Ep. 214 - Cass Sunstein: The World According to Star Wars

Transcript

Alright, ladies. This is a very important episode for all of us because we have doctor Alia Bhatti on, and she is a force. She is board certified OB GYN 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 OB GYN. She's brilliant. 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? Yeah. From where, though? I'm Persian. Persian. Okay. 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. Yeah. So I didn't apply to college, obviously. Yeah. So I came here literally, 6 months before graduation. Oh, okay. And then I went to Foothill College. And from Foothill College, I transferred to Berkeley after 2 years, graduated top of my class at Berkeley, applied to medical school, but because my English was still so weak, I took the MCAT 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? Really? So I started bubbling all b's and a few more. Way. I got I remember I got 6. 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 gonna 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 this program. Hell yeah. That's awesome. Out of 110, they took 14 of us, and I was 3rd in my cla*s. Yeah. So I once I got in, I was able to skip the 1st 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 actually to people all the time You do? All day long. Where where did I do it? I did it, I think, 3 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 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 it's honestly it's this. Once we're done with this podcast Yeah. You're gonna walk around and identify patients on the street. Really? You're not gonna 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. Okay. But that's what the studies show. Yeah. And partly is the reason is because 75% of PCOS patients don't get diagnosed. So think about it. 75% are not diagnosed. And of the ones who are diagnosed, the doctors don't know how to treat these patients. Wow. 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. Yeah. 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 because I'm busy. Oh. I have a patient in labor right now. Busy. I thought you're gonna 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 would I got home at 11 PM 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 Yes. Then I wanna 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 gonna ask you, though, because can is there, like, a scale? Like, somebody could have really bad PCOS. Somebody could have, like, minor PCOS. Let's go back to what PCOS is Yeah. So everyone can understand it. Yes. It's a hormonal imbalance. Right? You need to have 2 out of the 3 criteria to get the diagnosis. Okay. Number 1 is history of irregular periods. Mhmm. Number 2 is PCOS looking ovaries on ultrasound. Polycystic doesn't mean you have these giant cysts on the ultrasound. It's a specific look of the ovaries on ultrasound. They should change the name because not all p PCOS patients have PCOS looking ovaries on ultrasound and polycystic is not cyst. People get it confused with big cyst. These are fluid filled sacs that there are multiple, I call it filling defects or sacchar pearls Mhmm. In the ovary. 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 2, polycystic looking ovaries on ultrasound. And number 3 is elevated testosterone symptoms. You don't have to have a high testosterone in the blood to get the diagnosis. I'm gonna 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. Mhmm. So if you and you don't have to have all of it. There's a PCOS patient that has hair loss. Another 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. 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. Yeah. So stop telling PCOS patients not to overeat. They're not overeating. They just can't process the food like someone else does. Right. 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. Right. These are teenagers who eat exactly what their skinny friends are eating. Mhmm. 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 Yeah. That are suffering. I had a very good friend of mine. Her daughter lost £60 with me once I fixed her hormones. Woah. So do you know what I'm saying? She's 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 Mhmm. The quality of the points at me. Quality of the eggs goes down. But I want you to know that. No. I wanna know. I'd rather have you get upset and cry right now but do the right thing No. Than not do it. I know that. Like, I that's why I obviously did freeze my eggs. Everybody knows that I did on this podcast, but I and I wanna do it again. So I wanna do that blood work. But 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 loss, their confidence comes back. Yeah. Every single patient that I diagnose starts crying in my office because they've been dismissed for so many years. Heard finally. Yes. Yeah. Yes. That's exactly what they say. And it's so sad. Sometimes I do cry with them Yeah. Because sometimes they come to my office when they're in their late thirties. 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, she would have had a completely different life. Mhmm. I get severe male pattern hair growth. So I'm on spironolactone. 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 minoxidil to it. You can do the Rogaine solution on your head, or you can take minoxidil as long as you're not actively trying to get pregnant. Okay. As you know, you can't be on spironolactone if you're trying to get pregnant. Right. So a lot of these medications you have to come off of. Uh-huh. 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 stop taking the spironolactone, it's gonna 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 it can absolutely affect the symptoms again. Dang. But as you said, people sit on on the spectrum of PCOS. 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. Right. So there's a large spectrum of patients. Yeah. But the key is to know that, first of all, we can fix the symptoms, and number 2, the fertility aspect of it is huge because these patients go to the doctor. Mhmm. The doctor does an ultrasound, and they're like, oh my god. You have so many eggs. Right. If you have so many eggs, you should worry about the quality sometimes. Yeah. Do 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 eggs? Yeah. 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 wanna be pushy because they're gonna think I'm trying to sell it. But, no, this is not you have to educate patients. Yeah. 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. Mhmm. When they're 40 and they can afford it Mhmm. Nobody wants to freeze their eggs anymore. So true. So until we could you know, 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 Lululemon is A lot of companies do. A lot of okay. Good. I have written down this. 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 wanna 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 Yeah. As I'm talking to them. Okay. Okay? And once they know they meet the criteria for PCOS, they're gonna call their doctor and they're gonna 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 gonna show up and then I'm gonna say, wait a minute. I'm gonna help you drop your weight, but you have polycystic ovarian syndrome. And that's exactly what we've been doing at Trimly, 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 2 out of 3. 1 irregular periods, 2 elevated testosterone symptoms like acne, hair loss, facial hair, body hair, body acne, you need to have 1, not all of it Yeah. Or PCOS looking ovaries on ultrasound. If you have 2 out of 3, 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 so 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 Ozempic 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 percent of PCOS patients are obese. Wow. Women in general get dismissed when they go to the doctor. If PCOS I don't wanna be I don't wanna sound crazy or a feminist, but I am deep in my heart. I love that. Because I've treated women for 30 years. Yeah. As women, we get dismissed. Yes. 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. 1 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 said, okay. I'm gonna 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 give you get you help. Why is it? Why are we so dismissed? I don't know. Yeah. You know, it you know, I always say, if men had periods Oh god. And had endometriosis and painful periods, guess what? It would be a national holiday once a month. Yeah. Or there'd be a solution immediately. No. No. They would get a week off work. Yeah. 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 wanna talk about it. If you have painful periods, don't worry about it. You're being dramatic. Yep. I've gone to meetings with men when I'm the only woman. And when I walk in, and this is as of 4 years ago, the one of the men looked at me, and he's like, I hope you're not PMSing too. That makes me go. I, like, wanna go. That's so crazy. But this is 4 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 gonna 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 5 minutes to see you. Yep. They're not getting reimbursed. They're getting $70 to see a patient. You can't expect them to 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 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 I 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 yet like, to for example, I have anxiety and I have hormonal depression. So if I am PMSing, I am depressed. Like, I go dark sometimes. Oh. And I 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 I like to use my platform to share, and I get called crazy and a train wreck and messy and Can I be a mom to you? Please. 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 3, and I'm adopting 1, so 4 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. Mhmm. 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. Yeah. 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 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 Yeah. 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. Yeah. And they are projecting. So just 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, there I I know what you're saying, and I other people told me that too. But for some reason, that really resonated. So thank you. Oh, that's 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 have to say something. I'm like, listen. These are children. Mhmm. And if a mean bully shows up to school in 6th grade, you have to worry about her. The first thing you have to think is that she's being bullied at home. Yeah. If she's pushing, she's being pushed at home. Yeah. 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. Ozempic. We never talked about it. Oh my god. Yeah. Let's go back to that. How did we get this? I don't know. That's because I just started b***hing about trolls. Yeah. How does Ozempic help? That's what I was telling you. 38 to 88% of women who's 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. Okay. 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 take clear that sugar and store it as fat. That's the simplest way I can explain it so people can understand it. That makes sense. 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 they 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. Yeah. So Ozempic and not just Ozempic. By the way, I feel like Ozempic 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. Okay. I started using Trulicity, then I started using Victoza. I started with Saxenda, then I switched to Ozempic, then Wegovy, then now Monjaro. All of these medications are in the same family. Mhmm. Right? But the way it they work, they regulate our insulin. Mhmm. 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. Yeah. 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. Yeah. That's true for some patients, but not all patients. Okay. 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 go back. Insulin resistance is an issue. Metformin helps these patients a lot if you diagnose them correctly Yeah. And give them metformin. Like I said, you can, treat their other symptoms. But you have to remember, I have 100 and 100 and 100 of patients that I've 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, I didn't use these meds on her. Right. She's she never used Ozempic or Wegovy. She lost £60, but she's so she's a different person. Yeah. 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. Mhmm. Now that I know what it is, I don't eat those types of foods. Right. And she exercises. She looks amazing. Yeah. 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. It's How do you do knowledge or it's passion? Well, both probably. But 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 if you're undiagnosed? 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 And infertility. There's, I think, 263 diseases that are associated with obesity. Woah. 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. Oh. 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 they think they have endometriosis. Now what? Doctors are gonna dismiss them. Right? They're gonna 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 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 pain 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. It takes doctors 9 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 wanna go in every little girl's room with my megaphone Yeah. 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 so 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. Yeah. Oh, I had painful periods too. Yeah. You or the moms usually say, I have 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 thirties. Endometriosis and PCOS catch it catches up with you when in your mid thirties. Is endometriosis curable? Suppressible. Okay. There's no cure. So endometriosis is when the cells inside the uterus Mhmm. Endometrial cells, cells 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. Mhmm. 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 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. Okay. 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 uncontrolled starts killing the eggs. So their egg count and quality also starts goes 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 3 daughters. 4. Four daughters. Right. Like, you I wish I could have been your I mean but, like, I you know, you're you're gonna help them so much. Oh, my girl my daughter came home when she was 16. She was in water polo. She's like, mom, my coach is was doubled over in pain, and she couldn't function. I'm like, so what did you do? She's like, I went up to her. I'm like, 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 there are gonna be a voice for it too. All my patients are. Yeah. All my patients are. Okay. I'm gonna put you on to a little something. A hot tip, if you will, from 1 big wine guy to another. If you are going to drink wine in any amount, a glass bottle, you need to be drinking one that's low sugar. High sugar content in wine is the main culprit for hangovers, and the high sugar wine is not good. Nobody's got time for that. So next time the mood strikes for a nice crisp glass of vino, pick up a bottle of Spade and Sparrows. All 4 varietals are low sugar, made in California, and, of course, female founded by yours truly. You can locate your nearest bottle today by visiting spadeandsparrows.com/instore. All 4 of Spade and Sparrows varietals are honestly crowd pleasers. I don't think we've gotten any bad reviews. They're super easy drinking. It's what I drink for wine, and, of course, like I said, all low sugar. Find Spade and Sparrows in the wine aisle at Target in Florida, Texas, Georgia, Ohio, Oklahoma, Louisiana, or various other retailers across the US or shop online at spadeandsparrows.com. And, of course, my little vino community, you can use code off the vine to receive 15% off your first order. Spade and Sparrow's great wine without the rules. Okay. So I talked about this earlier, but I 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. Right? And then the spheroctone is the one that's gonna help with that. Okay. Okay. Birth control pills can help patients. Metformin 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 wanna be mean. I'm not gonna say it. Say it. I was gonna say it's lack of knowledge. Lack of education about it. But 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 gonna come off of it. That's why, you know what I did. I got scared. Yeah. Because I'm not educated. It's the 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. Mhmm. If you already have the diagnosis of PCOS and you have painful period, chances of you have endometriosis. 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, fertility doctor, and I see I have a PCOS patient or I have an endo patient, I feel like that's really mean, but I feel like they're doing this on the other side because they know these poor patients need them. Yeah. They have to pay tens of 1,000 of dollars to get pregnant. I always say if you send every 20 year old to my office one time, I don't need to see them again. One time at age 20 Yeah. 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. Do I wish I I you need a megaphone. I I don't 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 I you know what I tell them? I'm like, I don't wanna 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. But That's why it's scary to talk to any doctor because I'm like, would you know my body? And, like, the problem is the problem is you know what the sad part is? You can go to another 100 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 see if you see a billboard that says painful periods are not normal Yeah. That's my billboard. That's what this this that's what this podcast is gonna be called. But that let's get you a billboard. I know. If you had time, I would say start a podcast. I 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 I I have my foster daughter's story with you, PCOS story with you, endometriosis. These are all women health issues. We get dismissed. Do you know what my salute 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. Yeah. Let us run the world. Stay home. Be in a better place. Yeah. We don't even need you to clean the house. We'll take care of that too. Yeah. 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. Mhmm. If you give us that platform, we're gonna 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. Mhmm. Take positions of power and show men how 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. Yeah. Like, on this planet Earth. Yes. That's 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 gonna run the world better than anyone can. I frame. I'm gonna get if I get shot, you know a guy shot. No guys even listen to this podcast, so you're you've got the right audience here. Safe. Before I let you go, I did wanna 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. Mhmm. They biopsied it, and they told me it's atypical cells. I needed it 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 6 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. Mhmm. And when, I filled 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 3 little kids. Back then, I didn't have Coco, my foster daughter. And she's like, no. It's fine. You're look at you. You're so healthy. You don't have any family history. You're gonna be okay. I said, you know what? I'm a little uncomfortable with this. I wanna 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 like, 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. Yeah. They kept telling me there's really good chemo for breast cancer. I said, I don't wanna 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 wasn't experienced doing a double mastectomy, but she was willing to do it for me. She didn't wanna do it, but I've kinda because of who I was Mhmm. I convinced her to do it. Mhmm. She did it. It was an extremely difficult surgery. I was under for 10 hours. I think partly because of lack of experience Yeah. Of my surgeon. I bled out. I ended up getting blood transfusion. Oh, no. 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 a 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 Oh, that makes me sick. Yeah. 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 the mother of 3 daughters paranoid when she wants to remove her breast. This is this was my decision, my choice. And my doctor was right. I would have probably been diagnosed stage 3 and I would have needed chemo, But, unfortunately, the type of cancer that I had doesn't respond to chemo. So, you know, my mom called me. She's like, the reason you went to medical school was to save your own life today. Holy s**t. But got full body I just want you to know that when you go to I don't blame my radiologist. I don't blame my doctors. These tests are not a 100%. They're not bulletproof. But I want people to know what the risk is. Yeah. So my I'm launching a platform for breast cancer education in January. Good for you. And I will change the world of breast cancer Yeah. As I will change the world of PCOS and endometriosis and foster care. Those are my 4 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 like, good as it should be. What is your Instagram? Well, I treat my PCOS patients on Trimly. Trimly.com is my platform for PCOS patients. Okay. I'm gonna release an app that will help PCOS patients at home diagnose themselves on trimly.com. So we've been treating all PCOS patients. As I said, they come for weight loss. We diagnose them for PCOS. Yep. 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. And then, you know, they can go to their doctor or they can come on our platform Yeah. And we can help them with that. Wow. Where did this confidence come from in you? All girls school education. Really? Yeah. I had a 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'd go to all girls school there are 21 advantages of a girl going to an all girls school in middle school and high school, not elementary. Yeah. 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 percent of women go to all girls school. Madeleine Albright, Hillary Clinton, and Condoleezza Rice, 3 of the most powerful women in our country. What's common between the 3? All girls 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. There your daughter at age 12 can choose what who 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. K. I can't wait for you to have a podcast too. When is that gonna come out? 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, okay. It's awesome. Yeah. So I'm so glad. I tell you, even though I had a patient, even though I didn't sleep 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 Aw. To this podcast and go, wow. So, yes. Honestly, from the bottom of my heart, thank you. I'm Kaitlyn Bristowe. I'll see you next Tuesday. Hi, I'm Lauren. And I'm Chandler. And we're the hosts of Pop Apologist Podcast, a weekly podcast devoted to celebrity gossip, Hollywood deep dives, Real Housewives drama, and anything and everything Taylor Swift. We're 2 sisters who make no apologies for our love of pop culture and the fact that a listers might mean more to us than each other. Join us on your favorite podcast app every Wednesday for pop apologists. 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