The Squeeze - SHE MD: PCOS, Ozempic, and Women’s Health

Episode Date: October 23, 2024

This week, Tay returns for another girl-talk episode with the dynamic duo behind the SHE MD Podcast! World-renowned OBGYN Dr. Thaïs Aliabadi and women’s health advocate Mary Alice Haney share the story of how they met and what inspired their passion for creating a podcast focused on women’s health. We dive deep into polycystic ovary syndrome (PCOS), discussing what it is, how it’s diagnosed, and its root causes. The conversation also covers PCOS diets, their new business Ovii and its innovative PCOS supplement, along with their thoughts on birth control’s impact on the body. We also tackle the buzz around Ozempic and its relevance for PCOS management, plus they offer empowering advice for women to advocate for themselves!Be sure to follow Dr. Thaïs Aliabadi https://instagram.com/drthaisaliabadi/, Mary Alice Haney https://instagram.com/haneyofficial/, SHE MD Podcast https://instagram.com/shemdpodcast/, and Ovii https://instagram.com/oviihealth/!Check out the SHE MD podcast here: https://www.shemdpodcast.com/Check out Ovii and their PCOS supplement here: https://ovii.com/To email us your questions or share your story, you can reach out to [e-mail] sure to rate, review, and follow the podcast so you don't miss an episode! Plus, follow us on Instagram:The Squeeze: https://instagram.com/thesqueeze/Tay Lautner: https://instagram.com/taylautner/Taylor Lautner: https://instagram.com/taylorlautner/& TikTok: https://tiktok.com/@thesqueezepodcastTo learn more from The Lemons Foundation, follow https://instagram.com/lemonsbytay/ and visit lemonsbytay.comEpisode Sponsors:Take the online quiz and introduce Ollie to your pet. Visit Ollie.com today for 60% off your first box of mealsPut your water to work with Gatorade Hydration Booster.Produced by Dear MediaSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

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Zonikars. The following podcast is a dear media production. I call them the mafia right now. When I have the power, I want to force these insurance companies to actually pay for imaging that's necessary and the medications. I had breast cancer and I needed an MRI. I was told by someone, some insurance rep on the phone that it was not medically necessary to a gynecologist. She's telling me a gynecologist with abnormal cells in my breast that MRI is not indicated.

Wow. That's the problem, right? And then they say, why do women die? No one should die. Yeah. We can prevent all this. What advice would you guys give for women to just better advocate for themselves? Educate yourself.

That's the number one day. Listen to GMD podcast. Yeah. Listen to our podcast. Every Tuesday. Every week, there's a different women's health conversation. Again, if you educate a woman, you are creating an advocate. When life gives you lemons, what do you do with them?

Over here at the squeeze, we talk about it. Alice and Dr. A, welcome to the squeeze. Thank you for having us. I'm so excited. We just finished my episode of their podcast, GMD. So we're just continuing the conversation, which is really fun. And their episodes come out on Tuesdays so you can listen to their episodes and then come back here on Wednesdays. And it's just a good little teamwork thing we can get going on it. So we start each episode off with this jar, a little game called Citrus Got Real. if one of you wants to pull a little piece of paper out of there and it's Tais's birthday yesterday so I'm going to let her do this normally this would be my favorite yes let's see if you were a type of bread what would you be and why I would be a sourdough

a French sourdough because um we we yeah we yeah yeah jean jean That's all I got was Louis. French was my second language. I love South of France and I love, love bread. I think it's delicious. It's tasty. It's French. So yeah, it would be a French sourdough bread. I like that. What about you? Oh, I mean, I almost want to pick that too because I feel like it, I love, I lived in France twice and can, I'm from Tennessee. So my French accent was terrible. So nobody would ever reply back. So I mean, I almost want to pick that too. Because I feel like it, I love, I lived in France twice. And I'm from Tennessee. I'm from Tennessee. I'm from Tennessee. So my French accent was terrible. So nobody would ever reply back. So I. So I. So I I never learned to speak French, but that's a different story. But I would love to go pick those hard baguettes on the outside and then the gooey inside. And I would get like the tona, the tuna and the baguette. But I also think that it is a metaphor that we are as we are strong on the outside as women, but inside we're a lot of goo and yumminess and deliciousness. Oh my gosh.

That's such a good answer. Yeah, I was going to say sourdough because I like sourdough. That was that's the best that I got there. I don't have a whole metaphor. Okay, so I'd love to just kind of start off with giving our listeners a little bit of each of your backgrounds and how you guys met. Why don't you start? I always, what? Do you want me to start? Sure. Can you see who this bossy one is in this relationships? I love it. I'm a boss all day long. When I come here, I don't want to do anything. Tell me what to do. Tell me what to do. I, um,

moved out to Los Angeles, got a master's in film, and then moved into the, the world of fashion. So I was the West Coast editor of GQ, Allure, Marie Claire, Domino, and just did everything fashion in Hollywood and did a couple of television shows, created them, hosted them, then created my own brand, which was Haney. It was a luxury ready to wear a line. Netaporte launched me, and they were my first client. And then it was going great. I mean, it was an incredible company. And then COVID. hit. And we obviously red carpets, cocktails, nothing was happening. And at the same time, my father got diagnosed with Parkinson's disease. And my dad was just this larger than life, incredible American

dream story who had just was my idol. And just to watch him go from that to the decline that happened with Parkinson's was just extraordinary. So I started deep diving into podcasts. and medical information and really kind of went off the deep end a little bit in that way because I was sort of, I don't want to be that. How am I going to protect my children from ending up that way? And there was a lot of brain disease in my family. So one of my best friends, Molly Sims, has a podcast also on our network called Lipstick on the Rim. And she asked me to co-host some of her episodes. And I said, great, I'd love to do that. But I'd also love to bring some doctors that I really want to talk to an interview.

Yeah. And it was one of those days that this amazing human being walked in and Molly said, hey, you should stay. She's this incredible doctor in, in L.A., and we're going to talk about Ozympic. And I was like, well, I don't want to talk about Ozympic. Everybody wants to hear about Ozympic. And Taise walks in, Dr. A walks in, and we just sat down and she started talking about her breast cancer journey and how she had brought OZMPIC in.

for PCOS. And I was like, well, I've never even heard of PCOS. And she's, well, PCOS is the, one of the leading causes of infertility. 20% of all women have it. 15. 15% of all women have it. It's the number, you know, one of the number one causes of infertility, 75% don't know they have it. And this is what I do and this is why I do it. And after that podcast, it was literally a light bulb went off. And I said, this is my life's purpose. This is to get this woman and all of her knowledge into the ears and the lives and the homes of every woman on the planet. And then we can really change things for health and women's health specifically. So that's how it started.

And then we just came up with the podcast. The name, it was just, it was an avalanche. And we launched it in the same week, Olivia Munn came out with her breast cancer journey's story talking about how Dr. A had saved her life. And it just has been this roller coaster ever since. and we're getting ready to launch OV, which is our PCOS platform and supplement. So it's just, I know that's a lot, but that's sort of how it is. That's how much we've achieved, right?

In a year. In a year. Oh, my gosh. I think we met mid-July of last year. Oh, my gosh. We've done so much. This woman put me to work. I did.

I was like, I'm sorry. You thought you were busy before. And she's literally saving life. Every year, I'm like, I'm going to do less. I'm not going to work as hard. And then she walks into my life. Oh my gosh. And I guess what you're doing?

That is so good. But it's actually my passion. I mean, I've been in women's health for many, many years. I moved to this country when I was 17 from Iran. And I didn't speak any English. I went to junior college. From there, I transferred to Berkeley. That's where I met my husband from Berkeley.

I went to Georgetown. I got my master's in physiology because my English was not strong enough to get into medical school. so I had to do a year of master's in physiology. And I took classes with the medical students at the time. And I ended up on top of my class in that master's program. So I got into medical school. I went to Georgetown Medical School. And because my husband was in San Diego,

and back then USC was the second best program in the nation for OBGYN. I did an internship there. And I basically, I finished my residency. at County and I started my practice in Los Angeles and I've been practicing for almost 23 years now. And I think that what's, and I'm going to talk about you a little bit behind your back in front of your back, I think we hear a lot about the incredible celebrities that you have as your patients, you know, and they're very vocal. I mean, from the Kardashians to, you know, she's just delivered the Bieber baby and it's public. Like all this. We're not, I'm not saying anything out of, at a

of turn. But what struck me, well, first of all, she has no idea who anyone is. You know, we walked in here talking about your husband. We were laughing. And I was like, you know, Taylor Launder, he was in twilight. She's like, what? Like, you know, I just, no idea. I've been in my world for 30 years. Yeah. And I think it's just what the reason, you know, my why was very specific. But when we sat down and started talking about her why, it was very clear to me where she said, look, I cannot see everyone that wants to come see me. So that's first of all. Like, it's overwhelming the people that want to be my patients and I don't have enough hours in the day. And so, but also, I don't want them to come see me. You know, she doesn't take insurance

because she can't anymore. And there's reasons that you can talk about that. But it's, it's, I want to arm women with my knowledge and my expertise so that they can then go out into the world and be their own health advocate because when you educate a woman as her own health advocate, you educate a woman to help other women and other children. And it's just, it'll be this avalanche. And so that's why, so together, we just both had very different wise, but wanting to have the same goal, which is the medical industry is broken. There wasn't a podcast out there that I could find. I was listening to Peter Tew, who I think is the most brilliant person on the planet. But every now and then, there would be a segment about women's health. There wasn't a podcast that was doing what we do week to week,

which is talk about breast cancer, talk about endometriosis, talk about PCOS, talk about mental health, you know, and give, you know, have the biggest experts in the world from the lens of a woman. Yeah. And that's really what we're doing. And it's been, it's been a blessing and it's been a, it's been a wild ride. Yeah, I bet. I mean, this is so fun for me because I think maybe, maybe like a year and a half ago, Haley actually sent me your contact because I was looking for a new gynecologist. She was like,

she's the absolute best. I love her. And then since that, I've had so many friends talk about this Dr. A. Taise that they love. And I didn't know it was you. And I, you know,

we were with the same network and when we were talking about doing this, I was like, oh, I love what they're doing. And then truly, like a couple weeks ago, I finally put together that that was you

from a friend who had a, a very traumatic birth and just saying your praises how you literally came and picked her up because her husband was gone and just like, just the exceptional doctor that you are. Oh, I did go and pick her up. Yeah. She started screaming. She's like, there's no one home. I think I ruptured my bag of water. I'm like, I'm going to come pick you up, but you better bring a towel with you. But I'm just excited because I feel like this episode, honestly, I am kind of happy Taylor's not here. Sorry, honey, love you. But he's sick. He has a stomach flu, so he sends his wishes. But, um, but, um, but um, um, he's sick. He has his stomach flu. He has his

wishes. But I'm excited because I feel like this podcast is truly like for the ladies that are listening because I want to do a dive into PCOS. I have many girlfriends that have PCOS. And I texted them over the past week. I was like, hey, guys, what questions do you have? Like, we're going to deep dive into this. And so, they sent me so many questions. And part of me was like, this is great because this is great content for me. But also, do you not know this information about like the diagnosis that you have. It's insane. And a lot of them are like, no. And a lot of them have only just recently been diagnosed because they pushed and pushed and pushed and pushed. So I just want to like dive into that. I mean, I think a good starting

place is probably what PCOS is and how is it diagnosed? Good question. First of all, I'm so happy that you have so many friends that know that they have PCOS. That's the first step. because 75% of patients with PCOS are never diagnosed. I honestly think that number is 90%. But my office, I have a skewed view because that's all I see. But I feel like PCOS patients don't know they have it. People haven't heard about it. And 75% of patients are never diagnosed.

And if they're diagnosed, they're not being treated correctly. So there are so many layers of this. PCOS is a hormonal condition that affects 15% of women, 15, 15%. 15% of women in this country, if you go to Middle East, that number can go north of 20%. It's one of the top causes of infertility. And I always say if men had a condition that would cause them to be infertile and affected 15% of them, do you think that would get dismissed? Never.

That would never happen. Someone like me misdiagnosing it would have been in court, you know, defending myself. So it's a huge issue. but it's not just PCOS. I feel like in women's health, you know, women in general are dismissed. Every time we open our mouth, we're anxious, we're nervous, it's in our head, we're making a big deal out of something

that shouldn't be a big deal. And it goes to endometriosis, breast cancer. I mean, the list goes on and on and on. But going back to PCOS, it's a hormonal imbalance that 15% of women experience. And in order to diagnose it, you need to have two out of the three criteria. Number one is history of irregular cycles. That's off birth control. So if you're on birth control and your cycles are regular, that doesn't count. It's history of irregular cycles off birth control. Number two is PCOS-looking ovaries on ultrasound. This is an ultrasound finding. Unfortunately, a lot of doctors scan their patients and they still miss it. But polycystic doesn't mean that you have to have cysts on the ovary. These are little follicles all over the ovary. We call it.

a string of pearl or it, you know, it has a specific look on ultrasound. Yeah. So that's number two. And number three is either elevated testosterone symptoms or elevated testosterone in the blood. What are those symptoms? It could be acne. The most common is facial hair, body hair. It could be hair thinning.

And when it comes to, and the most important thing to know is you do not need to have a high testosterone in the blood to get the diagnosis. 90% of the time, these patients go to the doctor, they get a blood test, and they're, you know, they get a call back saying, oh, you don't have PCS because your testosterone's normal. So let's make that very clear right now. It's not part of it. Having a high testosterone in your blood is not part of the criteria for diagnosis.

So a lot of time, I can walk on the street and diagnose a PCOS patient. I can start now too. I've learned how to do it. I want a card that says, please, here. Do I have it? them scared all these things you're saying. I'm like, I don't know. You don't know because you're on birth control. Well, yes. I was going to say, well, that's our problem number one. And they have into. And she says, I'm going to say Dr. Haney is going to jump in here right now. Can you talk about

insulin resistance because that's what happened? And can you talk about sometimes you say a lot of them have mood disorders? So let's talk about that. So you need two out of the three criteria to get the diagnosis. But these patients tend to have mood disorders. They sit on the spectrum of anxiety and depression. They tend to be anxious people. But you don't have to have that. No. No. In order to get diagnosed, you only need two out of the three.

But generally speaking, these patients tend to be moody. They have mood disorders. They have family history of diabetes, overweight family members, or insulin resistance somewhere in their DNA. They tend to gain weight easier than other patients. 75% of BCOS patients are overweight or obese. 25% have no weight issue. shoes and we call them lean PCOS. But just because you're thin, that doesn't mean you don't have

PCOS. So that's a very important point. A lot of these patients, a lot of them have a history of an eating disorder because of the insulin resistance. And because these patients, you know, they're anxious. They have body image issues because they're gaining weight and they're, it's hard, you know, they eat the same thing as everyone else, but they're not losing the weight. And out of that frustration, they go down the path of having an eating disorder. And I always say if, you know, these young teenagers would go through my office and I would diagnose them with PCOS and I would treat their hormone imbalance and balance their weight, they would never go down this path, right? And it starts when you get your period, right? PCOS, the symptoms start. Okay. Right, right. And as you get older,

the symptoms can obviously become more significant. Yeah. And the last thing is, it's one of the top causes of infertility on the planet. These patients tend to have a lot of follicles. At 35, they go to the gynecologists and they're told, my God, you have so many eggs. Don't worry about it. You have all the time in the world. It's not true because after 30, the egg quality actually starts going down. So you might have a lot of follicles, but it's a double-edged sword. You have to consider freezing your eggs or starting a family anywhere between 28 to 32. If you're my patient, I'll start having that conversation at 25. So I mentally get my patients ready.

And I always obviously check their egg count once a year. But by 28 to 30, I have them freeze eggs unless they have a partner and they're, you know, yeah. Ready to do that. They're ready to get pregnant. Yeah. Today's episode is brought to you by Ollie. Clean, fresh nutrition your dog needs in five flavors. They'll absolutely flip over.

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are so different. Like one of my friends, she is like the tall tail sign of like, of having PCOS. Like she gained weight. She has abnormal like body hair. She like has those things. And then my best friend, she is the tiniest little thing ever. She's always just been small. She was a little ballerina. And she didn't get diagnosed with it until like somewhat recently. But she never had a regular period. She's had cis. She's had like all of these things and all, you know, she did struggle with eating disorders and things like that. But she, that all of these things you're saying, like, oh, that actually does track for her. But because, well, one, we're not even really like taught what it looks like.

But when you look it up, it's not those types of symptoms. So for her, it was, and she's a labor and delivery nurse. And so she didn't even, you know, know, but most doctors don't know it. Yeah. I did an episode with Dr. Phil on. cryptic pregnancy. These were overweight patients who don't get their periods and they all thought they're pregnant, right? They think they're pregnant for seven years, eight years. And Dr. Phil sent one of them to my office. I did an ultrasound. I showed her that her uterus was empty. This woman was

convinced, I don't know, that she had six kids inside of her and that she would deliver in another few years. And for the life of me, obviously because of the mental health component of her situation, I could not convince her that this was not true. And every single one of them, the diagnosis was polycystic ovarian syndrome, right? They were overweight. So their belly was growing. They were thinking they're pregnant. They didn't get their period.

They thought they're pregnant. So these are all PCOS symptoms. So I came back and I was like, you know what? I'm just going to do a study on PCOS. So I called the resident at one of the institutions that I worked at. and it was the chief resident. And I said, will you help me, you know, I need a few residents to help me do this study on PCOS that I want to do?

You know what you told me? What's PCOS? Yeah, this is poor. I said polycystic ovarian syndrome, the top cause of infertility. And she's like, can you spell that? I hung up the phone. Yeah. But that's why we created OV.

That is why we created OV because it's not only. do we need to educate women? Yeah. But also some doctors need to be educated or nurse practitioners or, you know, what do you do with this if you think you have these symptoms? So we created a risk assessment that says if you have a likely, high likelihood, a likelihood, or you're not likely to have PCOS. So that's the first steps, really understanding. And then we have so much educational information about what she just described and what she does for every patient that goes in. And then Dr. A and a leading scientist created. a supplement, the OV supplement, that is going to be a game changer for women with PCOS, because

it's an all-in-one, they take it once a day, and it deals with all the symptoms of PCOS, that normally you have to take a lot of supplements, tons of supplements, or a lifetime of prescription medicine. So this is going to be a game changer. Is it available yet? So we launched OV October 15th, and it's going to, it's OVI.com. Oh, we will leave a link down below. Do not worry. We're so passionate about this because women are so dismissed and there is such bad information.

And it's, you know, when you think of this and your friends are a great example. I mean, now you're going to notice PCOS everywhere. It's everywhere. Everyone knows somebody. If they don't have it, it's, and there hasn't been a resource or a place or a supplement that wasn't a prescription medicine that covers all these things. So this has been her life. life mission. And I'm really proud to be able to help with that. No, it's so, it's so amazing.

What you guys are doing with that is I'm, I'm so excited and I know my girlfriends are going to be so excited to take it and get to like learn more about it. But I am curious, is there, what, is there something that causes PCOS? Do we know or is it just? So there are different, you know, one thing we know is insulin resistance is at the core of it. for a majority of patients, it could be autoimmune. I mean, there are different hypotheses, but usually, you know, if you have it in your family, if you have a family history of diabetes or overweight family members, you're more at risk of having polycystic ovarian syndrome. But insulin resistance is at the core of it for many of these patients. And what that means is

when we eat carbohydrates or sugar, our body breaks it down into glucose. And glucose stimulates are pancreas to release a hormone called insulin. I'm sure you've heard of it. The job of insulin is it goes to our cells and opens up the receptors on the surface of the cell. These receptors grab the sugar, push the sugar into the cell where it turns into energy. This is the most simple way of explaining this.

Yeah. This is what's supposed to happen. But what happens with PCOS patients with insulin resistance when they have this carbohydrate meal, let's say, and their body breaks it down into glucose. Glucose stimulates their pancreas to release insulin, but their cells are insulin resistance. Insulin, they're not responding to that insulin.

Yeah. So sugar can't really go into the cell and turn into energy. So it bounces into the blood and pushes your sugar up. As your sugar goes up, your pancreas wants to clear it, so it pushes more insulin out, right? Insulin is a fat storage hormone. It's the last hormone you want your body to secrete. So what happens when we get these insulin spikes, our body clears that sugar and stores it as fat.

So these are patients who say, I eat the same thing as my best friend. She's skinny and I can't lose weight. And it's really frustrating to be them. And these patients go to the doctor and what do they hear? Well, you know, eat less. You're probably eating too much. And you're not exercise more. And they're just like, I can't eat less.

I can't exercise more. And that's the reality of it. And that's insulin resistance. So high insulin causes weight gain. But in PCOS patients, that high insulin can also stimulate the ovaries to release androgens like testosterone, male hormones. And when you have testosterone in your blood, some level of it is normal, right? It gives us our libido, secondary sexual characteristics. But you don't want your testosterone to be high as a woman.

So what happens, you get male pattern hair thinning, you get facial hair, you get body hair, you get acne, and your periods start becoming irregular. So I always say the food you put in your mouth by raising your insulin can affect all these symptoms. Yeah. So fixing insulin resistance is at the core of this issue. And so diet is very important. A low carbohydrate diet is very important. You know, I have insulin resistance. and not every woman with insulin resistance has PCOS.

I didn't have PCOS. But the insulin resistant part of it makes it hard for us to lose weight. So I know that I can't really have sugar. And it should be their religion, really. They just sugar poisons their body. So you have to have a low-carb diet. Exercise is very important. That's why we tell diabetics, go for a walk after you eat.

Why? Because when you walk, you open up these receptors on the surface of yourself, grabs the sugar and lowers your blood sugar. and lowers your blood sugar level. One thing I always recommend to my patients is go for a walk for 10, 15 minutes after each meal. Doing that will significantly reduce your sugar load in your blood right after. But the problem is a lot of patients, PCOS patients, they do the diet and they do the exercise and they're still not getting to the bottom of it.

So that's when we, if you want to use a prescription medication, you can go use a medication. We prescribe metformin. A lot of patients are under-treated. You know, they come with the smallest dose because it's tough on the stomach and on the GI symptom, on our GI system, it can cause nausea, diarrhea, just patients don't feel well. So it has a lot of side effects. So if you want to do metformin, you have to go up slowly. But then we do birth control pills because, and that's what, you know, I wanted you to listen to

because you were talking about post birth control syndrome. And what birth control pills do for PCOS patients, in general, PCOS patients have low levels of sex hormone binding globulin. This is a protein in the blood that grabs on to all the testosterone in the blood. When the sex hormone binding globulin levels are low, your free testosterone goes up. So all these symptoms happen. Birth control pills stimulate the sex hormone binding globulin. So it starts grabbing the free testosterone and the symptoms resolve.

Acne, hair, loss, facial, hair, body hair, your periods become regular. And that's why a lot of times doctors don't know how it works. But if you go to your doctor and you say, I have irregular periods or I have acne, they're right for a prescription for birth control pill. And so it works as long as you don't stay on. it for years and years and years. Yes. So if you are prescribed birth control pills, then you want to know your egg count. It's a simple blood test. It's called AMH. You can do it, you know, with your doctor. It's covered by insurance. And you need to know what that

account is. And in my office, I check it every single year. I'm never surprised. I've never, ever had a patient under my care at 30 not get pregnant. Never ever. Wow. Something that was brought to my intention, which I didn't know if it's true, if it's a myth, which I think you can clear up. Is OZMPIC good for people with PCOS? This is the best question. I love this question. This is the best question. And honestly, I will take credit for PCOS and OZMPIC. Take it. So I will because I started using these meds for my PCOS patients in 2014. Number one, it regulates your insulin. Number two, it affects your appetite, right? People feel full. And that's why if you're going to have a surgery, if you're going to have a procedure that requires sedation,

you have to stop these GLP1 medications two weeks prior to your procedure because of that delayed gastric emptying. We don't want people to aspirate when we put them to sleep. But otherwise, they're very safe. I've literally used these medications for 10 years. I've never seen anything complicated or bad with it. Is there, with that, with the GLP ones, is there like an amount of time people should be on it? Or is it like a... That's a very good question. So if you're a PCOS patient who's morbidly obese, right?

And you need to lose 100 pounds. And I have those patients that have lost like 100 pounds with me. Those patients can almost never come off of it, right? Because obesity is multifactorial. It's not just insulin resistance. So a lot of times when these patients respond to it, it's great. Some of them need to stay on it for a lifetime. My family, I have family members who've been on it since 2014, and it's fine.

But other patients who there are sometimes, you know, even I use it now for insulin-resistant menopausal patients. They gain 25 pounds and they're killing themselves and they can't lose the weight. So I give it to them. when they get to their weight, I take them off. And honestly, as a side note, this OV powder that I created for insulin resistance would work great for anyone with insulin resistance. Do you know what I'm saying?

Because it's anti-inflammatory. It's as antioxidants. It can regulate hormones. It can regulate the blood sugar. So any of these women can also be on it. And it does not interfere with any medication. So I think it's a great addition to these patients' routine. But to answer your question again, and to be clear, some patients need to stay on it for the rest of their life, and that's fine.

And others can get to their goal, come off of it and start maintaining it with diet and exercise. It's going to be interesting because I feel like when you start looking at all the research right now with these GLP ones, and they're saying they're geoprotective, there's a lot of geoprotective for your brain, for your heart. like all these things that are coming out. And they're saying that dementia is type 3 diabetes. You have too much insulin or whatever that is. Your insulin resistant in your brain. Do you, my question to you, and I've meant to ask you this,

do you think that that is because that they are truly geoprotective? So it would be geoprotective for you or I? Or is it geoprotective for so many people that were morbidly obese, that were taking it? And now they've lost all this weight. And of course their brain's going to function better. Their heart's going to function better. I don't think we know the answer to that. I think we need more studies.

There's so many studies. But personally, what I've seen, it makes a difference. Let me tell you, for example, you have someone who drinks a lot of alcohol, right? Alcohol is not good for you. You have someone who's smoking a lot. You give them these medications and it takes all their cravings away. I have patients who come and say, I used to pick my. skin all day and I don't I stop doing it. I used to bite my nails and I don't do it anymore. So I think

we've seen so many benefits with these meds and I've honestly, you know, I know doctors go, there are patients who get pancreatitis from it. There are patients who have alias from it. But I think if it's done right and prescribed correctly, then it can really, really help patients who are overweight, especially obese. It's been. a game changer in my practice. And like I said, I have 10 years of experience. The problem is I feel like even now, doctors don't know how to prescribe it. Well, and we still need a lot more research.

I mean, we're going to, thank God so many people are on it that we're going to have a lot of data. And there are different types of medications, how fast you go up, where you start, which medication you choose. Like if you have someone who needs to lose 100 pounds, you have to start with one, type of medication and then switch them to the other. It's not just one size. It's all formula for everyone. Wow. But there was something that just came out today.

I just saw an article where where the compounded, because a lot of it's compounded, I think that that's going to be taken away. Well, you don't want to use compounded medication. When a medication is on the FDA's shortage list, you can technically go to compounded medications. The problem with compounded medication, especially gLP ones, you don't know where the ingredients are coming from. Each pharmacy is mixing their own. You have to draw it out of a bottle. So it works and it has helped a lot of people who could not afford these medications. And, you know, the problem right now is

with these insurance companies, they're making it extremely difficult for patients to have access to these medications. So if you're someone who needs to lose 100 pounds and you're, and you really need the medication, right? And your insurance is still. denying it, then you don't have another choice but to go to these compounded medication, which is really, really sad. Part of it is, you know, the insurance companies are adding, and here's what I will say, because November is open enrollment. If you're overweight and obese, please call your insurance company, make sure they don't drop your obesity benefits. If they drop your obesity benefits, then what's going to happen is come January 1st,

you're going to call in your prescription and won't get covered. And sometimes they drop you without you knowing. I didn't know that was a thing. I didn't either. Oh, of course. You need to have the benefits. So what happened a couple of years ago, they dropped a lot of people. Wow.

So patients who really need these medications, they need to call their insurance companies if they don't have these benefits, pay for it. it and add it. The other thing I would say is for patients who don't really need it, if you need to lose five pounds, please don't grab these medications from pharmacies because they're overweight and obese patients who really need it. We define overweight with a BMI of 27 or more and obesity is with a BMI of 30 or more. So these prescriptions should be covered for these patients. And I will add one last thing is that if you don't have insurance, your insurance doesn't cover it. There are coupons now available for some of these medications that, you know,

patients can use. I think the length of that coupon right now as we speak is about six months. So after six months, you can't use the coupon. But with the coupon, it's about 50% off. But it's still expensive. I mean, we're talking about $650 a month. Yeah. Which is, I mean, it's really hard to afford these meds. And, you know, these meds should be available publicly. I mean, to these patients, especially the obese patients. Yeah.

Because it's a game changer for that. Yeah. That's crazy how needed it is. I didn't realize that at all when someone mentioned it to me. I was like, wait, what? That, like, correlates? But for the very, you know, obviously, because otherwise it's, you know, it's the ovipater or it's the metformin or, you know, I mean, it's, there are things to do

if you're, you know, even slightly overweight, you know. Yeah. Do you think that reason for it going on diagnosis just because doctors don't know or is it just? I think we don't get enough training, just like the resident I was telling you about. I've said this for many years, OB and GYN, obstetrics and gynecology should be separated. You should have doctors delivering babies all day long. and then you need gynecologists. What happens right now is doctors are doing both, right? I did that for years. And you burn out.

Not like before. I used to do at some point 80 deliveries a month by myself. Wow. And so imagine 30 days in a month. I was doing 80 deliveries a month. A lot of them were in the middle of the night and I had a full-time clinic. And these patients, when I was accepting insurance, I had maybe 10, 15 minutes with each patient.

You cannot possibly correctly diagnose treat. I mean, you can diagnose someone in one minute, but to educate them and to prescribe the medication and explain to the patient why they need to do it. So that's one limiting factor. The second one is doctors, patients, nurses, nurse practitioners are not educated enough about these two conditions. And the third one is doctors don't have time. They're exhausted, but they also don't have time. Yeah. That's, I feel like, something that I learned about the health care system in working in it. I feel like I was a little bummed to see that, that, you know, doctors will say something and then they'll leave. And then so many of my patients were like, well, what about this? Like, they didn't explain this. Like, they didn't, you know, they didn't explain what, like, heart disease they just. diagnosed you with or they're like, no, they didn't like explain like what this medication is. And

that was like such a common thing. And, you know, it is sad. But at the same time, it makes sense because, you know, like these doctors at the hospitals are just going in and out of rooms all day. You don't have time. Yeah. You don't have time. And you know what? The sad thing is they're not getting paid to see those patients for more than 15 minutes. You know, they're burned out. there's just it's just a combination of everything and on top of the list is as a woman we get dismissed anyways to begin with. So I always say the reason we started this our CMD podcast was to in order to be your own health advocate, you need to be educated about it. Right. So I'm educating everyone on PCOs. So if you have all the symptoms I listed, I guarantee you you have PCOs. You don't need to

wait for that ultrasound. You don't need to wait for that blood test. So educate yourself. Right now with chat GPT, you don't need a doctor. You don't need to come see me. Just punch in your symptoms and chat GPT will spit out your diagnosis. So it's going to make life so much easier. The problem is once you self-educate, then you need to have access to a good doctor, right? Like yourself, then you go to the doctor and you hope that they have time to spend some time with you in the office to listen to you, to educate you on why you have to take this medication, how this medication works. what are the side effects, otherwise you don't get compliant. And then even if you educate yourself and get a good doctor to do all that, the third step is you need to be able to afford the treatment, right? You come out, your PCOS, you need OZMPIC, you go to the pharmacy.

They're like, it's $1,500. So being able to afford the treatment is the third step. Yeah. And the list goes on and on and on. Yeah. So that needs to be changed. Women's health needs to be changed. Yeah.

I feel like that's something I'm, especially now, not in becoming a woman, but as I've gotten older and, you know, thinking about having kids, being on birth control, having to go get a papset. Like doing all of these things. And now all my girlfriends are having all these issues and things. We're all like, where, where's the research? Where is the help? Because even going to my old gynecologist, I've asked, does everything look good? She's like, yep, I'm like, but you didn't even really like do anything. You haven't checked my blood.

Like you don't know. Like I've never had these things tested. Let me tell you something simple. Pelvic ultrasound, right? It takes me, I can do a pelvic ultrasound in 30 seconds. I can look at the ovaries, look at your uterus, see if you have septum, see if you have PCOS, see if you have an endometrioma. I can see if you have fibroids, if you have polyp in the uterus.

I had a patient who called me last week. And she said, oh my God, I got pregnant. This woman for two years couldn't get pregnant. You know what she had? She had a small, not small polyp, but she had a polyp inside the cavity of her uterus. If you have a polyp inside the uterus, when the embryo comes into the uterine cavity, instead of implanting into the wall of the uterus, it goes on the polyp, you don't get pregnant. It took me five minutes to take her polyp out.

She's pregnant. Wow. But it's simple. This is why when I met this woman, I was like, okay, I'm sorry, but you, you, You know, you know, there's so many reasons why. We have to do a podcast on fibroids and podcasts. Okay, we're going to do that. We're going to do that.

But the point is, is that's the reason that we started the podcast so that we can arm women with this information so that they can take control of their health. Because right now, there's nothing out there. Yeah. And everything that we're doing, whether it was OV or CMD, is from that lens of let's change this system. Yeah. Let's, and she can't wait for AI doctors. You're so excited for robot, Dr. She can mean, anything that we can do to stop women from getting dismissed, to arm them with information and care that they can do, you know, by themselves without needing something else is the whole point of it all. And eventually, when I have the power, I want to force these insurance companies to actually pay for imaging that's necessary and the medications.

I call them the mafia right now. Do you know what I said? I had breast cancer and I needed an MRI and I was told by someone, some insurance rep on the phone that it was not medically necessary to a gynecologist. She's telling me a gynecologist with abnormal cells in my breast that MRI is not indicated. So I had to pay, I don't know, 3,200, 3,500. It was above north of 3,000. Wow. I remember where I was in my parking lot when she said.

that. That's the problem, right? And then they say, why do women die? No one should die. Yeah. We can prevent all this. No one should end up in the hands of these fertility doctors. That's why they're making so much money. That's why you go to a fertility clinic. You can't even get an appointment. Yeah. If you diagnose these patients at age 16, 17, 18, 20, they will hopefully never need a fertility doctor. Yeah. It's really sad. Yeah, it's so true. But we're going to change this. You are.

No, we need more doctors. We need a lot of support. Yeah. I don't know that I can, I can just educate. You know, you still need to have access to doctors. Doctors are busy. They're overbooked. Yeah.

We are, the reason I dropped insurance, I was burned out. Yeah. I went to my office manager one night and I had seen like 40 some patients. It was like 7 o'clock at night. I went up to her. I'm like, I'm going to kill someone working like this. Because I'm so exhausted. I'm going to miss something.

I'm going to miss something in one of these labs. I'm going to miss reading a pap smear. I can't do that. And I talked to a friend of mine, as a urologist, he's like, drop insurance. If you want to provide the level of care that you want to provide, you cannot work with insurance companies. You'll go bankrupt. I would, you know, I spent an hour with my PCOS endometriosis patients, 45 minutes. Yeah.

You think I can do that and get paid $80 and have 10 people work for me in my office? The system fails doctors. We're not paid enough for the number of hours we put in. We put our hearts, our souls. Everything we have for our patients, we give, give, give. But at some point, we need to get something back. in return. Yeah.

It's not as fancy as people think it is. Yeah. It's a lot of work. Yeah. Being a doctor. That was one of my biggest takeaways when working in the hospital. How that works and how insurance companies work? Because I was on an observation unit.

And if the patient wasn't diagnosed in 24 hours, we would get dinged. Like the doctor had to bring them into the, like they had to actually admit them into the hospital. And if they didn't get admitted within that 24 hour period, then we wouldn't like get paid. And sometimes they would just let patients go because they were, you know, if they're 24 hours was almost up, we had to discharge them. I'm like, no, no, no. Like they, something's wrong. They need to stay. But right. I can't. Yeah. So it's a broken system that needs to change. And at so many levels. So many. So many. So as women, we just have to stick together and just fix it. Yeah. What advice would you guys give for women to just better advocate for themselves? Educate yourself. That's the number one. CMD podcast. Listen to our podcast every Tuesday. Every Tuesday. But honestly, and then go on the website. And if you're not, if that week is about breast cancer and you, you need to listen to that one about breast cancer. But if the next week is about endometriosis and you don't have painful periods, go to the website. There's, we, every week, there's a different women's health conversation. And it's, we have the, in my opinion, and I get to say that, not just because you're my partner, but we have the most amazing.

amazing OB-GYN in the world, in my opinion. But we also have the biggest brain doctors, the biggest heart doctors, the greatest minds of everything but all from the lens of a woman. And again, if you educate a woman, you are creating an advocate. And that is what we are all doing. That's what you're doing on your podcast. You are providing education on your own website, somebody that has mental health. Like that's what, I mean, I get chills. Like, that's what we're doing here. That's the whole reason while we're doing this. We're creating a movement of educated women that are going to change the world. And you have to start somewhere and you have to, so yes, go to GMT podcast. No, I'm serious because, I mean, we're trying to just empower them to

be their own health advocate. If you listen to your body, you know what's wrong, right? Yeah. Chronic pelvic pain. You have pain. You're young. You're in your 20s and you always have pelvic pain. That's probably endometriosis. You need a pelvic ultrasound to make sure you don't have fibroids and polyps.

But most likely you'll do an ultrasound. Everyone will tell you everything's good. Yeah. But that's probably endometriosis. So if you, I'm going to say, I'm going to talk so much about PCOS and endometriosis until it becomes a household name. I have to tell you all. funniest thing that happened. So we had Shailene Woodley the other day, and she is in this amazing

TV show called Three Women. And I had watched a few episodes to understand, you know, before we talked to her. And I, and she's friends with some of my friends. And she's amazing. And she was, it was an amazing podcast. But I had my husband watching it last night. I was like, let's just, I go, you're going to love this. He's like, this is a chick flick. I'm like, no, you're going to really love this. This is so well done, well written, well acted. Is it out? It's out right now on stars. I'm just going to plug this for Shailene. But the funniest thing happened, and then it made me cry, was there's a scene where the doctor, this one woman, it's just exactly what we're talking about.

She's just been dismissed. She's got gloves on all the time. Her body's aching, like she's aching, and she's got just searing pain, you know, in her vagina. And she goes to this doctor in this small town. She's a doctor herself? No, she's a woman, just a woman living in the town. And he's from India. And he has a southern accent from Texas.

And he goes, he's holding her hand just like that. And he goes, you have fibromyalgia and endometriosis. And she starts bawling crying because somebody has finally given her. And you deal with this every day. You tell me patients come into your office and sob like every single day. But I laugh because it was so funny. You have fibromyalgia and endometriosis. But then I started crying because I hear this all the time from.

By the way, fibromyalgia, make sure you rule out everything else before you diagnose someone with fibromyalgia. I hate that diagnosis, honestly, because I feel like it's a real diagnosis, but a lot of patients with endometriosis automatically fall into that category. And the patients are dismissed. So if you have been diagnosed with fibromyalgia, make sure every other diagnosis is crossed off. Yeah, that's the advice I would give. Anyway, it was exactly. But at least they're talking about endometriosis. But it represented what we're talking about, that women are dismissed.

Women are told that nothing is wrong with them. And then just to be seen and heard and she was educated. And it was hilarious. But it was also, I was just like, oh, because the stories that you tell me all the time, just people are just, you know, they sob in your arms. And you know, when you educate when my girls were little, I've done this for so many years. They were in a water polo team. And my eldest daughter came home one day.

She's like, Mom, I'm like, what? She's like, you know, we were swimming. And the coach was doubled over and she couldn't sit up straight. So my daughter goes up there. She's like, no, I have really bad period pain. My daughter, I think she was like 14 at the time. She's like, Mom, I told her, I went up to her and I'm like, coach, I think you have endometriosis. You need to go see your gynecologist and get diagnosed.

But I think that's what you have. But my point is that's how you educate, right? My 14-year-old was able to tell her coach that being doubled over in pain is not normal. Painful periods are not normal. You know, having acne on your face at age 30 with facial hair, body hair, being overweight, having you regular period is not normal. Wow. I'm just, I'm just over the moon that you both came and sat with me today. Thank you for having us.

Just the work that you're doing, I'm literally about to talk to you about how I can, like, get involved because it's just, it's so important, truly what you guys are doing. And obviously, mental health is important, but women's health is not advocated enough for and there's not enough education behind it. So I'm just so thankful for the both of you. And mental health in women is not addressed, right? They're shy. They don't want to talk about it. They get judged if they open their mouth. So that's another monster that needs to be dealt with.

with. And you're doing that. So we thank you as well. Thank you so much for having us. Thank you guys. Please note that this episode may contain paid endorsements and advertisements for products and services. Individuals on the show may have a direct or indirect financial interest in products or services referred to in this episode.