Why Your Doctor Isn’t Helping With Your Period Problems (Episode 368)

Full Transcript: Episode 368

Welcome to the Fertility Friday Podcast, your source for information about the Fertility Awareness Method and all things fertility. I’m your host, Lisa Hendrickson-Jack. I’m the author of The Fifth Vital Sign and the Fertility Awareness Mastery charting journal. I’m a certified fertility awareness educator and holistic reproductive health practitioner with nearly 20 years of experience teaching women to connect to their fifth vital sign through menstrual cycle charting, balancing hormonal health, and optimizing the menstrual cycle without hormones. I’m outspoken about hormonal birth control and its impact on fertility and overall health because you have the right to know how your body works and how artificial hormones disrupt that natural process. I host live coaching programs to help you achieve optimal fertility and health because it’s important to have healthy menstrual cycles regardless of whether or not you want to have babies. I’m also a wife and mother of two beautiful boys. This podcast is designed to empower you to take full control of your cycles, your fertility, and your overall health, and I’m so excited that you’re here with us today.

Today I’m sharing a brand new interview with Dr. Aviva Romm. We are getting into what I feel is one of the most important questions and challenges that women face when they seek healthcare support, when they seek medical support. And that is those interactions with your doctor. Why is it that so many women have such a hard time getting their doctors to listen to them, to take them seriously, and even to get to the root cause of their symptoms? Why is it so hard for us to find real solutions to our health problems? And we really go in deeply and even ask the question — is your doctor always the best kind of first port of call when you have certain specific types of health issues? So if you’ve ever had a challenge with accessing support from your medical doctor, if you’ve ever had a time when you were either not believed, not really listened to, or taken seriously, or you really felt like you weren’t getting what you needed from your doctor, then you’ll certainly appreciate today’s episode — really candid and really honest. And in case you missed the previous interview episode with Dr. Aviva Romm, you can head over to fertilityfriday.com/259. In that interview, we talked all about thyroid and adrenals.

Aviva Romm is both a midwife and a Yale-trained MD and board-certified family physician with specialties in integrative gynecology, obstetrics and pediatrics, with a focus on women’s endocrinology. She’s also a world-renowned herbalist and author of the textbook Botanical Medicines for Women’s Health, as well as seven other books including The Adrenal Thyroid Revolution and her new book Hormone Intelligence — a practitioner, teacher, activist, and advocate of both environmental health and women’s reproductive rights and health. She’s been bridging the best of traditional medicine, total health ecology, and good science for over three decades. So without further ado, let’s go ahead and jump into today’s interview with Dr. Aviva Romm.

Lisa: And I’m really excited to have Dr. Aviva Romm back on the podcast. Aviva, welcome to the show.

Dr. Romm: Lisa, thank you for having me back. I love talking with you. I love listening to you.

Lisa: I feel like we had a moment when you were on the podcast the first time. I feel like we really connected. It’s just incredible how similar some of the things that we do are. And I just want to wish you a huge, huge congratulations on your new book, Hormone Intelligence. I’d love to just take a few minutes. For anyone who isn’t familiar with your work, you can let them know a little bit more about you, but also tell us about Hormone Intelligence — why you decided to write that book now.

Dr. Romm: So for who I am: I’m a midwife and an herbalist and a Yale-trained MD and a mama of four and a grandmama of two. My pride and joy is that I got to midwife my grandchildren at home — that is so special to me. I’ve written a lot of books, and I have really spent a lot of my life trying to help women navigate and negotiate their own health, their health as it interfaces with the conventional medical system, how to not interface with the conventional medical system when there might be safer alternatives available, which is often the case. And increasingly my work is just about really shining a light on where women aren’t seen and heard and helping women feel seen and heard in those areas.

Dr. Romm: The reason I wrote Hormone Intelligence now is — I think I’m turning 55 this year. I got my own first cycle when I was 12, so I went into menopause a year ago. I’ve really been in the full at least first three cycles of maiden, mother, and now — I don’t quite feel “crone,” so I’m using the term “queen.” And when you get to where I am in life, I’ve seen a lot. As a midwife and an herbalist and physician I’ve been doing this for 37 years now, and it just got to a point where I’m seeing a critical mass of women struggling with everything from period problems and just living in period hell to endo, PCOS, fertility challenges — and at younger and younger ages. Just looking at the constellation of hearing women blaming themselves: “What am I doing wrong? What am I not eating right?” And looking at all of the complex environmental and social and socioeconomic factors that lead to our health — it was just time for me to kind of step out in a new way and put all this information into one place.

Dr. Romm: I really wanted to create a book that on the one hand addresses women’s immediate health needs: Is this normal? Is this not? How long should a period be? How regular should a period be? How much should I be bleeding? How much pain should I actually have with my period? The answer to that is actually none. Helping women who are struggling with getting an endometriosis diagnosis, a PCOS diagnosis — find a place where they can identify, “Yes, it actually does seem like I have this.” Helping women advocate for themselves to get the answers they need. And then also providing the solutions that are the out-of-the-box solutions that most physicians never hear about that actually have really good, solid, legitimate science behind them.

Dr. Romm: I also wanted it to be the kind of book that you could pick up through any part of the arc of your life — whether you’re 18 and wondering why your period hurts so much and trying to sort out if it’s endometriosis, to whether you’re 48 and you’re having vaginal dryness and your moods and libido are changing. To really have that book across the arc of our lives. The premise of the book is that there’s a hidden hormone epidemic going on. These problems existed before the pandemic — endo, PCOS, women struggling and not knowing what’s right, not being able to get answers — and they’re going to exist after the pandemic. When we see the timeframe that has happened with research around the pandemic, and then we think about the fact that we haven’t really had any new innovations in birth control in a really long time or menstrual health products in a really long time — it was just time. It’s got to change.

Lisa: One of the things that I love about talking to you is that you have a unique perspective, being that you were a midwife for so long and then you went to med school. But I suppose where to start — why is it that women have such a hard time getting help?

Dr. Romm: Oh, it’s so layered. So I’m going to start with just the fact that medicine itself as an institution — and please remember, listeners, I’m saying this as one trained in like one of the white temple institutions, one of the most prestigious universities in the United States of America, and I’m still going to talk about it — the history of medicine is based on misogyny. So if you go back to one of the fathers of Western medicine, we go back hundreds of years. Bacon actually said women’s bodies are like the earth, to be plundered and used as men need to. And the word “rape” actually was in there as a figurative word. That is one of the fathers of modern medicine. And Western medicine from its inception has diminished or devalued women’s lived experience.

Dr. Romm: We have had our bodies treated as if they were just vehicles for reproduction. And we are treated as if there’s something very much wrong with our bodies — the very fact that we menstruate, there’s something wrong with that. And so on top of that, you’ve got layers of tacit sexism, tacit racism. And I say tacit — I mean it’s not always tacit. Sometimes it’s overt. Quite overt racism very often. Quite overt sexism very often. And so medicine — even though we have half of all primary care doctors who are women, half of all OB-GYNs are women — we’re still going through the same system of training that is very much patriarchal, very much based on this absence of the presence of women in important parts of research studies.

Dr. Romm: And so when a woman goes into her physician’s office with — and I’m going to say this in air quotes — “complaints,” because I have expunged that word from my vocabulary. Women don’t have complaints. We have concerns. If we have complaints, it’s about how we’re treated. But the word written in the medical chart is “complaint.” And to me, that says it all. “A woman is here complaining about her period pain. A woman is here complaining about her headaches.” And we are treated with the sort of metaphorical, but quite literal sometimes, eye roll: “Oh, well, that’s just normal. It’s normal to have pain with your period because that’s what women have, right?” We misinterpret “common” and “normal.” And what is now common has been considered normal.

Dr. Romm: And then when you add on layers — how Black women’s bodies are treated, how Black women’s humanity is treated, or women who are described, in air quotes, as “fat” — the amount of fat shaming in medicine. So let’s say a woman comes in with fatigue and weight gain and she is “overweight” — a doctor is most likely not going to say “let me check your thyroid.” They’re going to say, “Well, if you just lost that weight.” A woman with endometriosis who’s Black comes in reporting pelvic pain that’s been going on for ages and asks, “Is there a medication I can take for the pain?” — may actually be profiled as drug seeking.

Dr. Romm: And it goes on and on. There are studies in the sociology of medicine that look at women reporting pain across all demographics that show that if a woman comes into a medical appointment and she has chronic pain or any pain, but she looks really well dressed and put together — she’s likely to be dismissed: “How could she be in pain if she had all the time and energy to put herself together like that?” Versus a woman who comes in in a ponytail and sweats and looking like she’s in pain — who may then be treated as if she is drug seeking. And there are actual studies that show this.

Dr. Romm: Another problem is that the average doctor has about 14 minutes with a patient, and we know the average doctor interrupts their patient within about 90 seconds of the start of an appointment. And so the doctor’s got this checklist of things they’re supposed to get through, and we’re trying to communicate something while we’re flapping open with our back half in a Johnny. Power differential is huge. Someone’s in a rush. And then you add to that a really important layer: as women, largely, we are taught not to confront authority, not to challenge authority, not to be disruptive, not to make waves, to just sort of accept what we’re told. And we don’t know — because we’re not taught intergenerationally — that it’s actually not normal to have pain with sex or pain with your period, or to be doubled over with bowel discomfort every time you have a cycle. So the biases, the lack of time, and then our lack of sometimes confidence and empowerment and ability to confront that — and then when you do confront it, you run the risk of being labeled as difficult and compounding problems.

Lisa: I feel like you very succinctly described many — not even all — of the challenges that women regularly face. I have had clients who present to the doctor, the doctor perceives them as thin, and they have all the signs of PCOS — hyperandrogens, ridiculously irregular cycles that are so obvious on a chart — and the doctor looks at them and says, “You can’t have PCOS because you’re not overweight.” This is like a consistent theme.

Dr. Romm: Exactly. I’ve had patients who have come and just asked a question — not even challenged their doctor, just said, “Well, is there something else I can do? I read on the internet about such and such.” And I’ve had several patients who have come to me over the years who have said a doctor said something like, “Well, where did you get your medical degree — Dr. Google?” These very dismissive statements. There are so many stereotypes of how women are perceived and it runs deep.

Dr. Romm: If you look at the literature on endometriosis back in the 70s and 80s, women with endometriosis were defined as career women whose career choices kept them from having children. And the fact that they didn’t have children meant they weren’t getting good pelvic blood flow, so if they just did their “duties” then they wouldn’t have the endo. The history of women and migraines is astonishing — women with migraines were considered frigid women who didn’t want to have sex with their husbands, and that’s why they either got migraines or used migraines as an excuse. And so these are the cultural myths that doctors have internalized.

Dr. Romm: And when it comes to just lack of knowledge — there’s a man named J. Marion Sims, who was a slave-owning doctor. When enslaved women were having medical challenges, he would take them in, give them “housing” that was apparently like pigsties, and do these horrible experiments on them — repeated gynecologic surgeries with no anesthesia, with other men holding the women down, to see how you could repair vaginal damage that happened often after childbirth in those days. And I was in my medical school class and the professor started teaching about this guy as the father of medicine. I raised my hand and said, “Excuse me, we need to have a conversation about this.” But it was like complete ignorance about the actual history. And when we don’t teach that, we’re perpetuating it — and that’s part of the problem.

Dr. Romm: So what I would say is — there are some wonderful doctors out there, and you can find a wonderful doctor. But there are also other care providers that you can go to. You don’t always have to go to an MD. I would say if you do go to an MD and you have gynecologic concerns or problems that you need addressed, going to a woman — you will be more likely to be heard than if you go to a man.

Lisa: On that, because I think one of the challenges for women seeking support is that you do go to a woman and you want to get better support. But as you mentioned, women are still going through the patriarchal medical school training. And in order to succeed sometimes you have to take on even more of those traits and be even more firm — so sometimes the experience with a female doctor can be the opposite.

Dr. Romm: I talk about this quite a lot — it’s not only an identification with the oppressor, but you almost have to overcompensate, to overprove that you’re “one of the boys.” I can remember I was on my medical rounds when I was in my internship year and I was on OB. I had a patient who was having her fourth baby and had had three C-sections previously. She was having complications with the placenta that were a result of scar tissue — so she had to be in the hospital for a few months. Every morning I would always save her for last and have time to spare to sit on her bed and really chat with her because she had three kids at home, she was worried, she was scared, she was looking at some major surgery with the birth. And I remember walking out of her room one morning — one of my mentor doctors walked by me and said, “Dr. Romm, if you’re ever going to be a good doctor, you have got to spend less time talking with your patients.” And I just remember going, “Mental check — okay, I guess I don’t want to be a good doctor. That’s the definition.”

Dr. Romm: But what I was going to say is: you can actually not go to an MD. Certified nurse midwives, nurse practitioners who specialize in women’s health — even though they do have to go through the medical system, it’s often through a different framework and a different lens. And so those can be primary care providers for you. A lot of gynecology stuff, most cycle stuff, well-woman stuff, pap smears — all of that can happen through a nurse practitioner or certified nurse midwife really beautifully. And if you’re not getting what you need from an MD in your community, or your insurance just doesn’t cover an MD that you can feel good about, often having a different provider is a wonderful option.

Dr. Romm: So many women I know — particularly women who have experienced trauma, like sexual trauma — find that going to a practitioner like a midwife, who tends to be softer in their approach and more just warm and woman-centered, will cry. I’ve had women cry because I’m a midwife first when I’m a doctor. A pelvic exam or a pap smear that was done gently. One of the things I hear most often is: “I wish I knew that. I wish somebody had told me this before — that this was normal, or that this wasn’t normal, and I didn’t have to spend years struggling.” And there’s so much that we can do to advocate for ourselves.

Dr. Romm: I want to share a personal story. I have always had very healthy, easy menstrual cycles. And I went through a period of time that was very stressful — coming out of residency, starting a new job, there were some pretty significant misogynist challenges that arose in that time. And I started having pain in my lower right abdomen and my bowels just went constipated. I know enough to know that stress can cause that, but I also have seen enough as a physician and a midwife to know that so can ovarian cancer in a woman in her early 40s. So I called up a local primary care doctor.

Dr. Romm: She got me in the next day — this was two days before I was supposed to take my board exams. She had an appointment so she got me in with her nurse practitioner. When her nurse practitioner came in, I was sitting on a stool that was probably two feet lower than the nurse practitioner. The nurse practitioner never looked me in the face. She was on her computer the whole time. I would never have a power differential in any way with my patients — we’re on the same level. I don’t ask them to change into a gown until we’ve had the conversation. And then when it’s time for an exam, then they can change. Because who could talk and feel clear and advocate for yourself with your back half flapping open? So I was in my street clothes. Never made eye contact. Then when she went to examine me, she did not do an abdominal exam, did not do a pelvic exam. I was like, “Maybe I should get referred for an ultrasound.” She’s like, “Okay, yeah, that’s a good idea.”

Dr. Romm: I got the ultrasound that afternoon. I didn’t hear anything Thursday. Friday at five o’clock my phone rings and I missed the call. There was a voicemail to call back the clinic. Some doctor gets on the phone and says, “We’re really worried about these findings and I don’t think we’re gonna know what it is until we get in there and have it out.” I’m like, “What are you talking about?” He’s like, “We need to go in and have a look at your ovary and maybe remove it.” I’m like, “What is going on?” So he describes what he sees and I’m like, “What you’re describing from your ultrasound report does not sound like — I mean, I’m trained in gynecology. This is what I do.” He says, “It’s a simple cyst, I think.” I’m like, “No, that’s not what a simple cyst is.”

Dr. Romm: So this is what I did — I called the hospital where I got the ultrasound, asked for the radiologist on call. The nurse asked, “What are you calling about, ma’am?” I said, “I’m calling about a mutual patient.” I get the radiologist on the phone and he said, “I’m actually calling about myself — I am the mutual patient.” And he laughed and said, “I read your ultrasound report. It’s totally fine. You don’t need follow-up. They have no idea what they’re talking about.”

Dr. Romm: But here’s the thing — I played the “doctor card” four or five times. I got myself the appointment in a day because I’m a doctor. I got myself the ultrasound because I knew to advocate for myself. I got that crappy phone call at five o’clock in the afternoon. Can you imagine getting a phone call like that and then waiting all weekend thinking you might have ovarian cancer? That next day I posted it on my Facebook — this was about 10 years ago — and there were 1,500 stories by the next day of women who had gone through things like: “Yeah, I went in for a laparoscopy, I had my ovaries out, my uterus out, and then it turned out it was just benign.” Story after story after story. And while this sounds shocking, when we think about the fact that let’s say sterilization was still legal in California on Black and Latino women in the 1980s — it’s not actually that shocking.

Dr. Romm: So learning what is normal for yourself — which you do such a gorgeous job teaching about in your book — and learning what’s not normal, learning how to pay attention to your cycle. My book is about helping women take that next step when things may not be normal, but also knowing what is normal and learning how to advocate for yourself. And that may mean bringing somebody in with you who’s a really good friend or a family member that you trust. And here’s the thing — it’s not like any individual doctor’s fault either. A study was done looking at physicians’ knowledge of endometriosis and 70% of physicians said they wouldn’t know how to diagnose it, and if they did know how to diagnose it, they’d have no idea what to do next for their patients. And so we wonder why it takes on average nine years for a woman to get a diagnosis of endometriosis.

Lisa: So I’m thinking about this — it does feel very negative at first. But this is something you shared when you shared your personal experience. You advocated for your own ultrasound because you had some idea of what the pain could mean. And so if we think about it for the listener — everything we’ve talked about today — I feel like it’s safe to say it’s stacked against us. Even when I go to the doctor, I have to have a plan and a goal in mind. Why am I there? What is it that I want? I think a big part of what I hope the listeners take away from this conversation is that we need to know where doctors are coming from. Doctors are not evil, they’re not bad, but they are trained in a certain way and there are limitations to that training.

Dr. Romm: Going in prepped, knowing why you’re going, having your questions written down, making sure you’re going in for an appointment specifically for that concern — so let’s say something’s been bothering you for a while and you really need time to talk about it, but you’re going in for your annual exam. There’s going to be a pap and this and the other — tacking it on at the end, you might not get heard. So scheduling an appointment that’s specifically for what you are concerned about, writing down exactly what your questions and your points are, bringing an advocate if you need to, having a little bit of research with you — if you even printed it out from Dr. Google, that’s fine, but bring it with you and say, “This is why I’m concerned about it.”

Dr. Romm: One of the reasons I went to get the MD was to add that level of credibility — so that when a woman who might be listening who is printing something out and bringing it to her doctor can say, “Well, I’m actually printing this off the website of a Yale MD.” Because when you go to your doctor, that’s going to mean a difference to them. And that’s part of managing their emotions — if you’re going into a situation where you know that people are trained to treat you as if it’s ridiculous if you ask about alternatives, finding ways to talk that help de-escalate and manage where someone’s coming from, and honoring their humanity.

Dr. Romm: Because doctors are really stressed and really burned out. The suicide rate amongst female doctors is one of the highest populations of suicide rate in the United States. The more empathetic the physician, the more likely she is not to fit into the system herself. So a lot of the doctors who would be the kind that we want — burnt out of the system, which is really interesting too. But going in with that moment of humanity — saying to your physician, “I know you’re really concerned. I know you might be trained to do this a certain way. What I’m really looking for is a partner in my health and I really value what you’re bringing to the table. I value the years of medical education that you’ve had, and that’s why I’m here. And also I value my own lived experience of my body, and I do know that I wasn’t having this symptom three months ago.” Appealing to that human being can be really helpful and can actually create that connection that then gets someone on your side, rather than going in with an adversarial attitude — which does almost always backfire when interfacing with a physician.

Lisa: What is actually happening in medical school? What is that medical machine? When a woman has issues with her menstrual cycle, should she be going to her doctor for her first protocol?

Dr. Romm: You know, I think of it this way — like you can be a really great farmer who doesn’t do anything organic. You can be really skilled at knowing what pesticides to use to kill pests. But if you’re looking for organic food, you’re not going to go to that farmer. And that’s how I think of it when we go to the medical system — we could spend a month talking about this. The people that go into medical school: I loved my class, I had an amazing experience. We literally had a rocket scientist in our class. I have seen people go to bat for patients in the most humanitarian, incredible, beautiful, phenomenal ways. But it’s still a system that basically only uses pharmaceuticals and surgery as solutions. Abraham Maslow said that if all you have is a hammer, you see everything as a nail. And that is pretty much the problem with medical training.

Dr. Romm: What is happening in medical school is that, fundamentally, we’re taught that diseases are genetic, that lifestyle factors and diet are given like a minute of lip service. I had 40 minutes in seven years of medical training dedicated to nutrition. The first 20 minutes of which was a celebrity doctor who spent 20 minutes reading a poem about polar bears and Pepsi Cola. We’re not taught that the disease or the condition starts the minute you get the diagnosis — that everything else that happens up to then is really irrelevant. There’s lip service given to trauma, to eating a better diet. And we are definitely taught in one way or another that we know — we were told on the first week of medical school that we are the top two percent of intellects in the United States, if not the world. So there is this attitude that we know, and who is anyone else to question? And besides, “I don’t really have time for your questions anyway because I have to go on to the next patient.”

Dr. Romm: And so back to the analogy of the farmer — if you have a really significant problem, that may be where the answer is, and it may be that you don’t know, so you go and get the diagnosis and you find out, and then you weigh your information. Short of trauma or an emergency, there’s very little that has to happen all at once. So there are very few incidences where you go to the doctor, get a diagnosis, and then have to make your decision about treatment right then. You can think about it. One of the things I always tell people is: “Oh, thank you — I’d really like to think about it.”

Dr. Romm: I think if we can reframe going to the doctor as going to a consultant — much like you would hire a consultant to help you pick a paint color or decorate your house or fix your car — we would be able to remember that just because we’re hearing it doesn’t mean it’s the only answer. It doesn’t mean another doctor will have the same answer. And it doesn’t mean you have to do something about it right now. Like today. This minute. You don’t have to make a decision unless again it’s a trauma or an emergency. So if you were hiring an interior decorator and you only liked mid-century modern and your decorator was showing you everything in country French — hopefully you wouldn’t just let them decorate your home in country French. You’d either say, “Actually no, this is really not what I need,” or you’d go to another decorator. But when we go to the doctor, especially if we have a symptom, we feel vulnerable, we feel scared — so we’re not at our most empowered. And we are really taught that their learned experience is more true than our lived experience. And so if we can shift that and say, “This is just another set of information. I’m doing information gathering. And this is one set of information. And now I’m going to digest this and unpack it.” And look — it may not be what I want to hear, but if it seems true and right and I trust this person, then I will go forward with that. Or I’m going to get another opinion, because that’s just a smart thing to do. It’s really about rethinking that medicine has all the answers — because what is true right now might not be true in a year.

Lisa: Oh my goodness, I could talk to you all day. I think at some point we have to kind of wrap it up, but I feel like this conversation was really important and I’m really glad that we had it. And so with that in mind, I’ll kind of leave it to you to share any last words or wisdom for the listeners, and then also please tell us about your book.

Dr. Romm: So thank you. One thing that’s coming up for me almost instinctively — when this hard stuff comes up as it probably has for some listeners or maybe many listeners — I would almost say this is a great time to hit pause and grab a journal and write down what’s come up for you and just unpack it for yourself a little bit. Or if you have someone that you can talk with about it, that would be really great. And if you’ve had an experience with a healthcare provider that’s left you feeling less than whole — sometimes writing them a letter, even if you don’t send the letter — and then you can do a little ritual and burn the letter or rip the letter up and put it in a river, whatever works for you. But to really release that. And if you have had a bad experience with a physician, sometimes letting them know is actually really important, because a lot of people don’t, and so there can be a lot of people in a community having bad experiences and the physician doesn’t even realize they’re doing it. So just right now it’s a great moment — when we’re finished — to go inside yourself, be really gentle with yourself, really compassionate with yourself.

Dr. Romm: So the book — it does have a chapter on advocacy, which is really important. But the book is really about: what is going on? Why are so many women having hormone problems? Why are one in eight or ten women experiencing PCOS or endometriosis? Why is one in six women going in for a fertility consultation? Why do 80% of women have significant enough period problems that they at some point go to a physician for help or a diagnosis? And so this book looks at the interaction of all of our ecosystems as women — our food, our microbiome, our stress, our sleep, the world we live in, and how that affects what’s going on in our bodies. It’s really a call to reclaiming our own inner wise woman. A deep understanding of the fact that we are told that hormones make us unpredictable and irrational and untrustworthy in so many different ways in our culture — and yet as you know, from your book, our hormones and our cycles are actually gorgeously predictable and gorgeously consistent. And when they’re not, there’s nothing wrong with you. There are things going on in your ecosystems that are very likely contributing, and the book helps you personally tease out what those things are and gives you real tools that you can use to realign with your cycles.

Dr. Romm: The book covers from early menstruation all the way through perimenopause. It’s a really open, candid conversation that invites women — people with wombs and ovaries — into a new conversation with their bodies in a really beautiful, empowering way. And it also has five weeks of meal plans and a whole section on advanced protocols on all different period problems: heavy periods, irregular periods, painful periods, skipped periods, PCOS, endometriosis, fibroids, sexual health, perimenopause symptoms, fertility. So I’m very, very proud of this. All folks have to do is go to avivaromm.com/book, and there’s so much free content on my website too — so this isn’t about buying something. If you want the book, I’m delighted and thrilled to see it get into as many people’s hands as possible. And you can also go to my website and get so much information on all these different aspects of our health and hormones and cycles — and then print it off and bring it to your doctor’s appointment.

Lisa: Thank you so much, Aviva. This has been incredibly informative and I’m really excited to share this episode. And so until next time, thanks again for coming today and for sharing your wisdom.

Dr. Romm: Thank you for having me, Lisa. It’s always a pleasure.

Thank you for listening. If you enjoyed today’s show, please share it with a friend. You’ll find the show notes page for today’s episode over at fertilityfriday.com/368. I hope that you enjoyed today’s interview with Dr. Aviva Romm. This conversation was so important and I’m so thrilled that we had it. I feel like this especially, if this is relatively new for you, was one of the most honest and raw conversations that I’ve really had about some of the challenges that women routinely have accessing medical care. I think one of the most refreshing aspects of this conversation is that it’s literally coming from the horse’s mouth, so to speak, because Aviva Romm is legitimately a medical doctor. And in this instance we can kind of appeal to that authority and have even more credence to the experiences that we have had as women. We shouldn’t need it, but certainly this is kind of what we’re dealing with here.

So I think what was really important and refreshing is that it’s coming straight from an MD and it really shows us that this is real — it is a real challenge to get proper care when you’re a woman. I feel like if you ever thought it was in your head, or if you ever even kind of had some doubt in your mind as to how big of an issue this really is, hopefully this episode just kind of puts it all out there. So — it’s real, it’s not in your head, it’s systematic. It’s not necessarily your doctor’s fault in the sense that your medical healthcare practitioner is not sitting there with negative intentions trying to harm you. It’s a product of the training, it’s a product of the modality, it’s a product of how the medical system itself was designed.

And so I think that at first it can feel really daunting and really discouraging to accept the reality of the challenges of getting adequate care. But I feel like we can also look at it as kind of a starting-off point — a springboard — because if you know the challenges associated with the system that you’re seeking care and support in, then it gives you the opportunity to go in there with your eyes open and with a plan and a strategy for how to get the care that you need. First and foremost is to accept the reality of the situation and really educate yourself as to what it is that this particular modality can provide for you. So if you have period issues, if you have menstrual cycle concerns, this is why it’s really helpful to know generally what options are going to be provided by your doctor — and are those the options that you’re going to want to pursue? And if the answer is no, then the question comes: who can provide me with that type of assistance?

So with that said, I hope you have a wonderful week — whenever you’re tuning into the show — and of course, as always, until next time: be well and happy charting.