Discover vital insights into women's health as leading experts share their journeys and expertise on the Global Black Economic Forum stage. This essential conversation delves into the mental, physical, and emotional well-being of women, highlighting critical issues and offering pathways to solutions.
Learn about the unique challenges Black women face, including alarming rates of postpartum depression, maternal mortality, and exacerbated perimenopause and menopause symptoms. The discussion also addresses the prevalence and severity of uterine fibroids and endometriosis among this demographic, and why timely diagnosis remains a struggle.
Hear from Dr. Davida Hunter Cummings, Dr. Topeka Sam, and Dr. Jennifer Tropez as they share their personal motivations for entering the women's health space. Dr. Judith Joseph moderates this powerful dialogue, emphasizing the importance of Black healthcare providers and culturally competent care.
Explore groundbreaking solutions, from telehealth platforms addressing healthcare access for justice-impacted individuals to methods aimed at supporting women through life transitions. This session offers hope and actionable strategies for improving women's health outcomes globally.
#WomensHealth #BlackWomenHealth #HealthcareSolutions
Learn about the unique challenges Black women face, including alarming rates of postpartum depression, maternal mortality, and exacerbated perimenopause and menopause symptoms. The discussion also addresses the prevalence and severity of uterine fibroids and endometriosis among this demographic, and why timely diagnosis remains a struggle.
Hear from Dr. Davida Hunter Cummings, Dr. Topeka Sam, and Dr. Jennifer Tropez as they share their personal motivations for entering the women's health space. Dr. Judith Joseph moderates this powerful dialogue, emphasizing the importance of Black healthcare providers and culturally competent care.
Explore groundbreaking solutions, from telehealth platforms addressing healthcare access for justice-impacted individuals to methods aimed at supporting women through life transitions. This session offers hope and actionable strategies for improving women's health outcomes globally.
#WomensHealth #BlackWomenHealth #HealthcareSolutions
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LifestyleTranscript
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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