dr. thais aliabadi: endometriosis, freezing your eggs, and everything we wish we knew sooner - ep. 25

If your bookshelf and your for-you-page are equally important to your personality, welcome home. Pro Society is a weekly podcast that's part book club, part group chat for anyone who thinks pride and prejudice and love island deserve the same level of discourse. Each week we're connecting the dots between books, the internet, and pop culture. With your favorite writers, book talk creators, and plenty of overthought opinions. Yeah, I'm obsessed, so I'm obsessed. Listen to Pro Society on the iHeartRadio app, Apple podcasts, or wherever you get your podcasts. Hey, this is Hayes Davenport. And Sean Clements. We host the podcast, Hollywood Handbook. Each week we talk to someone in show business and try to help them with their careers and see what they have to offer us. Everyone has a good time and no one gets mad at their publicists for letting them do our show. We've had a lot of great guests like Sarah Sherman, Adam Scott, Danny McBride, Ben Stillert, and a lot of other big shots that wouldn't be where they are without us. Listen to Hollywood Handbook on the iHeartRadio app, Apple Podcast, or wherever you get your podcasts. On the new podcast, Solita, we share the messy reality of traveling alone as a woman. I can wait four hours for the next bus, or this random dude is offering the ride on his motorcycle. I choose Option B. I'm Julie Pinero, and I travel by myself because it's a rare space where I can say yes without asking anyone else first. I'm on a mission to reclaim the word Solita, trading the pity for possibility. Listen to Solita on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. I survived nine months in captivity, and I've spent my life exploring how other people survive what should have destroyed them. I'm Elizabeth Smart, and these are the survivor files. Every week I'm with survivors who live through the unthinkable, abducted, stalked, controlled, and nearly silenced. These are stories about what it takes to make it out alive. Listen to the survivor files with Elizabeth Smart on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Our hometown is not a test tube. 90 miles northeast of Nashville, a battle for the future of America plays out in one small town. Developers with right wing ties have purchased hundreds of acres of land. We need cities on a shining hill. This is our town. A podcast about what happens when a small town becomes the site of a social experiment and fights back. I guess you didn't move in on a bunch of dumb hillbillies now, did you? Listen to our town on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Hi everyone, hey guys, welcome back. I feel like we have to address this first because I'm feeling super weird. This is the first episode we are filming without our headphones on. And it feels weird to not hear myself in that phone. It's okay. I like it. Today we're sitting down with one of the most respected OBGYNs in this country. You might know her as Dr. A. And we're gonna have conversations that every woman deserves to know and learn and understand. And things that I don't even understand, we're gonna ask her today. Yes, whether you're in your 20s, 30s, or 40s, or trying tough kids, just trying to better understand your body, this conversation is packed with information every woman, and honestly every man should know. So I'm Stas. I'm Vic. And I'm Dr. Tais Aliyabadi. My patients call me Dr. A. And this is better half. So we have spent so much of our life hearing advice from friends, from the internet. You know, I feel like as woman, it's to get an understanding of your body is very hard. And there is not a lot of information and a lot of misinformation. So we are very excited to have Dr. A here. Me and Vic are going to share about our experiences as women and things that we've struggled with. And she's helped us through it all. So do you want to give a little background about yourself and, you know, tell them a little bit about you? Thank you for having me here. They started with my makeup artist not showing up at my 21 year old did my makeup. Well, you look very special. This is my 21 year old. Well, she's good. But I love being here because any opportunity I have to literally grab the mic and talk about, you know, the common causes of infertility, especially in women, your ages. I run. And I'm so grateful to be here because I do want to teach your audience about everything that is normalized. You know, if you think of women's health and if you think of standard of care for women's health, people think, you know, we're up here. If you want to know the truth and I've always said it, standard of care for women's health is literally, I don't want to be rude, but it's in the sewer system. But women get every single day is not. They deserve so much better. And because of these podcasts and because of social media, because of chat GPT and cloud and all these platforms, women are learning to become their own health advocate. And you know, I've been in women's health for 30 years now. And I can tell you my office is the office of dismissed patients. These are women who bounce yesterday. I had two from San Francisco, one from Arizona, one from New Mexico, one from Chicago. Why? They fly to see me to just get validated. They already know because they've done their research. They just fly to have someone validate their symptoms. And one of the most common things that happened to women is their symptoms are dismissed. Their symptoms are minimized. They're told that what they're feeling is completely normal, that their painful period is normal, that their acne is normal, that they're anxious, they're stressed. It's in their head. None of it is true. Women, they're so in tune with their body. And when a woman says something's wrong, nine out of 10 times, something's really wrong. And so, you know, and that's why I started my podcast. I mean, I'm going to have you guys on it, but I started GMD because I want to empower women to become their own health advocate. I literally take every condition. I dive deep in it. And then at the end of it, I give them the tools of what they need to do, so they can get educated. They have the tools. Then they can go to their doctor and ask the right questions. Yeah. And I tell them that if you feel like your voice is not heard, someone's dismissing your symptoms, go get a second opinion, go get a third opinion. But I see so many patients, you know, I always say, if every 20 year old went through my office, once I would literally bankrupt half of these fertility clinics. Why, if you go to these fertility clinics, who's sitting there, the endometriosis patient who's been dismissed, the PMOS or PCOS patients, these two, it used to be PCOS, we can get into it. And it's not called PMOS. The two of them are the leading causes of infertility on this planet. Majority of endometriosis patients are never diagnosed. 75% of PMOS patients are never diagnosed. Think of men. Okay, let's take guys. If they had, if as physicians, we would miss the top two leading causes of their infertility. And we would have them, and they would experience painful sex, their penis would hurt every time they had a erection, their sperm, it would be figured out in two seconds, in two seconds, it would be figured out. It's true. I want you to see how disturbing this all of it is. And that's why I get so emotional. I want to grab any opportunity I have. I rather not close my clinic half a day, come on this mic, spread awareness, spread awareness. And we have done it. And you know, my podcast right now blew up. Why? Because women don't get the information they need. All these health podcasts address men and their condition. No one talks about women. Top two leading like leading causes of infertility on the planet. Women are not diagnosed. So what is endometriosis? Because I'm, I feel horrible saying it, but I'm not really sure what it is. Great. And you should know, right? I should know. Like if you know what a migraine headache is, if you know what appendicitis is, you better know what endometriosis is. And every single girl, every single girl should be screened for both as a teenager, not even. Yes, absolutely. And it says, so what is it? And how do you screen it? So let's talk about it. Endometriosis is a condition that affects almost 20% of women. And this is when we find cells similar to the lining inside the uterus outside of the uterus to simplify it. Every time you have a period, right? You shed the lining of the uterus, which is called endometrium. Okay. Some of those cells, there's a hypothesis that said, some of those cells, instead of, I should have brought my model. I know. I love your model with like the little, it's, I'm going to pull it up for Vec while you're talking. But basically, as you shed the lining of the uterus, some of the cells go outside from the tube into the pelvis. If this is a uterus, you have the two tubes and ovaries. As you're shedding the lining, some of the cells go out the tube into the pelvis, right? So in a normal immune system, your immune system gets rid of those cells. Right. But in an endometrial patient, the immune system does the opposite. Imagine taking those cells and attaches it to the wall of the bowel, anywhere in the pelvis, of the bladder, of the uterus, of the tube, and each of these individual cells become an island of their own and they start expressing this aromatase enzyme and they start making estrogen because they depend on estrogen to grow. So they start making their own estrogen. They grow blood vessels, they grow nerve fibers, and depending on where that nerve fiber goes, that's where the patient experienced pain. These are patients who complain of painful periods, painful sex with depenetration, bladder pain. These are a lot of these patients say, "I constantly have a bladder infection" and they bounce, you know, from doctor to doctor, they get prescribed antibiotics when their urine culture is negative, but they have these UTI symptoms. They have pain, sometimes will bowel movement, back pain, leg pain, chronic pelvic pain when you can completely ignore it. So the most common symptom is pelvic pain, right? So I always say if you have pain in your pelvis and it's recurrent, you cannot dismiss that because that's the big elephant in the room is endometriosis until proven otherwise. As these cells, this happens month after month, endometriosis progresses. The problem is these - what's that? - He's calling me. - Okay, cause he wants to probably say something. - Say answer, she wants to question. - Sure. - We're in the middle of filming. - Hi, honey. - Hi, honey. - Do you want a question? We're on the air. - Wait, what did I say yesterday? - I told her like, how do you, how do you manage the uncertainty? - We'll get into that, yeah. - Was the answer. - We haven't gone that way. - Where she's just getting into it. - I'm in the middle of endometriosis. - We love you. - I'll answer that question, too. - She really wants to curious about one. - So anyways, these endometriosis patients get dismissed, right? These are young girls who, you know, they get a, the parents get a call from the nurse saying, come pick up your daughter from school, or they can go to school, or they skip work, or they can't have sex, or they plan their trips around their period. None of that is normal. If I could print a t-shirt that says painful periods are not normal, I would print it and walk around with it. - Cramps are normal, like a bit of a cramp. - A bit of a cramp is fine. - But it shouldn't be like, if it affects your eye, like I would, like I would ask to be taken to the hospital. - There you go. - Right, okay. - Big, big difference. - It's like something is wrong. - Like I get really painful cramps, but I can live with, like it's nothing like, you can take a mitle, and it goes away a little bit, and it comes back. - Always say, if you end up in an urgent care, if you end up in the emergency room, if you have to be picked up from school, if you skip work because of it, if you have to plan your social life and your trips around your period, none of that is normal. - Okay. - That's. - Not just because you don't want to bleed, right? - Right, right, right. - Not that. - Like for people, just like, how, I'm just confused why no one is being told, "Oh, you have this." Like, do they just, if you figure it out, let me know, honey. - Yeah. - Because historically, women, you know, had a patient who brought her daughter. Her daughter used to pass out from pain, and they had to go pick her up from school. And after, like a couple of days, when she goes back, this girl is like 14. The teacher says, "You're doing this not to come to school, right?" - That's how I'm ending it. - Like you're acting. - Yeah, like you're pretending. - Like you're pretending. - Like you're playing. - The gaslighting is so, it's so traumatizing. A lot of these patients, I had one yesterday, 26 years old. They have PTSD because they have 10 years of dismissed symptoms. These are women who go to the doctor complain. Imagine a 15-year-old who says, "I can't breathe. They throw up. They pass out. They need to get picked up." And they go to the doctor and the doctor looks at them in the eye and say, "There's nothing wrong with you." - Yeah. - Put yourself in her shoe. - So you can be, you can have it as soon as you get your period. You can be 15 and have it. - Absolutely. - Absolutely. - And it's their other way. - Listen to her story. - Yeah. - She said she would end up in the emergency room. - Yeah. - But why would you end up in the emergency room as a teenager? - So how do you get screened for that? - So let's talk about that. - Well, isn't her a new thing? I saw someone say that you can like, it's like a swab, swab or something. - So I'll go over all of that, but I want you to understand one thing. - Well, I also want to ask you about endo. - So this is not just pelvic pain. - Yeah, I was going to be a little implant. - These little implants start an inflammatory process in your pelvis. - Okay. - That chronic inflammation, when it gets ignored, causes scar tissue formation. Your causes bowel adhesions. Everything starts getting stuck. Your tubes can get blocked. And that inflammation can affect your account and of a quality, especially if you have endometriosis inside the ovary that eventually causes a chocolate cyst. Those can really crash someone's account in quality. I've had 30 year olds come to my office from Canada, nine years of dismissed symptoms, at 30 her account is zero. How about that? Zero. And I see this all the time and they go to the fertility doctor and they're like, well, go get an egg donor. You have no more eggs left for something that could be completely suppressed. But that, it doesn't end there. This chronic inflammation and these, the nerve pain that these patients have eventually, they get central sensitization. What happens is that their brain starts perceiving, it gets rewired and it starts perceiving that pain as a 10 out of 10. So if I feel that pain as a, I don't know, three out of 10, the endopation, her brain gets rewired over time and starts feeling it as 10 out of 10. That's why as they get older, they start having more and more pain and they start bouncing from doctor to doctor. So the gold standard treatment for endometriosis is laparoscopic surgery, right? You go in with three, you know, we put a tiny camera in your belly button and two tiny incisions, we go in and we have to grab these implants, one by one, cut them, one by one, cut them. Absolutely, got it. Absolutely, absolutely, absolutely. Didn't it help you though? Yeah. I haven't like, well, I mean, I also have my ID, which is something that I want to get into because we, I briefly talked about it. I think on the podcast or my vlog and everyone was like, isn't that bad that you don't get your period? So let's talk about that. You tell me, take me to surgery for endometriosis, but you cannot suppress you. I'm not going to allow you to suppress me. I would say, I don't like doing that. Why? Because surgery will help you for six months to two years and then the end will come back at a patient last year from Northern California, new patient. She walks into my office. She's like, I'm here. I'm like, you know, chief complaint. Why are you here? She said, I'm here for my 12th laparoscopic surgery. And I was like, excuse me. She's like, yeah, I go every year. I check in around this time, but this month, my doctor's not available. So I'm here for you to do my laparoscopic surgery. What? No. No. Surgery alone is not enough because it can come back. So that's why I'm not coming back at all. I resect, except what my idea was expiring. I felt my crown. You see? Why? So what happens is endometriosis, these little implants, they love estrogen. Think of it as they love, they grow with estrogen. They tend to be progesterone resistant, but they also, you know, they're growth slows down with progesterone. So you can do progesterone birth control, which I don't like because some people get moody, you have to take a pill every single day. Yeah. But I absolutely love a progesterone, IUD. And whoever's telling you that that's not okay. It's the best thing you do for yourself. A, you lower the amount of bleed. Remember I, the hypothesis I told you that the blood goes the other way. Yeah. And it suppresses that helps suppress the implant, the implants from growing back again. And for patients who have more advanced disease, like stage three and four, in addition to surgery, putting a progesterone IUD, like I use Kailena for women who haven't had children. If they've had children, I use the bigger one, Marena IUD, or you can do LILETA. But what happens is for patients with advanced disease, we put them on a medication called oral ESSA or my February, these basically act on the hormones of the brain and lower the ovarium production of estrogen. And as estrogen goes down, it strangulates these little implants. So you can't just put everyone in one group and tell them everyone needs to do this. Every patient is different. Some patients, you can just treat with a progesterone IUD. Some patients, they need laparoscopic surgery. Gold standard is always go in, remove it. It's an outpatient procedure. You go home the same day and the recovery is super fast. And that is, you know, for someone who's been in the ER and whose social life is changed and who can't have sex for different reasons, that's gold standard. And then you go down the path. The problem is, as your brain gets rewired, the other thing that happens, you're bowel that's sitting in that inflamed area for years, a lot of these patients develop leaky guts, which we call SIBO, small intestinal bacterial overgrowth. These are women who say when I eat, I get bloated. So those patients after surgery, if they're still bloated, I usually offer them an antibiotic called Zyfaxin. They take it three times. a day for two weeks and it helps with that bloating, but you can't, but you know, like 90% of endopacians have SIBO. So almost all of them complain of bloating and you have to suppress the endometriosis before you get to their SIBO treatment. Otherwise, they can keep getting treated for SIBO and they bounce back and the GI doctors scratched their heads are like, I don't know what's wrong with you because I can't get it to get better, you have to bring down the inflammation. But how, for example, for me, like, could I test for endometriosis? Recently, there is no test for me. If I- Let's talk about it. Let's talk about it. If you come to me, my accuracy is over 99% just by listening to you. All you have to do is listen to women. They'll tell you the truth. The problem is no one listens and when they listen, they dismiss women because we are all crazy until proven otherwise in the healthcare system. And it should be the opposite, right? I had a patient who said, the doctor told me my problem is between my two years. Can you imagine? And endopation hearing that. But that's the messaging they're getting from everyone, from their parents, from their doctors, from their gynecologists, from their primary care, from anyone who's around them. So that's why, you know, you have to be your own health advocate. If you're listening to this podcast and you have painful periods, be your own health advocate. Now, recently, there's a blood test. So for me, clinically, it can get you to 99% if you listen to patients for diagnosis. You don't need a fancy test. But because women get dismissed, there's several tests. But one of them that's approved recently to be used by some fertility doctors, OB/GYN offices, for endometriosis, is a blood test. And they look for microRNA changes in the blood. And they use an AI algorithm to predict who's at risk. The sensitivity of the test is about 84%. It's a low-false positive rate, but it only picks up eight out of 10 patients. So it's not set in stone, but it's great for women who are getting dismissed. I rather have everyone take this blood test. In the UK, right now they released a test. It's a saliva test. It's a little bit more accurate with a little higher sensitivity and specificity. But that's not available. It's only they're doing it there. But again, you don't need a fancy test if you just listen to patients. That's all you need to do. All this effort to develop a test when just by listening, you can get to 99%. Yeah. When I was 14 years old, I was kidnapped and health captive for nine months. I survived. And I've spent my life exploring how other people survive what should have destroyed them. I'm Elizabeth Smart. And these are the survivor files. I just remember this low-taunting voice next to my ear saying, "Shut up. Don't say anything." Every week, I'm with survivors who live through the unthinkable. I knew if he woke up, without a doubt, he was going to hurt me. I started feeling that there was someone at the end of my bed and I just started screaming. They are abducted, stalked, controlled and nearly silenced. But these aren't stories about what's taken from them. Their stories about what it takes to make it out alive. Listen to the survivor files with Elizabeth Smart on the iHeartRadio app Apple Podcasts or wherever you get your podcasts. If you're a bookshelf and you're a four-year page or equally important to your personality, welcome home. This is Pro's Society, the weekly podcast that's part book club, part group chat for thought daughters, pop culture obsessives and anyone who thinks pride and prejudice and love island deserve the same level of discourse. I'm Eli Rallo and every week we're connecting the dots between books, the internet and the conversations everyone can't stop having. I'm going to have to look up this story. I'm obsessed. From best-selling authors and your favorite book talk creators to the latest pop culture moments, nothing is off the table. It's like if you can hide some real messages inside compelling characters and that is of Trojan horse, whether you're looking for literary deep dives, smart pop culture conversations, or a community of readers who love to think a little too much, you're in the right place. Listen to Pro's Society on the iHeartRadio app Apple Podcasts or wherever you get your podcasts. See you between the pages. I can wait four hours for the next bus or this random dude is offering me a ride on his motorcycle. I chose option B. I'm Julie Piñero and I travel by myself because it's a rare space where I can say yes without asking anyone else first. Every time I try to be alone, I kept meeting people and they were like, "You smiled at us, not a lot of people smile around here." It's when you're alone that you're most receptive to the world as it is and not the lies you're sold about it. It can be a time where you push your limits, change your mind, or wake up to a new version of yourself. So whether you're a solo travel veteran or you're too nervous to book your first trip, I hope you listen to Solita on the iHeartRadio app Apple Podcasts or wherever you get your podcasts. Hey, this is Hayes Davenport and Sean Clements. We host the podcast Hollywood Handbook on the Big Money Players Network. Our show is extremely accessible to first-time listeners. Each week we talk to someone in show business, aka The Biz, and try to help them with their careers and see what they have to offer us. We've had a lot of great guests like Sarah Sherman, not that great. Can you help me shape this? How about we flip it on his head? How about we flip the screen? What is the surprise one, man? Actually, you think it's the straight man, it's actually the one who's acting weird. Adam Scott, this entire time you've been expecting Adam Sandler to come to visit the show. I would never let go of that. I would never set expectations for something like that. If the universe allows for something like that to happen, I am open to it. I'm always going to accept. You know, Danny McBride, fine. Yeah, it's all this fragile masculinity exuding. I could smell it walking on the hallway to be honest with you. I was like, "Is that weed?" Nope, it's fragile masculinity. Ben Stiller, no. I think there's a lot of times out of context, people don't get it, or even know what a circle is. You know what I mean? Like, girl, I go work just so stupid. Everyone's so dumb. And fake. Right, fake, and also not interested, or just like, "Oh, I've got my pipe. I don't care about your life." And a lot of other big shots that wouldn't be where they are without us. Oh, and by the way, Will Ferrell told us personally he loves the show, and he wants to be a guest on every episode, but he's just so busy. Listen to Hollywood Handbook on iHeartRadio app Apple Podcast, or wherever you get your podcasts. Our town is small taters by most standards, right? But to the people who grew up here, it's everything. What happens when a quiet Tennessee town becomes the front line in a battle over the future of America? Developers with right wing ties have purchased hundreds of acres of land in the area. The first thing you see when it pops up is high nears and apple etch. But they weren't just planning houses. We need cities on a shining hill that exemplify and embody the Christian way of life. Stop right there. Is that normal? A podcast about what happens when a small town becomes the sight of a social experiment. God need men to rule! Great! And decides to fight back. Do not use my hard work to sell your b****. They're not just opposing what's being planned for here. Our hometown is not a test too. They feel like they're standing in opposition to an entire administration. Listen to our town on the iHeartRadio app Apple Podcasts or wherever you get your podcasts. You know I've always wondered obviously because these new these tests are new about Endo. Have you ever listened to someone and like gone in to do the Lapperscopic surgery and not found Endo? Or you've always found it. I would say 99.9%. And if I didn't find Endo, I probably that's 0.1%. I found Inguinal Harnias. That was called, you know, I found something. Do you know what I'm saying? But a lot of you know a lot of patients have other issues too and the central sensitization for someone who's had Endo dismissed for 20 years it takes like six months to a year to calm the brain down from firing, you know, and it's really sad. I had a 50-year-old who told me she's been to 100 emergency rooms. She's been to every emergency room in every country she's ever visited. At 50, I diagnosed her with Endo. This woman never had children because she couldn't have sex, never had a partner, severe anxiety and different. But I started crying. My PA was in the room. We all started crying for her because at 50, the best years of your life were wasted for something that could have been reverted. It's so heartbreaking that I went on Jay Shetty and he asked me about Endo. I started crying because I feel like- Lindsay's friend has Endo when she- told her that she was, that you were coming on today and she started crying, that we were talking about it. I cried for them. I cried for them because they're trauma for 30 years. It's now my trauma. I can write a book this stick about my experiences with these patients. It's so unfair. What they go through is so, it's beyond it. And the desperation of this women, but I will change that. And like someone just always just change them always. Watch me change it. Yes, you are. I'm going to change it. Give me two years. I'm going to change women's health for the world. Yeah. Oh, yeah. I will. I will. I will. I was placed on this planet. I always tell my kids, I will not die. And I'm going to save here for the person until I have a solution for the way women get treated in the healthcare system. I will not leave this planet. This was the reason I was placed on this planet. And there's no way I won't change it before I leave. There's zero chance. Oh my God. I'm literally going to start crying. But it's true. But it's true. I believe it. I believe it in my heart. You know it. So it's so clear for me of what I need to do. And I will do it. So if some people are going to a doctor that's being dismissed, what's your recommendation? Just become your own health advocate, but like just go to another question. The first step is educate yourself. You cannot advocate for yourself. If you're not educated, go online. Go on GMD. Look up all I literally dissect everything down for them. Go listen to all the podcasts that I've done. Okay. Educate yourself. Once you educate yourself, find a doctor around you that is familiar with your condition, endometriosis. Let me tell you guys, not only women get dismissed in the first place with their symptoms. If you give 100 laparoscopes to 100 surgeons, 50% of them will wake the patient up and say, I didn't find endo. Oh, really? How about that? 50%. 50%. I just operated on someone. In April, she was told that she has no endo. This woman has nine out of 10 pain, right? She almost passes out. I scoped her. She had endo three months later from when a doctor told her you didn't have it. Talk about the level of dismissal. But then how do they know that? Because the reason I say find a doctor, you have to have done so many of these because it could be in so many different places. Places and not all endometriosis looks alike. A lot of time people look for purple lesions in the pelvis. You can have stromal endometriosis, which is it's missing the glandular part, so it's not purple. But when you zoom in with your camera, it's a clear, tiny dot. It's like a little ulcer. Those tend to be more inflammatory, more painful, but almost always missed. So find an endometriosis specialist near you. Make sure the person who's doing your surgery has done at least, I don't know, 500. Do you know? No, all these other types of stuff. What they look like. And if they dismiss you, go to another doctor. The problem is a lot of times, even when they get the diagnosis, they can either not afford the surgery. They can't find the surgery. You guys 50% listen to this of counties in America don't have an OB/GYN. What? Five zero. How about that? Like, can we start there? How does it make any sense? These women, I had a patient who came last Monday. I operated on her last Friday. She had a giant mass in her pelvis. 20 years, no one did a pelvic ultrasound on her. And Maguire, you hear? She said, I had an appointment with my doctor for a year later. The day of her appointment, they cancel her. They give her another appointment eight months later. They cancel that appointment. And at that point, she's like, I'm going to LA to see this doctor. She came, she had a giant mass. I wasn't sure if it was an ovarian cancer or a uterine to occur to surgery. She did great. But my point is a year to eight. And a lot of women don't even have, they have to drive six hours to see a gynecologist. And for that doctor to tell them there's nothing wrong with you. You guys, it's so bad. I can sit here and vent. It's crazy. It's crazy. You guys are so privileged. Do you know, but when you consider yourself privileged, of course, how long did it take you to get the diagnosis? Like four years. That's crazy. And you are one of the most privileged humans on this planet. So if it took you four years, do you think other women have a chance? No. Well, honestly, not even four years. I would say, it's into a teenager in the year. Well, from my teenager, but like when I was 14, I didn't go to the gynecologist. Right. I was like, when I first went to my gynecologist appointment with you, it was like, you told me. Yeah. So it wasn't even that. But it's, so it's a big issue. And there's a strong correlation between endometriosis and PMOS, which is the old PCOS. Do you want to learn about? I would love to learn. I didn't even know that it changed. And what you didn't know. What does PCOS? I don't know what it is. So I'll tell you. So PCOS leading cause of infertility on the planet affects 15% of women, 75% are never diagnosed. Why do I have all these infertility things? I know, but it's like stocked up against me. But isn't it crazy that the two of you don't know about it? Well, I know about it. You know, but I didn't know where the M came through. But do you know what PCOS means? Like what is it? I don't know exactly. What is it? Polycystic. It used to be polycystic ovary syndrome. It's like something with your insulin. She tells me the time. I'm supposed to be taking this medicine. I still haven't started my mind. Okay, so what is I'm assuming I don't have any of this cause I go to you. Yeah, I would have caught it. Trust me. I have everything. Don't worry. But I'm going to have to go again because I'm a low nervous. I want to know if you've seen me. You would know. You would know if you had evidence. I've never dismissed a woman with PMOS or windows. So you don't have to worry about that. As far as PMOS or PCOS, it used to be called polycystic ovary syndrome. Okay. And a lot of doctors would look at, do an ultrasound and say, you don't have a cyst. So you don't have polycystic. Go home. And that's why they changed the name. 75% of women, I think that number is north of like 85%. We're always dismissed, never diagnosed, leading cause of infertility. In order to diagnose PCOS, which we now call it PMOS and I'll tell you why, you need to meet two out of the three criteria. Number one is history of irregular cycles. Number two is PCOS ovaries on ultrasound. And polycystic does not mean cyst. There's a specific look on ultrasound. We call it sacroperals. There's a lot of little tiny follicles everywhere. So it's a very specific finding. Again, doctors do an ultrasound and they're like, oh, you have so many eggs and they completely dismiss it. And the third is symptoms of high testosterone. You do not need to have a high testosterone in the blood, but you need to have symptoms of it. What are those symptoms? It could be facial hair, body hair, acne, facial acne, back acne, hair thinning, different people have different symptoms. So you need to meet two out of three criteria. Recently, on the second criteria, which is polycystic ovaries, because a lot of doctors miss it, they added elevated egg counts in the second category, AMH anti-malarion hormone, which I do on every single patient. All of you guys have it. If it's high for age, that meets the second criteria for polycystic instead of having an ultrasound. You can't use the second elevated AMH criteria for teenagers, because teenagers have a lot of eggs. So you can't use this AMH factor for girls young teenagers. I'm always careful, you know, labeling them with PMOS. If I think they have it, I treat them, but I wait until they're a little bit older, but they have to have the irregular period in the high elevated testosterone symptoms. Which is my two symptoms, right? Right. And you had elevated testosterone in your blood, which is another way of diagnosing it. Now, PMOS patients tend to have mood disorder. They tend to be more anxious. They tend to be more at risk for PMOS PM. That sounds about right. Every time I see her, she's smiling and giggling. So I can't. That's what I'm crying. And they're more at risk of irritability, PMOS, PMDD, sometimes lack of motivation, cravings, binge eating, they get hungry, they're windy. Okay. So that's over there. I can hear it. I can feel you. In which of you with the ice cream? I can feel her eyes being like, yeah, another one, another one, check, check, check, check, check, check. I know that ice cream. Okay. So PMOS patients have mood disorders. 75% of them, 75% gain weight, even though they're doing everything those skinny people are doing, 25% are lean, lean, lean, and they never have issues. So you can't look at someone and say, you're not overweight, so you don't have PMOS. Yeah, but it could be the opposite too. But also the weight fluctuation. Yes. The other thing is a lot of them have either disordered eating or a history of an eating disorder. I always say if you want to find young PMOS patients, go knock on the doors of eating disorder centers. All of them are sitting behind those doors, but instead of someone saying, "Wait a minute, this is a metabolic dysfunction, this is PMOS, let's check you for it, what do they do? They get them a psychiatrist, they put them in these eating disorder centers, they get treated for anxiety for depression, they get put on anxiety medication without anyone addressing their metabolic dysfunction. And it's the leading cause of infertility. But it's core, KMOS has insulin resistance. And usually these patients have someone in their family who was either overweight a lot of time, even in the paternal side of the family, diabetic, prediabetic, overweight, history of gestational diabetes, somewhere in the DNA, there's some insulin resistance. 50% of humans are insulin resistant, so it's very, very common, it's almost in every single family. And what happens is when we eat carbohydrates and our body breaks it down into glucose, glucose stimulates our pancreas to release a hormone called insulin. Insulin goes to the receptors, mostly on the muscle cells, opens up those receptors, and pulls the sugar from the blood into the cell and turns it into energy. This is what's supposed to happen. But what happens with insulin resistance and PMOS patients when they eat carbohydrates and their body breaks it down into glucose and insulin gets secreted, their cells are insulin resistant. They don't listen to insulin, so these channels don't open. So instead of sugar going into the cell, it bounces in the blood. When sugar bounces in the blood, it causes a spike in your insulin. That insulin spike causes a cascade of events in the body. Number one, it tells your liver take this sugar and store it as fat. So these are patients who say, "I go to lunch with my skinny friend. I have the exact same thing. If anything I have less, I have one slice of pizza, she has the entire pizza. I gain weight the next day she's thin." And that's where the frustration comes. The fat that you store with PMOS is a visceral fat. It's very inflammatory. It causes bloating, it causes fatigue. It makes patients feel exhausted. They crash after 2 pm in the afternoon. They have brain fog. They just don't feel well and they feel very inflamed. So that's one thing that happens with high insulin. But that spike in insulin does one more thing. In PMOS patients, even though they're insulin resistant everywhere, their ovaries are insulin sensitive. So that spike in insulin tells their ovary to release testosterone. And it is for that reason that they start having irregular period. They have acne, hair loss, facial hair body here. But that testosterone that gets released in the ovary is toxic to the follicles in the ovary. Why? Because it causes an inflammatory process. So these fall every month, certain number of follicles get recruited in the ovary. They come to the surface. They grow with the hormones that get released from the brain. One matures and mid-cycle, you get a surge of LH hormone from your brain that causes ovulation. When you have testosterone, it freezes these follicles. That's why it gives that polycystic ovarian looking ovaries on ultrasound. So their ovulation becomes irregular, 70% to 80% of PMOS patients don't ovulate. Of the ones who report regular cycles, monthly cycles, they sometimes ovulate. Their ovulation is suboptimal because of this issue. That's why they can get pregnant. They can get pregnant. So what do we do? The most important thing you need to address is that insulin resistance, right? Now that spike in insulin causes a crash in the blood sugar that causes craving after they eat a high-carb food. They start craving it more. They get irritable, they don't feel good, they're already bloated. So all of this, and the spike in insulin tells the liver to reduce the production of a protein called sex hormone binding labyrinth. This is a protein that grabs free testosterone in your blood. When your liver doesn't produce that, your free testosterone goes up. So then you have even more testosterone in the body. All of this. So you have a situation where inflammation is high, testosterone is high. Immigration is not optimal so your progesterone is low because progesterone gets released after ovulation and all these little follicles are secreting estrogen whenever they want. All of this affects your brain and your limbic system. Our limbic system, which is your hypothalamus, amygdala, and hippocampus, is the emotional headquarter of our brain. All of our emotions are in this limbic system. For the limbic system to be calm, you need low inflammation, normal testosterone, normal estrogen, and high progesterone. Progesterone has a calming effect on the brain. What do we have in PMOS? High inflammation, high testosterone, irregular estrogen, and low progesterone. So now you have a limbic system on fire. These patients say I'm anxious, I'm depressed, I'm at PMS, I'm at PMDD, I have cravings, I've binge eating, I'm unmotivated, I can't function, I don't feel good, I have brain fog. Right, and the list goes on and on and on. And then we have a prefrontal cortex which acts as a break and controls the emotions that come out of your limbic system. The prefrontal cortex needs the same thing, low inflammation, high progesterone, low stress, good sleep, PMOS patients are not good sleeper, low anxiety, low cortisol. So all of that blocks the prefrontal cortex from doing it's function, right? So now you have a car going 100 miles an hour, and the brain will break more work. But then you can treat it. So when you treat the source, which is metabolic dysfunction, what happens? When you blunt that insulin spike and make someone insulin sensitive, you start pushing the sugar in, insulin goes down, your visceral fat goes down, your weight starts adjusting. As insulin goes down, your sex hormone binding, globuline goes up, it grabs the free testosterone, your symptoms get better. As the insulin goes down, your ovaries don't release as much testosterone, the inflammation in the ovary goes down and patients start ovulating and they get pregnant. And it's one pill? It's like a pill you take. So there's the multiple, so that's why I started. If you're listening to this podcast and you think you have PMOS or the old PCOS, I have your powder, but more important than that, go on ovii.com, take the quiz. I cannot diagnose anyone online, but I can tell them basically it's a quiz I created and it tells you with a high likelihood whether or not you have PMOS. If you flag positive, because these patients get dismissed, listen, you can go and say I have PMOS and the doctor is like, no, you don't have polycystic ovaries in my office, right? The reason they change the name is because it's a metabolic dysfunction and it affects your hormones, not polycystic ovaries, right? There are no cysts. So now the new name is poly endocrine, it affects all your hormones, estrogen, progesterone, testosterone, metabolic, which is your insulin resistant, ovarian because it affects your ovary syndrome. It's a better, it's a better name, so it's PMOS. It's all inclusive now. Yeah. So it's becoming, it's becoming, it's becoming all the bit. Yeah. It's basically teaching the health care providers that these are for more than actually, not just cysts on the ovary. So there's powder. I just bought it. So what does it do? So it's amazing. I used to give like 10, 12 supplements to my patients literally years ago. So I put all of them together, but one of the hero products I have in it is wild malberry leaf extract. If you take this OV powder before your heaviest meal of the day, whether it's lunch, dinner, whatever it is, you can take it once a day, but if you take it before your heaviest meal, it blocks the absorption of carbohydrates in that meal by 42%. So if you're going to go have pasta or pizza or in and out, have your, I like the tropical flavor. I mix it. I take it every single day because I have insulin resistance. So what it does, this lowers your absorption of carbohydrates. Then it has different supplements in there that makes your body insulin sensitive. Remember, so now the sugar can, you don't absorb as much. And whatever you absorb, it goes into the cell. It has a lot of anti-inflammatory supplements in it. It lowers your craving. It helps with energy. It helps with insulin sensitivity. So these are patients who come and see my mood is better, or my period started coming back. Why do you think? Because it's blunting, it's helping with insulin sensitivity. So and it's lowering inflammation. So that's the supplement, I always start with the supplement. Then you can go to metformin. What's metformin? Metformin is a prescription for diabetes, people who are insulin resistant, I take metformin twice a day. I've taken it for like eight years with my OV recently. I added OV back then we didn't have OV. So what the metformin does, it works at tissue level and makes you insulin sensitive. Again, blunting that insulin spike and these patients start ovulating, especially when they want to get pregnant. - In 2014, I started using GLP1s, believe it or not, from my PMOS patient. I think I was the first person on the planet using these for PMOS. And like in 2014, I had patients losing 60 pounds on these tests. - It was like 600 days, right? - No, it was trillicity days. - But GL, whatever, that's a diabetic-- - So the Italian had those. - Yeah, yeah, yeah. Back then, we had trillicity, which was a diabetic medication, but when they started giving it, these diabetics were losing a lot of weight. So I knew insulin resistant was the issue with PMOS. So I started giving my patients trillicity back then. And they were doing so well until it blew up a few years ago. And people thought it's a new thing. It's not, I mean, it's been around since 2014. But what these GLP1s, and if you remember, when people started using ozampag, they were all saying, this is a miracle drug. I'm getting pregnant, why do you think? - Yeah. - Because ozampag makes you, or DGLPs, make you insulin sensitive. They blunt that insulin spike. So by doing that, they were lowering the testosterone in the ovary. So these patients were starting to ovulate. - So all those people probably had PMP? - No, for sure. - For sure, there were videos. - Because they had metabolic problems. - And then they started ovulating for the first time in their lives when they were taking the GLP1. - And to this state, they still don't know that they have PMOS. But they had metabolic dysfunction. And when you address the metabolic dysfunction, you can act as a whole thing. - You're a bad person. - We have ozampag babies. - They have ozampag babies. And that's why I get so emotional and upset when people would come and say, these medications are poison. They're poison if you have an eating disorder and you're using it. It's not poison if you have metabolic dysfunction and you need to fix the hormones in the body. These patients, I mean, I cry, I have a text from a patient. I started her treatment way before all of this happened. But she texted me a picture of her when she was really overweight. And she just texted, she'd sent me a picture before and after, years later. She's my size. She's wearing this, she's better. She looks better than me, obviously, on 55. But she's wearing a bikini, she's wearing a bikini and posing and I literally started crying. I have patients who come to my office. I had one who lost 100 pounds. You know what she told me? She said, "I never could wear boots." I never thought of that. - Boots? - Boots with her calves. - And now I'm wearing boots. And you know what she told me? She said, "For the first time, this girl is like in her 20s." She said, "For the first time in my life, I know what it means to be happy." - Oh, no. - Don't you wanna cry for them? And then you have people saying, don't use these medications. I think, and I don't think any, I'm one of the handful of doctors who started using these in 2014. I don't know anyone who's around me, who's used it as long as I have. I've never seen complications with these meds if done correctly under the care of a doctor. - Right. - And I really think they're longevity medications because what kills us? Inflammation and metabolic dysfunction. - And high stress. - And high stress. But the first two is addressed with this. And a lot of the stress is also addressed with this because when you're overweight, when you're inflamed, when you have brain fog, when you don't feel good, when you have no energy, it's horrible. - It's horrible, right? - The quality of life is just not good. - Yeah, they're horrible. - Anyways, thank you for letting me talk about it. You know, these two are my passion. - I can tell, I love that. - I'm gonna, I'm like, I feel like I learned so much. - Me too, I'm like, I wanna go see you again and do everything I can. - No, I've done, you don't, I know, but I still wanna go again. - I wanna be checked again. - No, I check every single. - What do you guys, I've been practicing 25 years. I've never missed cancer in my patients. But I do it all at 20, I also have those pre-cancer cells. - Yeah, I had something similar. - At 25, I check genetic testing if you have family history. - You're the cancer testing too, right? - All of it. I calculate everyone's lifetime risk of breast cancer. By 30, I know what that risk is. Did you know that if your lifetime risk of breast cancer is 20% or more, you do not start imaging at 40. You start imaging at 30. - Which is what I did, by the way. - Yeah, I had to go get a breast. - Let's go, let's go, let's go. - Yeah. - If you're a bookshelf and you're for you page are equally important to your personality, welcome home. (upbeat music) This is Pro's Society, the weekly podcast that's part book club, part group chat for thought daughters, pop culture obsessives and anyone who thinks pride and prejudice and love island deserve the same level of discourse. I'm Eli Rallo, and every week we're connecting the dots between books, the internet, and the conversations everyone can't stop having. - I'm gonna have to look up this story. I'm obsessed, I'm obsessed. - From bestselling authors and your favorite book talk creators to the latest pop culture moments, nothing is off the table. - It's like if you can hide some real messages inside compelling characters and that is a Trojan horse. - Whether you're looking for literary deep dives, smart pop culture conversations or a community of readers who love to think a little too much, you're in the right place. Listen to Pro's Society on the iHeartRadio app, Apple podcasts, or wherever you get your podcasts. - When I was 14 years old, I was kidnapped and health captive for nine months. I survived, and I've spent my life exploring how other people survive what should have destroyed them. - I just remember this low taunting voice next to my ear saying, shut up, don't say anything. - Every week, I'm with survivors who live through the unthinkable. - I knew if he woke up, without a doubt, he was going to hurt me. - I started feeling that there was someone at the end of my bed, and I just started screaming. - They are abducted, stalked, controlled, and nearly silenced. Their story is about what it takes to make it out alive. - Hey, this is Hayes Davenport. - And Sean Clements. - We host the podcast, Hollywood Handbook on the Big Money Players Network. - Our show is extremely accessible to first-time listeners. Each week, we talk to someone in show business, AKA The Bizz, and try to help them with their careers and see what they have to offer us. Everyone has a good time, and no one gets mad at their publicists for letting them do our show. - We've had a lot of great guests, like Sarah Sherman, not that great. - Actually, can you help me shape this? How about we flip this around, okay? How, what is the surprise one then? Well, actually, you think as the straight man, is actually the one who's acting weird. - Adam Scott, love. - This entire time, you've been expecting Adam Sandler to come to visit the show. - I would never let go of that. - I have, you would never set expectations for something like that. - It sounds like if the universe allows for something like that to happen. - I am open to it. - I'm always going to accept, you know? - Danny McBride, fine. - Yeah, it's all this fragile masculinity, exuding. - I was like, is that what you need? Nope, it's fragile masculinity. - Ben Stiller, no. - I think there's a lot of times in out of context, people don't get it, or even know what a circle is. Like you're like, "I don't like to save it." - Everyone's sold comics for you. - And fake. - Right, fake and also not interested, or just like, "Oh, I've got my life. I don't care about your life." - And a lot of other big shots that wouldn't be where they are without us. - Oh, and by the way, Will Ferrell told us personally, he loves the show, and he wants to be a guest on every episode, but he's just so busy. Listen to Hollywood Handbook on the I Heart Radio app, Apple Podcast, or wherever you get your podcasts. - On the new podcast, Solita, we share the messy reality of traveling alone as a woman. - I can wait four hours for the next bus, or this random dude is offering me a ride on his motorcycle. I chose option B. 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So whether you're a solo travel veteran or you're too nervous to book your first trip, I hope you listen to Solita on the I Heart Radio app, Apple Podcasts, or wherever you get your podcasts. - Our town is small taters by most standards, right? - What happens when a quiet Tennessee town becomes the front line in a battle over the future of America? - Developers with right wing ties have purchased hundreds of acres of land in the area. - The first thing you see when it pops up is high nears and apple at you. - But they weren't just planning houses. - We need cities on a shining hill that exemplify and embody the Christian way of life. - Stop right there, is that normal? - A podcast about what happens when a small town becomes the site of a social experiment. God need men to rule, great, and decides to fight back. Do not use my hard work to sell your bulls**t. Listen to our town on the iHeartRadio app, Apple Podcasts, or wherever you get your podcast. If your lifetime risk is high, I'm sending you. I never have a 34-year-old show-up stage 4 under my care of the person. Ever, never, ever, because I don't dismiss their symptoms and I don't dismiss their family history and the data and the data that I collect. And it's so easy, you guys. If everyone spent five minutes listening to women, you would not see any of these things that we see. You heard it here, ladies. Go check them because they're on advocate and do not take no front answer for your feeling is real. Don't let them gaslight you into thinking you don't have anything. Thank you. We're here for you. Comment below and we'll help you. The two doctors here will help you. We'll help you. Let's talk about eggs. Freezing eggs, fertility, all of that. I am in my, I'm high in my 30s. I am in my, I am high in my 30s. Well, not really, but I'm high in your 30s. I'm not even in my 30s. Okay, I'm almost mid 30 and I'm like, what on earth? She's like, can everybody's, I every time, 40 or something. Every time I go to the doctor, I say, look at my eggs and tell me and she told me last time that my eggs look good. And if I'm trying to have a baby in the next year, then I'm okay. And I am otherwise free. So here's what I say. You first told me to freeze my eggs since I was like 27. But I also have all my fertility babies that, yeah, I'm up against and that's why I love talking about it. Okay, okay. Talk to us. So you're born with millions of eggs. By the time you're a teenager, that number is like half a million. By the time you're in your 30s, it's 100,000. When you're menopausal, it's 1,000. So they declined super fast. Now you add conditions to it. Autoimmune, endometriosis, PMOS, they can affect a counten quality. PMOS patients tend to have falsely high number. Remember those follicles get frozen and they release, I mean, they freeze in the, not frozen frozen. Those follicles stay in the ovary and they falsely elevate your AMH anti-malarion hormone. And when that happens, doctors will look at it and say, you're fine, you're fine. But if you have PMOS, those follicles, because of all that inflammation and testosterone, their quality is not as good. So it's falsely positive. So PMOS patients have a high AMH, but the quality is poor. One, endometriosis patients, especially the ones with endometriomas, with chocolate cysts in the ovary, their egg count and quality goes all the way down. That's why when you have surgery, you want to be with a surgeon who knows what they're doing. You don't want someone going after the ovary and starting to zap. I don't touch the ovaries. I clean around them to bring the inflammation down, unless the patient has an endometrioma. But even if they have a large endometrioma, I peel it off and don't zap the ovary because you want to preserve as much as you can of that ovarian reserve. So endometriosis lowers a counten quality, autoimmune conditions, patients with chemotherapy. I mean, the radiation, the list goes on and on. So every single girl in my practice gets their egg count checked between 18 and 20, right? Everyone. And AMH does not mean you're, it basically tells you you're ovarian reserve. It doesn't mean that you're infertile, you're going to get pregnant or not get pregnant. But it's the only test we have that kind of gives us an idea of what your reserve is, right? And that's a good number to have. Why? Because if at, I don't know, 25, your egg reserve is the reserve of a 40-year-old. Guess what? I'm going to have you freezex. Yeah. But so because whenever I'm your, because it keeps it declining, especially if you're dismissing your endometriosis, then it's going to come and destroy your ovarian reserve. So that's why it's so important to screen these young girls for endo and PMOS, check their ovarian reserve. I check it every single year on every patient because I want to make sure suddenly it doesn't crash. And I watch these patients very carefully. My patients who have PMOS and endometriosis and don't have a partner, I start having that conversation with them. I'm not pointing finger. About X freezing, I, you know what the problem is, X freezing is expensive. And that's what breaks my heart. Of course. When women are young and the quality of their eggs are good, they can't afford it. When they're 40 and they have no ovarian reserve, the quality is gone, then they can afford it. But why is that not part of insurance or something like that? Like this is a woman's issue. Of course. It's so sad. Look at what we've talked about. I mean, put yourself in the shoe of a young girl who's being dismissed with endo and PMOS. By the way, 61% in my practice, 61% of my PMOS patients have endometriosis. So it goes hand in hand, right? So when you see one, you have to make sure you don't, you don't miss the other. They don't get diagnosed, they get dismissed. And then finally, they figure out that they need, they have no eggs or their quality is bad and they can't get pregnant. They go to these fertility clinics and they have to pay tens of thousands of dollars. It's so expensive. And no one can afford it. I've had patients, you guys, they come to me. They're like, we sold our home to pay and it didn't work. And let me tell you one thing I didn't cover, endometriosis has a sister diagnosis called adenomyosis, which is endometriosis. It's similar, sell similar to endometriosis in the wall of the uterus that can give heavy painful periods and those increase your risk of miscarriage. PMOS increases your risk of miscarriage because of that inflammation. So all of these, you need to pre-treat these patients before they go to get pregnant. Otherwise, a lot of fertility doctors who don't diagnose these patients correctly make an embryo. So these poor patients pay for it and they go to transfer it and then you take the things while you are pregnant. Like the metformin and the things that help you call me or you stop once you're pregnant. But the problem is endometriosis won't the inflammation come back and then that risk of miscarriage will come back. Let's talk about that. Let's talk about it. So it's very true. So for patients who have adenomyosis, the sister diagnosis endo, which you would know if I had that right. Yeah, I'm scared. And I have an IUD, which is sort of like these work great for that. But when these patients get pregnant or they want to go get pregnant, I always call the fertility doctor. I treat the uterus with lupron for a couple of months to calm down these glands, calm down the inflammation and then do the transfer. The other thing that I want patients to really understand because no one does it endometriosis is an autoimmune condition. When you have an autoimmune condition, you have a 33% chance of having another autoimmune condition. So when these patients are ready to get pregnant, I always run a full autoimmune panel on them to make sure because, for example, if you diagnose someone with protein C deficiency or antifusural lipid syndrome, you transfer that embryo and then their body attacks the pregnancy. These are patients who you have to put on blood thinners during pregnancy. But if you don't diagnose that, these patients bounce back with miscarriage after miscarriage. They come to me, they're like, I did five transfers with my IVF doctor and nothing worked. And I do an ortho sonoma, get an anomyosis. Let's do our immune work up. So I actually did a really good fertility podcast on GMD. I literally go through every bucket and I teach women who have tried for a year and they haven't gotten pregnant. Where to check? And you have to literally put a check in front of all those buckets. If you can't put a check in front of it, go back to your doctor and say, "Check me for this." Wow. So go get checked and freeze them eggs if you have to. If you can, freezing is important. But it's so expensive. I remember back in the day I wanted to do it, but it's like, "I can't afford this." It's like 10, 15,000. And then you've got to pay for storage. It's just like a really hard. There are some companies that I actually have a friend. They pay for her egg freezing. Google pays. All these big, amazing companies pay for their hard because they're really paying for these. But one thing, I mean, it's really sad. And you know, a lot of these patients, let me tell you one more trick to know. Whatever your number of AMHs. So AMH is a simple blood test. Most of the time, if you have an insurance, they will cover it. It's one poke. You know, they should check your hormones so you can add an AMH to it. Every point one of AMH is a follicle that the fertility doctor can pull the egg out of. So if your AMH is one, that means with the cycle of egg freezing, it's not set in some, but generalizing it, your doctor should be able to get 10 eggs out. I want 20 frozen eggs. If you're going to freeze eggs, I want 20. So that means I want an AMH of at least two when you're going for your egg freezing. So if you have an AMH, that's one, guess what? You're going to meet me and chances are I guarantee you have to go twice. twice, so the younger you are, the more you are. The higher the AMH, you do one cycle. But if your AMH goes to 0.5, you're going to need to do four cycles. So you have to pay four times 10 or four times 50 for the X freezing. Every month is a new charge. Think about it. And how expensive. Who can afford this when I want to know, I need to know my numbers are good. But for you, because of your endo and PMOS, I really want to take, I mean, I say it, I feel like a broken record, but we said this year, I know I love it. We said this year. So basically, I got tests, I've got a blood work, an extensive blood work. Not with you. This is with another like a longevity doctor. I was there when she was getting this and I was just getting my results. And she goes, oh my god, Victoria, so interesting. Your testosterone levels are of a 90 year old woman. She said 90 and she said, not nine, not 90. And I was like, oh, so basically I have no sex drive. So testosterone in the blood when it's low, it's not as significant as when it's high. And not all labs know how to run testosterone. See, that's not like, because I want to you, you're not sure that you're fine. Yes. You're fine. And the other thing is, if you're on birth control pills, if you're on birth control pills, it can lower your testosterone. If you're stressed, if you are on spinal act on all of that, will affect your testosterone levels. But if you are not using protection, okay, we can usually give testosterone cream. But yeah, but you told me you can't because if I get pregnant, it's a girl, she could have a little penis. Yes. Or she could be offered. You can't. Yes, you cannot be using testosterone if you're trying for pregnancy. For the same reason, you cannot use testosterone blockers or medications like Acutein or Spirinal Lactone when you're trying to find some natural things like your powder, OVV. You can do OV for pregnancy. If you have a PMOS, even if you're lean, remember I told you even lean patients are more likely to obviously, I still put them on metformin if they're not getting pregnant. So I start with OV for everyone. For lean patients, I leave them on OV. For regular patients, I double up their OV when they're trying for pregnancy. And then I add metformin, stop their GLPs, you cannot be on it when you're trying for pregnancy. And usually, but you know when you come to me, I've already checked you for autoimmune. I've done an ultrasound. I don't like surprises. I don't want you to come back to me after a year of not getting pregnant. And then I see that you have a polyp in your uterus. That's why the other thing that I want to make mandatory in this country is for women to get a pelvic ultrasound every year. It takes one minute to scan someone's pelvis. That's what you do for us every year, right? Every time, right? Every time. Every time. Every time. Yeah. I rather not do a pathway. I don't do that. I don't do that. Because the ultrasound, I can find if you have fibroids, if you have polyp, if you have cysts, if you have endometriolmas, India. Which, you know, I didn't know that that was not like a common thing. Like I didn't know that that was just something you did because obviously I've been seeing you for since I've been to the gynecologist. But I was, one of my friends had gone to the gynecologist and she was like, "Oh my God, it was so weird." Like, I've never been to the gynecologist and they like put the ultrasound up me and I was like, "What?" I'm like, "Every time I go, she does that." Absolutely. That's why, you know, I diagnose ovarian cancer almost always stage one because of pelvic ultrasound. Like women with septum, uterine septum, right? You don't know if you have it, but every time, if you're my new patient, you come and you're young. You have to do a 3D image of your cavity to make sure you don't have a septum. Like Haley Bieber discussed it on my podcast. We talked about urine septum. She had a septum. She had a, she had a small septum and she did fine with it, but patients with large septum, these are women who keep getting miscarriages and they don't know why. I've had patients come from fertility clinics with failed IVF and they have a large septum. You cut their septum, they get pregnant. You removed their polyps, they get pregnant. So basically, I wish we had a hundred clones of you in the public clinics where every meeting doctors. You know, they're amazing doctors out there, but generally speaking, women get dismissed and they don't care. They don't get the care they deserve. That is a fact. Do you have, like, for people who are looking for people, like do you have people that you know of that are good, like, where you share other doctors like around. I do. Like, if you, if you're in New York, you come, if I, if I know someone, I will. But if I don't, I don't randomly record it because, you know, you're only as good as your referral. Yeah. So it, you have to be very careful when you refer patients. So I have a very close, you know, for like in my network in LA, like I work with the best ophthalmologist, best GI doctor, best rheumatologist for pregnancy, best endocrinologist, best cancer surgeon. So I have, I've built a little, and most doctors hopefully have that, you know, these are all doctors who function at my caliber. And they don't dismiss my patients and, you know, the best neurologist, it doesn't matter who it is. I've found the best of the best. And over the years, I've tried to find the best of the best in other states, so I can refer patients. Yeah. Which is, which is crazy because when I broke my ankle, it was like two a.m. And I'm like, I don't know what to do. I text and call Dr. A, and I'm like, can you help me with this? And she put me with like, like you just know the best people for everything. And I'm like, everyone's like, why are you calling your gyno right now? Like she knows how I'm like, because she is going to make sure I'm good and like take care of me in all aspects of life, like you know everything, always, and you know what I always say you guys, well woman exam, for 90, some percent of women in this country is what? They get a pap smear. They get a quick breath exam. They maybe get an SDD check. They maybe get a birth control prescription. And maybe they get a mammogram order when they're 40 and off they go. That's not well woman. Yeah. You have to have a holistic approach to the patient from their anxiety, depression, bone health, cardiovascular risk, risk of dementia, fertility screening, PMOS, endometriosis, neck count, hormones, thyroid, metabolic dysfunction. You have to, when, you know, OB/GYNs we function as primary care for women. Most of our patients don't go anywhere else. So you don't want to miss. Yeah, I don't have a primary doctor. I mean either. Yeah, yeah. I don't know how many there. But that's what I want women to get. I want women to get a pelvic ultrasound. I want them to be screened for genetic cancer testing. I want every woman on the planet by age 30. Every woman needs to know her life than risk of breast cancer. If that number is above 20 they need to start breast imaging. There's no reason why a 34 year old should get stage 4 breast cancer and die from it. There's no reason, absolutely no reason for that. It's all preventable. Not all of it, but a lot of it is preventable. And you just have to, you just have to take their family history seriously. You have to do the correct testing for them. They need to know that these tests exist to this day doctors say, oh, you have a lump. I lost a friend of mine years ago. She was 39. She went to a doctor in Santa Monica. She had a lump in her breast. The doctor says you're too young for mammogram. Go come back in six months. She when came back in six months, she had stage 4 breast cancer. She lost her life three years later. And it could have been treated if she would have just done the mammogram six months earlier. I get a baseline mammogram. If you have no family history, I get a baseline at 35 and I want that needs to be done right now. Because right now it's like 40. But if your lifetime risk is 20% or more, not even 35, you have to go to 30. If you have a genetic mutation, I test everyone with family history, significant family history at 25 per genetic cancer testing. If you have a genetic mutation, let's say you have a check to mutation, bra, commutation, at 25, you start mammogram ultrasound and MRI. So every patient is different. You can't say, oh, everybody mammogram at 40, yeah. That's misleading. It's crazy. When I went from a mammogram, I was looked like a crazy person. They were like, why are you here? And I was like, I can't call the train. I heard like, just do it like listen, like, whatever. But they were like, oh, like, what are you doing here? Like, you're too young. Like doctors orders, like, let's just do it. But they were like, they looked at me like I was crazy. Olivia Munn, she talked publicly about her story. She had a negative mammogram negative ultrasound. Her lifetime risk was high because I calculated it. And I was like, Olivia, you need to go get an MRI. And then she called me. She said, my doctor friends are saying, why is your doctor paranoid? I don't need an MRI. I'm like, your lifetime risk is high. You need mammogram ultrasound and MRI. She said, okay, she went and did MRI. She had bilateral breast cancer, the most aggressive cancer, multiple location in her right and one on the left, completely missed on mammogram and ultrasound. That MRI saved her life. She removed her. She removed her breast. She's going to have a normal healthy life for the rest of the world. Wow. That's quite different. How does the mammogram miss that? The most common breast cancers are ductal cancers. They come from the ducts of the breast. They just get picked up really easily on mammograms and their calcifications show up. But the second most common type is lobular breast cancer. tend to spread and the mammograms tend to miss it. MRIs pick those up. So for high risk patients, you wanna add, first of all, 50% of women have dense breast tissue. So if you have dense breast tissue, women need to have a 3D mammogram. In addition to mammogram, they need to do an ultrasound. And if their lifetime risk is high six months later, they need to do a breast MRI. If they have family history, they need genetic cancer testing. You guys, this is like, this is basic though. - Yeah, but it's not basic. - But it's not basic. Because a lot of people don't get that. - Don't know about it. - And doctor don't do all this stuff. - But it should be standard of care. It should be like, okay, let's make sure that you're like all good. And you're gonna live like along healthy life. - We need to lift standard of care for women. - I agree. - Like lift it. Raise it up. - Raise it up. That's crazy. - Wow. - I wanted to ask you, what is a daily life? A daily day in your life looks like. - A day in your life. What does it look like? Because are you, is it crazy? The uncertainty of your schedule? Like someone could give birth at 2 a.m. And do you, like, how does that work? How does it look for you? - So, first of all, I've done it 30 years and I've done 9,000 deliveries. So I'm pretty good at predicting 9,000 deliveries. - 9,000 more between 8,500 to 9,000. - That's crazy. - And I have it down to a science. - Right. - I know exactly what they're gonna do. - And you know a lot of my patients. - It's like I know. - And I have a nurse, nurse Miranda. I don't know. Well, you guys don't know. Once you get pregnant, you get to know. - Yeah. - Kylie, that's her, but she's amazing. And she stays with my patients in labor. So I have a good handle on my pregnant patients. A day in my life, I want to start Kylie's question of how I do it all. I want to say I literally do it all because I have the nicest husband on the planet. I've been with him 35 years. He's my first boyfriend. We met at Berkeley. This guy is everything to me. The way he treats me, the minute I walk into my house, I'm a queen and has nothing. If you see him, you're gonna think we met yesterday. - He's the sweetest human. So I'm able to do what I do because of him. Because you know, people take drink alcohol and you Xanax and I call him my Xanax. Like he calms my nervous system down. I mean, I'm always like, even when we watch movies, we're like stuck together. Like my kids are like, can I sit with you? I'm like, no, I'm not with that. (laughing) - So that's why I have four amazing daughters. So they're my support system. Today my makeup artist didn't show up. My daughter on my 20 year old step thin and did my makeup. Like that's the kind of support I have. But the day in my life is a lot of love for my family. I will always start and I hope that every woman on this planet has the chance to experience a love like this. If you haven't found it, I would say wait for it. - Don't settle. - Don't settle because you wanna wake up every single morning. When I open my eyes and I see his face, I'm like, I'm so lucky, he's the nicest guy in the world. He really is the night, not because he's my husband. He's just a nicest human and I got so lucky. So I start there. That gives me a lot of energy and calmness in my life. I usually wake up around 6 a.m. Three times a week, I exercise with my trainer in the morning, coffee, shout out to him. He's amazing. I do weight training exercises with him. Once a week on Sundays, I do yoga with my Kundalini yoga teacher who's in Cannes, South of France. I do it on Zoom, her name is Ashika. I should do it. She grounds me 9 a.m. on Sundays. - Let's do a group Zoom. - Can we join the Zoom? - Yeah, you can join any Sunday. If you wake up in your house, it's so good. She plays the nicest music and she grounds me literally. I do that with her with Ashika every Sunday. And then, what else do I do? I wake up, if I have to exercise, I exercise on Fridays, I operate all day, line up of hysterectomies and endometriosis patients every Friday. I do that. And then. - Are you in the office every day? - I take my GMD podcast usually on Tuesdays. This week is a little different. I usually tape on Tuesday, so I do a lot of my podcasts on Tuesday. I'm in the office on Monday, Wednesday and Thursdays, and I usually stay on, I get there around 8.30 after I exercise and do everything. And I leave about 6.30, I have long days, and I usually take a five-minute lunch, so I'm seeing patients a lot. It's getting hard for me. I used to do 80 deliveries a month, now I'm 55, so it's harder for me to do all that. And so I see patients three days a week, I operate on Fridays, and I go home, and usually we have, it's summertime, so my girls have two at Stanford, so they're all at home. My little one, Coco, who's adopted is five and a half. It's a little challenging to have a five-and-a-half-year-old at 55. - Wow, that's a five-and-a-half-year-old number. - Wow, I remember when you adopted her. - She looks like you, just the blue side. - I knew this week. - The white skin, she looks like her mini-meet. She could totally be your little daughter. So she keeps us busy, and then I have my beautiful 14-year-old. So right now, all four of them are at home. We always do movie nights at night. We have dinner together. One thing we do as a family, we always have dinner together since they were little, which I think is very important. - Yeah, I think it is. - You learn a lot about your children, and my two daughters are now working on a project for Women's Health that will change women's health around her. - Really? Are these the ones that are in Stanford? - Yeah. - Well, are they studying to be like you? - They're studying bioengineering. They're not gonna go to medical school, because I told them instead of becoming a doctor like me and helping thousands of patients, do something that you can change the life for millions and millions of women. That would be better, and that's what they're doing. And I think they're gonna be extremely successful. - Wow. - I'll be a client. - I'll be a customer. - Yeah. - Wow. - That's amazing. - That's beautiful. - Thank you so much. - Love you guys. - Thank you so much. - So nice and helpful, and I think everyone listening will appreciate it on me or something. - And you guys, if you have any questions, leave them down below, because we are gonna go on Dr. A's podcast, and then we can bring some of your questions to her. - Absolutely. - My pleasure. - Thank you. - And love you guys. - Thank you for sharing your mic with me. - No, for something like you. - We need an expert to shine some light. - We started talking, but I'm like, no, no, no, no, no, we need Dr. A on here. - What do we do? - We don't know what we're saying. - But it's sexy, it's sexy to be educated, and it's sexy to be on top of your health and get your exam done with your body. - Yes. - Bravo. - Yeah. - It's sexy. - Mic drop. - Guys, we'll see you next week. Like, comment, subscribe. - Bye. - And where can they find you, Dr. A? - For the sake of this podcast, GMD podcast, educate, listen to every episode, you learn a lot, and if you think you have PMOS or if you have someone around you with an eating disorder, someone struggling with their weight, with acne, hair loss, facial hair body, hair anxiety, go on ovii.com, ov.com, and take the quiz. And, you know, have the most amazing supplement. I did it for you guys. I do all of this for you, and I hope to see a world where women will not get dismissed. - Yeah. - Yes. Amen to that. - Love you guys. - Bye. - If you're a bookshelf and you're a four-year page are equally important to your personality, welcome home. - Yeah, I'm obsessed, I'm obsessed. - Listen to pro society on the iHeartRadio app, Apple podcasts, or wherever you get your podcasts. - I survived nine months in captivity, and I've spent my life exploring how other people survive what should have destroyed them. - And Sean Clements. - We host the podcast, Hollywood Handbook. - Each week we talk to someone in show business and try to help them with their careers and see what they have to offer us. - We've had a lot of great guests like Sarah Sherman, Adam Scott, Danny McBride, Ben Stillert, and a lot of other big shots that wouldn't be where they are without us. Listen to Hollywood Handbook on the iHeartRadio app, Apple podcasts, or wherever you get your podcasts. I can wait four hours for the next bus, or this random dude is offering me a ride on his motorcycle. I choose option B. I'm Julie Beniero, and I travel by myself because it's a rare space where I can say yes without asking anyone else first. 90 miles northeast of Nashville, a battle for the future of America, plays out in one small town. This is our town. Listen to our town on the iHeartRadio app, Apple Podcasts or wherever you get your podcasts.