Off The Vine with Kaitlyn Bristowe - Painful Periods Are Not Normal with Dr. Thaïs Aliabadi

Episode Date: November 21, 2023

Ladies, this is an important conversation! Dr. Thaïs Aliabadi, board-certified OB/GYN, joins Kaitlyn to educate and empower women to advocate for their health. For far too long, women have been dismissed in the doctor’s office with significant health concerns going undiagnosed. And, you know what? Enough is enough! Are you experiencing irregular periods? Do you have acne? Do you have male pattern hair loss? Well, you could have PCOS (polycystic ovary syndrome). Dr. Aliabadi explains what PCOS is, how to self-diagnose, and shares steps to manage symptoms. She also sheds light on another commonly undiagnosed disease affecting fertility—endometriosis. Knowledge is power; remember, painful periods are NOT normal, and you’re not alone. To learn more, go to @TryTrimly on Instagram. Thank you to our sponsors! Check out these deals for the Vinos: QUINCE — Go to Quince.com/vine for free shipping on your order and 365-day returns. PROGRESSIVE — Try the Name Your Price® tool at Progressive.com. SKIMS — The SKIMS Holiday Gift Shop is now open at SKIMS.com. Plus, get free shipping on orders over $75. See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Okay, let's talk about the original enemies to lovers story. Before all of our reality TV couples, before the rom-coms, we binge, there was Elizabeth Bennett and Mr. Darcy in pride and prejudice. An Audible has just dropped a brand new original that will have you completely hooked, I am. It's not just any audiobook. This is a full cast performance. So Marisa Abella, you might know her from industry, brings Elizabeth Bennett to life.

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So whether it's your first time experiencing Pride and Prejudice or you've read it a million times, you're going to fall absolutely in love all over again. So go listen to Pride and Prejudice now at audible.ca slash Jane Austen. All right, ladies, this is a very important episode for all of us because we have Dr. Alia Badi on and she is a force. She is board certified OBGYN and is here to educate us on our bodies to help us advocate for our own health. As women, I think we get dismissed. Actually, she said it. She's an OBGYN. She's brilliant.

We get dismissed all of the time, all of our feelings, our symptoms, and enough is enough. So my hope is that you can gain confidence and validation from this knowledge to be able to diagnose yourself and advocate for yourself in the doctor's office because knowledge is power and you're not alone. Do you live here? From where, though? I'm Persian. I was born in Iran. I came here when I was 17. Oh, wow. And then got into, like, started going to education and... I went to the last year of high school because I didn't speak English. So I didn't apply to college, obviously, because I came here literally six months before graduation. Okay. And then I went to Foothill College. And from Foothill College, I transferred to Berkeley after two years. Graduated at top of my class at Berkeley.

Wow. Applied to medical school, but because my English was still so weak, I took the MCAC. and the verbal reasoning, the English part of it, when I was halfway into it, they're like, time's up. I was like, what? So I started bubbling all bees. And of course, I got, I remember I got six. I think it was out of 15 for medical school. That's a big no-no.

Yeah, yeah. And even though I was top of my grade at Berkeley, they told me you're not going to be able to keep up with the readings in medical school. So I went into a graduate program. you would take classes with medical students at Georgetown. I kicked everyone's butt in that program. Hell yeah. That's awesome.

Out of 110, they took 14 of us, and I was third in my class. Wow. Yeah. So once I got in, I was able to skip the first year. So I just tutored the medical students, and then that's how I got into medical school. Oh, my gosh. And you've dedicated a lot of your work to PCOS, which is so important because so many people have it and probably either don't know or know.

or someone said that you could see it from like a mile away if someone has PCOS. How can you tell? Or could you go up to people all the time? You do? All day long. Where did I do it? I did it, I think, three days ago. I do it all the time.

Do I have it? I don't know. With you, it's difficult. But certain patients that have the clinical features of it, like if I see an older person with male pattern hair loss, they're slightly overweight or overweight, if they have acne on their face, if they're women and they have facial hair.

Yeah. Sometimes I go up to them. I'm like, I'm really sorry, but can I ask you a question? I'm a gynecologist. They're like, yeah. I'm like, do you have irregular periods? They're like, how did you know? No way. You're like, I'm a doctor and a medium. Oh, my gosh. So it's honestly, it's this, once we're done with this podcast, you're going to walk around and identify patients on the street. Really? You're not going to be able to identify every single patient because they're skinny PCOS patients. But I always say if you see a 30-year-old with acne covering their face, you better. suspect PCOS. I mean, that's probably hormonal, which obviously means there's something. Can you explain what PCOS is and how it affects women's health? PCOS polycystic ovarian syndrome

is a hormonal imbalance that affects women in the reproductive age. It affects 15% of women in the reproductive age. I think that number is so much higher, but that's what the studies show. And partly the reason is because 75% of PCOS patients don't get diagnosed. So think about it. 95% are not diagnosed, and of the ones who are diagnosed, the doctors don't know how to treat these patients. So it's really sad. It's been my mission for many years, but I think I'm finally getting it out there through my patients. Yes. You know, because I don't have a voice, but my patients do. As I talk about it and I educate my patients, they do stories on it, and then their followers learn about it. So I feel like I have been able to bring awareness to this. And now you're on a podcast about it. That's why. And honestly, it's so hard for me to come to these podcasts.

But I do it because I'm busy. I don't have a patient in labor right now. I'm booked and busy. I thought you were going to be like, I'm shy. No, no, not at all. Yeah, you literally, one of your clients is in labor right now. In labor right now. I got home at 11 p.m. last night.

I have a little bit of a headache right now, but I still take the time to come. Thank you. Because if I can change one person's life, and I want to do it. I appreciate that. I know it's hard to squeeze things in when you're that busy, but thank you for doing this. I do have PCOS. Okay. I was going to ask you, though, because.

Is there like a scale? Like somebody could have really bad PCOS, somebody could have like minor PCOS. Absolutely. Let's go back to what PCOS is so everyone can understand it. Yes. So it's a hormonal imbalance, right? You need to have two out of the three criteria to get the diagnosis. Okay.

Number one is history of irregular periods. Number two is PCOS looking ovaries on ultrasound. Polys cystic doesn't mean you have these giant cysts on the ultrasound. It's a specific look of the ovaries on ultrasound. should change the name because not all PCOS patients have PCOS looking ovaries on ultrasound, and polycystic is not cyst. People get a confused with big cyst. These are fluid-filled sacks that there are multiple, I call it filling defects or sac of pearls in the over. It's a very specific finding on ultrasound. But you have to be experienced to look at it and diagnose someone

with it. So that's number two, polysistic looking ovaries on ultrasound. And number three is elevated testosterone symptoms. You don't have to have a high testosterone in the blood to get the diagnosis. I'm going to repeat myself. You don't need a blood test to diagnose PCOS. If you have elevated testosterone, great. But if you don't have it, that doesn't mean you don't have it. I still get patients who say, my doctor said, I don't have it because my hormones are normal. False. Right. It's not one of the criteria. What are elevated testosterone symptoms? Male pattern hair loss, right up front, facial hair, body hair, acne, body acne. So if you, and you don't have to have all of it.

There's a PCOS patient that has hair loss and other patient suffers from acne. It's, if you have one of the elevated testosterone symptoms and you have PCOS looking ovaries or irregular periods, then you get the diagnosis. Okay. PCOS patients tend to be moody. They usually suffer, you know, a lot of them suffer from anxiety and depression. Yeah. Mood disorder is definitely part of it.

A majority of them have insulin resistance, so they tend to gain weight. They go to the doctor, and the doctor says, well, don't eat as much. They're not overeating. So stop telling PCOS patients not to overeat. They're not overeating. They just can't process the food like someone else does. So weight gain is another part of it. Eating disorder, very common.

It breaks my heart when I see teenagers with PCOS who have an eating disorder and their PCOS is the underlying condition, but it gets dismissed. These are teenagers who eat exactly what their skinny friends are eating, but they gain weight, they have acne, they already have the mood disorder. So you put mood disorder plus weight gain, it equals to eating disorder. I would probably have an eating disorder too if people dismiss me. That's one of my biggest mission in life is to diagnose these little girls that are suffering. I had a very good friend of mine.

Her daughter lost 60 pounds with me once I fixed her hormones. So do you know what I'm saying? she's living her best life right now. You know, people go down the wrong path because of that frustration. Absolutely. All they hear from their doctor is, well, eat less. It's not eating less. They need their hormones checked.

They need their insulin resistance fixed. So eating disorder is also part of it. And the last aspect of PCOS is infertility. Yeah. So PCOS patients in general tend to have a lot of eggs. but as they get older, the quality of the eggs go down. But I want you to know that. No, I want to know it.

I'd rather have you get upset and cry right now but do the right thing than not do it. I know that. Like, that's why I obviously did freeze my eggs. Everybody knows that I did on this podcast, and I want to do it again. So I'm going to do that blood work. So with PCOS, you know, and you say you treat people, how do you treat it? So it depends. So you look at their symptoms and you treat their symptoms, right?

They're skinny PCOS patients that don't have weight issues, but they have acne issue. They have hair loss issues. So you identify what the problem is and you fix it. There are multiple medications. You do a blood test. You do an ultrasound on them. But at the end of the day, you're treating their symptoms. PCOS is not a condition that you just can erase.

It doesn't go away. Right. But you can absolutely manage the symptoms. And by fixing, especially when you help them lose their weight, clear their skin, stop their hair, their confidence comes back. Every single patient that I diagnose starts crying in my office because they've been dismissed for so many years. They feel heard finally.

Yes. Yes, that's exactly what they say. And it's so sad. Sometimes I do cry with them because sometimes they come to my office when they're in their late 30s. They already have almost no hair on their heads. They've struggled with obesity. They're already very depressed.

No self-esteem, no partner. And in my heart, I'm like, oh, my God, if I had met her at 20, you would have had a completely different life. I get severe male pattern hair growth. So I'm on spirolactone. Good. What dose are you taking? I take 75 milligrams.

Once a day. Once a day. Is it helping? Yes. Good. Perfect. Oh my gosh. It helps so much.

But I still have really, like I have extensions in right now, but I do, I have really fine hair that feels like it's thinning. And I don't know if that's. So there are other medications you can take? I take Nutrafol, which has made a difference. Yes, but you can also add monoxidil to it. You can do the rogene solution on your head, or you can take menoxidil as long as you're not actively trying to get pregnant. Okay.

As you know, you can't be on spirinalactone if you're trying to get pregnant. Right. So a lot of these medications you have to come off of, but while you're not trying, you should absolutely do it. So once you come off of those medications, do the symptoms come back? Yes. Oh. Yes, unfortunately. So like, when I stopped taking it.

in the spirolactone, it's going to just come back. If you have androgen sensitivity or your testosterone are high, as you're suppressing it, it'll suppress your symptoms. But as you take off that suppression, the levels start going up. Right. It can absolutely affect the symptoms again. Dang. But as you said, people sit on the spectrum of PCO. Some patients have very mild symptoms. Some patients have very severe symptoms. Some patients with mild symptoms have elevated testosterone. Some people with Severe symptoms have normal or upper range of normal testosterone in their blood. So there's a large spectrum of patients. But the key is to know that, first of all, we can fix the symptoms.

And number two, the fertility aspect of it is huge because these patients go to the doctor. The doctor does an ultrasound. They're like, oh, my God, you have so many eggs. If you have so many eggs, you should worry about the quality sometimes. You have to make sure we're not missing PCOS. I spoke to a fertility doctor last year, and I said, when do you send your PCOS patients for egg freezing? He said, you know, by 32 latest 34. And I was like, what about your daughter?

If you had a daughter with PCOS, when would you freeze her egg? You know what he said? 28. So I said, why would you treat your patients different than your daughter? And he said, because I don't want to be pushy because they're going to think I'm trying to sell it. But no, this is not you have to educate patients. I would freeze my daughter's egg at 25 if she had PCOS. But here's the problem.

When you're young and you have good quality eggs and the count is good, patients can't afford it. Egg freezing is not covered by insurance. Yeah, it's so expensive. It's so expensive and it's so unfair. When they're 40 and they can afford it, nobody wants to freeze their eggs anymore. So true. So until we have to work together, insurance companies have to freeze, have to pay for egg freezing at least for patients who are diagnosed with endometriosis,

PCOS or other conditions, premature menopause. There's so many reasons. This is a medical condition. But until we bring awareness to it, everyone, including insurance companies, will deny all treatment. I have heard of some companies starting to do it. I think Lulu Lemon is a lot of companies do.

A lot of, okay, good. I have written down, doctors offices and doctors in general can be so intimidating sometimes. And we said it earlier, how we always have to, like, prove ourselves almost or ask more questions, but we don't know the questions to ask and we don't know. So I wanted this podcast to be really educational for women who go into the doctor and they want to advocate for themselves and say, okay, I have

this symptom and then ask the right questions. So if someone might have PCOS, what questions should they ask the doctor going in? So here's the thing. I don't want them to ask the doctor any questions. Okay. I want them to diagnose themselves at home right now as I'm talking to them. Okay. Okay. And once they know, they meet the criteria for PCOS, they're going to call their doctor and they're going to say, do you treat PCOS? And if they say no, then they better look for someone who's experienced enough to treat them. The reason I started my online platform was not to help people lose weight. I'm not in the weight loss business. My passion has always been polycystic ovarian syndrome. Yeah. But over the years, I learned that if I say if you have acne, I

can help. People don't show up, but if you say I can drop your weight, they're going to show up, and then I'm going to say, wait a minute, I'm going to help you drop your weight, but you have polycystic ovarian syndrome, and that's exactly what we've been doing at Trimley, which is life-changing. Remember, you have to figure out the underlying condition. Otherwise, you drop these patients' weight, but you're still not helping them, right? They still have the acne. They still have the hair loss. They still have the fertility issue. You need to educate these patients. So if you're sitting at home, And you're wondering if you have PCOS, I'm telling you, you need two out of three, one irregular periods, two elevated testosterone symptoms, like acne, hair, loss, facial, hair, body, hair, body acne. You need to have one, not all of it.

Or PCOS looking ovaries on ultrasound. If you have two out of three, your diagnosis is there. Okay. So it's more about going in with the confidence of saying, yeah, okay, I've got this. Okay. And then it's, and then it's, you're able to balance hormones and do certain things to help. Absolutely. We can help them. Talk to me about Ozympic because it's obviously such a buzzword and buzz thing that's going on in the world right now, but does it help with PCOS? It does. Okay. So, you know, studies say anywhere from 38% to 88% of PCOS patients suffer from obesity. Wow. Close your eyes and think of that number of women. Can you say it again?

38 to 88% of PCOS patients are obese. Women in general get dismissed when they go to the doctor. If PCOS, I don't want to be, I don't want to sound crazy or a feminist, but I am deep in my heart. I love it. Because I've treated women for 30 years. Yeah. As women, we get dismissed. My breast cancer was getting dismissed.

If I did not have an MD in front of my name, I would have been on chemo right now. Wow. I had to fight every step of the way for my own health. women get dismissed. We need to be our own advocate. My job, what I do with my patients, I get Kaiser patients that I'm not a Kaiser doctor. My visit is not covered. Do you know what I'm saying?

But these patients come. I teach them what they have. They become their own advocate. One of them came to me and she's like, doctor, I went to my doctor at Kaiser. I sat her down and I said, this is my condition. I have PCOS. These are the medications I need. I need this because of this.

I need this because of this. And she said, my doctor was just sitting there with her jaw open. And she's like, okay, I'm going to write for all these medications for you. That's what we need to do. We need to empower women to be their own advocate. If something doesn't sound right, if you know in your heart something's not wrong, you have PCOS. I'm already telling you how to diagnose yourself at home. And you go to your doctor and your doctor is dismissing you.

Walk out and find another doctor who will get you help. Why is it? Why are we so dismissed? I don't know. You know, I always say if men had periods and had endometriosis and painful periods, guess what? It would be a national holiday once. Or there would be a solution immediately. No, no.

They would get a week off work. Do you know what I'm saying? Because they're on their period. But for us, it's like, don't complain. Come to work. We don't want to talk about it. If you have painful periods, don't worry about it. You're being dramatic.

I've gone to meetings with men when I'm the only woman and when I walk in, and this is as of four years, ago, one of the men looked at me, he's like, I hope you're not PMSing today. That makes me go, re, re, re, I like, want to go, that's crazy. This is four years ago. I'm an OBGYN. I'm extremely confident. Yeah. Do you know what I'm saying?

But that's the problem right now we have in the world. And I'm not here. I love my husband. I have the nicest husband on the planet. He's a symbol of a guy. He's such a gentleman. But until men and women are equal, yeah. we're not going to get out of this situation, but we need to be our own advocates, right?

And I think the reason PCOS is not diagnosed is PCOS patients are complicated, right? I spent 45 minutes with my new PCOS patients. You have to educate them. That education takes time, right? So what happens? Doctors have five minutes to see you. They're not getting reimbursed. They're getting $70 to see a patient. You can't expect them to want. I mean, it's not fair to them either to spend. all this time on a patient when they can see 10 other patients. So until we just need to be our own advocate. And that's with endometriosis. It's with breast cancer.

It's with painful periods. It's with PCOs. It's with everything that affects us. So as women, we need to stick together and help one another. Gosh, it feels like, I think they said it on the podcast and I heard it on the Barbie movie, but they're like women hate women and men hate women. It feels like we need to advocate for each other. But, yeah, like, for example, I have anxiety and I have hormones.

hormonal depression. So if I am PMSing, I am depressed. Like I go dark sometimes. And I share a lot on social media and I shouldn't go shopping for pain and reading comments. But people call me like a train wreck all the time when I'm really just trying to like either talk about PCOS or talk about how hormonal I can get or like I go through hard times. I have anxiety. And I share. I like to use my platform to share. And I get called crazy and a train wreck. and messy and... So, can I be a mom to you for a second? Please.

First of all, the reason we love you, the reason I'm here sitting with you is because you and I share the same passion to help women. So I admire that about you, but just know, and that's what I tell my daughters, and I have a lot of them at home. You do? I do. I have three, and I'm adopting one. So four daughters.

I always tell them, when someone says something hurtful, don't take it personal. they're hurting themselves so when someone is calling you mean don't take it personal her heart is hurting so i always that's the first thing i learned as a physician when you have an angry patient that comes in it has nothing to do with me right she doesn't even know me if she's upset i never take it personal so you should do the same what you're doing is amazing this podcast will help i don't know how many followers you have but whoever is listening yeah it will really help these girls so you just have to do the right thing and not worry about people who are hurting at home. The girl who's giving you a negative comment, God knows what's happening to her at home.

Let it go. She probably had a rough childhood. She's probably in a rough situation right now. And they are projecting. So don't take it personal. I've heard that so many times for some reason why the way you said it to me just really resonated. Like I know what you're saying and other people told me that too, but for some reason that

really resonated. So thank you. Oh, I was at a party and this mom was really talking bad about these kids at school who are not inviting her daughter and that they're mean and they're this. And I had to say something. I'm like, listen, these are children. And if a mean bully shows up to school in sixth grade, you have to worry about her. The first thing you have to think is that she's being bullied at home. If she's pushing, she's being pushed at home.

So don't take it personal. So true. It'll make life so much easier. I did read that book, The Four Agreements, and one of them is to not take anything personal, and it's so simple and so hard at the same time. Ozmpic. We never talked about it.

Oh, yeah, let's go back to that. How did we get that? I don't know. Because I just started bitching about trolls. Yeah, how does Ozempic help? That's what I was telling you. 38 to 88% of women who have PCOS suffer from obesity. Yes.

Obesity in PCOS mostly comes from insulin resistance, right? insulin resistance mean when we eat sugar right our body breaks it down into glucose glucose stimulates our pancreas to release a hormone called insulin to put it in simple terms insulin opens up the receptors on the surface of the cell grabs the sugar puts the sugar into the cell where it turns into energy this is what's supposed to happen yeah PCOS patients can have insulin resistance when they eat sugar and their insulin gets secreted the receptors are insulin resistant. They don't open up. So sugar stays in the blood. And as the sugar goes up, our insulin can go up. High insulin is the enemy. Insulin is a fat storage hormone. So it

stimulates our body to clear that sugar and store it as fat. That's the simplest way I can explain it. Yeah. People can understand it. So insulin resistant patients don't use their sugar the way they should, and they tend to store that sugar as fat. That's why if they eat, I always say if you, eat one slice of pizza, they can gain weight, but their skinny friends eat the entire pizza, and she's in her skinny jeans the next day. And that's how they get frustrated. So OZMPIC, and not just OZMPIC, by the way, I feel like OZMPIC blew up in this country because so many of my patients lost weight on it. I've been using these meds for my PCOS patients since 2014. Oh, wow. This is not something new. I started using Trilicity, then I started using Victosa, I started with Saxenda, then I switched to

Ozmpic, then Wagovi, then now Mungaro. All of these medications are in the same family, right? But the way they work, they regulate our insulin, so it helps with the PCOS patients. It basically, they cause delayed gastric emptying, so we feel full. It also shuts down our appetite, so people don't eat as much. A lot of patients, whether you're depressed or you have insulin resistance, patients tend to snack, so these patients are not eating as much. So their intake goes down so they start losing weight.

Right. But I want PCOS patients who are suffering from obesity or if they're overweight to understand. These medications will help them lose the weight, but we're not addressing the underlying condition. That's why you hear on the news or on these blogs that you have to be on these medications for life. That's true for some patients, but not all patients. If you diagnose these patients and treat their underlying condition, once you get them, to their goal, you can take them off of these medications. Not all patients need to stay on it. So once you take them off, has the body kind of learned how to take the sugar and I don't

know the terms, but like, no, insulin resistance is an issue. Medformin helps this patients a lot if you diagnose them correctly and give them metformin. Like I said, you can treat their other symptoms, but you have to remember, I have hundreds and hundreds and hundreds of patients that have treated with PCOS, that once they lose their weight, they become so confident, they start exercising, they eat healthier. That teenage girl who lost 60 pounds, I didn't use these meds on her. She never used Ozzympic or Wagovi. She lost 60 pounds, but she's so, she's a different person. And what she told me a year later, she's like, I didn't know I had an underlying condition. I didn't know that I had insulin resistance. Now that I know what it is, I don't eat

those types of foods. Right. And she exercises, she looks amazing. So that's why education is, you know, knowledge is power. Oh my gosh. And you are a ball of knowledge. Like, it's so cool. I don't know if it's knowledge or his passion.

Well, both probably. I can feel the passion from you, but also I'm like hanging on to everywhere because I'm like, wow, you are so smart. What happens if you go undiagnosed with PCOS? Like if you don't go in and find the right doctor, have the confidence to go in, what happens for patients who are overweight and obese, they end up becoming diabetic. They have high cholesterol, heart disease. The list goes on gallbladder disease. And infertility. There's, I think, 263 diseases that are associated with obesity. 263. That's crazy. Right? So it's important

to diagnose them, but also the fertility aspect of it. I always tell my PCOS patients or endometriosis patients, the top two causes of infertility on the planet, that I can help you with everything. The only thing I can't help you with is your egg count and your egg quality. I had an 18 year old in my office yesterday whose egg count is the same as a 35 year old. Had she been not my patient, she would have probably not had any eggs by 30. Wow. Because of endometriosis. And one thing I want you to understand, and I don't know if you have this issue, but a good percentage of PCOS patients also suffer from endometriosis. So they do have painful periods. I have extremely painful periods.

You need to come to me. Like I see stars and I black out sometimes because the pain is so bad. Not every time, but like quite a few times. People listening to me. Yeah. Do you know for my birthday, I wanted a billboard on the 405. I wasn't able to get it. But I wanted the billboard to say painful periods are not normal.

Yeah. hashtag endometriosis. And then I went home and my daughter said, okay, mom. So now they think they have endometriosis. Now what? doctors are going to dismiss them, right? They're going to get, why do you think there's an opioid crisis? Crisis in this country. Yeah.

These poor patients, they go to the doctor and they're complain, complain, complain, and finally someone gives them Vicodin. The next doctor is like, oh, she's a drug seeker. Yeah. That's why she's here. No, she's not a drug seeker. Painful periods, periods can be excruciating with endometriosis patients. These patients get dismissed all the time.

So I think maybe 40% of PCOS patients suffer from endometriosis. And it takes doctors nine to 11 years to diagnose endometriosis. Average age of diagnosis is 32. Majority of them go undiagnosed. Do you know what I'm saying? You know what I want? I want a megaphone. And I want to go in every little girl's room with my megaphone and say, listen, are you 18?

Do you have painful periods? Do you have irregular periods? Do you have this? Do you have that? Here's what you need to do. Yeah. Because, yeah, we are. Why have we gone through?

many years of our lives just thinking like this is, well, it must be what happens. This is just how periods are. Because it's us, right? Oh, you're being dramatic. Oh, I had painful periods too. Yeah, you, or the moms usually say, I had painful periods. I know, but you also had your first child at 20. So endometriosis didn't have a chance to destroy your eggs and your ovaries. Yeah. More and more women are getting pregnant in their mid-30s. Endometriosis and PCOS catches up with you in your mid-30s. Is endometriosis curable? Suppressable. Okay. There's no cure. So endometriosis is when the cells inside the uterus, endometrials cells, cell similar to that are around the tubes and ovaries on the outside.

And once a month when our uterine lining breaks down, the easiest way I can describe it is our ovaries are trying to get us pregnant, right? So they secrete a hormone. The lining inside the uterus gets thick and juicy ready for pregnancy. When we don't get pregnant, the lining breaks down and comes up. out. 10% of women on the planet have these cells around their tubes and ovaries, similar cells. So when the ovaries are secreting hormones, these cells get stimulated. And when we don't get pregnant and our lining breaks down and comes out as a form of period. These cells on the outside also bleed. I have videos of it. I'll show you before I leave. Blood is an irritant to the pelvis.

It causes pain. It causes bloating. It causes painful sex eventually. It causes scarring in our pelvis and eventually because these women get dismissed their egg count goes down so think of a PCOS patient that has a lot of eggs right but the quality slowly goes down yeah if they also have endometriosis then their endometriosis that's going on controlled starts killing the eggs so their egg count and quality also starts going down with the endo that's why it's so important to do the egg count and see where these patients are yeah god is real that you have three daughters four daughters right I wish I could have been here

I mean I love my mom but like I you know you're you're gonna help them so much oh my girls my daughter came home when she was 16 she was in water polo she's like mom my coach was doubled over in pain and she couldn't function I'm like so what'd you do she's like I went up to her

I'm a coach are you okay and she's like yeah yeah I'm on my period so my daughter bends down and whispers in her ear she's like I think you have endometriosis you need to go see a doctor. I love it because they're going to be a voice for it too. All my patients are. Yeah. All my patients are. Okay, so I talked about this earlier by personally experienced hair growth and terrible menstrual cycles.

But so is that the hair growth? Is that the testosterone? Yes. It could be from high testosterone or androgen sensitivity. So you can have normal testosterone, but your body is just sensitive to the amount of Androgens that you're making. And then the spear lactone is the one that's going to help with that. Bravo. Birth control pills can help patients. Medformin can help. But that's why you have to figure out what symptoms patients have, what underlying conditions

they have, and then fix it. Why am I so scared to go on birth control? I don't want to be mean. I'm not going to say it. Say it. I was going to say it's lack of knowledge. Lack of education about it. That makes sense.

Because, you know, I was listening to this guy on Instagram saying birth control is dangerous. You shouldn't go on it. Right. My heart sank for all those endometriosis patients that I'm treating with birth control. So these endometriosis implants grow with estrogen and we can slow down their growth with progesterone. How can you give a young girl progesterone? Birth control pill.

You can pick a low-dose combination birth control pill or give them a progesterone-only birth control or a progesterone IUD. And here's this guy telling patients birth control is dangerous. My heart sank. I'm like, oh, my God, all these endometriosis patients that their pain is controlled, they're saving their fertility because they're on birth control. listen to this guy, they're going to come off of it. That's why, you know.

That's what I did. I got scared. Yeah. Because I'm not educated. It's not your fault, though. You don't have an MD in front of your name. But that's why it's good to know that if you have painful periods, that's not normal. If you already have the diagnosis of PCOS and you have painful period, chances of you have

an ametheosis. And when you go to try on your own to get pregnant, don't get disappointed if you're not getting pregnant because when you have that much inflammation in your pelvis, it makes it hard for you to get pregnant. Every time I see a doctor, if I call the doctor a fertility doctor, and I see I have a PCOS patient or have an endop patient, they know these poor patients need them. They have to pay tens of thousands of dollars to get pregnant. I always say if you sent every 20-year-old to my office one time, I don't need to see them again, one time at age 20, I'll diagnose them, I'll tell them what they need to do, and they will never end up in the hands of the fertility

doctors. Damn, I wish I, you need a megaphone. I don't have a single patient like you who walks around with painful periods. Gosh. So you would recommend going on birth control. I would not give you an option. And when patients don't listen to me, I ask them to leave. Because you know what I tell them? I'm like, I don't want to go down that path with you.

I don't have the heart to watch you suffer. What one should I go on? What's a low dose? I don't know anything about you to make a comment. It's very dangerous to make a comment. That's why it's scary to talk to any. doctor because I'm like, do you know my body and like put me in the right one? The problem is, the problem is, you know what the sad part is? You can go to another hundred doctor in this town

and say, I have painful period. They're like, take Advil. Why do you think I wanted my billboard? Yeah, yeah. I didn't get it though. One day, if you guys, if you see a billboard that says painful periods are not normal. Yeah. That's my billboard. That's what this, that's what this podcast is going to be called. But let's get you a billboard. I know. If you had time, I would say start a podcast. I am starting my podcast. Good. You know, just for this. I swear I don't have time for this.

But I feel like one day when I have time, I'll share my breast cancer story with you. I have my foster daughter's story with you, PCOS story with you and the metriosis. These are all women health issues. We get dismissed. You know what my solution for the world is? What? Women need to run the world. Yeah.

But in order for women to run. the world, we need to educate our little girls to have a voice. In order for girls to have a voice, they need to get an all-girls school education to become confident. So it starts at a young age. From the minute we open our eyes, they tell us we're not good enough. We're not smart enough. We need to stay home and clean. No, dude, no. Let us run the world. Stay home. Everyone will be in a better place. Stay home. We don't even need you to clean the house. We'll take care of that too. But I'll show you where the world will be if women run it. I said that to a friend of mine and he said, you're sexist. I'm like, I'm not sexist. This is the reality of life. And he's

like, well, I don't see any woman coming up to be the president. I'm like, I know because we don't have equal rights yet. If you give us that platform, we're going to show you how we can change the world. Human trafficking, sex trafficking, gun violence, nuclear wars, all of it will end. But until women unite, start believing in themselves. I tell my girls, my daughter's at Stanford, my second one's applying to Stanford, I tell them, take positions of power, take positions of power and show men how it's done. I just got so riled up. That's the solution for the world, people, but nobody listens to me. And then everyone just says like, oh, you must hate men and blah, blah, blah. And it's like, no, I love men. I have the nicest husband on the world.

on this planet earth. Yes. But this has nothing to do with that. Women need to have the platform to do the right thing. Yeah. We need, just like we run that household, you know, we're going to run the world better than anyone can. I'm going to get, if I get shot, you know a guy shot me. No guys even listen to this podcast.

So you've got the right audience here. Before I let you go, I did want to know just how you diagnosed yourself and found out you had breast cancer. Oh, my God. That's a long story. Oh, it is. I can tell you in how much time I have? Whatever time you have. I, when I was, I have no family history of cancer, none.

Well, I didn't. I didn't take hormones. I don't eat animal products. I've never done drugs in my life. I know people don't believe that. I've never tried drugs. I've never smoked. And I rarely drink.

I was the poster child of someone who was not supposed to get breast cancer. I did a genetic cancer test on myself and it was obviously negative. When I was 48, I went for a mammogram. they saw something and they said, you know, we need to biopsy it. It was on my left breast. They biopsyed it and they told me it's atypical cells. I needed to do an excisional biopsy, which means they go and take a little area out. I did that.

I went to my doctor and she said, go home, come back in six months. I said, okay. I went back to my office and I calculated my lifetime risk of breast cancer as I've always done for all my patients. And when I failed out the questionnaire at the end of it, my lifetime risk was 37%. So I called my doctor. I'm like, you told me I'm okay, but my lifetime risk is 37%. I have three little kids. Back then, I didn't have Coco, my foster daughter.

And she's like, no, it's fine. Look at you. You're so healthy. You don't have any family history. You're going to be okay. I said, you know what? I'm a little uncomfortable with this. I want to take my breasts off because 37%.

If you told me, I had a 37% chance of getting hit by a car, I would sit my butt at home. Can you take these off? She's at absolutely not. This is crazy. And she told me that her lifetime risk was higher than, mine and that her mom passed away from breast cancer, that she wasn't doing a double mastectomy. And I said, I understand, but this is my choice. This is my body. And this is an informed

decision. And I want, I already had implants. And I'm like, I don't care about my breast. I care about my life. They kept telling me there's really good chemo for breast cancer. I said, I don't want to wait. 37% take it off. They told me go and come back when you're 50. So I found another doctor across town who was willing to do it. She had not, she was an experience doing a double mastectomy, but she was willing to do it for me. She didn't want to do it, but I kind of, because of who I was, I convinced her to do it. She did it. It was an extremely difficult surgery.

I was under for 10 hours, I think partly because of lack of experience of my surgeon. I bled out. I ended up getting blood transfusion. Oh, my hemoglobin. It was rough. My blood pressure, I think, was 60 over 30 after surgery. I don't remember any of that, but after they gave me blood transfusion, my memory came back. But a week later, they called me and they said, well, we got your path report and you have breast cancer.

Oh, my gosh. I was like, I was at Staples doing it back to school shopping with my husband with drains coming out of my chest. I have a video of it. I started bawling my eyes out in the car. And I was like, why? I've had, for a year, I've asked someone to remove my breast. My cancer was on the right all this time. They were digging on the left.

And afterwards, when I looked at my images, my cancer was sitting on my MRI, but it was read as benign. So many people called me crazy, including the head of radiology at my hospital. The day before my surgery, she's like, you're paranoid. So I went back, I'm like, don't ever call a mother of three daughters paranoid when she wants to remove her breast. This was my decision, my choice. And my doctor was right. I would have probably been diagnosed stage three, and I would have needed chemo. But unfortunately, the type of cancer that I had doesn't respond to chemo.

So my mom called me. She's like, the reason you went to medical school was to save your own life today. Holy shit. I just got full body tests. I just want you to know that when you go to math, I don't blame my radiologist. I don't blame my doctors. These tests are not 100%. They're not bulletproof.

But I want people to know what the risk is. So I'm launching a platform for breast cancer education in January. And I will change the world. world of breast cancer. Yeah. As I will change the world of PCOS and endometriosis and foster care. Those are my four wishes in life. And then I'll be ready to go. When people have the passion and the knowledge that you have, you will do it. I fully believe you will. I will. It's my mission in life. No one can stop me. As I have brought a lot of attention to PCOS already. I'm so glad my patients are like, it's all over Instagram. I'm a good, as it should be. What is your Instagram? Well, I

treat my PCOS patients on Trimley. Trimley.com is my platform for PCOS patients. I'm going to release an app that will help PCOS patients at home diagnose themselves on Trimley.com. So we've been treating all PCOS patients, as I said, they come for weight loss. We diagnose them for PCOS. It will have, I have an easy solution for people at home to click on a button, answer a few questions, and it'll tell them if they have PCOS or not. then, you know, they can go to their doctor or they can come on our platform. And we can help them with that. Wow. Where did this confidence come from in you? All-girls school education. Really? Yeah. I had to talk at my house with my daughters go to all-girls school. That's another thing.

Women are not aware, you know. There's 40-some years of data that says girls who go to all-girls school. There are 21 advantages of a girl going to an all-girl school in middle school and high school, not elementary. And there's zero advantage of a girl going to a co-ed school. This is data that's been proven, right? Yet only 4 to 5% of women go to all-girls school. Madeline Albright, Hillary Clinton, and Condoleezza Rice, three of the most powerful women in our country. What's common between the three? All-girl school? Yes. No way. I think 50% of top 500 CEOs come from all girls schools. Wow. The information. So that's why I say send your daughters to all girls school. I had parents at my house, but my daughter has to choose. I'm like, no, she doesn't. Your daughter at

age 12 can choose which friend to play with, which color shirt to wear. But your daughter cannot choose, make a decision on something that will possibly affect her, will affect her for the rest of her life. My daughters go to Archer School for Girls. Hands down, it's the top school in this town at least it's an all-girls school education my daughters came out of there wanting to be the president of this country that's how you empower little girls to do the right thing that is so cool okay i can't wait for you to have a podcast too when is that going to come out a january january and the app and everything oh my gosh thank you for taking the time to come here and like so many people have asked for this kind of conversation oh yeah that's awesome yeah so i'm so glad i

tell you, even though I had a patient, even though I didn't sleep, but even though I have a headache right now, I always come when the topic is PCOS, endometriosis, or breast cancer. Thank you, honestly. Thank you for having me. You're so sweet. And I love your honesty. Thank you for doing this. You will help a lot of women. I hope so. I know so. I know so. You'll see. Yeah. Thank you. I know I can't wait to hear the response of people that listen to this. And then even down the road when they actually do go to their doctor and change their life. And then they'll come back to this podcast and go, wow. So, yes, honestly, from the bottom of my heart, thank you.

I'm Caitlin Bristow. I'll see you next Tuesday. See you're next Tuesday. Thank you.