Last month, I had the chance to attend an incredible event at a friend's home in NYC. A group of women who don’t have children were invited to ask any of their burning questions to two top doctors from New York Presbyterian who specialize in women's health. There was Zev Williams, MD PhD, who is the Chief of the Division of Reproductive Endrocrinology and Infertility, and Mary Rosser, MD, PhD, who is the Director of Integrated Women's Health.
The host was inspired to put this event together after having a conversation with a group of women where fertility had come up, specifically freezing your eggs. It was a group of women from all different backgrounds, a variety of industries and stages in their careers, and all of the women were in their 20s and early 30s. The woman who posed the question about freezing her eggs took time to work after college then decided to go to law school. Now she's a first-year lawyer at 29 and she thinks freezing her eggs might be a good option for her because the first few years as a lawyer are extremely demanding. No one in the room could offer her much insight or advice; realizing we don't know enough about our bodies or our options as women who may or may not want children one day.
So, my friend decided to throw this amazing event for us to ask all of our questions in an intimate setting and, while she was worried women may come without questions, there was no shortage and I'm sure we could have kept the conversation going all night. It was clear that we aren't getting the information we need elsewhere and the need for this event for women everywhere is very real. This is an event I strongly encourage you to produce if you're interested. It will take some effort on your part, but if you're passionate about this, let me know! I would love to help you put it together in your city!
Over this three-part series, I'm going to cover three main topics we covered and I'll include our questions and the doctor's answers. This is not going to go in as much detail as it could, but it will hopefully answer any questions you or someone you know may have. Today's post will cover women's health in general. Next week will highlight fertility and then I will cover our discussion on egg-freezing. Please submit any additional questions you have as I am in touch with the doctors and I'd love to have a list of questions I can bring to them to keep the conversation going!
Questions & Answers: Health and Wellness
Answer: "Yes, in more comprehensive visits we usually get to those deeper issues. What is good to do is Google things, educate yourself and then come in with some knowledge so the doctor can help guide you based on what they feel is accurate or not. Also asking the doctor, what is it about my health that I need to know now? is okay too."
Dr. Rosser doesn’t want us to rely on Google or WebMd but she said it doesn’t hurt to do some research on issues you’re personally dealing with so you can come in to the appointment as an advocate for yourself.
Answer: "We love the IUD, they are appropriate for young women without children and women in their teens/early 20s are tolerating it very well. Many women are put on birth control in their teens to control cramping. If you have been on it for so long, you aren’t sure what your regular cycle will be when you get off. It takes time for hormones to regulate. We recommend 3-6 months to get back into your regular cycle. If you go off and have a normal cycle and get pregnant, that’s ok too. If you're on an IUD with progesterone, it can take 7-9 months to see a regular period. Birth control pills get blamed for a lot of things that they may not be responsible for. The pill could be masking symptoms of other issues."
Answer: "We should be using the visit specifically targeting your needs. If you have a history of irregular paps, you should be doing more tests. Everyone should be getting the HPV vaccine and we should be discussing health screenings and cancer screenings, mental health, preconception planning, birth control, family planning, domestic violence, sex."
She suggests women make a list of what’s important to them. Paps for women without the HPV vaccine should happen every 1-3 years starting at 21, paps for women with the HPV vaccine should happen every 3-5 years depending on your personal situation. She recommend we still go see an OB every year to look at anything else we may be concerned with.
Answer: Dr. Goldstein explained that Endometriosis happens when the cells that normally grow inside of the uterus, live and grow outside of the uterus. This can lead to pretty painful periods. Interestingly enough, the interval between women first experiencing it to the time they finally get their diagnosis is 9.3 years! You can be living with this pain but if your mom, aunt, and grandma all had it, for example, they could be telling you it's normal so you might just get used to it and accept it as your fate. Usually the tipping point when women finally receive their diagnosis occurs when they start missing too much work or can't have sex with their partner due to the pain, so they go to their doctor to find a solution. Otherwise, you may not bring it up with your doctor if it has become a normal part of your life every month for years and years.
Dr. Goldstein joked that when something is called a syndrome, like PCOS, it just means there are a whole bunch of symptoms and doctors don’t totally understand what is going on so they group them together. PCOS is diagnosed in over 200,000 women per year in the United States and while it might not be totally understood, some of the symptoms include menstrual irregularity, excess hair growth, acne, and obesity. It is diagnosed when women are having irregular periods and hyper-androgenism. If somebody gets diagnosed with PCOS, they have to think about lifestyle changes to help alleviate the symptoms and they must monitor their health for the rest of their lives to avoid chronic diseases. Treatments for PCOS include birth control pills to regularize periods, a medication called Metformin to prevent diabetes, medication to control high cholesterol, hormones to increase fertility, and procedures to remove excess hair. A blogger I love, Lee Tilghman of Lee From America, has a bunch of great articles on PCOS and how she copes with it through her lifestyle choices. You can find more about her experience here.
The overall message of the night was that maintaining your health in your teens, 20s, and 30s, will predict your health later in life. More specifically, it will effect women’s chances of getting pregnant and men’s chances of getting someone pregnant. Eating healthy, exercising regularly, keeping a low BMI, consuming a moderate amount of alcohol, not smoking, and eliminating drug use is the quick list of what we can keep top of mind when it comes to our health. Dr. Rosser made it clear that our lifestyle affects every system in our body, which includes our fertility. When we are stressed, we turn to different things like drugs and alcohol. We may start eating too much or not eating enough. So on top of the physiological effects stress has on the body, we add to it through our behavior.
What I loved about these doctors was their holistic approach to health. There was more talk about prevention and screening and less about medication and treatment. I asked the doctors how they help their patients focus on all aspects of their lives when it comes to health and their answer was so interesting to me and so applicable to this blog. Dr. Goldstein said there is no one way to tell patients to live their lives to get the best results. They do their best to bring in mindfulness coaches, acupuncturists, masseuses, and more to help patients, but he said that if the process of booking an appointment and scheduling those visits into our busy days cause more stress than benefits, it is cancelled out. Appointments with specialists can also get expensive and insurance might not cover them either, so they aren't usually an option for most of us anyway. A simple walk in the park could be enough and just as beneficial to provide us peace of mind and lowering our stress. We have to do what helps us and what calms and soothes us best . That really resonated with me and I hope that will always come through with every lifestyle topic I share on Not A Mama Yet; the general rule is we each do what’s best for us. I believe knowledge is power and the more we know allows us to make the best decision for ourselves.
What we your biggest takeaway from this post? Do you have any questions about your reproductive health? What lifestyle habits have helped you?
-Natalie