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Dr. Kemi Doll is one of the country's leading voices on Black women's reproductive health. This circle will explore fibroids, fertility, and the systems that fail us. Presented by Penguin, this is a conversation about reclaiming care and rewriting the script around the body.
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00:00Okay. Well, I was very excited when you landed in my inbox that you were going to be a part
00:05of festival. I mean, before we even drop in, anyone here been dealing with fibroids, friend, family member, yourself?
00:15Heavy bleeding, cramping pain. Okay.
00:20Okay. And so I was just so moved by your book, by your body of work. I feel like for
00:27those who might just be walking in, can you tell us a little bit about you and your book before
00:32we really drop into the conversation?
00:34Absolutely. Hello, everybody. And again, I just want to thank you for being here considering there are a lot of
00:38different places you could be at the Essence Fest today.
00:41My name is Kemi Dole. I'm a double board certified gynecologic oncologist, which means I spent way too much time
00:48in school and training, learning everything, the ins and outs of womb health, including womb cancers.
00:55I'm also a uterine cancer scientist and a health equity expert in black women's reproductive health.
01:00So my entire career has been about black women and the womb, and all of my work is about understanding
01:08something that I call womb suffering, which is our inappropriate inheritance of these severe gynecologic diseases, fibroids, endometriosis, heavy bleeding,
01:21which we are often, unfortunately, taught is just our normal.
01:24And that mixes with a health care system that tells us that we don't really, we're not really the priority
01:30and they don't really see our pain.
01:32And it means that we have normalized living with this suffering for way too long.
01:37So I do a lot of science to ease this suffering, to understand what we should do differently.
01:42But I wrote this book called A Terrible Strength so I can share with our community what I have learned
01:49so that we can break this cycle.
01:51So thank you again.
01:52So happy to have you.
01:54So let's get into fibroids for a second.
01:57You know, again, I was just talking to you outside.
02:00I had a myomectomy, which is an open surgery to remove fibroids from my womb three years ago.
02:08I had 25 removed.
02:09Yeah.
02:10And, you know, up until then, I had a lot of what you're talking about.
02:15I had, you know, heavy bleeding, like bleeding through like the heaviest pad in an hour, like feeling just so
02:22much.
02:23Like shame, not even just shame, actually, because at a point that was no longer the issue.
02:27It was just like vulnerable.
02:29Yes.
02:30Very vulnerable every time I was on my period if I was going to travel.
02:32Like, I mean, not being sure if it was going to leak through my clothes.
02:36Yeah.
02:36You know, just not even able to focus in a meeting being like, wait, did that just leak?
02:39Like, you know, like that being the story of my life.
02:42And, you know, I was a doula, health educator for, you know, throughout 15 years.
02:47And I only learned about fibroids, I'd say maybe seven years ago.
02:53Yeah.
02:53Right.
02:54Prior to the seven year mark, there was very little conversation about fibroids.
02:58It just was like kind of undercover.
03:00And then when I started learning about it, I was like, whoa, wait, why don't more women know about this?
03:06And I really took it upon myself to be very public about my experience, my surgeries.
03:11And it's been, you know, it's been amazing to learn more and more as the years have gone by.
03:16But I feel like I have not felt more moved and more curious about fibroids than learning about your body
03:22of work because of how you're seeing it.
03:24And so I'd love for you to just talk a little bit about, you know, what is your point of
03:28view on fibroids?
03:29Like, how do you see them in the world?
03:30And what is the way that you see them that very few people see them?
03:36So first of all, I just want to say your story is so common in terms of like I was
03:41even in women's health.
03:42I was a doula.
03:43I was in this space and I didn't learn about this because so much of our conversation about women's health
03:48is just about the reproductive part.
03:50It's just are you pregnant or not pregnant and maybe STD screening and safety.
03:56And it's wild because we spend most of our time not pregnant and we spend most of our time dealing
04:01with these cycles, et cetera.
04:03But that's the smallest part of the conversation.
04:05And so I just want to say one of the perspectives I have is that this is a crisis in
04:12plain view is how I think of it because we're all walking around dealing with this.
04:16But there is comparatively so little discussion.
04:19Listen, fibroids are not new.
04:22Fibroids have been found in mummified bodies.
04:25Fibroids were written about as early as the 1800s.
04:28They were referred to as stones in the womb.
04:32The stones in the womb.
04:35It's only recently that we have begun studying them scientifically to understand why they come about.
04:42And I shared this with you.
04:44Each individual fibroid, the reason why it grows is that y'all have to do anatomy for one second.
04:49We can all hang in there.
04:51The uterus has three layers.
04:53It has the inner layer, which is called the endometrium.
04:56That's where a baby would grow.
04:57It has the middle layer, which is the muscle layer.
05:01That's the biggest layer because that does all the cramping and et cetera.
05:04And then it has an outer layer that's like saran wrap.
05:07A fibroid is when a cell in the muscle layer, it's a muscle cell, it gets a mutation.
05:14And instead of growing nice sheets of muscle, it's like this disordered cramped ball of muscle with calcifications.
05:22That happens because of a mutation, and then they grow, and sometimes they don't make it, and they die off
05:28themselves, and sometimes they continue to grow.
05:31It starts from the mutation.
05:33Those mutations come from a lot of different places.
05:35You can inherit them.
05:37They can be from environmental toxins.
05:39And we are increasingly understanding that they are also a product of chronic stress, early childhood abuse, as well as
05:51anger suppression, something called anger squelching, which is, this is so interesting.
05:58This was a study in black women, black women who reported very frequent episodes of not, of suppressing their anger,
06:07being angry, but pushing it down.
06:08It's called anger squelching, had the highest prevalence of fibroids.
06:13This was a study with thousands of women.
06:14This is not a small study.
06:16So we are starting to understand there's a relationship between the sensitivity to our hormones, our mental health, our environment,
06:25and our genetics.
06:27And when we understand that is when we can start to then make moves, both in medicine and outside of
06:32medicine, to heal this.
06:34So I think my perspective, just to wrap it up, is that womb health represents your health.
06:40It's not this other thing.
06:42We learn about it, like you said.
06:43We learn about it, like, don't even think about what's going on down there.
06:46I don't know about you, but I feel like as a child, when I got my period, the very first
06:50thing I learned was how to keep it a secret.
06:52That's what we teach little girls.
06:55This is how you keep this a secret.
06:56We're not telling them what is normal.
06:58We're not telling them how much bleeding is okay and how much isn't.
07:02We're not talking about that.
07:03So we grow up into adults, and what do we do?
07:05We just disassociate.
07:07There's nothing going on down there.
07:08If it's not leaking out, I'm not even thinking about it.
07:12It's not happening.
07:13And that is the kind of thing that leads to so much neglect because by the time we say, I
07:17need help, it's so severe.
07:19Yeah.
07:19So I'm going to back up for a second.
07:20Yeah, I gave you a lot.
07:21Oh, no, no.
07:22You gave me a lot.
07:23But I love to just kind of pull the thread and unpack things a little bit more.
07:27So I want to go back to what you just said from an anatomy perspective because I think what folks
07:34in this room need to hear again, actually, is the thing that you just broke down, those three different layers.
07:40Because oftentimes when someone's like, I have fibroids, you know it's in the womb or in the uterus, but you
07:47don't really understand, like, where it is or what's happening.
07:49And so I would love for you to just bring that metaphor back again and explaining what those three layers
07:54are.
07:55And then also, if you wouldn't mind going into, like, the locations of where fibroids can be.
08:00So those three layers, so that inner layer is called the endometrium.
08:05I mean, that's a medical term.
08:07It's a mouthful.
08:09But you can think of it almost like a lawn of grass, like soil with grass that grows.
08:14And so every month the grass grows, and then if there's no seeds that are planted for anything like life
08:21to grow, then that grass is shed.
08:23That's how you can think of it.
08:25That's that layer.
08:26Then you have the muscle layer on the outside, which is almost like this strong fence around that lawn that's
08:33made of muscle, and then the saran wrap on the outside.
08:36So where a fibroid is completely changes the symptoms you have.
08:41So that's why you can't compare yourself to other people.
08:45If somebody has a two-centimeter fibroid, like just the size of the end of your knuckle, but it's in
08:52that lawn layer in the endometrium, they could be bleeding.
08:56Like, they could be hemorrhaging every month because the disruption of that very sensitive layer is just full of blood
09:03vessels, and they'll just be bleeding.
09:04Somebody else could have a five, ten-centimeter fibroid the size of a grapefruit, the size of a mango in
09:11the muscle layer, and because it's in the back or on the top, they don't even feel it.
09:17They just think maybe they're a little bloated.
09:19So I want all of us, I was saying this to you before, we're smart.
09:23I believe black women are smart.
09:25We can understand these things.
09:26This is why we can't just so easily compare our symptoms across, and this is why I really advocate as
09:33much as people have had difficulty with gynecologic care, because I have, and I write about it in the book.
09:39My first experience was horrific, and I suffered many years forward in gynecologic care.
09:46But as a gynecologist and a scientist, I also know we have so much to offer, and it is in
09:53those visits where you can get into the details of where these things are, what layer are they in, what
09:59size, what position, that can lead us to the treatments that make the most sense.
10:04But we can't get there if we're not even going to the doctor.
10:07So I would love to hear, just briefly, because I know we're sitting here now, obviously you are an incredible
10:15source of knowledge, you are a provider now, but you just said that you had a really challenging time initially
10:21with your own gynecological journey.
10:23Can you just share a little bit about that and what it was like for you?
10:29You know, I will say that the first time I went to the gynecologist, I think my mother took me
10:34just because she figured that's what she was supposed to do as a checkbox.
10:38I was going off to college, and so she was like, we should go to the gynecologist.
10:41She didn't go back in the room with me.
10:43I was 17, and I got back in the room, and I was pretty severely mistreated.
10:51It wasn't really until I wrote it out that I realized I was essentially assaulted.
10:55There was no explanation.
10:57There was no preparation for what was going to happen.
11:01I had no idea.
11:02That was my first visit.
11:04I didn't go back for years.
11:06During those years, I'm having more and more pain.
11:09I'm having suffering.
11:10I'm having heavy bleeding.
11:11I'm thinking all of this is normal because you know what?
11:13I can still function, and that's why my book is called A Terrible Strength because I was strong enough to
11:18still function so there's not a problem.
11:20It wasn't until I was in my mid-30s on the table getting cut open for a C-section having
11:26my first child that I was diagnosed with endometriosis myself.
11:30I think what's important for me to share about that is I was already an OB-GYN.
11:35I was already a board-certified OB-GYN.
11:38I knew all of the diagnostic criteria for endometriosis, but I never thought I had it because I didn't think
11:44my periods were painful enough.
11:46I was like, well, I'm not really suffering that bad.
11:50I mean, I take 1,200 milligrams of ibuprofen just to get out the door, but I can make it.
11:56And I emphasize that for myself because I want to emphasize it's not just about the knowledge.
12:02It's about how we are taught as black women to stand up straight, put your armor on, go out into
12:08the world, and deal with the racism, the sexism, the threats from all sides.
12:12You don't get to be vulnerable.
12:15You don't get to excuse yourself from the meeting because my cramping is a little bit heavier.
12:19We don't get to do that.
12:21But when you don't get to do that, how do you then learn what is it I'm even supposed to
12:26tolerate?
12:27How do you learn what the threshold is?
12:29So when that happened to me...
12:31Good afternoon, good afternoon, Essence Festival of Culture 2026.
12:36There are no drones allowed in the building.
12:41Again, no drones are allowed.
12:44Any drones should cease operation immediately.
12:50I don't, I lost my train of thought.
12:52Okay, so I don't remember what I was saying.
12:57I do.
12:57Sorry, it's gone.
12:58You were talking about the fact that you can't take, you know, time off in the middle of a meeting
13:02to be like, my cramps are really bad or I'm bleeding really heavy.
13:05Yeah, it's very hard for then you to, it's very hard for you to recognize that I am experiencing something
13:11that is worthy of help and that actually is a diagnosis.
13:15Dysmenorrhea is the medical term for painful periods.
13:18It's a medical term because it's a diagnosis.
13:21It's not about I don't have a high threshold of pain.
13:24Dysmenorrhea comes.
13:25There's three components to a period.
13:28Okay, there is something called hypoxia.
13:31There is inflammation and there is repair.
13:34I talk about this in the book.
13:35It's very, actually, it's very interesting because the womb is the only place in the body where you have a
13:40wound with a scarless repair.
13:43It's the only place in the body every single month you have a complete open bed wound and it heals
13:49without a scar.
13:50So how's that for a metaphor for womanhood?
13:53However, when you have dysmenorrhea is when that inflammatory phase of the menstrual cycle is too long and too strong.
14:02That's why it's a diagnosis.
14:04But I don't know that if I just think I'm supposed to be cramping and I'm supposed to deal with
14:08it.
14:09Yeah.
14:09So I, that's my own journey is really recognizing that.
14:14And I also share in the book how as a physician, I was taught to look for pain a certain
14:19way.
14:20And it's not for how pain shows up on black women.
14:23Black women, I was taught to look for pain of people in the throes, people can't handle themselves.
14:29We don't get to do that.
14:30If we walk in hysterical, we'll end up in the clink clink.
14:34You know what I'm saying?
14:35Like we don't, we'll get drug tested because we're in pain.
14:39And so I'm very vulnerable because I don't want to come from this place of holier than thou.
14:45I spent decades in medical training.
14:47I was in the same soup.
14:50I discharged a woman that I shouldn't have who was pregnant and told me she had pain and symptoms that
14:57essentially were concerning for not just a bladder infection,
15:01but like a kidney infection, which is very dangerous when you're pregnant.
15:04And I discharged her because I didn't think she looked like she was in that much pain when I was
15:09in training.
15:10She came back very sick.
15:12She did okay in the end.
15:14And I could have made all these excuses for, oh, well, her labs were borderline and this, but I remembered
15:19what I thought.
15:20I remembered thinking she doesn't look like she's in that much pain.
15:23And that really shifted something in me too because I said, why, what, what was I looking for her to
15:29perform for me before I just simply believed her that she hurt?
15:33She wasn't somebody who got to do that.
15:35She worked in a grocery store.
15:36She was a cashier.
15:37She doesn't get to scream and she came to the hospital because it was severe.
15:42So that is like, these are the pieces of my journey that just give me so much empathy about what
15:47we're up against in terms of what we need to unlearn.
15:49But also because I know the medicine and the science and because I do the research, I'm so passionate about
15:55us getting that help because I know it's there.
15:58I know it's available.
16:00So let's dig into that a little bit.
16:01So thinking about performing and science.
16:06So I want to talk about this idea for anyone who didn't hear, this idea of anger squelching because that
16:13in itself is its own performance and what the science is around anger squelching and our fibroids.
16:20Let's talk about that.
16:21Yeah.
16:22So first of all, I think there's a few things here.
16:28It's so interesting.
16:29That statistic is so interesting to me because they looked at it in white women too and they didn't see
16:35the same correlation.
16:36Can you run that statistic back again just so folks can...
16:40There was actually a host of things this study was looking at.
16:43It wasn't just anger.
16:44It was looking at other mental health factors.
16:46But one of the factors they were looking at is something called anger squelching, which is when you feel angry
16:52but you suppress it down.
16:53They asked women to basically rank, do you do this once a month, once a week, several times a day,
16:59et cetera.
16:59So the women in the highest category, several times a day, I am like pushing it down, pushing it down.
17:05They had the highest prevalence of fibroids when they were doing ultrasounds and looking at what was going on with
17:10their wombs.
17:11Okay, this was a population health study.
17:13So what that doesn't tell us, it doesn't tell us that the anger caused this molecule to change, caused this,
17:19caused this.
17:20That's what we still have to work out.
17:21But it shows that there's a connection here for us to work out.
17:25When I think about black women and what's going on and the fact that we are constantly facing this angry
17:30black woman stereotype,
17:33we literally have to perform differently when we're angry because we, again, do not have the freedom to just go
17:40off on people and just express all of that.
17:43And I would argue we're also socialized in many ways to avoid looking like that.
17:48So we're coming in baseline, suppressing the anger, right?
17:51Baseline.
17:52Baseline.
17:52So that is a form of chronic stress when you have, when you're basically presenting something different than what you're
17:59feeling inside.
18:01And from the literature on stress, we know that stress is very detrimental to your immune system.
18:06It's very detrimental to that surveillance system that goes around in your body and goes,
18:10you cell, you're messed up, you need to die.
18:13That cell is messed up, clear it out.
18:14That's what our immune system does.
18:17Remember when I said fibroids are from a mutation?
18:20So if you have a fibroid cell, you have that cell that mutated, your immune system is supposed to go
18:24around and scoop it up.
18:25So now do you start to see the connections?
18:28You don't have as strong of a surveillance.
18:30So, again, I want to emphasize, this is where the theory is to start to work out how we can
18:35make these scientific connections.
18:37But before we get all that theory worked out, before we get all the steps worked out and somebody develops
18:42a drug for $15,000, can we just be angry?
18:46Can we express our feelings?
18:47Can we be free enough?
18:49It is, I don't think it's hyperbole when I say, I don't think it's an exaggeration to say, I do
18:53think that womb health represents our health.
18:56There are so many connections emotionally.
18:59Also, your self-concept and like what you feel like you deserve in terms of well-being is tied up
19:06in the womb.
19:06A lot of women's sexual identity is tied up in their womb.
19:10Women who've had pain with sex their entire lives and they assume that they just don't, you know, they don't
19:16feel desire or anything like that.
19:17And it's like, no, you actually have a condition called vaginismus and we could treat that.
19:22But they have a whole identity around it.
19:24So I'm just so passionate about making, I think women, we deserve to live full lives, all of our lives,
19:30not to pretend that this organ between our belly button and the top of our thighs isn't there unless you're
19:36trying to get pregnant.
19:37And that's true.
19:38I think so much of our focus on the womb or the uterus is about pregnancy and not necessarily about
19:44just keeping it well.
19:47Yes, health.
19:48And again, too, you know, one of the things I wanted to get your take on.
19:53So when it comes to periods.
19:55Yes.
19:57Periods should not be painful.
19:58Is that correct?
19:59Periods can be mildly painful and covered easily with over-the-counter pain medication taken at the dose suggested.
20:06So that's 200 milligrams for ibuprofen because I know I was eating it like candy.
20:11So, yes, because ultimately what's happening when you bleed is that your uterus is squeezing to get it out.
20:18That squeezing is going to be like a cramp.
20:20So that's fine.
20:21That's normal.
20:22But little girls who can't go to school because they're in so much pain.
20:26Was that?
20:27That's not.
20:28That's actually one of the early signs of endometriosis is early painful periods in little girls having to.
20:35The way I think of it is like, listen, sometimes if you're on your cycle, you're just like, I'm tired.
20:40I don't really feel like going anywhere.
20:42You take a couple of Tylenol.
20:44You feel better, but you just don't feel like going anywhere.
20:45That's fine.
20:46But if you want to do things, you're like, no, I actually need to get stuff done or I want
20:51to get stuff done, but I can't because it hurts too bad.
20:54That's too much pain.
20:56Yeah.
20:56And that represents that cycle, that inflammatory hypoxia signal being off.
21:02Yeah.
21:03So let's talk about black women, us.
21:05Yes.
21:06Us.
21:06Us.
21:07Getting the chance to be angry.
21:10Because that's a whole entire thing.
21:13I'm having so many flashbacks right now as you're talking of just times where, and I'll tell you this, like
21:20I'm turning 40 this year.
21:22Congratulations.
21:23We made it.
21:24Yes.
21:25And I really don't have time anymore.
21:27No.
21:28So now, like I was saying to my partner the other day, I was like, I am actually excited when
21:33someone gets me angry because they can catch it.
21:36Yeah.
21:36Yeah.
21:36They can catch it.
21:37Yeah.
21:37Everybody's up.
21:38Like I, I am no longer, because I, because I know this now, I know that when I push down
21:43my emotions and I'm, I'm not, I know that there's a systemic impact.
21:47Like if you don't get angry, if you don't express your feelings, it makes you sick.
21:51Like.
21:52Yes.
21:52Like that.
21:53And now we're seeing the science to help us connect that.
21:55But I'm curious to see, like, if you have a patient and you're, and you're, and she's another black woman
22:01and you know about the anger squelching and you know what that's starting to look like.
22:05Like, what are you telling her?
22:06Like, how are we managing this?
22:07Yeah, I just want to say the whole third part of my book is, it's called The Hidden Crisis of
22:12the Black Womb and Your Survival Guide to Healing, because I'm not giving a problem without a solution.
22:17In fact, that's my pet peeve.
22:18So the whole back half of the book is how we do better.
22:21And I just want to say that because it's a holistic approach.
22:24And one of the first approaches is this internal sense that I deserve more.
22:30I deserve more.
22:31I deserve to be pain free.
22:33I don't need to suffer like this.
22:36I don't have to spend a week, a month in the house.
22:39That's actually very important because it switches also what you're talking about.
22:43When you decide I deserve better than to be suffering like this, it bleeds into other areas.
22:49Now you're messing with me.
22:50And you know what?
22:50No, Tom, we're not going to do this today.
22:53So there are ways in which this carries over.
22:56When you center womb health and you realize I need boundaries for this, it helps express these things.
23:02So that's the kind of thing I tell women is like, let's start from the inside out.
23:07And I feel good when I can do things to help myself, even if I also need help.
23:13I find most people want to say, what can I do to help myself?
23:16And then how can you help me?
23:18I want both, right?
23:19So when you know I'm going to do things to help me, I'm going to drink my green tea.
23:23I'm going to take my vitamin D.
23:25You know, Dr. Kemi told me to set up my boundaries and you are stressing me out.
23:28So I'm not talking to you today because it's not helpful.
23:32That helps you be in a better frame of mind.
23:34And then now I get to come in and the treatments I have are going to be better.
23:39They're going to work better because they're not being counteracted by all this stress in your life.
23:43You know, and so it might be, you know what?
23:45You're doing all these things.
23:46That's really great.
23:47I'm also going to give you an endometrial stabilizer.
23:49I'm also going to give you something so that you're not bleeding so much.
23:52So we're going to work together.
23:54So we're going to pause right there.
23:55I have two things, three things that I want to say.
23:57Can you talk about why green tea, vitamin D are the two things that you brought up?
24:01Because I think there's clinical reasons for that.
24:04And then can we talk about the endometrial stabilizer and the thing that's going to help reduce the bleeding?
24:09Because I don't think a lot of people know.
24:10They hear about that.
24:11About tea and they need to.
24:13So let's run through those.
24:15Okay.
24:15So first of all, there are so many.
24:17If you throw a rock, there's a claim about fibroids out there.
24:19Okay.
24:20It's like, it's crazy because they're all conflicting.
24:22Eat pineapples.
24:23Don't eat pineapples.
24:24Be vegan.
24:25Eat meat because you're losing blood.
24:26I mean, it's like, it doesn't end.
24:29And the reason why even I am, I'm a biomedical.
24:31So I tell people I am a, I'm a woo woo girl with a scientific heart of gold.
24:35Okay.
24:36And I understand how hard it is to parse through and understand.
24:39And so I take time in the book to actually tell you what has clinical scientific evidence behind it and
24:45not.
24:46And the reason why I brought those two things up is because we have clinical evidence, scientific evidence behind one,
24:53vitamin D.
24:54Vitamin D stabilizes fibroid growth.
24:57So it has this effect where it doesn't necessarily shrink fibroids, but it stabilizes growth.
25:03It's very helpful for people who learn early they might have fibroids.
25:06Maybe they're not a problem now, but let me get on my vitamin D because it can help stabilize from
25:12things growing.
25:13Green tea.
25:14It's something called ECGC, I think is in green tea.
25:18Green tea is already known to have anti-inflammatory properties.
25:21But this EGCG also appears to be more sensitive to those, to hormonally sensitive cells, so like fibroid cells.
25:31And so it has this antioxidant, anti-inflammatory effect as well.
25:35And we've also seen women who take ECGC supplements or drink green tea also have lower, more fibroid stabilization and
25:45a little bit of shrinkage depending on the study that you look at.
25:48But there are things that don't work.
25:49Vitamin C doesn't do anything.
25:51Vitamin E doesn't do anything.
25:52So like we actually do have this information.
25:54And when you're online and people are selling you supplements with all these things, I encourage you to look at
25:58the ingredients.
25:59Because if the ingredients are vitamin D, ECGC, and then 16 other things, girl, just go get your vitamin D.
26:05You don't need to spend $100 a month on that supplement.
26:08That's why I brought those things up because there's data behind it.
26:11You asked me something else?
26:13Oh, yeah, the endometrial stabilizer.
26:14Okay, so am I going too fast?
26:17No, she's doing great.
26:18Okay, okay, I just want to make, okay, because I feel like I'm like trying to get as much information
26:21out as possible.
26:21I'm trying to get it because you don't have all the time.
26:23I want to get all that.
26:23Okay, so I'll just say I have a little bit of a beef with my field.
26:26I just want to say this right now because we have been very lazy, very lazy.
26:30And what we have done is we have taken a whole class of medications that have hundreds of different formulations,
26:36multiple different components, all different ways to deliver it.
26:39And we've put it all under one title, birth control.
26:43And it drives me crazy because it's so inaccurate.
26:47It's so inaccurate because some of these medications, they've been developed specifically for gyne problems, for womb problems, from those
26:56conditions.
26:56But because we only see women through reproduction, because we only care about pregnancy, they all get the same label
27:03of birth control.
27:04And you don't know, actually, this medication was designed to treat your painful cycles by helping your hormonal balance.
27:13So if anybody's ever felt like, you know, I feel like I went to the doctor.
27:16I talked for 20 minutes about all my problems, and all they did was throw me birth control pills.
27:20What I would tell you is that that doctor is lazy and did not spend time to explain to you
27:24why that formulation made sense for you.
27:28And the side effect is that you might not get pregnant.
27:30Okay, so that's my aside about birth control.
27:32And so we lean into your lexicon of what you called it.
27:37Yeah, so I don't like saying birth control because I don't think it makes any sense.
27:42We usually call drugs by the goal that they have.
27:45Like we say blood pressure medication, antihypertensives because we treat hypertension.
27:50So what some of these medications are doing is a lot of the heavy bleeding comes because the endometrium has
27:56this very, that's that inner layer of the uterus.
27:58Y'all with me?
27:59Okay, it has this very intricate balance and dance of growing and shedding according to the hormonal input.
28:07If the hormonal input is off, that balance can be off.
28:12And literally, literally the blood vessels in the endometrium, they get holes in them.
28:17They get leaky and they bleed too much.
28:20So some of the medications that we use, they stabilize that endometrium.
28:26They close those holes in the vessels so that when you have a cycle, you don't have that extra bleeding
28:33and it doesn't last too long.
28:35Okay?
28:36So I think instead of calling that birth control, we should call it what it's doing, an endometrial stabilizer.
28:43That feels totally different when you're like, oh, I get now how you're helping me.
28:46As a side note, you're not going to get pregnant.
28:49The other thing that is something called transexamic acid, it's called TA, transexamic acid, that is non-hormonal.
28:57But what it does for people with heavy bleeding is it comes in and it helps your body clot up
29:03that blood as quickly as possible in the uterus so that you don't bleed as much as well.
29:07And it helps those blood vessels close down.
29:10I talk to women all the time who have been bleeding, bleeding, bleeding.
29:14They are severely anemic, which we haven't even gotten into anemia and how all the symptoms of anemia, all that.
29:21And they have never heard of what I just said.
29:24Meanwhile, we've had these medications for like 15 years.
29:27So that's what I mean about this gap between us suffering as normal and what is actually available for help.
29:34There's so much there.
29:35And it's where the passion that you hear my voice comes from because I want us to be well.
29:39And we all want us to be well.
29:42And then also just to follow up and kind of just reiterate what you just said.
29:46So green tea.
29:47Yes.
29:48We have vitamin D.
29:49Vitamin D.
29:50Making sure those levels are right.
29:52Calcium is also really good.
29:54Calcium.
29:54Calcium because?
29:56Calcium works with the vitamin D well.
29:58And it doesn't matter where you get your calcium.
30:00I'm sorry.
30:01I'm sorry for the influencers.
30:02It doesn't matter.
30:03It doesn't matter if it's milk.
30:04It doesn't matter where you get it as long as the calcium is there.
30:09Endometrial stabilizer, a.k.a.
30:10birth control.
30:11And then tramxanic acid.
30:13Tramxanic acid.
30:14Yeah.
30:14Which also helps the hyperpigmentation, P.S.
30:16Yes.
30:16So people will be dealing with that.
30:17There are all these excellent little benefits.
30:20Yes.
30:20And I'll just say that, like, within an endometrial stabilizer, there are different kinds.
30:25So people who have more of a PCOS, which is now PMOS, they'll be on kind of more we call
30:31androgen-like stabilizers, whereas somebody who doesn't have that might be more on an estrogen-driven side.
30:38So there are all these nuances, but you can't get to the nuance if you don't go to the doctor.
30:44And I encourage you to get my book because I talk about the languaging that we need to use in
30:50order to get into these conversations.
30:51Because I know people are listening to me, and they're like, ain't no doctor ever told me any of this.
30:55And I know I've been in there talking to them, and I get it.
30:59I get it.
30:59And so I've talked, I've given you sentences, language, vocabulary to use to open up this kind of conversation.
31:08Because, unfortunately, as doctors, the way we're trained is, are you having any problems with your period?
31:12No?
31:13Great.
31:13Moving on.
31:14So if you don't come in like, okay, because I done read the book, so let's talk about my layers,
31:18let's talk about my levels, let's talk about this, all that's going to go by the wayside.
31:23Well, what I want to say, too, and we actually have already gone over time.
31:27Oh, really?
31:27Yes, we have, ma'am.
31:28Sorry, y'all.
31:29But it's all good.
31:30But the thing I want to say is I'm so happy that we're having this conversation today.
31:34For anyone that also, just as a caveat, anybody who's not using any AI here in their lives, this is
31:43a reason to, mostly because you can take the notes.
31:46I'm going to tell you, let me tell you what I'm about to say.
31:47Okay.
31:49The notes from today, you can put them into AI and continue the conversation to learn more about these things.
31:56Because my thing is you, in terms of a lexicon, and I'm like, I use a lot of AI and
32:02I'm more, it's very commonplace for me now.
32:05But I think with what we've been talking about, going to doctors, like coming up with a script that feels
32:10like you to be able to have these types of conversations, that's kind of one of the main ways I've
32:14been finding AI to be very supportive in terms of just preparing for your doctor's appointments in a way that
32:20you might not be able to prepare for on your own.
32:23I want to hear what you have to say about that.
32:25I would encourage you to get my book.
32:27I wrote it.
32:28But she needs to get the book.
32:29A human being wrote it.
32:31And I promise you, I have scripts in there.
32:33But I understand what you're saying.
32:34I do.
32:35Use the tools that you need.
32:36But I want everyone to get your book.
32:38It's actually a couple in the book.
32:40Yeah.
32:40So, no, I'm not saying you're going to look.
32:42I'm not, no.
32:43Let me just be very clear.
32:45You're reading the book.
32:46But maybe you're making notes and you want to remember what you're saying.
32:48Yes.
32:49Yes.
32:49Yes.
32:50I got you.
32:51I got you.
32:51I didn't think you were doing that.
32:53I want to be clear that that's what I've said.
32:55Because for people who are like, I'm not going to get to talk to you today or whatever it is.
32:58If you've taken notes on your phone, I just want to encourage you to continue extracting that knowledge.
33:03I know that we're wrapping up, really.
33:05So, there are just a couple things I want to say, if that's okay.
33:07So, one is that we can and we will break this cycle.
33:14And I just want you to know that we've talked a lot about periods.
33:17We've talked a lot about pain and suffering.
33:19But this is also life and death.
33:21And uterine cancer is on the rise.
33:24It's more common in black women.
33:26We're twice as likely to die if we get diagnosed.
33:28And one of the risk factors is irregular periods.
33:31I'm not just talking about this because I want us to, like, feel better.
33:34I'm talking about it because I sat on the other side of too many 50, 60-year-old, 70-year
33:41-old black women who are supposed to be matriarchs, supposed to be coming into their own.
33:44And they're dealing with a cancer and dying.
33:47And nobody's even saying what kind it was.
33:49So, I just wanted to say that this womb health really is about your whole life.
33:56There's nobody that's done.
33:57It doesn't matter if you're done with kids.
33:59It's your whole life.
34:01And once we decide that we deserve better, this whole thing is going to change.
34:05So, thank you all so much for this time.
34:08Thank you for being here.
34:13Oh, my book is available across at the book festival.
34:17They have a bookstore in there.
34:19My book is available there.
34:20There are still more copies.
34:21I have a couple copies if it runs out there, if anybody wants to just get it from me.
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