The MiDOViA Menopause Podcast: Real Talk on Hormones, Work, and Wellness for Midlife
Welcome to The MiDOViA Menopause Podcast — your go-to source for science-backed, expert-led insights on menopause, perimenopause, and midlife wellness.
We cover everything from hormone therapy to hot flashes, brain fog to bone health, workplace policies to personal empowerment. Whether you're navigating menopause yourself or supporting others, this podcast offers practical tools, real talk, and trusted guidance.
Brought to you by MiDOViA, the first and only U.S. organization offering menopause-friendly workplace accreditation, we’re on a mission to change the narrative—at home, at work, and in society.
🔗 Explore free resources at midovia.com
⚠️ Medical Disclaimer:
This podcast is for informational purposes only and does not substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or qualified healthcare provider with any questions you may have.
The MiDOViA Menopause Podcast: Real Talk on Hormones, Work, and Wellness for Midlife
Episode 051: The Truth About Menopause: Black Women and Menopause
Menopause isn’t experienced equally—and the differences are too big to ignore. We sit down with Dr. Kudzai Dombo, OB-GYN and Director of Advocacy and Outreach at Alloy Health, to explore why Black women often face earlier menopause, longer and more severe symptoms, and far less access to effective treatment. Drawing on the SWAN study’s decades of data, we connect dots between evidence, everyday experiences, and the systems that shape both.
Dr. Dombo shares her own perimenopause story—misdiagnosis, expense, and relief once hormones were recognized as the driver—and uses it to illuminate the barriers many women meet: clinician bias, gaps in menopause training, insurance hurdles, and historic medical mistrust. We talk through the shocking 0.5% hormone therapy usage among Black women, why that number reflects more than preference, and how to navigate choices from bioidentical hormones to nonhormonal options. The message is clear: treatment should be personalized, iterative, and explained in simple terms that empower informed consent.
We also zoom out to where health meets work. Symptoms can derail sleep, focus, memory, and confidence—undercutting performance, promotions, and pay. We outline practical steps employers can take now: flexible scheduling for sleep disruption, breathable uniforms, localized temperature control, paid time for medical care, and benefits that cover evidence-based menopause treatment with follow-up. Finally, we highlight the power of community support groups that replace isolation with knowledge, self-advocacy, and a sense of “not just me.”
Don’t normalize suffering. If your care stalls, bring the latest guidelines, ask for options, or change providers. If this conversation resonated, subscribe, share it with a friend who needs it, and leave a review so more listeners can find evidence-based, equitable menopause care.
Dr. Kudzai Dombo is a board-certified obstetrician-gynecologist, and currently serves as the Director of Advocacy and Outreach and Prescribing Physician at Alloy.She combines deep clinical experience with a commitment to health equity, focusing especially on the midlife health of Black women.
Website: www.myalloy.com
MiDOViA LINKS:
Website: https://www.midovia.com/
Instagram: https://www.instagram.com/mymidovia
LinkedIn: http://www.linkedin.com/midovia
Email Us: info@midovia.com
MiDOViA is dedicated to changing the narrative about menopause by educating, raising awareness & supporting women in this stage of life, both at home and in the workplace. Visit midovia.com to learn more.
The information, including but not limited to, text, graphics, images & other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment.
Welcome to the Medovia Menopause Podcast, your trusted source for information about menopause and midlife. Join us each episode as we have great conversations with great people. Tune in and enjoy the show. Hi everyone! Did you know Medovia has the first and only menopause-friendly accreditation program in the U.S.? Our program is the benchmark of excellence, backed by five years of experience working with hundreds of employers around the globe with our worldwide partners. You can join now with a 20% discount off your first year's membership in honor of Peria Menopause and World Menopause Month. Join before October 31st to receive your discount by visiting menopausefriendlyus.com.
SPEAKER_02:Welcome to our special four-part webinar series in recognition of Menopause Awareness Month. We're proud to bring this important conversation to life through a partnership between Alloy Health, a leader in evidence-based menopause care and telehealth solutions, and Medovia, the U.S. workplace leader in menopause and midlife health. Throughout the series, we'll break down the myth, share the latest science, and highlight the real experiences of women navigating menopause, menopause, perimenopause, and beyond. Our goal is simple: to replace silence with knowledge, empower women to advocate for themselves, and give organizations the tools they need to build supportive cultures. Together, Alloy Health and Medovia are working to change the way menopause and frankly this stage of life is understood in healthcare, in the workplace, and in society. So thank you for joining us as we open the door to honest, informed, and hopeful conversations. Today, we are addressing Black women and menopause, and Medovia is joined by Dr. Kudzai Dombo. Dr. Dombo is a board-certified obstetrician gynecologist and currently serves as the Director of Advocacy and Outreach and prescribing physician at Alloy. She combines deep clinical expertise and experience with a commitment to health equity, focusing especially on the midlife health of Black women. Welcome to the show, Dr.
SPEAKER_00:Dombo. Thank you so much, Kim. It's such a pleasure to be here today.
SPEAKER_02:Yeah, we're happy to have you. What drew you into this work? We talked a little bit about it before we started pushing record, but why are equity and representation in women's health, especially in midlife, important to you?
SPEAKER_00:Kim, that's a really great question. And I think it started by my own Perimenopause journey that started about two and a half years ago. And as I navigated through some of the symptoms, which weren't typical but debilitating, I realized that I not only number one, wasn't aware of what was going on in my body, but then number two, when I encountered the health system, you know, I ended up in the emergency room for an episode of severe dry eye, um, where my vision was compromised, it was just painful, gritty, I was not able to work. So I had to take a week out of work. I couldn't type, I could like, like I couldn't do anything. And I was diagnosed as having a condition called phytokeratosis, like in an emergency room, which was Welder's disease, is what he said. And, you know, of course, that leaves me in a panic of what does this mean for my career? End up seeing a female ophthalmologist who was in midlife herself. She was in her 50s, and she was able to say, Tell me, this is an actual severe form of dry eye. And this can occur, you know, with contract chronic contact lens use, but specifically like in midlife, when you're you start to have hormonal changes, you know, that are consistent with, you know, menopause or perimenopause, these are some of the precipitating factors. And so it was such a relief to be able to hear that, number one, but also to be correctly diagnosed, and then also to have to navigate, okay, what is next for me? And I think the journey was fraught with you know, pre-ops, medications costing$700 a month. Like it was, and I thought to myself, if I'm having such trouble navigating this, yeah, what is the and I'm in the health system, I'm in the health system. What is the standard woman who is, you know, not within the system, who has access to being able to meet with a doctor within a couple of days of an incident like this happening? What are what is their experience, number one? And then number two, as I continue to take care of women who were perimenopausal and menopausal, and I noticed that, okay, the tides are changing and how we are, you know, the ability to really advocate for them, like I started to see less and less black women in the conversation in at the at different uh in the different rooms where we were talking about this and having these conversations. And I would start to wonder, okay, if I'm one of the two, you know, in a room of a hundred, where are the other women, you know, and not only that, but is this information getting to them? Because as I did more research, I understood that black women are impacted differently, you know, during this time. And I felt so, you know, and I don't know if the word is inflamed, but you know, impassioned to be able to bring the conversation to women who in different ways, right? To see how we can engage them in the conversation and help them look at their options, not just for symptoms, but for their long-term, right? Their long-term health care. Because as we'll go into, you know, black women were, you know, higher risk for cardiovascular disease, higher risk for hypertension, diabetes, some of the more chronic diseases. And this information may not be known. And the way to a road to prevention is really treatment during before, but also during that menopausal transition to reduce the risk.
SPEAKER_03:Yeah. I'm so glad that you have the fire in your belly and you're doing something to change, to change the narrative, and actually not change the narrative, but bring it forefront, right? Because it's a really important conversation. Um, you mentioned that the menopause journey is different for Black women. And I'm wondering if you can that a little bit for us and talk us through those unique health disparities that you see in your work.
SPEAKER_00:Yeah, absolutely. And I'm gonna go um and really discuss the research, the data, you know, because I think it's important for me to be able to speak from information that has come from studies. So the Swan study, which was started in the 19 like 1996, and it spanned about two and a half decades. And what they did was they looked at women across the nation. So it stood for the study of women across the nation, and this was in all cities across the United States. Um, and what they did was they enrolled 3,302 women, and what they wanted to make sure of is that they had a cohort of Caucasian women, black women, Hispanic women, Japanese and Chinese women, okay, so that they can kind of look at throughout the midlife transition, and these women were aged between 42 and 52. Throughout that midlife transition, what do they find when it comes to their menstrual periods, to their symptoms, to you know, some of the conditions that they experience when it comes to, you know, uh discrimination. They wanted to look at how their bodies, what kind of exercise, what all these different aspects of during this midlife transition, you know, what happens. And what they found specifically for Black women is that black women enter menopause earlier, so approximately 1.2 years earlier than Caucasian women. And they also found that Black women experienced their symptoms longer, um, and specifically the Viva motor symptoms, and they also found that their symptoms were more frequent and they tended to be more severe. So these are statistically, you know, documented um data points. And I think it's also important to know that there was a breakdown that looked at hormone replacement therapy or menopause hormone therapy, as we call it nowadays, and the just prescribing fact, you know, the prescript the prescribing practices of physicians in 1999 before the women's health imperative, it was about 27% of women were on you know hormone therapy. 2020, it was about 4%. And out of those, that 4%, when it came to black women, it was 0.5%.
SPEAKER_03:0.5. Wow. Wow, wow. I have never heard that statistically. Oh, so that's shocking. Stunning.
SPEAKER_00:Yeah. Yeah. So I think these are some very real, this is some very real data. Um, and it's not just observational, it's really based on longitudinal, you know, studies where they followed women over time. So they do experience a very different, you know, experience. I mean, I could go into more detail where, you know, when they looked at sleep, right? I think it was Caucasian women tended to complain the most about sleep symptoms, but when they actually did the activity, and the activography is the test, you know, you know, when you have a sleep study, they really examine the length of sleep they found that for black women, even though they didn't complain about it, their sleep was on average less, you know, that like in terms of the time than it was. They got less hours of the restful sleep than you know, other women. And so it's it's just important to notice that there are very specific changes. I could go into even, you know, when it came to comes to depression, you know, there there were very specific statistic and that statistical analyses that were done on a large scale to assess these differences.
SPEAKER_03:I find it interesting. Um, so so black women experienced uh menopause earlier, uh, longer and more severe, right? It's what you've said in a nutshell. And you're and you noted the swan study, and we're familiar with the swan study, but you know, we even in the menopause space, we don't really hear the swan study referenced that often. And I find that interesting. I'm wondering if you can can speak to that a little bit and also talk about some of the other root causes that might be driving inequities, um, whether it's in research, whether it's in those systemic barriers in healthcare, um wider bias. I mean, we could probably have a whole podcast just on that uh topic alone. But can we can we move into that conversation a little bit and unpack that?
SPEAKER_00:Yes. So when it comes to the Swan study and why it hasn't been discussed, um, I, you know, I I think what I've seen is having this conversation enter mainstream has been the focus, right? Because if we're going from shame to like a 2023 article in the New York Times to like it's just been a building up of really getting the conversation into mainstream so that people are talking about it. Um, and I my desire is that with time, you know, these statistics from the Swan study will become more a focus. Because I think right now we're focused on like, okay, how do we bring this about, no matter who it is, whether it's a celebrity that brings it out, who can bring this conversation so that it can be taken seriously. And so that clinicians in general can realize that, you know what, women are actually self-advocating for themselves based on this information. So I feel like we've reached a major milestone. I mean, the next milestone is the FDA and this black box warning, right? So we are reaching great milestones. Unfortunately, when it comes to the Swan study, being able to have enough voices that bring it up and talk about it, I think is one thing that my desire is for for, you know, as we move forward. Um, I know that, you know, the findings around Japanese women and Chinese women, they tended to have less severe, you know, symptoms compared to Caucasian, you know, and for Hispanic women, I think what one of the things that they noticed is that the vaginal symptoms are what they complain about, even though they have really bothersome, you know, vasomotor symptoms. But it was more the vaginal symptoms that they complained about. So these are all nuances that I think it's important when it comes to clinician education, right? That this is going to be important when it comes to making sure that we're looking at equity. Because, you know, if we're not looking at these inequities, you know, like what are we truly, you know, how are we truly making the space equitable for women to see themselves representing, representing? And then the second question you asked was root causes, you know, driving these inequities. I think, again, there's clinician bias. I know, I think one of the things that I know, especially when I was still, you know, delivering babies and in the hospital, is that, you know, we know the maternal mortality rate is three times higher for black women than it is for, you know, other women. And so knowing that a lot of, you know, the underbelly of that has been, you know, part of it has been clinician bias, right? And systemic barriers. But I think we have to address that clinician bi clinician bias because I think sometimes symptoms can be minimized and reframed as stress. And so it's really important that there is not just, oh, you have to complete your um, you know, bias training once every two years.
SPEAKER_01:Right.
SPEAKER_00:But I think as we as we um bring about change in you know, education for clinicians, that that bias is also something that is consistently brought to front. So that as clinicians, we are aware of what our biases are, and that that women's symptoms will not be memized or reframed as stress, especially if you're a black woman and that you can just handle it. So that's one. And then I think, you know, systemic, you know, barriers like insurance inequities, you know, occur. And then access, you know, to menopause specialists, people who are trained, you know, in being able to. So what I hear a lot, especially in our support groups, is that, you know, I have patients, black women, who go out, ask their doctors, their doctors send in synthetic hormones, and then because they've done their research, hey, I don't want synthetic hormones, I want bioidentical hormones. And then it's like, okay, here you go. And then the next thing they're like, I'm bleeding. What do I do? We don't know. So being able to have access to specialists, you know, women who or doctors who or clinicians who can actually help women, you know, is very, very important. And that is another systemic barrier that I have noticed. And then I think research, right? It hasn't evolved, it hasn't involved a lot of black women to date. So even with the swan study, for every single location, right, they had a white cohort and then they had either, again, the Hispanic, the um Chinese, the Japanese. So every, every every location they have had a white court, but they had to have, you know, a cohort that represented a different ethnicity. So I think I mean, and I'm just grateful for what this Swan study has showed us and the information. But I also think that we need to do better when it comes to you know research in general, because even in the WHI, the number of women, even though it was a large study, did not have a significant portion of black women involved in that. So I think that there's no data reflecting black women's experience. Yeah. Besides one.
SPEAKER_03:That's interesting to me. Um, there's layers, right? There's not enough um research for women in general, period. Um, let's note that. And then you add that additional layer on top of, right? So now we don't have um, you know, we don't have representation for Black women with the little research that we have for women in general. So it's it is an obstacle. And I, you know, I think often about um the insurance, um, the way that our health care is structured today and the inequities that we are, it seems like we are uh we're not doing better. We're doing, we're going the other direction right now. Um and I can see where that would be extremely challenging. Hopefully that is changing. Um that there are, you know, alloy does a fantastic job in caring for women in menopause, but certainly not having access to certified menopause specialists, um, you know, is another barrier. Um you're being dismissed by your um GP or you know, fill in the blank, whoever it is that you're seeing um that they're they're not, they don't know. Um I'll give them that maybe, right? We don't know because we we know that they're not um not, we have a very limited number of physicians that are trained in menopause adequately. So another layer, right? Yeah. Right. It's complicated.
SPEAKER_00:Yeah. And I think there's one last thing, April, the mistrust in the medical system that I see within, you know, you know, in general, like black women, not all black women, but I think there is this underlying fundamental like, you know, mistrust. And it's rooted in historical, you know, you know, things that have happened, historical harm. So overcoming that as well is a huge um part of, you know, what what what is contributing to these inequities is is really this mistrust. And how do we, you know, outside of a community, how do we really address this so that women can understand that, you know, okay, we'll walk you through your process, you know, to getting what you are comfortable with at, you know, at as you go along with it. Because I really do believe, you know, in hormone therapy for those who are candidates in terms of reducing the risk for chronic disease and even when we talk about longevity, you know, estrogen is a very in general, you know, more harmless than it is harmful. And it obviously involves a very personalized approach so that patients can understand, you know, okay, let's address that there is a little bit of mistrust, but let's educate you as well, you know, as what the pros and cons of all the options are.
SPEAKER_03:Do you think black women are suffering more? Um because of that, you know, I'm I'm it it really I have to ask that question because um because I'm truly curious. I I don't know woman. Um, do you think that because there is that mistrust uh with the healthcare system that black women are suffering uh more?
SPEAKER_00:I I do, I do, and or they're willing. I shouldn't say that, but there's a level of, okay, I'm I'd rather just go this route versus this, you know, I can navigate, you know, suffering through. Um because there is that level of, uh, I'm not sure. I don't want to add anything into my body. And when you break it down for them and share with them that, especially with bioidentical hormone therapy, all I'm doing is replacing a little bit of what your ovaries aren't naturally producing anymore. That's all it is. And it's almost like, you know, like it's like a wow, I've never heard of it like that. If that's all it is, you know, because explaining to them that this is bioidentical, this is similar in structure to what your ovary naturally produces, it really makes a difference for them be, you know, to be willing even to take take the first step, you know, versus it having this connotation that, oh, they're treating me with hormones and their side effects and all these different things that could happen to me. I feel like it really requires just breaking it down simply.
SPEAKER_02:And I can also imagine that if you know you're hanging around with your group of friends and nobody's doing anything about this and is not informed, then why would you go out on a limb to, you know, do something that somebody that you don't even know or looks like you is doing and you know, we don't talk about it and it's fine, and I'll get through it. Because when I look around at you know, my peer group, we're all in, we're all like talking about that. This is an important thing, probably because this is what I do all day long. This is what we do, right? That's what I do all day long. But I I know that if I didn't see people like me who or no one was talking about it and everyone was just suffering to get through it, because that we've done that so many times with so many other things that it would be a hard sort of mind to change.
SPEAKER_00:100%. And I have a story for you because I had a very specific patient who found me on Instagram. I brought her into Alloy because I was like, look, we can't communicate on Instagram about health issues. And so she came into you know, alloy, and we went through absolutely everything. She had a group of friends and they were Buddhist, you know, and she was black, but she had her Buddhist group of friends, and they all had told her hormone, she had prescribed to what they prescribed through, and they had basically were like anti-hormones. And so it wasn't until she started to be like, okay, I'm starting to feel miserable, and I'm starting to see Oprah's talking about it. All these different people are talking about it. And so now I'm gonna do my research. So she took time to do her research while she was doing her research. She had her doctor start her on VIOSA, which is in non-hormonal therapy. But then by the time she came to me, she DM'd me, brought her into Alloy. We did a full consult where we went through all her options, you know, and she was ready. She was ready and she said, I'm actually going to choose this for me, because even though my friend group isn't there, I want to be able to plan for not only what I'm dealing with now, but also for my long-term health. And she probably and it was a victory, yeah, for her.
SPEAKER_02:And she probably told her friends. Yeah, there's a ripple effect on the other side. Yeah. Yeah. Yeah. Um, okay, switching gears a little bit. Um, I read a New York Times article recently that um black women have been experiencing more unemployment in the past two years, that the workforce hit black women particularly hard.
SPEAKER_01:Yeah.
SPEAKER_02:How does menopause intersect with race and workplace inequities as it comes to menopause? Because I was surprised by that. And I know that you know, the women that are probably being laid laid off in the federal workforce have worked there forever and are probably of menopause age. And so it again, the workplace is being, you know, in uh discrimination, you know, in intentionally discriminating with women in the workplace. But can you talk about the sort of race and workplace inequities as it's related to menopause for black women?
SPEAKER_00:Yeah. And so I think just as you said, I think in general, black women are already navigating these, either whether it's pay gaps, racial bias, they face an extra burden when it just comes to the workforce in general. But when you think about going through menopause, and I've seen this with my patients, you know, their symptoms, they affect their concentration, their energy, their confidence. And when that starts to happen, you really need a level of workplace support, right? In whatever way that looks like. So I have patients who have told me that they either are business owners, they can't get off the couch because of these symptoms. They're just energy is depleted. You know, they're running their own businesses and it's just like, I just don't have the energy to do it. I have other patients who, you know, are responsible for billion-dollar contracts, right? And they are unable to, like they're in meetings and their confidence is affected because their memory is, you know, they have issues with their memory, concentration, and they are really lacking confidence when it comes to, oh my gosh, what is it that I, you know, need to do now? Because I really think that my boss is not going to fire me, but they're just thinking my work performance is poor and I'm going to be in trouble with, you know, at my work evaluation. So I think when it comes to black women in general and what we're seeing with these federal layoffs, so I can't control what's happening with the federal government because they're choosing to do like, or we can't control what's happening right now. But I do think that when you look at the workspace for black women, they're even going to be more impacted because you know, if they're not getting the cure for some of the symptoms that they're experiencing that are affecting their performance, right? You know, without that workplace support, you're gonna have mixed missed promotions, you know, when it comes time for promoting somebody, if they're having issues with concentration, they're not gonna really be on the top, you know, tier for a promotion, reduced pay, you know, and some of them cut back from their careers, right? You know, and that's the sad part because, you know, I one of my greatest joys is being able to see some of these women, you know, go from where they were, start hormones, and then they're just like, oh my gosh, you know, I'm actually participating in meetings, and I feel yeah, and I feel like I feel better. And you know, all that lack of confidence that comes with you know your symptoms, it goes away. And you know, I see patients and I'm like, you're a different person. So, so, so, so I think looking at you know, black women, again, 0.5% on hormone therapy, you know, to be able to like have like you know, and a lot of black women have more physically demanding, you know, job positions. So this already sets them back to some degree, you know, because 0.5% is a very low dose, low low percentage of black women who are on hormone therapy. And as we know, this can be something that's really helpful in just restoring the estradiol levels and getting you back to um a better performance, whether it's mental clarity, you know, and all the different things that can contribute to, you know, reduced performance.
SPEAKER_03:So the um access to healthcare uh is important, you know, I'm hearing that over and over and over again here uh in this conversation, so that they can get the support that they need. I'm wondering as we think about employers and the workplace, because that's the space that we sit, right? Um I'm wondering what role employers can play in reducing those healthcare disparities. So, you know, moving beyond, um, I don't want to say just um healthcare benefits, because it's extremely important to have those benefits to get the help that they need so that they can get back to the workforce and perform at that at that peak, right? With the confidence, yeah, feeling better. It's really important. But what else can employers do um to play a role there in re in in reducing those healthcare disparities?
SPEAKER_00:Yeah. And that is such a great question because I think, yeah, okay, awareness is one thing, but I think changing policies is really where, you know, the the the the you know, that speaks volumes. Okay. And so when I think about um, you know, flexible scheduling, you know, there may be women who have really debilitating problems with their sleep and maybe just starting a little later, you know, and and ending a little like having that flexibility for scheduling, I think is is is one core aspect. Um, if you have to wear a uniform at work, having breathable, you know, material so that it's not something that's gonna, you know, be worse off for you if you are having and experiencing the hot blushes um and uh you know, sweats, having having material that's breathable that's that's one way to look at it I think you know I look at temperature controls like do patients have like do do um employees have the ability to you know regulate temperature within their spaces um and then I think you know even looking at paid time off for doctor visits you know does that employer offer time for patients to actually you know get the care that they need because I think sometimes you're looking at oh I don't want to take the time off because I won't get paid for it but then is there that time paid off available um and then I think you know insurance covering you know menopause care so that women can go over all their options and know what their options are and then I think it's important to know that okay if one course of treatment isn't working let's move on to another so that you know women don't feel like they're stuck in a okay I used my one benefit or one whatever that I get like but that is something that's available you know consistently so that you know I think what I found is that validation and options are something that women like even just getting that it's like a huge weight off their shoulders and they feel like more empowered in this journey. So it's not just okay you had your appointment here's your treatment goodbye. Right they need that um and then training managers because I think sometimes managers okay you can but what what are you training them to be looking for you know in some of the the the women because I think what tends to happen is if a manager isn't isn't aware of what maybe what some of the what the lived experience is of you know their the employees it's really hard for the manager to be able to identify and ask more questions.
SPEAKER_02:Yeah you know when they see something you know within a patient like concentration they're not like the assumption can always be oh you know not working hard enough not you know and so I think it would be nice to be able to train or efficient like it would be imperative I shouldn't say nice imperative you know for managers to be trained to be able to identify those are those are great those are all the answers that we usually talk about on why supporting women in the in the menopause space is important. I want to go back to something you just said a few minutes ago about you know start trying something and then you got to keep sometimes you got to tweak it. You got to be experiment and you got to get curious about what's working for you. And I don't know if I mean my experience is that women are not good at that I take the prescription and I just deal and I would imagine that you probably have to talk to your patients and I don't know if this is a a black woman issue or not but really figuring out what works for you might take a minute. And and and it takes some time to figure it out and you might have to experiment a little bit to feel really good. But feeling good is just so important especially at the stage of life where we're sandwiched between you know taking care of our children and our parents and you know our careers and all those kinds of things to feel crappy in the middle of that is not helpful at all. Can you speak to that a little bit?
SPEAKER_00:Yeah no I I completely like understand what you're saying about feeling good and what I find with patients is um it's so interesting because this is what I have to tell them. They come and they're like so confused about okay do I do this but then if I lock myself into this then you know or should I choose this and you know and then if I lock myself into this like they see it as a fixed one fixed solution. Meanwhile this is like trial and error and I tell patients this all the time your body and your girlfriend's body are completely different bodies okay so your genetics your body chemistry is going to be different. So what worked for her may not work for you. And I think changing the mindset that it may take a little bit to get you to the sweet spot. So we may start you with progesterone only if you're an early perimenopause after three months because that's usually how long it takes to adjust to any form of like you know a new hormone within your system right we all have estrogen receptors in different parts and how those estrogen receptors respond, it can take a minute you know because it's again we have them all over our bodies we may notice some side effects we may and again it takes your body what a good few weeks if you have side effects for them to go away. And so I think it's really important to understand that, you know, okay we start within three months we're looking at making tweaks if necessary and then boom we go another three to six months we need to make tweaks we do that if necessary. So it's not a one size fits all it's very personalized. And your symptoms the ones that are the most burdensome are different from somebody else's so we will only know what works for your body based on what you tell us and we try to tailor it to again not only your symptoms but your age your family history your medical history right and your allergies so there are a lot of factors that come into play in determining where we start and then also how we make adjustments after three months. I've had women who it takes a year for them to get to a point where you know they know that things work. So that's where I always tell patients that it's important to be patient with your body and that this is a journey. You know we're we're it's not a one and done it's it's it's it's a journey where we you know require frequent check-ins to see what modifications need to be done.
SPEAKER_02:I think that's huge for all women to understand we're all different.
SPEAKER_03:Yeah yeah my symptoms are different than Kim's and yours and right um and we all have comfort levels and how we want to manage those symptoms and to your point our backgrounds and our genetics and it's all different. So I I love that you bring that up because we sing that song every time we gather with a group of women we were just saying that last night in the fireside chat and we were also it's interesting you said something earlier too that I want to come back to um it's it's interesting that you mentioned community groups um because at the end of the fireside chat last night um really the conversation turned to isn't this great that we have each other that we can we can share ideas we can share what's working for one maybe have you tried this and I think that's important because you don't know what you don't know right oh I didn't realize that that was available so I'll I'll ask my healthcare provider about that. The the community groups and um support building that tribe is really important. And I know that there's research that shows that it will actually lessen our symptoms just by thinking about it and being there's you co-lead uh support groups, right? Wellness support group. And I'm wondering what you're hearing directly from the women in your support groups and I'm also wondering how that can help fill gaps with the traditional healthcare systems.
SPEAKER_00:Yeah it's it's I mean they're powerful they're so powerful uh we get you know black women from you know different parts of the country and um the one thing that I know is that I hear women share about I thought it was just me. Right always you know I thought it was just me. And then I also see you know how to learn self-advocacy right so one woman who maybe further along in her journey and then somebody else who's just starting her journey they are actually like wow you know I never thought to ask my doctor that and so you know we have women come back just as I shared earlier wow next time you I come back you're gonna hear that I'm on hormones you know for somebody who was not a believer in them. You know I had another patient who was on hormone therapy and she had a history of fibroids had started some irregular bleeding and they couldn't get it under control. So they told her okay let's do a hysterectomy because she was 55. And you know what she did? She said you know what I want to know what my other options are you know and she came to the group and she asked hey I was looking them up and a uterine artery embolization I looked at and I thought about that. Lo and behold there was somebody else who had a uterine artery embolization in the group she could share her experience and just things to consider. And it was such a moment of um uh like integrative support and her feeling good about being able to go back to her doctor and share why she wanted this you know more empowered and so I think you know learning that self-advocacy is something that I see in the groups and then I think it's like you know just of course group validation you know shared solutions you know women come back and say okay well this worked for me or I tried this you know sugar that's non-glycemic or you know it's more expensive but this is what really helped me get you know my um blood sugar control improved when I chose to adjust my nutrition you know and so there's this sense of sisterhood. It's like I'm looking out for you you're looking out for me I want to help you understand what worked for me with my skin symptoms like I use this brand I use that brand and it helped me again I'm just sharing knowledge that I've gained and I think that you know really fills the gaps that the traditional healthcare system leaves open. And they feel like okay yes I may not have had a long conversation with my clinician but I came to this hour support group and I felt like wow this answered my question because I could tell her what a uterine exactly was right explain it, how it's done, what some of the side effects may be, you know, and I'm not sharing this with them as their doctor but just as a source you know of you know medical information that they may not necessarily get within that short visit with their doctors. And then they have that information and they can then take that to their health provider right yeah yeah so yeah works both based I love that before we move on I want to um just can you please tell us how um our listeners can be a part of those community groups yeah um so alloy at www.alloy.com we actually have a um I'm gonna send this to you we have um event rights and we actually send them out um every for you know and as long as you're on the email list we can actually send you one you can register and then as long as you're on the email list you'll you'll get them you know every time they go out and that way you'll know when they are at least a week before and we do them twice a month. So that allows women who aren't able to attend every month but we have women who come every single time we have like a crew of women who are you know who are like these are my people now and yep yeah yeah it feels good to be a part of a community that you're familiar with we all want it we all want that right yeah I want to feel connected and I also have younger perimenopausal women like in their early 40s who actually come and they say I am so glad I am getting to hear this see this learn this so that when my symptoms get worse right it's just good to see women who look like me who I can actually be like wow yeah I know what to expect.
SPEAKER_02:That's fantastic. Dr. Dumbo we could talk for another couple hours um really appreciate your um knowledge experience your um what did you call it fire in your belly fire in your belly yeah I love I just I just love that but if you could leave our listeners with one key takeaway um what would what would you want to leave them with?
SPEAKER_00:I would say don't normalize suffering I did that you know and I ended up with debilitating symptoms where I actually started to cut down on my shifts at work because I was doing 24 hour shifts but don't normalize suffering you know because I think you can it's very easy to say oh my gosh I'm getting older because I'm 50 turning 52 and I was like okay this is maybe just what happens as I get older you know and and I normalized it to the point where I you know I was you know in emergency room but I just didn't know what was going on. So that is one thing that I would say do not normalize suffering. And then I I would also say you know um you know if your clinician is not being proactive you know in addressing your symptoms and discussing all of your options because I think it's really important for there to be agency you know you you have you you leave feeling with a sense of agency. There are always other options and you can always give your clinician you know um opportunity by maybe taking an article with the 2022 guidelines, you know, for menopause, you know, hormone therapy if you really are considering hormones. But I also say that if you're reaching a wall, you know your your story is not over like there's always somebody else or there is somebody else who would be able to help you.
SPEAKER_03:That's great. We always say you can divorce your you can divorce your divorce your done if you if you need to yes and go find it's okay.
SPEAKER_00:Yeah absolutely yeah absolutely so where can people find you um I am at alloy women's health or x it's www.alloy.com excuse me my alloy dot com so they can find me at alloy and that's where I spend majority of my time excellent and you're on Instagram you know yes I'm on oh that's right and on Instagram at dr dot couldseye fantastic where I try to share pearls show notes okay yeah I'm gonna go follow you as well yeah okay wonderful before before we sign off we ask everyone what the best piece of advice you've ever received has been what would you say to that follow your gut you know follow your internal like that internal voice about what you may experience or feel and know that one door that may appear to be closed there's another door open somewhere else so I do that for patients for other clinicians for myself I think it's really like we have wisdom within us and we know.
SPEAKER_03:We do just we do and when we go against gut oftentimes it doesn't work out. So we need to listen to our gut. Yeah yeah thank you for that and thank you so much for spending this time with us and sharing your expertise I'm sure we'll have you back because there was a lot that we didn't have an opportunity to discuss. But until we meet again go find join the journey. Yeah absolutely thank you so much take good care all right bye bye thank you for listening to the Medovia menopause podcast if you enjoyed today's show please give it a thumbs up subscribe for future episodes leave a review and share this episode with a friend. Medovia is out to change the narrative learn more at medovia.com that's M I D O V I A dot com
