Menopause Demystified-Insights for Women Worldwide

[00:00:00] Paula: Hello, everyone. I am Paula Okonneh, host of Chatting with the Experts, TV show spotlighting the professional journey of immigrant women from Africa and the Caribbean. Who have excelled in Europe, North America, Australia, the UK. Join me weekly as I engage with these accomplished women and sometimes their descendants offering insights, knowledge, and expertise that educate and uplift women worldwide.
[00:01:12] Paula: Today, my guest is Dr. La Toya Luces-Sampson. She’s affectionately known as Dr. Toya. on social media, and she is a multifaceted individual. She’s a mom, she’s a wife, and she’s a board certified OBGYN.
[00:01:36] Paula: Born and raised in Trinidad and Tobago, she journeyed to the United States, where she earned both her BS, and that’s her medical, and her bachelor’s degrees from Howard University in an accelerated six year BS MD program. Her medical training was further honed at Pennsylvania Hospital in Philadelphia, but she’s also the founder and the CEO of Amina OBGYN Consultants, which is a virtual gynecology practice focusing on supporting women through the extended postpartum period.
[00:02:20] Paula: Welcome. Dr. Toya to Chatting with the Experts. Today, we are going to be talking about menopause.
[00:02:29] La Toya: Yes. Thank you for having me.
[00:02:32] Paula: Absolutely. So one thing you told me is that we are really going to be talking about menopause 101 because for most of us, women, we think of menopause as just, when your period stops, but you told me there’s more to it than that.
[00:02:48] Paula: So, can you tell us more about that?
[00:02:50] La Toya: Yes, so technically, menopause is when your period stops after the age of 40 for 12 months. That’s the definition. But the reason is because the ovaries stop releasing eggs. And the hormones stop being released as well. And it’s that decrease in estrogen that gives you all the symptoms that comes along with menopause.
[00:03:13] La Toya: So it’s a little bit more than just no period, but yes, no period for 12 months after the age of 40.
[00:03:21] Paula: No periods for 12 months after the age of 40. So I know a few women who before the age of 40, they had no periods. So what’s that? How do you define that?
[00:03:33] La Toya: Yes, so that’s actually something that’s different.
[00:03:36] La Toya: It’s called primary ovarian insufficiency, and that is something that is pathological, whereas menopause is a natural, normal thing that happens for anyone who was born female. If you stop before 40, that needs to be investigated.
[00:03:54] Paula: So I know there’s something that I’ve also heard about perimenopause.
[00:03:59] La Toya: Yes. What’s that? Yes. It is an enigma. That’s what it is. So it is this period before the time that your cycles stop where you have the fluctuation in your hormones, the estrogen starts to go down and you start to get some of these symptoms and the effects of menopause, but you’re still having a period.
[00:04:21] La Toya: So it is usually associated with many symptoms. So hot flashes, night sweats are the ones that people know the most, but it’s also urinary incontinence, prolapse, UTIs, joint pain, brain fog depression, anxiety, the list goes on. So, that’s why it’s an enigma because One, it can happen in young people because it can occur from 7 to 10 years before your periods actually stop.
[00:04:51] La Toya: So say you go through menopause early at 45, then at 35, you could be having these symptoms, right? Nobody’s really thinking about menopause at that time. And then because it’s so far. before. And there are a lot of other things that could be causing all of those symptoms. Sometimes it gets confused for something else, right?
[00:05:14] La Toya: So you really have to have an astute physician who is aware of these women’s health issues to really kind of tease out what exactly is going on and determine if it is perimenopause. So it is what we call a diagnosis of exclusion. Because we have to make sure it’s nothing else causing all of those symptoms.
[00:05:33] La Toya: And if we can’t find anything, then, we assume that it is perimenopause.
[00:05:37] Paula: The reason I asked you that is because, it seems relatively I guess it has always been there, but it seems relatively new, like if, not a lot of research has been done about that, correct?
[00:05:47] La Toya: Yes.
[00:05:48] La Toya: So it’s one of those, what I like to call forgotten areas of gynecology where, nobody really was paying attention to it and I won’t go into the reasons why, menopause and the perimenopause or menopause transition, it’s really getting like they glow up at this point, everybody’s focused on it because we are doing more research and really getting interested because it’s not just about comfort, right?
[00:06:13] La Toya: It’s not just because I’m hot. There are medical things that can happen. Effects on your general medical health from that decrease in estrogen that really needs to be investigated so that women can be healthy and not just suffer through this time that everyone wants to live long enough will go through.
[00:06:29] Paula: So what else can you tell us about that? Because I was talking recently with a younger woman, but she’s almost 17. And she was saying to me, growing up, nobody talked to us about menopause. Nobody told us what to expect, and now there’s so much information, but we’re still not sure what’s true and what isn’t. So can you expand a bit on that?
[00:06:49] La Toya: Yeah. So it’s more of the same, right? As somebody who’s 70, I’m sure nobody ever mentioned anything about menopause. But that decrease in estrogen can decrease your overall life expectancy.
[00:07:04] La Toya: Estrogen is needed for your heart health, your bone health, so many different things. So that’s why you get those symptoms, even the health of your vagina. That’s why you get the vaginal dryness. The UTI is because the tissue thins out a bit and it breaks easily and the protective layer that’s there because of the estrogen goes away.
[00:07:30] La Toya: So there are so many areas of the body that are affected that, it’s kind of criminal that it was not a focus, because like I said, everybody wants to live long enough is going to go through this thing. And we investigate so many other things that are so rare, whereas half the population is going to experience this thing right so, we really need to focus more on it now and educate women that if you are having issues, bring it up with your doctor because there may be treatment for it. It may be because of perimenopause. It may be because of menopause, right? So it’s definitely something that we want women to know more about now.
[00:08:10] Paula: Okay. So what are some of the treatment options that we should, we should be aware of because, it’s one thing to know what we have, but then I was speaking to someone again recently, and she was like, well, if I was better educated, I may know better how to describe what I’m feeling. And when the options are given to me, I know which one I think will work best for me.
[00:08:30] La Toya: Yes. So the gold standard treatment for the symptoms of menopause are hormones, right? So, as I mentioned, menopause is caused by the ovaries basically shutting down at the end of their life. They no longer release eggs.
[00:08:45] La Toya: They no longer release the hormones and the estrogen being that dominant hormone. And it’s that decrease as giving you the symptoms. And the effects on your health. So we want to give it back. And that’s why we say it’s hormone replacement. So we give it back to you. So that it helps mitigate some of those risks and side effects, estrogen and hormones have gotten a bad rap.
[00:09:08] La Toya: And the main reason is because many years ago, there was a study women’s health initiative that kind of demonized hormones. And since then we have found a lot of issues with. The publicity that it got and the messaging around it, but the damage was done, right? The general idea is that hormones are not safe and you shouldn’t take it.
[00:09:31] La Toya: It’s going to give you breast cancer. It’s going to give you blood clots and all these things. Everything has risks, right? Most of that stuff is overstated and women are suffering because of it. So for most people, hormones are safe and it is the best treatment for menopause and the changes that come with it.
[00:09:52] La Toya: Now there are other things because we do holistic treatment. We treat the entire body in different ways. So yes, we do medication, but there’s also lifestyle modifications, non-hormonal treatment options. So you really get treatment from all different angles to help you I don’t want to say survive, but get through this time of your life.
[00:10:15] Paula: Okay. So the non-hormonal treatments like can you give us some examples?
[00:10:20] La Toya: Yes, so and actually the menopause society used to be the North American menopause society recently released a statement about some of the non-hormonal treatments that we were previously recommending, and they said a lot of the ones that we recommended were no longer recommended, but I want to give my personal expert opinion on that. A lot of it was not recommended because there’s not enough research. But as you mentioned before, this is a area that is not researched a lot. So I think it’s a little bit unfair to say don’t do these things because they don’t work. Because we don’t have evidence, right?
[00:11:00] La Toya: So that’s the caveat to this is that if you hear anybody with the new recommendation, say, well, no, that’s not recommended. Just know the research isn’t there for most of those things. So will it not work for anybody? We don’t know. But the ones that do so. Actually, things like hypnosis, cognitive behavioral therapy.
[00:11:23] La Toya: So people who don’t want any medications at all, there are techniques like that can help. And one thing that I always tell people is antidepressants. So it’s not that I think you’re crazy or I think your symptoms are due to mental health. Or anything because those are the, I don’t like to use that term crazy, but that’s what people think when we see use antidepressants for the treatment of menopause, right?
[00:11:50] La Toya: These things work for the specific symptoms for the hot flashes and night sweats. So we’re not seeing. It’s all in your head. They actually do work. So there are a number of different antidepressants that we know proven studied research that work for menopause. And then there’s a nerve pain medication called gabapentin.
[00:12:13] La Toya: It can help with hot flashes as well. And I like that one because it makes you sleepy. So if you have insomnia and the night sweats. It really helps just take care of both of those. So there are lots of different options if you’re not interested in hormones, but remembering the hormones are the number one.
[00:12:31] Paula: Okay. That’s good to know. I guess you’ll give me the name so I can put it in the show notes later on. So some of the other symptoms that go along with weight gain, those are symptoms. Are those things considered? They’re considered normal, but are they, are doctors more willing to talk about that now?
[00:12:48] Paula: Because that affects our health as well. Not in every aspect. So, now there’s a lot more awareness on all these symptoms, the joint pain, the weight gain, the bloating, the headaches. What else is being done for us, especially we minorities who sometimes get overlooked.
[00:13:06] La Toya: So it’s one of those things where, I’m doing my part, but I’m just one person. I can’t change the system, but I think in general, there is a movement, especially with this younger generation of doctors, of which I am a part to really understand and focus on what I call the forgotten areas of gynecology. So I think a change is coming. The workforce and OBGYN is becoming younger and more female.
[00:13:32] La Toya: So we take care of our own, right? So we focus on these things and really finding someone that. Who is NAM certified. So North American Menopause Society certification. That’s an extra thing you can do. And so they are aware of all these different changes, the treatments, the advancements. The research, because I can’t tell you, you’re not going to find somebody that’s going to disregard your symptoms.
[00:14:01] La Toya: It’s going to happen, but knowing that they are specialists, knowing the the words to use to describe your symptoms so that you are able to advocate for yourself is very important. So, that’s it. Doing this is what I’m doing to help educate people and then my colleagues as well.
[00:14:21] La Toya: But there are people out there that are specifically menopause providers.
[00:14:26] Paula: Oh, that’s good to know. Menopause providers. Alright . So it’s almost like a subspecialty is that?
[00:14:31] La Toya: Yeah. So you have to study and take an exam and everything. I’m going to take, I’m going to take the exam. I have my book. See, it’s right here.
[00:14:39] La Toya: Yes. So this a special certification for people who are interested in. Menopause and know how to treat it properly.
[00:14:50] Paula: Okay. So, I know this topic is about menopause and you termed it menopause 101. So what’s menopause 102? Is there something more that we need to know about? Because I know you’re probably just giving us like the tip of the iceberg. Is there anything else?
[00:15:07] La Toya: Well, yeah, it’s the real effects on your health. So the increase in your all cause mortality and what that means is when the estrogen goes down, you are more likely to pass away from all different causes. So it’s not just specifically menopause things, but any other issue you have, you’re more likely to die from it when you’re in menopause when your estrogen is low, right?
[00:15:40] La Toya: So it’s not just a comfort thing and that’s something that we need to make sure everyone understands. It’s not because you’re having discomfort with intercourse. It’s not because you’re hot and sweaty. This is your health and your longevity and your mood and, all of those things are equally important.
[00:16:02] La Toya: So that would be, going a little bit deeper into it because the majority of time we just assume, Oh, well I’m uncomfortable. I don’t have a period, but it’s more than that.
[00:16:11] Paula: Okay. That’s good to know. This is a question I got recently that there’s a trend more to having, female OBGYN than male.
[00:16:20] Paula: And I know a lot of my friends say, I’m not going to any man. We have nothing against the man, but I’m… sorry?
[00:16:26] La Toya: No, I said, right. Yes, I agree. Nothing against men.
[00:16:29] Paula: But did you also notice that trend when you were training? In medical school?
[00:16:33] La Toya: Yes, so in general, for this field, it has become more female. And so people have their preferences. And I think acknowledging that there has been a lot of trauma. That has been caused by male gynecologists and understanding that people have very valid reasons for not wanting to see male gynecologists. I think respecting their experiences and the issues that they may have is very important.
[00:17:06] La Toya: And, we always try to accommodate anyone who does not want to see a man, but because it has. And it’s been so female now. It’s pretty easy to find a female gynecologist, but there are a lot of excellent male gynecologists and they’re also a lot of terrible female gynecologists. So it really is just vetting whoever you’re going to see and whoever you’re entrusting with your care to make sure that they align with your values, with your goals, and that they listen to you and really take care of you, how you deserve to be taken care of.
[00:17:40] Paula: Because that was another question I was going to ask what should women, people who are born female look out for if they’re looking for a good gynecologist. What are some of the tips you would give on finding a good gynecologist?
[00:17:52] La Toya: Yes. So somebody who is board certified or board eligible.
[00:17:55] La Toya: So when you first graduate, you have to practice for a certain amount of time before you can become board certified. So, somebody who is one of those things and someone who practices evidence based medicine. So that may be difficult to determine as a lay person, but the internet is free and I don’t really tell people to Google stuff, but if somebody is telling you something that you know for a fact is like old, something like, the cervix does not have nerve endings, that is just not true.
[00:18:29] La Toya: And that’s something you don’t need to be seeing. But just being comfortable. This is, one of the most intimate parts of healthcare, you really need to be comfortable with whoever you’re seeing, trusting your gut and making sure that they are listening to you and, not just checking off boxes to get you out of their office or, to end your visit.
[00:18:52] Paula: So I know Dr. La Toya, you are an OBGYN, and I’ve had teenage girls ask me what’s the difference? This program is meant to educate women and women of all ages. So what is the difference between being an OB and, or going to see the obstetrician and going to see the gynecologist? That may sound to a lot of people like, very basic, but I have had people ask me that.
[00:19:15] La Toya: Right? Yeah. So we are trained as obstetricians and gynecologists . It’s one field. And we split our time during residency between the two. After you graduate from your training, you decide if you want to continue.
[00:19:30] La Toya: Practicing both, or if you want to just do one or the other, or if you want to subspecialize into something else. So obstetricians just deal with pregnancy, delivering babies and everything surrounding pregnancy. Gynecologists deal with everything else that has to do with women’s health. There is overlap, especially in postpartum period, but it is technically all one field.
[00:19:56] La Toya: It just depends on the physician and where they want to focus. But in the most traditional sense, older OBGYN would have done both.
[00:20:06] Paula: Okay. Thanks for clearing that up. I know we’re talking again, the topic is menopause, but before we become menopausal, we’re still younger. So I know you treat with your virtual clinic, younger women between their 20s and their 40s.
[00:20:21] Paula: So my question is now that we, the world is changing and we’re hearing so much, so many other different things how are you adjusting your practice to deal with the change in world where this may be a bit controversial. Not everybody is. I noticed you specifically said people who are born female, how are you dealing with the changes in the world?
[00:20:41] La Toya: Well, like with anything else with understanding and respect. And, people think that differences in gender and, as you say, the changes in the world are like a new thing, that it’s new age and 2023, but gender fluidity being intersex, all of these things.
[00:21:04] La Toya: Have been existing in the world for many years in different cultures in Africa, different places like that. So acknowledging that you may not understand everything about different genders and sexuality and all of those things, and that’s okay. But being respectful and understanding that your experience is not the primary experience of the world.
[00:21:32] La Toya: And I don’t want anybody discriminating against me as a black female who’s from the Caribbean. It’s kind of the same thing, right? My experience is different. I’m my own person. And I try to extend that to everyone else. And I tried to be as inclusive as possible, which is why I said, anybody who was born female, because I understand that there are people who are born that don’t identify as a woman.
[00:21:58] La Toya: They’re non binary. So I try to just proceed with understanding and respect.
[00:22:05] Paula: Thank you. Thank you for answering that. Yeah so we’re almost coming to the end. I can’t believe we’ve been speaking for over 25 minutes now. So what are the top takeaways because the focus is menopause, what are the top three things at least, or if it could be more than that, that we as women should take from this?
[00:22:23] La Toya: Yes, that menopause is normal and natural. Perimenopause can happen seven to 10 years before the period stops. So if you are having symptoms, And I’ll go through them again, it’s a long list. So, hot flashes, night sweats, mood swings, brain fog, insomnia, weight gain, joint pain, vaginal dryness, UTIs incontinence, and I’m sure they’re ones that I’ve forgotten.
[00:22:50] La Toya: And there’s nothing else explaining your symptoms. It may be perimenopause, right? And I’ll give the third one to be an anecdote. So this is not backed by science, but I found, I always ask my patients, when did your mom go through menopause? Cause sometimes there’s a correlation. So you can say it might be around the same time.
[00:23:13] La Toya: So if I know it’s seven to 10 years before, well, maybe that’s what’s going on. And just educating yourself, having the knowledge to bring to your doctor. To say, I think this is what’s going on and really being able to advocate for yourself. And then the last thing is that hormones are safe for the majority of people and it is the gold standard for treatment of the symptoms of perimenopause and menopause.
[00:23:38] Paula: Wow. I love that. The last but least is that hormones are safe because as you said, hormones have, for want of a better word, taken a bad rap and a lot of us women, when we have been told about hormone treatment, we’re wary, we’re afraid, because you’ve heard of all the negative things that could happen to us if we take hormones.
[00:24:00] Paula: So thank you for clarifying that.
[00:24:03] La Toya: You’re welcome.
[00:24:03] Paula: Yes. Thanks. So, Where can you be found online because you as I described you and you have described yourself as multifaceted you’re a mom, you’re a wife, you’re an OBGYN, but you’re also a business person.
[00:24:15] La Toya: Yes. So I can be found at drtoyaobgyn. com. And I made it really easy. All of my handles everywhere. Facebook, YouTube, Instagram, TikTok is all at drtoyaobgyn. So that’s D R T O Y A O B G Y N. So that’s where you can find me.
[00:24:34] Paula: Okay. Alright . And on social media platform, is there one that you prefer? Is there one that you know that you’re like, I know I’m more comfortable with LinkedIn. So is there any way that…
[00:24:43] La Toya: Oh, I forgot about LinkedIn. But yes, I’m on LinkedIn as well, but my entire name La Toya Luces-Sampson, so I primarily create for TikTok. But you can find my videos on all those other platforms. And if you are looking for a visual gynecologist, I am at drtoyaobgyn. com/ telehealth.
[00:25:00] La Toya: So T E L E, health. And I’m focusing right now on the postpartum period, like you mentioned, but I also do consultations for general gynecology, things like menopause and stuff like that.
[00:25:13] Paula: Thank you so much, Dr. Toya. I have learned so much.
[00:25:19] La Toya: Yes.
[00:25:19] Paula: From you. And as I’m sure a lot of our listening and viewing guests have as well.
[00:25:25] Paula: And for those of you Who have enjoyed this show, please join me again every Wednesday at 10 a. m. Pacific time. I have to remember that because I’m used to saying 1 p. m. Eastern and even if it’s not Dr. Toya, we’ll have somebody else. Another amazing immigrant woman from Africa or the Caribbean. Educating you, inspiring you and encouraging you to be a woman of excellence, wherever you are in the world.