Transcript
Speaker: This idea that women's health can be reduced to what feels a lot like a fashion style trend, diet culture optimization is deeply misogynistic. It is ridiculous. Tell me why you don't see the kidney disease world doing this. You don't see the cardiac world doing this. You don't see people talking about their thyroid in these click, click, click, click energy styles. like It is because we play around with women's health. because we play around with women's lives. wow And so what I want people to do is to say, I disenroll from this. And what I'm actually interested in is finding a fantastic board certified gynecologist that does not have conflicts of interest, that is interested in talking with me about my body and figuring out how we can optimize my womb health. And that is what I'm interested in doing, because I'm not going to participate in this.
Speaker: I'm Laurel Beversdorf, strength and conditioning coach. And I'm Dr. Sarah Court, physical therapist. For too long, women have been sidelined in strength training. Oh, you mean handed pink dumbbells and told to sculpt?
Speaker: Whatever that means. We're here to change that with tools, evidence, and ideas that center women's needs and voices. Welcome to the conversation.
Speaker: Welcome to the Movement Logic Podcast. I'm Laurel Biersdorp doing a solo intro today, but you're about to hear Sarah and me interview Dr. Kimi Dahl, a physician and researcher who is double board certified in OBGYN and gynecologic oncology. We're going to get into a lot of topics today with Dr. Kemi, all of which we have never talked about on this podcast before. So we're super stoked that we got Dr. Kemi on the show. I personally learned a ton. Now, before I give you a little bit more context about the interview, I just want to remind you that we do have a barbell mini course, which is free that you can sign up for via the link in the show notes that will walk you through
Speaker: some of the stable lifts using barbells, the squat, the bench press, the deadlift. You can use other forms of equipment to learn about these exercises as well. And that will teach you about some of the most important tools in strength training, RPE e and RIR, and also how to warm up specifically for a lift. So you're basically going to get some strength training technique and tips and some exercise technique and tips. So if you would like to sign up for this free course, you'll also be put on our mailing list while you will hear about future courses and discounts on courses.
Speaker: Sign up via the link in our show notes. As always, it always helps us out if you could rate, review, and subscribe to the show and share it with a friend.
Speaker: Okay, so we recorded our conversation with Dr. Kimmy back in late May, a few months before. had finally worked up the nerve to listen to a three and a half hour episode. Well, it's really just part one was three and a half hours of Stephen Bartlett's podcast, The Diary of a CEO. And the title of this episode is a Hormone and Fertility Experts. We've been lied to about women's health. If this happens, call a doctor.
Speaker: And the guests on this episode were Dr. Mary Flare Haver, Dr. Vonda Wright, Dr. Stacey Sims, and Dr. Natalie Crawford. So these women, who all purport to be experts on female health and physiology, and Dr. Crawford is an expert in fertility, their messaging around contraception and hormonal birth control and then, of course, estrogen, it veered between useful and between youold they aired some legitimate criticism of the medical system, some of which you will hear echoed by Dr. Dahl.
Speaker: And then they also made a lot of claims and a lot of insinuations around hormonal birth control, the use of hormonal birth control that frankly he made me sick. It actually made my stomach turn. And It's around this time that I'm sitting with this and and I start to see content from Dr. Dole on Instagram.
Speaker: And one reel in particular that she posted pushed back quite directly and forcefully against birth control misinformation, reminding people how extensively hormonal contraception has been studied. She talks about this in the episode that you're about to hear.
Speaker: And how conveniently conversations like the one that I had heard on Diary of a CEO leave out the risks of pregnancy and childbirth to women's lives and also the myriad ways that hormonal contraception is its own type of medication.
Speaker: that is used successfully to treat diseases and conditions that affect women like endometriosis, fibroids, painful periods, and PMOS, which was formerly called PCOS.
Speaker: And we talk about all of those diseases and conditions on this episode with Dr. Kemi as well. And so we selected out several recurring themes from this Diary of a CEO roundtable to run by Dr. Kemi.
Speaker: And so you're going to hear her talk about misinformation around the idea that women need to ovulate or need to menstruate in order to be healthy. Or that hormonal birth control is somehow an inferior treatment that fails to address what's really wrong.
Speaker: And she was also going to explain like what fibroids are, what endometriosis is, what PMOS is, why it was renamed. We're so lucky that she agreed to come on and give us some background around some of the misinformation you might be hearing around hormonal birth control, menstruation, ovulation, that might be steering you or women in your life away from effective treatments. You'll also hear Dr. Kemi acknowledge how the medical system has indeed failed women, especially Black women, through dismissal, inadequate treatment, and poor communication, and then how these real failures have become opportunities for influencers to be able to sow distrust in well-established treatments, well-researched treatments, in order to sell alternative treatments, products, courses, promises.
Speaker: Throughout this conversation, Dr. Kemi sets a lot of facts straight while also taking women's suffering seriously. Two weeks from now, Sarah and I will follow this interview with one of our Make It Make Sense episodes on this Diary of a CEO roundtable.
Speaker: We're going to examine specific clips from the episode, and we're going to expose some of the recurring narratives that these four purported experts present and repeatedly support with their anecdotes, claims, and advice.
Speaker: We're going to apply evidence to contradict a lot of these claims from our expert interview with Dr. Kemi, as well as expert guidance from individuals like Dr. Jen Gunter, and research.
Speaker: So stay tuned for that episode two weeks from now. And now, without further ado, here is our conversation with Dr. Kimi Dahl.
Speaker: We are here with Dr. Kemi. Dr. Kemi Dahl is a double board certified gynecologic oncologist and OBGYN, professor at the University of Washington Schools of Medicine and Public Health, and the founding director of the Gynecologic Research and Advocacy for Community Equity and Survivorship Center, also known as the Grace Center. She is a researcher and clinician whose work focuses on gynecologic oncology, endometrial cancer disparities, reproductive justice,
Speaker: black women's health and the ways women's suffering, especially black women's suffering, becomes normalized, dismissed, or under treated within medicine. She is also the author of a Terrible Strength, The Hidden Crisis of the Black Womb and Your Survival Guide for Healing.
Speaker: Dr. Kemi, thank you so much for coming on the show. We are huge fans of your work. Thank you so much. I'm very happy to be here. um My life has basically been saved by my physical therapist over the last two years. So I was like, physical therapists want to speak with me? I'm like, what are we going to talk about? Because I could tell you about the journey with my knee and this woman who has saved my life. we'll talk about the womb today. But i was i was never kind i was naturally inclined to say yes.
Speaker: Fantastic. Sarah, yes, Sarah is our resident physical therapist at Movement Logic. I'm the resident strength and conditioning coach. um we're glad We're glad you're here. We've been following your work for a while on Instagram. And one thing that really captured our attention recently was a social media post you made. pushing back quite forcefully, quite directly, quite clearly against some of the birth control misinformation circulating online, particularly in wellness and quote hormone health spaces where hormonal contraception is increasingly from our perspective being framed as harmful in various subtle and not so subtle ways. Words like suppressive and unnatural are frequently used alongside
Speaker: hormonal birth control. And you reminded folks in this reel, and we'll link it in the show notes, that hormonal contraception is one of the most widely studied medical interventions we have. And one thing that often gets completely left out of these conversations is that pregnancy and childbirth themselves carry enormous consequences for women's health, safety, and lives. And it seems like the absence of that and then the presence of all of these words insinuating know hormonal birth control as being somehow um dangerous or unnatural that this is what we want to get into with you today so we're yeah we're very happy you're here
Speaker: I am so happy to get into this conversation. It is so deeply concerning. Yeah. Yeah. So before we home in on the birth control aspect specifically, we we'd love to start with your book, A Terrible Strength, and the broader body of work you have devoted to Black women's gynecologic health. um This book focuses on the normalization and dismissal of Black women's suffering, delayed diagnoses,
Speaker: and the ways that conditions like fibroids, endometriosis, severe bleeding, and uterine cancer can go unrecognized or minimized for years, in particular for Black women.
Speaker: um Dr. Kemi, before I ask you about the book, before we talk about the book, I actually just want to talk to our listeners for a second about it first. sure Because, and I think this is also, i had mentioned to Dr. Kemi before we started recording that I was a little bit starstruck. And I think the reason is, as a writer, you have this incredible, like, just humanity that shows up as the the grace and the kindness with which you tell each woman's story in your book.
Speaker: I felt on a personal level, a deep connection with Maya and her experience trying to find treatment for endometriosis. um It has so much similarity to metastatic cancer, which is actually what I'm dealing with and is why I related so much. And I just couldn't help thinking as I was reading about it, if endometriosis was a disease that affected men, there would be a cure.
Speaker: i Agreed. Or at least more, way more research, right? And percent I wanted to be clear to our readers, because our our sort of general population is women.
Speaker: i would take a guess. We don't have, you know, more details in this, but but I would guess that they're probably mostly white women. So I want to be very clear to our listeners that this is not just a book for Black women or women of color.
Speaker: to read and process. This is a book for all women to read because if your politics, your ethics, your religion, your morality has permitted you so far to turn a blind eye to the treatment of others of your sex who just have different amounts of melanin in their skin, it's beyond time for you to change that. So if you think of yourself as an ally or woke or liberal socialist or any of those other terms that get flung around, it is your duty to read this book.
Speaker: And I'll also say, while most of our listenership is female, if you are in our male listenership, you also need to read this book because the number of conversations I hear among men that I, where I'm like, wow, they should really know better and know more than they know ah is pretty wild about like really basic things. Like how long is a period on average? but So what I'd like to, it's wild. What I'd like to start with though is because of my sort of personal response to it, I wanted to start with endometriosis.
Speaker: Because it's also not only, it wasn't really my personal response, but it's what I learned the most about as a condition from your book. And not least the way, i mean, it's wild what it does, the way it can move around inside your abdominal cavity and just spring up in other places. And while the correct medical terminology for this is ectopic or heterotopic, I immediately thought of it as metastatic.
Speaker: Because while at the moment we only use metastasis to describe cancer cell behavior, The amount of damage and devastation caused by endometriosis struck me as metastatic. Is that something that you would agree with? And before you answer, could you help our listeners who might not be familiar with endometriosis and just give a little definition of what it is and its behavior?
Speaker: Absolutely. First of all, you have to so let me say thank you for having me and thank you for those amazing words that you said about my book. I agree 100% with you. i i think this book is for all people who have a uterus and everybody who loves them. So that's basically everybody. um It's intentionally written for Black women and with Black womb on the cover because we so rarely as a Black woman have things directed to us. And it it was really important for me, for my community to feel so seen, like you created something for us. But what I've heard over and over again is exactly what you said, which is that everybody feels seen actually by reading this book. And um I can like go off on how when we focus honestly on the groups that are doing the worst, everybody benefits. But I really um i really have been pleased to hear that because I think that these are universal issues that affect everyone. um
Speaker: Endometriosis. I feel like it's probably obvious in the book. um I couldn't hold back completely, but I have a love-hate relationship with endometriosis because I hate the devastation that it wreaks on bodies. I have it myself. I do not like how it makes me feel. It can create so much suffering in somebody's life. And at the same time,
Speaker: As a scientist and and my anatomical physiology brain, I am like obsessed with endometriosis and that it is so fascinating. And I feel that it is a metaphor in a way that what these cells do is wild. And it just... um My imagination kind of goes wild with like what endometriosis is capable of. So having said all that, what is endometriosis? So it is when endometrial-like, so tissue that is very, very similar to the tissue that lines the uterine the inner uterine wall, which we call the endometrium, that's where the name comes from.
Speaker: essentially that tissue is growing in places that is not the inner lining of the uterus. And so that can be on the outside of the uterus, on the ovaries, in the pelvis, on the abdomen, in the liver, in the belly button. It has shown up in the lungs. It has shown up in people's arteries and veins. It has shown up everywhere. Everywhere it could show up, it it has shown up.
Speaker: So it's totally wild. So in that sense, yes, to your point, it does have this odd parallel to- um how we think about cancer and carcinogenesis, which is essentially defined as the ability of a cell to mutate to the point where one, it can grow without checks and balances, and two, it can spread and grow in places that it and otherwise natively, wherever it came from, it would not be. So that basically sounds like the same thing. And I've actually heard a lot of push in the endometriosis advocacy community to think about maybe reclassifying it as a type of malignancy or a type of cancer. I don't agree with that and I will explain why, but I understand where it comes from. So if you ask me how I think about it, um yes and no. Yes, I think about it as kind of metastasis because of the fact that it can spread. The other thing we know about it though is that um it's not all of endometriosis is because the actual cells are moving and spreading. Like there's something also happening where the body will transform normal cells into endometriotic cells.
Speaker: which again, magical, crazy, but also but also is not really what happens with cancer. So I find that like, that's like a distinction for me and that we haven't yet figured out all the different ways that endometriosis comes to be. um and And ultimately, um and hopefully this doesn't sound cold in any way, but ultimately the other feature pretty much pathognomonic for cancer is that Without treatment, it leads to fatality almost every time. And the thing with endometriosis is that it will make you miserable, but very very, very, very, very rarely without treatment does it lead to death. And so the reason why I tell the advocacy community, like I get why there's this push, but frankly, as a gynecologic oncologist, you don't want endometriosis defined as a cancer. Mm-hmm. we already have problems getting funding for gynecologic cancers within the cancer world because of misogyny. Like we already have a problem with this. If you think that ah defining endometriosis as a cancer will make it more important, I get again where it comes from. It's not because immediately now you're fighting against prostate cancer, lung cancer, colon cancer. Like I promise you, you are going to lose because you're going to come and say now endometriosis a cancer and it has a mortality rate of 0.2%.
Speaker: that's No funding, right? Like, no, you're not going to get anywhere. So I think- Or even compared to something like breast cancer. That's exactly right. Like, so it's, I get the the impulses take us seriously as you read in Maya's story, right? Why don't people know about this? Why don't they take us seriously? Why why do they think it's something we can just, we should just endure?
Speaker: Why does it take so long to get a diagnosis? I agree with all that. We need more money. We need more awareness. But- I think the goal is not to leave women's health and leave gynecology in order to be taken more seriously. The goal is that women's health and gynecology is taken more seriously. Right.
Speaker: Yeah. Very good, very well explained. Thank you very much. um I wanna move on now to the topic of fibroids. In your book, you write about fibroids, which seem to become something many women, especially black women are just expected to simply live with for years.
Speaker: And for listeners who may not be familiar, could you briefly explain what fibroids are and why you think so many women normalize or endure symptoms for so long before getting meaningful care?
Speaker: Yeah. Fibroids are so interesting. I have to tell you, they were like described in mummies. Like they're like they're so old. They've been around for a long time. um They were originally described as uterine stones, stones in the uterus, which I find fascinating. But essentially what fibroids are, are when the uterus has three layers. It has that inner lining, the endometrium we just talked about. It has the middle layer, which is the muscle layer, the myometrium, and then it has the outer layer. This middle layer, the myometrium, is made of muscle cells and then the stem cells that make the muscle cells.
Speaker: What happens with a fibroid is that you get essentially an abnormal muscle stem cell. So that muscle stem cell, instead of growing into nice sheets of muscle that contract and do everything it's supposed to do, Instead, it grows this like really irregular clump of muscle cells with a lot of what we call extracellular matrix, like basically a lot of scaffolding, too much scaffolding. So instead of being these nice, smooth sheets of muscle, you get this ball of disordered muscle cells and scaffolding, and that we see as a fibroid.
Speaker: That is essentially what a fibroid is. Each one comes from one mutated muscle stem cell. So the problem with fibroids, again, we call them, quote, benign because they're not cancerous. However, you can get a lot of them in your uterus. They can grow, ah honestly, on the ovary. They can grow on the tube. They can grow in other places, but primarily the uterus. They can grow very, very, very large. um They often do.
Speaker: And I can tell you... the way that I learned to treat fibroids is basically don't do anything until somebody has symptoms. Right. And then if they have symptoms or if it's bothering them, if it's not too bad, you know you can give them some medication. And if it's bad, you just need to take it out.
Speaker: And it's it's it's the neglect. like Honestly, this goes back to the same thing you were saying, Sarah. If if men had random stones growing in their prostate... if Are you kidding me? The idea that it would be like, just let us know if if at some point it hurts to pee. But until then, it's fine. They'd be like, what? This is absolutely... So again, I indict my field on this, right? Because it started in so much patriarchy. OBGYN dead. OBGYN was an exclusively male field for so long. yeah So we are still undoing some of these ideas, which is basically like, let somebody suffer until they can't tolerate it. And then we'll do something about it. For Black women, fibroids start growing earlier. In our late teens and early 20s, they grow bigger. And also, which is really critical, we were kind of taught that once you go through the menopause transition, like fibroids essentially will regress and get smaller and smaller because they don't have the same hormonal stimulation to grow. And that does not happen at the same rate for Black women. And so what happens is Black women also tend to have larger, more symptomatic fibroids for longer. yeah um
Speaker: So that's my answer to what are fibroids. That's that's great. We're doing a definition of terms here. We are going to talk about birth control. And um I have a feeling that some of some of what you ah refer back to will have to do with some of these these conditions. And I just want to make sure that the audience is all on the same page about what we're actually talking about here. Also, these are these are topics that are featured very prevalently in your book as well. um So I want to talk now a little bit about uterine cancer. um I can say personally that uterine cancer is something that has touched my life. I lost my mother to uterine cancer. I'm so sorry.
Speaker: Thank you. Her first diagnosis was stage four after years of avoiding gynecologic care following menopause. And she admitted herself, she said, I have always had a phobia.
Speaker: of going to the doctor. So she just avoided going to the doctor for many years. And, you know, there were multiple red flags that would have been followed up on for sure. But they went unchecked. So this conversation resonates very personally with me. um so So uterine cancer is another major area of your work. And, you know,
Speaker: like with my mother warning signs can sometimes go overlooked or minimized until that disease becomes more advanced. Could you briefly explain what uterine cancer is and why, why delayed diagnosis seems to happen so often, particularly for black women?
Speaker: Yes. Okay. I'm going to be more brief this time. Uterine cancer. Most of uterine, not all, most of uterine cancer is what we call endometrial cancer. So it's a cancer that grows again in that inner lining of the uterus.
Speaker: I have to say it's not related to endometriosis, which is a yeah really common question I get. right They just have similar names. yeah endometrial cancer um is, it's the most common gynecologic cancer. It is what I call, quote unquote, the bread and butter of gynecologic oncology, even though it's not talked about as much.
Speaker: um The problem with, or let me say this, the way that we diagnose uterine cancer is that it tends to happen to women who are in their late 50s, 60s, and 70s. So the average age of diagnosis is like 62, 63 years old. yeah Most women by that point are through menopause. They've stopped bleeding.
Speaker: And what happens is they start to have a little bit of what we call postmenopausal bleeding or spotting. That's what a lot of women- Okay. A lot of women actually describe like a little reddish discharge. They describe... I mean, it's so subtle and that's what is the issue because if we don't have awareness about it, people don't realize that that's a sign of cancer. Anyway, based on that based on having postmenopausal bleeding, we then do a series of diagnostic tests, which should include an ultrasound and an endometrial biopsy. And then we diagnose the
Speaker: endometrial cancer or uterine cancer. What happens with Black women is really multifaceted, but I'll give you a few reasons of why there is consistent delayed diagnoses and twice the risk of death for Black women with uterine cancer, which is unconscionable. One is Black women, we we have this experience of being very normalized in terms of having irregular cycles, heavy bleeding, et cetera, from the fibroids we already talked about, from higher rates of heavy bleeding, et cetera. Black women also have a lot of negative experiences getting gynecologic care. So by the time we get to like 60, 62, and we see a few spots of blood, we're like, this is no big deal.
Speaker: I can manage this on my own. And you might have noticed that you have not ever seen a public health campaign from the CDC or from the NIH or from anybody about uterine cancer. How often have you seen the whole football team wearing uterine cancer colors? How often have we talked? So people don't know the signs. yes So that results in delays in getting care.
Speaker: The second reason is unfortunately we have also documented that providers miss these signs in Black women because they also assume it's fibroids or they don't know enough about the risks that Black women have. And then finally, up until very recently, our actual diagnostic algorithm did not work as well in Black women. because it was based on data from populations that did not include Black women.
Speaker: And so what happened was we had this ultrasound triage mode where we said, well, we'll give you an ultrasound, and if the ultrasound looks okay by a certain measurement of your endometrium, you have no risk of having uterine cancer. And that was wrong for Black women. In fact, it was missing up to 10% of cases in Black women. So we had multiple things that were lining up creating delayed diagnoses. And a lot of the work of this book, as well as my research work, is to undo that harm.
Speaker: Yes. i'm Yeah. I watched your conversation with Dr. Jen Gunter. Oh, yes. Yeah. And um I remember because ah one of the areas that we report on a lot, we're not trained journalists, but we we do a fair amount of reporting on things, is is we talk a lot about what we we call the menopause and this um almost wanton sales pitch for anything containing estrogen and how it's often evangelized as just being good for you, right? Like put it on your face and put it in your vagina and put it anywhere you can. And I remember you when speaking with Dr. Jen Gunter pointed out the real risks of using estrogen as a product like this when it hasn't been tested. We don't actually know the risks specifically as it pertains to uterine cancer. Can you just speak briefly about maybe that? Because it's definitely a topic we've we've we've talked about a lot on the show.
Speaker: Yeah, I can. And I i try to just... like I just speak as a gynecologic oncologist and somebody who doesn't want people to die of uterine cancer. I just want to be very clear. i'm like, I have no stake in the menopause wars. This is my concern.
Speaker: okay My concern is that one of the most enduring things we know about uterine cancer, there's no controversy about this at all, is that excess estrogen is a major risk factor for uterine cancer. We know that it is documented and we see it in multiple different ways. We see it in breast cancer survivors who are on tamoxifen, who have a uterus. We have to be very careful and monitor their endometrium because we know there's an increased risk of uterine cancer. We saw it on the WHI study in women who were on estrogen.
Speaker: We saw the changes to their uterine lining. We know once again that that increases the risk of uterine cancer. We know that women who are obese and they have excess fat cells that make estrogen, they have increased risk of uterine cancer. So like, I just have to say, this is not a single data point for people who are new to this conversation. This is not one study. This is absolutely on a saleable connection that we have known in gynecology and gynecologic cancer research for decades.
Speaker: Nobody has ever argued this. What we've also always known is that menopause hormone therapy is safe when you give it alongside a progestin when you still have a uterus because you have to protect the uterus. You need to give somebody estrogen because they're having hot flashes. That's great. You need to also give them progestin to protect their uterus so they don't get uterine cancer. It works great.
Speaker: What we don't know is what happens when you start to keep increasing that dose of estrogen, whether you're increasing the dose because you're chasing a lab value instead of chasing symptoms, whether you're increasing the dose because the person is not just taking menopause hormone therapy through a patch or a pill, they're also using estrogen creams on their face. They're also using estrogen in their vagina. they're adding on excess estrogen.
Speaker: We have no data about that and how much progestin needs to be used to protect the uterus. And then in addition, what's also happening is that multiple different kinds of progestin or progesterone is also being used. So there's a lot right now, I would call it, there's a lot of creativity that is happening in the menopause hormone um space. And I want to say I get it. I get the agency that we want, right? I get the idea that it's like, you know what? It made no sense to throw all these pills away. It was such a blanket issue. it
Speaker: What underlined it, right, was that women can suffer. Who cares? All of that, we're on the same page. yeah But also, right, we need to take responsibility at least to tell people, I am creatively experimenting with your hormone therapy.
Speaker: I actually don't know what this means about your uterine cancer risk. And by the way, uterine cancer is the number one gynecologic cancer in this country. It is rising every year, every year. We don't have a screening test for it. So all we can do is detect it early if you get it.
Speaker: yep I mean, and our death rate is climbing. That's not unreasonable to share with somebody and then say, what do you want to do Maybe somebody might say, you know what let me stick with the evidence-based menopause hormone therapy yeah that I know will keep my uterus safe. yeah I want people on therapy. I do. i just, I worry about asking the question of uterine cancer risk. And I only ask that we do that. That's all. I'm just saying, can we, can we try to balance this out? or your Yeah. you're I was just about to say your word choice there is incredibly charitable. It's very general. We just call them grifters. Okay, excellent.
Speaker: And it seems like, you know, there was obviously this big swing away from hormone therapy for menopausal women because of that WHI study. And now suddenly we've swung all the way on the other direction. and And it's like, yeah, you know, they're handing it out for free on the corner. It's just such the wild west online now because I could very easily not talk about any of my cancer.
Speaker: I go online, i get myself some estrogen to put on my face, i or even to probably put ah topically, right? Or which actually is fine for me, but like I could i could hide everything about who I am, and that's get it online and and with no warning about all this stuff that you just said. And I'm not trying to become sort of like panicky, to like overly cautious. I mean, obviously it is very beneficial for lots of women, but in this like online space where I could start a company and get some vaginal hormone cream and sell it to you and tell you to put it on your face. like or You know what I mean? like it's yeah It's literally, the credentials are not necessary. No, agree. It's messy.
Speaker: You know what it is? It is probably my latent, I'm still a physician I'm trying to like bring us all back together. I don't know. I don't disagree with you is what I'm saying. We're in a capitalist economy. There's a lot of profit to be had right now in the menopause space. They call it the menopause gold rush for a reason. I mean, like you can follow the money. There's a lot of investment in this space. There is all of that. And what they are doing is they are capitalizing on the fact that women have been undertreated and have not felt listened to. And still today, right now, I still get texts from women who are like, I went to the doctor and they won't give me menopause hormone therapy. And I'm like, this is crazy. So what I am trying to
Speaker: advocate for is more moderation and a recognition that we are going to be the bad guys in 20 years if we're not careful. That's the thing. It's so easy right now in 2026 to look back at the WHI and be like those horrible people. It's so easy. And I have critique too, obviously. i mostly have critique about how it was interpreted and the articles and I mostly have critique about that. because I think people, again, forget why the study happened, right? But if we're not careful, in 2050, when uterine cancer becomes the second most common cancer, it will be the second most common cancer among women in this country in 2050. That is not that long from now. They will look back and they will go, what in the world was happening? We knew estrogen was related with uterine cancer. We knew it was on the rise. We knew it was a huge public health threat to women. And look at all those doctors who just shilled estrogen all over the place and didn't explain to people. And I think most of the time people are like,
Speaker: at least in the CYA level, like, hey, this, this, and that. But when I talk to people, I will tell you that it's much more likely that a lay person who's consuming content, who's in the perimenopausal years, she for sure knows that the estrogen in her menopause hormone therapy, she knows that it's helping her hot flashes. It's helping her mood. Maybe it'll even help her weight, all this stuff. I ask her, what do you think the progestin is doing? And she has no idea. So that means that from just a communication standpoint, I know we are not doing a good job. And the problem with that is because we're in this creative space, women will drop the progestin. They'll be like, you know, I didn't think this made me feel that good. I noticed that I didn't have to take both. So when we're in a world where people are like, I take progestin and estrogen and testosterone, So now you get you get individuals, right, saying like, you know, I decided to drop this and try that.
Speaker: And that's also my concern is like when people don't know why they're getting it, they don't understand this isn't about you feeling better. Right. This is cancer protection. So when I explain that, usually the eyes go like this and they're like, whoa I didn't realize that.
Speaker: I'm like, yeah, you can't just be playing around with your doses like that. I think, Sarah, I'm worried. I'm literally saying on behalf of all of us, can we please have moderation? I do not want to be in 2050 trying to explain to people what the hell happened here and why everybody has uterine cancer.
Speaker: And I don't think, obviously, the rise right now is not because of what's happening. We would see that in another 10, 20 years, but we will see it if we're not careful. Right. Yeah. yeah i and also like just from the corporate standpoint like hello like who wants a class action lawsuit like guys think about this like it's yeah like i'm just like anyway so yeah those are my thoughts those are my thoughts thank you
Speaker: What is this barbell mini course you keep talking about? It's a free course that teaches you the squat, deadlift, and bench press, as well as important lifting concepts like progressive overload. Oh, well, I don't have barbells, so I guess it's not for me. You can use dumbbells. They also work. What is the point of that? You're still going to learn the mechanics of using a barbell, but that way, once you're ready for it, you'll be good to go. heard barbells make you bulky.
Speaker: That's not a thing. Why can't I just tone? Toning is also not a thing. I just don't want to use barbells. Okay, but just so you know, if you want to keep getting stronger, at some point, you're probably going to have to upgrade to barbells. That's why you'll want to watch our free barbell mini course. You'll learn good technique and form so your lifts look and feel good. Why do you have answers for everything? It's 2026.
Speaker: Get in, loser. We're going to the gym to lift.
Speaker: yeah yeah All right. We're going to talk briefly about our last condition that we needed here. Yeah, we want to talk yeah just quickly about PMOS. So polycystic ovary syndrome recently got renamed, so that was PCOS, got renamed PMOS, polyendocrine metabolic ovarian syndrome.
Speaker: ah And this is important. Can you give us some background on the diagnosis and why this name change is important in terms of women's ability to access treatment and and diagnosis as well?
Speaker: This is such a, this is a great example. Actually, it's a great contrast to what we started with talking about about like endometriosis and cancer. So PCOS, formerly polycystic ovarian syndrome, the issue with that name is that it was way too narrow to describe what was happening. Even if you just hear that name, it basically sounds like this is a problem of people who have cystic ovaries. First of all, not everybody with cysts on their ovaries have PCOS. Also, a lot of people with PCOS at the time, as it was called, didn't have any cysts on their ovaries. And it also makes it sound like it's essentially an anatomic problem. Like you have too many cysts on your ovaries. Maybe we should take them out. Whereas the cysts on the ovaries were just a consequence of the actual issue
Speaker: With PCOS, now PMOS, which is an a metabolic and endocrine relational issue where your balance of your sex hormones and how they interact with your metabolic hormones and your metabolic system is out of whack.
Speaker: That's actually what goes on. And that manifests in a lot of different ways for people with PMOS. So polyendocrine metabolic ovarian syndrome makes so much more sense because now, one, you are actually naming all of the different arenas, the endocrine system, the metabolic system, the ovaries. Now, also, you're opening up to say, hey, maybe more than gynecologists need to know what's going on here, which, as we know, is important because in medical education, if it's down there, nobody cares. So like I'm very happy to open it up. um And then also it helps women. I think it helps the people who suffer from the condition recognize one, just how broadly it can impact them. And I hope take some of the stigma away, honestly, which is that if you have an endocrine system, you're going to need endocrine treatment. If you have a metabolic syndrome, you're going to need metabolic treatment. Like these are, these are things that are evidence-based now. We know they work. And my issue is that by calling it PCOS, it also led a lot of women down this road of like
Speaker: I don't know, holistic, non-evidence-based. Like if I have cysts on my ovaries, somehow I can like meditate my cysts away. And I get where that comes from because again, cysts are very common on the ovaries. You can have lots of stories about that. But when you have a polyendocrine metabolic syndrome, like this needs to be taken care of by a physician. So it opens up treatment options. It's also a patient-driven change. It took 14 years, but it was patients who also said, this is not making sense We don't think that this description is correct. It doesn't actually represent us. And, you know, it took a lot of global organizations coming together to kind of redefine what this is so it makes more sense going forward. So that's why the name has changed. And I think it's a great thing. Perfect. Perfect. Thank you so much. We're now going to shift to talking about contraception, specifically hormonal contraception.
Speaker: Let's do it. Let's do it. You have a thought. Let's hear it My thought is that isn't it wild that at the same time we're having the menopause gold rush, we're also having the birth control is actually bad for you. Maybe you were going to go here, but I'm like, y'all. We're going directly there.
Speaker: Okay. Like, this is like, take, like, look at what's around us. Like, I feel like the emperor has no clothes. Like, if you just pay attention, you can see the grift here. You can see what's happening. Okay. Let me be quiet. Go ahead. Absolutely. Thank you for foregrounding or foreshadowing. What's about to come. Okay. So hormonal birth control, specifically hormonal birth control. So we're not going to talk too much about non-hormonal birth control, is often prescribed not only to prevent pregnancy, which is probably one of the most important advances in medicine for women and women's lives ever.
Speaker: Ever. yeah Thank you. Correct. Ever. We are not going to focus so much on that topic. We are going to get into it in a later episode, listeners. But I want to talk with Dr. Kimme specifically about how hormonal contraception is often prescribed not only for preventing pregnancy, but also to help treat or manage symptoms of the conditions you described earlier. so So in cases where hormonal birth control is used for these conditions like endometriosis, fibroids, PMOS, painful periods, How effective is it generally as a treatment tool?
Speaker: And what kinds of symptom relief does it actually provide for women? Oh my gosh. Thank you for asking this question. i I will say, I think gynecology has really messed up here.
Speaker: And I talk about this in the book. i I don't think we should have moved with calling all of these things birth control. I think because we have had this very easy shorthand, that all of these different kinds of combinations of hormones given different ways at different formulations are effective in contraception. It has made people think that when they come in for these gynecologic conditions, we're not really trying when we just, quote, throw birth control at them instead of them understanding that we have done clinical trials. There's decades of research about these different formulations and how effective they are in painful periods.
Speaker: heavy periods, endometriosis, fibroids, specifically about that. I am actually calling us to be maybe more specific with people about, hey, I'm giving you this because it's an endometrial stabilizer.
Speaker: Now this is a whole different conversation. Because you have abnormally heavy periods and part of what is going on is that your menstrual cycle, you have way too long of an inflammatory phase of your menstrual cycle and it's being driven by not Y, Z. What we know is that this medication will come in and help stabilize that by shortening the inflammatory phase. Now you're like, okay, this is actually specific to me. And then I could say, as an aside, you're not going to get pregnant on this. So it also benefit, side effect, that is a different conversation. And sometimes-
Speaker: And I think that I get it. We have short appointments, whatever. But I just think that if people understood that, they would also feel more seen. Right. You know, as opposed to feeling like we're not really listening or we're just like throwing birth control at everybody. Right.
Speaker: To your point though, like, okay, this is a great study. There's a study, it was 15,000 women or something like that. It was a survey study. It covered multiple different countries, including the US and Canada. And it had to do with women who were having heavy menstrual bleeding. They were bleeding way too heavy. They're anemic. They had all sorts of problems. it On average, it took them three years, three years, three years to even go to the gynecologist and be like, um I think my booking is too heavy. Three years. Before then, they're online. They're trying to fix it themselves, all that stuff. They get to the gynecologist. And here's the problem with my field is that only a third of them, only a third of them actually receive any help.
Speaker: So they're dismissed, they're normalized, et cetera. But of the third that actually got help, 65% had their heavy bleeding symptoms normalized and had no other issues, did not need surgery, did not need procedures by being prescribed hormonal types of quote birth control. That's two thirds. So it is very, very effective in treating heavy bleeding. Those are very similar statistics than we see in dysmenorrhea, especially in the absence of endometriosis. If you don't have endometriosis, but you have painful periods, these kinds of medications are extremely effective.
Speaker: Is dysmenorrhea painful periods? Is that what that means? Painful periods. Yeah, dysmenorrhea is painful periods. um In terms of endometriosis, there's also really good research because we were always worried. Like if we give estrogen and progestin to somebody with endometriosis, like are we making it worse, right? That's like a reasonable question when you know that there is somewhat of a hormonal growth factor effect with endometriosis. It turns out, no, it makes it better.
Speaker: What is happening, there's something about endometriosis where it's the fluctuation of the hormones that especially drive the flares. So when you use something that starts to normalize that out and creates a much more lower steady level, then you also improve endometriotic cyclical pain.
Speaker: It doesn't necessarily include non-cyclical pain, which is why we use multiple agents for endometriosis. The IUD, d the hormonal IUD d has been shown also to improve fibroid symptoms, fibroid symptoms of bleeding and pain.
Speaker: So that also is something we had to study because we're like, that is not necessarily intuitive, but it turns out it does. By creating this progestin rich environment in the endometrium, there's a feedback loop happening back with the fibroids themselves in the myometrium. And they can stabilize in growth and they can definitely decrease in bleeding and pain symptoms. So these these medications are extremely important in the way that we treat these gynecologic conditions. And I just want to add for endometriosis, there are now triphiocles. I don't think they actually call them triphasic, but there are three drug medications, oral, that don't just combine like an estrogen and progesterone-like medication, but then they combine another medication that gets at the way that the endometriotic cells grow and like can make their own blood vessels. So there are these three pill combinations, and they're ah very effective in endometriosis pain cyclical and non.
Speaker: You call those birth control, they start getting on the chopping block. Right. So we have to be careful about how we name things. Right. Now, there is a very real tension because there is a long history of medical misogyny. There's a long history of medical racism in which women, and especially black women, have been, as you said, dismissed or their pain and suffering have been minimized.
Speaker: And so what we've noticed is that we have real critiques and concerns and experiences from women who feel like they are being dismissed in part when they're handed birth control like candy, right? That's even a phrase that we've heard. Yes. um Actors in the grifter, griftoverse use, yeah right? And then the, you know, the wellness influencers slash doctor brands come in And they start to refer frame hormonal birth control as a type of band-aid, as a yes, a way you are being dismissed. And as a way that is actually not only, ah you know, sort of insinuated as being not a sufficient treatment for whatever is causing you suffering, but that it it actually fails to address the, quote, root cause. cause. And so alongside all of this communication and rhetoric is this brewing of a broader mistrust of medicine and medical instances generally. Yes. Yes. While at the same time, these influencers are often very much advancing their own brand narratives, their own ideological frameworks, and they're selling products, courses and and supplements. So can can you help us parse through that tension? Yes. Like how do we simultaneously validate women's very real experiences, the history that does exist, yeah the dismissal, the undertreatment, while while recognizing that the people sowing this mistrust are often building their own brands and audiences and businesses and using fear to do it, using yes hormone balancing and and other catchphrases to to basically scare women away from hormonal birth control.
Speaker: Laurel, I think we have to recognize again that what is happening is that there's a capitalization on a real true harm. And that's the thing is the first step is always saying, of course, there's a kernel of truth to what they're saying. If they're not standing on any truth, it's actually really hard to get off the ground, right? Right. You start with something that's true. You've been dismissed in the past when you went for pain. You start with something that's true. You try to go for help and somebody just throws pills at you. By the way, you don't understand what those are. Maybe you didn't get a conversation about how long it's going to take. Maybe like all these things I talk about in the book, right? Like if you actually understand what we're doing, you won't feel like anything was thrown at you. So you start with something that is real. And for black women, yes, there is a horrible history in this country of forced sterilization of women. I'm on book tour right now. I have had two women directly come up to me and tell me I was one of those people. I didn't even know they took my uterus out until afterwards. So if this is not remote history, right? This is the thing that's happening right now. um i also posted a reel about this in Virginia. I think in the early 2000s, there was a man that was just taking uteruses out of all these Black and Latino women in his hospital. He's in prison now, but that just happened. Yeah. So they are capitalizing on something that is real. yeah And the other thing they're capitalizing on is that we don't have enough public awareness and understanding of one, like honestly, how the menstrual cycle works, what it is. Two, what combined hormonal contraception is doing or not doing to your body and why it's important. And so...
Speaker: Instead, you get this idea, for example, of hormone balancing. And I'm always like, tell me the definition of balanced hormones. And usually what you'll hear, right, at the end of the day when you get to it, what is the definition? The definition is I feel good. I feel like myself. And I'm like, okay, that is literally the definition we use in gynecology too.
Speaker: And actually in gynecology is a field very driven by how do you feel? We have a few tests. We have a few labs, but mostly it's, do you feel better? Are you sleeping better? Are your cramps better? Is your bleeding better? So we are doing the same thing. And what's happened is the grift has taken that fact and then shifted people away from the most effective treatment available. So I love the nuanced conversation because I do think we have to acknowledge that they're standing on a foundation of truth and then using that to exploit people away from what's helpful. Now, why would you do that? Well, because if you exploit people away from something that's helpful, then you have more opportunity to sell them something that isn't, right? um
Speaker: The placebo effect is important and I don't talk about it as in a derogatory way. I'm like, it's a great thing. Like if I could just placebo everybody, I would. When your body tries to heal itself, that is great. But also you might not need a supplement to do that. Like, Like mindfulness, there's all sorts of things, meditation like that. All these things also can activate that effect. yeah So these are the things I think people don't know about. I also want to say something about languaging and how effective it is.
Speaker: And I think it's why I keep harping on like, what do we call things and how do we talk about them? Birth control has the word control in it. we need We need to recognize some of these things, right? When birth control came out, and it was actually, we didn't call birth, right? We call it the pill. But birth control felt liberating for the women who were the first wave to receive it. yeah Today 2026, birth control sounds It sounds coercive. yeah It sounds suppressive. It doesn't sound like freedom to these women anymore. This is why we're having young liberal women saying like, oh, I heard birth control is actually really bad for you. So I think we can't underestimate the brilliance of, I mean, I'm sorry, but like the brilliance of recognizing some of these rhetorical issues. Yes, of course.
Speaker: You know, and so that's one thing. And then another thing is, I don't know that we've done a great job of actually talking about the health benefits, like what how you started with. This is one of the most important medical advances, and not just because it is able to control pregnancy, which is the number one factor towards women's liberation in any society. There is no society where women thrive and they don't have control over reproduction. So that's a basic. Number two is in terms of the benefits, right? Decreased risk of ovarian cancer, decreased risk of uterine cancer, way better quality of life in terms of the pain and the bleeding and the the cycles that people get into. Sometimes a great temporary treatment for people who have a ruptured cyst or things like that. Like there's so many ways in which it's helpful because it's able to reset essentially your quote unquote natural rhythm.
Speaker: So getting to the natural rhythm of it all, and you know, cause you all read my book, which I appreciate. I talk about this in the book. What they're able to do, this is what I think is happening, is that some of the people in this space that are predatory, I'll call it that, they are able to create a fantasy of a history that never existed.
Speaker: So they're able to create this idea that like before the pill, yeah right, before birth control, women were in tune with our bodies. We were living with the earth. Everything was organic. You know what I'm saying We had no problems. And then this thing has come on and created all these problems. And the reason why they can say that is it's ahistorical. It does not exist. You can't go back into the history and actually find these records of these beautiful times. They don't exist. 10% women... who went into birth were dying. One in 10 women died in childbirth, died. People had 10 babies because four of them died. That's what happened. Life expectancy was very short.
Speaker: Women were married off at 13 and 14 because that's when their cycle started. I don't know what world you are referring to where everything was natural and great and And we were healthy. Like you were dead by 55. So I'm so confused. And we were all organic during that time. So I think that that's part of what is happening. And that's why I feel like it has a lot of MAGA vibes. Let's go back again, right? Make America great again. Let's go back to this time that never existed. this Make your period great again.
Speaker: yeah Make your period great again. And what's really true is because women were just pregnant more before we had any contraceptive options that were medicinal, right? That were not behavioral, women were pregnant much more often.
Speaker: That meant that they cycled way less for the duration of their lives. And this is the point that I try to push on. If you want to be like your ancestors and you're not on contraception, girl, you're cycling like 10 times more than they did. Right. Yeah. so Why is that bad? Well, because that increases risk of ovarian cancer. That increases inflammation. That increases endometriosis. If you want to be like it was before and you don't want to take birth control, you're going to need to be pregnant every other year. All the time. Yeah. But this idea that like you can be off it, but also not pregnant all the time, that's a fantasy.
Speaker: I'm sorry. that I just felt like that was like a long rant. I don't even know how to land it. i guess This is all what we are talking about. is We want to be talking about this with you right now. that this is You literally started answering my next question, which was about this idea of like you know this whole MAGA right-wing pushed you know It's all very in line with like the trad wife and make America great again. And like let's go back to this time when things were better for white men and pretty much only white men, right? Correct. 100%. Yes. And I was so struck by when you wrote that in the book about this idealized return to the past when we're all just having our period all the time. The fact that women were pregnant for so much of their lives means they weren't actually having their period that often. That was really struck me. And so the language that's being used nowadays is sort of like MAGA language is about like, you know, losing your cycle or you're not cycling normal. and Like that's automatically dangerous or automatically unhealthy if you're not having your period as many times as you possibly can during your life. Right. And so yeah we know we know from other conditions, like, you know, anorexia is a great way where the menstrual cycle is genuinely a very important clinical window into their health.
Speaker: Right? Yes. But yes there are also non-threatening reasons why someone may not be ovulating or may not be menstruating, like menstruating, like if they're on hormonal contraception. Is it, you know, in other words, do we, is is the biggest mistake being made that by this concept, let's say this, this framing is that, uh, your menstrual cycle cessation or any sort of like artificial stopping or pausing, or changing of your menstrual cycle is automatically dangerous? I think two things. One is that this idea that the menstrual cycle is required to be healthy, it's factually not true, but I think the reason why it might resonate with people are a few reasons. One, like you said, we know in anorexia, right, or athletes that are pushed so hard, that athletic amenorrhea, like, so I think that's in people's mind, oh, ooh that's not good. And also I'll say on the other side, There's this idea, well, you need to have your period to clean things out. And what's interesting is that did have some merit. It made sense when, again, we didn't have any hormonal ah treatments and people who, for example, had bigger body size or people who had PCOS or PMOS, right? One of the manifestations was that maybe they'd only have three periods a year.
Speaker: And it was right that, hey, that's not healthy. But in that case, they're not cycling because, again, their hormones are like way out of whack. They're estrogen dominant so much that their endometrium grows and grows and grows, and it doesn't shed until like months and months later. So again, we come back to this idea that there's always a kernel of truth, right? That yes, there are times in which not having a cycle is an indication of a problem. But that doesn't mean that somebody who's taking contraception that has the effect of suppressing ovulation and suppressing the menstrual cycle is endangering their body. It's not the cycle that is making you healthy, right? right right So that I think is what is confusing and maybe where is some of the lines are. So I do agree with you. The idea that stopping your cycle is somehow bad for your body
Speaker: is wrong. Number two, the only reason why the pill started on this 21 days, seven days off was just because basically the Catholic church would not endorse it to be used unless it simulated a cycle, right? Like really? Yes. Oh, the, oh, the background history of the pill, this, it is fascinating. Yes. So it' in order to make it more palatable, yes. So we come back to men. Anyway, it was a way to make it more palatable to basically be like, oh, you know, like it's kind of like we're not really doing anything. So we would. So that's why it was literally arbitrary. It was arbitrary completely. We'll do three weeks on one week off. oh wow It was arbitrary. so There would just be this this simulation of what was going on. There was no medical reason to do it that way. And since then, yes, of course, again, because this is the most studied medication we have looked at, is there a problem with continuous use? What if people just use it straight on and they don't have the bleeding break? There are no long-term deficits. The things that we see with long-term use that are specific that I think is worth calling out is like Depo-Provera. An injectable long-term progesterone type birth control used for very long periods of time, like over years, does eventually cause bone density issues. That's a question that we have. Is that the only example of a birth control that could cause bone density issues? Or are there any others?
Speaker: That is the only one that I am aware of. It's just because it's like a depot of a lot of progesterone over a really long period of time. I see. If you talk to gynecologists, most of us will tell you it is our least favorite for multiple reasons. It causes a lot of irregular bleeding. A lot of people don't like it. But you know the people who don't bleed on it and are like, poof, every three months an injection and that's it. It's very convenient. you know like There are pluses and minuses there. So so yes, that's that's the main one. So when you hear people talking about birth control destroys your bones, no, not correct. um And they never talk about the benefits. Right. They never talk about the benefits and not just cancer reduction risk. Can we talk about quality of life? Like, why is it okay? Because this is the other thing you hear about, right? This whole cycle syncing. Why is it okay to just remove yourself from society for a week? Like, I'm sorry, I'm on my period. I can't take it, whatever. Like, I still think it comes back to this idea of like, why are we going back to limiting ourselves as women
Speaker: in these biological ways to say, we can't function, we can't do this. You have to do this on this part of your cycle and this on that part of your cycle. That's going to quickly move to you can't work. do you guys understand how quickly that moves to like some handmaid's tale nonsense? So I will be passionate about this because it's a slippery slope.
Speaker: It's a very slippery slope, but I do want people listening to understand from a medicinal standpoint that there is no reason that you must ovulate. Thank you. Or bleed. Or bleed. No. If it is, again, when you are taking a combined oral contraceptive or if you have a progestin IUD, when you have something that we know, one of the ways that it works is it thins out the endometrium or it suppresses ovulation, you do not have to bleed.
Speaker: Yep. Okay. um I want to be sensitive of your time. yeah um oh yeah. Oh, my gosh. We're at an hour. Yeah. We could clearly talk forever. Yeah. Let's do a closing question. Okay, great. Perfect. I'm going to combine our last two. Part one, what concerns you most about the misinformation environment right now around contraception, specifically for for all women, for Black women especially? And part two, what do you wish more women knew about contraception?
Speaker: Okay, what concerns me most is that is that there is a real pain in terms of being neglected and not feeling well and wanting to be seen and wanting to be cared for in like a person-centered way that is that is a true need.
Speaker: And what concerns me is that the wellness space where people truly are not there to actually help people, they're there to make profit, That space is innovating and connecting with people way way, way, way, way faster than the American College of Obstetricians and Gynecologists, way faster than physicians, way faster than all of us. like We are slow. And it it concerns me because I feel like we're always trying to play catch up.
Speaker: And i think we need a fundamental shift in how we connect with people, which is why I wrote the book, We have to change how we think about science communication. There is something being tapped into that is a correction in how clinical and impersonal medical care can be.
Speaker: yeah And we are not going to be successful in fighting it until we also adjust and become more warm and person-centered and holistic and empathetic. That's what worries me because I just don't think we're moving fast enough. What was the last thing? What do I want people to know? Yeah. What do you wish more women knew or what what do you wish they heard more ah of about contraception or knew about contraception? Okay. Let me think for a second.
Speaker: I wish they knew that there is nothing about gynecology or womb health or contraception that should feel like a click. This is not about click energy. This is not like my friends are doing this, so I have to do this. My friends are on this supplement, so I have to be on. And I include some of the things that gynecology offers. My friend has an IUD, so we all have IUDs. This idea that women's health can be reduced to what feels a lot like a fashion style trend, diet culture, optimization is deeply misogynistic. It is ridiculous. Tell me why you don't see the kidney disease world doing this. You don't see the cardiac world doing this. You don't see people talking about their thyroid in these click, click, click, click energy styles. like It is because we play around with women's health because we play around with women's lives. wow And so what I want people to do is to say, I disenroll from this. And what I'm actually interested in is finding a fantastic board certified gynecologist that does not have conflicts of interest, that is interested in talking with me about my body and figuring out how we can optimize my womb health. And that is what I'm interested in doing, because I'm not going to participate in this.
Speaker: Nice. Damn. Mic drop right there. Yeah. Can I ask just a quick follow-up? For menopause, we usually recommend if people are looking for a good practitioner that they go to menopause.org online. Is there a similar, for women not going through menopause, is ACOG or is there a resource? I would say I would say ACOG. They have done a lot better on the patient-facing side of things now. I think there's like a lot more information there that's a little bit easier to digest. If people are interested in uterine cancer information, they should go to ecanawomen.org, E-C-A-N-A, women.org that has a lot of really easy patient-facing information and also a lot about abnormal bleeding just because there's a lot of overlap there. To be super nerdy, if you're like, I want to read about whatever, go to UpToDate, the patient version and of UpToDate.
Speaker: It has every article you could possibly want to know about like what the data is on anything. And if I might say so, these AI engines, they don't they don't pull the right studies. They don't know what they're talking about. As an example, I did a little thing where I i asked it because I wanted to know what it would say. What's the evidence about long-term ovulation suppression?
Speaker: You know, it it returned to me a whole summary of articles about ovarian suppression and ovarian failure, which is not the same thing. So if I was a person asking that question, it gave me all this information about essentially putting somebody into surgical menopause early.
Speaker: Right. So it looks horrible. i was terrified. So AI is not the answer. Please. We're going to link all of those resources in the show notes.
Speaker: Dr. Kemi, where can people find you and where can they find your book? You can find me. I'm mostly social media wise on Instagram and my government name, K-E-M-I-D-O-L-L. I'm also on LinkedIn, but I don't check my messages that often over on that platform or my website, www.kemidoll.com, where you can find links to buy my book. You can find information about my research center, which I'm still running and all the different studies that we're doing. Yeah, I would love to connect with whoever's listening. So definitely come find me.
Speaker: my Fantastic. Thank you so much. Thank you. really appreciate it. This was lovely. Thank you.
Speaker: Thank you again to Dr. Kemi for joining us on this episode. Women deserve accurate evidence-based explanations and effective treatment recommendations. This way they can make the best informed decisions for their bodies. Anything counter to that is a form of misogyny.
Speaker: And being dismissed by a medical doctor is a real problem, and it still is today. So then when that reality is used as a means by which to get attention, frighten women away from well-researched treatments and contraceptive options, and then possibly also sell them on an unproven or unresearched solution or bring them into the brand narrative, this is an especially insidious and harmful phenomenon that has become all too common.
Speaker: We're going to link Dr. Kemi's book, A Terrible Strength, her Instagram account, and the resources that she recommended for you in the show notes. Stay tuned for two weeks from now when Sarah and I return with a Make It Make Sense episode on the Diary of a CEO Roundtable featuring Dr. Mary Claire Havert, Dr. Vonda Wright, Dr. Stacey Sims, and Dr. Natalie Crawford.
Speaker: We're gonna play specific clips for you so that you can hear for yourself to be able to examine the claims and the rhetoric that they're using. You'll hear emotionally powerful anecdotes. loaded questions, vague warnings about lifelong harm and appeals to what is natural.
Speaker: We'll look at how birth control's benefits get acknowledged briefly, but then vastly overshadowed by fear. And we'll also look at how they'll present with ease preliminary alternatives and how these alternatives will receive a lot of enthusiasm without any scrutiny.
Speaker: you're going to hear our opinions as always, but you're also going to hear direct rebuttals grounded in this conversation with Dr. Kemi, as well as the work of Dr. Jen Gunter and published research. If you know a woman in your life who might be experiencing some confusion around the conditions that Dr. Kemi spoke about, send this episode her way.
Speaker: Please also subscribe so you don't miss the follow-up two weeks from now. And finally, our free barbell mini course is waiting for you in the show notes. Go click that link and sign up.
Speaker: Thank you so much for listening to this episode of the Movement Logic Podcast. We will see you in two weeks.
