bodies.
36:49And so we really have to advocate for this change so we get evidence-based care because we're worthy of
36:57that.
36:58And I'll give you all one last chance to touch on anything that you'd like to discuss that we didn't
37:05talk about women's health.
37:07I'll start with you, Dr. Tropez.
37:10I guess my last words would be to know the language that you need to use to go into the
37:15doctor.
37:16Like I said, provide that objective data, A, for yourself as well as the doctor.
37:20Not that it's just like random recall because we often don't recall things the way it actually happened.
37:25And then always ask about what's the whole plan and what's your differential.
37:30I love that.
37:32Dr. Sam.
37:34I would just say, we've all said a lot here.
37:38All the information that I've shared today you can find on our website, epichealthpbc.com or thelohm.org.
37:46Dr. Hunter Cummings.
37:48Yeah.
37:49I'm a big advocate for journaling, right?
37:53So I think that women should journal these moments that they're having because they slip and then we forget.
37:58So I think that every symptom that you have, every, I think even journaling for food, everything that you're doing
38:06and putting in your body, I think it's important that you journal.
38:12And again, try stagemethods.com if you want to, you know, visit us and see what we have in store.
38:18I think it's a great way to approach perimenopause and menopause.
38:24And I'll add something that I tell all my clients.
38:27Number one, do your research before you go to the appointment.
38:31Look it up.
38:33Educate yourself.
38:34And that way you have an understanding.
38:36Science shows us that when we don't know something, we get stressed out.
38:41If something's uncertain, we don't think as clearly, we don't make good decisions.
38:46So educate yourself beforehand.
38:49Number two, like what Dr. Hunter Cummings said, take a journal, write down your symptoms.
38:54What did you eat that day?
38:55You know, the day that you had hot flashes, the day that you had brain fog.
38:59Who were you around?
39:00Were you stressed?
39:01What was your sleep like?
39:03And then lastly, when you go to the doctor's appointment, have a clear goal.
39:08Know what you want when you leave.
39:10And if the doctor is not meeting that goal, then get a second opinion.
39:14Please give our panelists a round of applause.
39:17And thank you so much for being curious today.
39:26How you feel, man?
39:27I feel all right.
39:28I call your name.
39:29I don't want people to know you're in here.
39:30How you feel, fella?
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