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What happens when the womb is treated as separate from the rest of women’s health? In this episode of hol+, Dr. Taz sits down with Dr. Kemi Doll, double board-certified gynecologic oncologist, equity scientist, researcher, coach, and author of A Terrible Strength: The Hidden Crisis of the Black Womb and Your Survival Guide to Healing, for a powerful conversation about womb health, uterine cancer, fibroids, HRT, health equity, and why so many women are still being taught to normalize symptoms that deserve care.
Together, they explore why womb health is not only about pregnancy, fertility, or menopause, but a lifelong part of women’s physical, emotional, hormonal, and whole-body health. Dr. Doll shares how her grandmother’s death in childbirth, her mother’s near-death experience, and her own work as a gynecologic cancer surgeon shaped her mission to bring the uterus back into the center of women’s health.
Dr. Taz and Dr. Doll also discuss why uterine cancer is rising, why Black women are twice as likely to die after a uterine cancer diagnosis, and how gaps in research, screening, and diagnostic tools may leave women of color especially vulnerable. They unpack the role of ultrasound, endometrial thickness, post-menopausal bleeding, and why women need clearer conversations with their providers when something feels off.
This conversation also takes a closer look at the explosion of hormone replacement therapy, or HRT, and the questions every woman with a uterus should be asking. Dr. Doll explains why estrogen without proper progesterone protection can increase uterine cancer risk, why some women may not understand the role progesterone plays, and why monitoring the uterus matters when using hormones.
If you’re listening to this and thinking, “I know something is off in my body, but I don’t know where to start,” join the Circle here: 👉 https://holplus.co/circle
Womb health is not just about periods, pregnancy, fibroids, or menopause. It is shaped by hormones, stress, inflammation, medical history, race, research gaps, diagnostic bias, body literacy, emotional suppression, and the way women are taught to silence or normalize pain. In this episode, Dr. Taz and Dr. Doll look at the womb as a vital part of women’s health that deserves attention across every stage of life.
Learn more about support related to this conversation:
Cancer Support: https://holplus.co/services/cancer-support/
Hormone Imbalance: https://holplus.co/conditions/hormone-imbalance/
Cancer Support: https://holplus.co/services/cancer-support/
Hormone Imbalance: https://holplus.co/conditions/hormone-imbalance/
Dr. Doll shares why fibroids often begin earlier and become more severe for Black women, why many women are not believed until symptoms become unbearable, and how chronic stress, anger suppression, vitamin D deficiency, and delayed care can all become part of a larger womb health crisis. She also explains why some women may still have options beyond surgery, while others need honest, compassionate conversations about myomectomy, hysterectomy, fertility preservation, and quality of life.
Dr. Taz and Dr. Doll also explore the connection between traditional medicine, Chinese medicine, science, and what Dr. Doll calls “womb suffering.” They discuss why women need better language for their symptoms, why bringing an advocate to medical appointments can help, and why prioritizing your womb in your 30s, 40s, 50s, and beyond may change the trajectory of your health.
If you are navigating fibroids, heavy bleeding, endometriosis, pelvic pain, post-menopausal bleeding, HRT, menopause, hysterectomy decisions, fertility concerns, or the feeling that your symptoms have been dismissed, this episode offers validation, education, and a deeper way to understand what your body may be trying to tell you.
About The Guest:
Dr. Kemi Doll is a double board-certified gynecologic oncologist, equity scientist, researcher, coach, speaker, and author dedicated to advancing healing, liberation, and leadership for Black women in medicine and beyond. Her groundbreaking research on racial disparities in endometrial cancer has been funded by the NIH, PCORI, and the Robert Wood Johnson Foundation, and has been featured in The New York Times, NPR, BET, and Good Morning America. She is the author of A Terrible Strength: The Hidden Crisis of the Black Womb and Your Survival Guide to Healing.
Dr. Kemi Doll is a double board-certified gynecologic oncologist, equity scientist, researcher, coach, speaker, and author dedicated to advancing healing, liberation, and leadership for Black women in medicine and beyond. Her groundbreaking research on racial disparities in endometrial cancer has been funded by the NIH, PCORI, and the Robert Wood Johnson Foundation, and has been featured in The New York Times, NPR, BET, and Good Morning America. She is the author of A Terrible Strength: The Hidden Crisis of the Black Womb and Your Survival Guide to Healing.
About Dr. Taz:
Dr. Tasneem Bhatia (Dr. Taz) is a triple board-certified integrative medicine physician,
bestselling author, and founder of hol+ a multi-location integrative medicine practice.
Learn more: https://doctortaz.com/about
Dr. Tasneem Bhatia (Dr. Taz) is a triple board-certified integrative medicine physician,
bestselling author, and founder of hol+ a multi-location integrative medicine practice.
Learn more: https://doctortaz.com/about
Stay Connected:
Connect further to Hol+ at https://holplus.co/ - Don’t forget to like, subscribe, and hit the notification bell to stay updated on future episodes of hol+.
Book a Hol+ Consultation: https://holplus.co/locations/virtual/
Connect further to Hol+ at https://holplus.co/ - Don’t forget to like, subscribe, and hit the notification bell to stay updated on future episodes of hol+.
Book a Hol+ Consultation: https://holplus.co/locations/virtual/
Follow Dr. Taz on Instagram:
https://www.instagram.com/drtazmd/
https://www.instagram.com/liveholplus/
Subscribe to the audio podcast: https://holplus.transistor.fm/subscribe
Subscribe to the video podcast: https://www.youtube.com/@DrTazMD/podcasts
Subscribe to the video podcast: https://www.youtube.com/@DrTazMD/podcasts
Get your copy of A Terrible Strength: The Hidden Crisis of the Black Womb and Your Survival Guide to Healing
Host & Production Team
Host: Dr. Taz; Produced by ClipGrowth.com (Producer: Pat Gostek)
Chapters
00:00 Uterine Cancer Is Rising
02:27 Why Dr. Taz Wanted This Conversation
03:32 Dr. Kemi Doll’s Personal Connection to Womb Health
06:04 Why Womb Health Goes Beyond Pregnancy
07:16 Why Medicine Has Missed the Womb
09:05 The Uterus, Menstruation, and Scarless Repair
11:25 Uterine Cancer, Diagnosis, and Delayed Care
12:42 What Doctors Look for on Ultrasound
13:15 Why the Research May Not Protect Black Women
14:26 Why There Is No Standard Uterine Screening
15:19 Why Women Normalize Pain and Heavy Bleeding
18:08 HRT, Estrogen, Progesterone, and Uterine Cancer Risk
20:41 The Womb Health Crisis for Black Women
21:43 Why Fibroids Affect Black Women Differently
24:20 Anger Squelching, Chronic Stress, and Fibroids
25:45 Chinese Medicine, Liver Stagnation, and Estrogen
28:23 Estrogen, Progesterone, and Fibroid Growth
30:15 Vitamin D and Slowing Fibroid Growth
31:25 Medical Options Beyond Surgery
35:06 When Fibroids Become Harder to Treat Holistically
40:08 Why Women’s Pain Gets Dismissed
50:01 How Young Women Can Advocate for Themselves
53:45 Bringing an Advocate to the Doctor
54:00 Prioritizing Womb Health in Your 30s
58:05 Menopause, HRT, and Protecting the Uterus
Creators and Guests
Host
What is hol+ with Dr. Taz MD | The Future of Medicine is Holistic?
hol+ with Dr. Taz MD is redefining modern medicine through a comprehensive, evidence-based holistic approach; integrating functional medicine, integrative medicine, and time-tested healing systems to treat the whole human, not just symptoms.
Hosted by Dr. Tasneem Bhatia (Dr. Taz), triple board-certified physician in integrative, functional, and holistic medicine, bestselling Penguin Random House author, and founder of hol+; a comprehensive evidence-based holistic medicine platform with clinics in Atlanta, New York City, and Los Angeles, and virtual care available nationwide.
At the heart of hol+ is a revolutionary framework: the Five Body Map- physical, mental, emotional, energetic, and social/community bodies that create whole health. This whole-human approach connects hormone imbalances, gut dysfunction, microinflammation, cortisol dysregulation, metabolic disease, autoimmune conditions, perimenopause, and stress-driven illness to the full spectrum of who we are; body, mind, and spirit.
Each episode explores Dr. Taz’s original clinical frameworks ;The Cortisol Loop, Microinflammation, and The Invisible Load alongside conversations with leading experts, celebrities, and thought leaders including Sophie Grégoire Trudeau, Katherine Schwarzenegger, Cameron Mathison, Carol Alt, Jane Seymour, Tamsen Fadal, and Kris Carr.
Topics include hormone health, gut health, GLP-1 and metabolic therapy, thyroid dysfunction, weight loss, inflammation, autoimmune disease, mental and emotional wellness, energetic health, and the future of holistic medicine.
This is the show where science and spirit converge- driving health, happiness, relationships, and family ecosystems.
Want to go deeper? Join Dr. Taz’s private community, the hol+ Circle ; medicine beyond the exam room. (holplus.co/circle)
A 2025 Webby Award honoree, recognized alongside the Mel Robbins Podcast in the 29th Annual Webby Awards, hol+ is built on the foundation of Super Woman Wellness, which surpassed 1 million downloads over 8 years.
This is medicine beyond the exam room. Welcome to hol+
34P1 Hol+ S06E10 - Dr. Kemi Doll - Audio - ClipGrowth.com
[00:00:00] Dr. Kemi Doll: If uterine cancer is on the rise, and it is, it's the number one cancer on the rise.
[00:00:04] Dr. Taz: [00:00:05] Interesting. It's
[00:00:05] Dr. Kemi Doll: one in 32 women, and it will be one in 17 by 2050.
[00:00:09] Dr. Taz: Wow.
[00:00:09] Dr. Kemi Doll: [00:00:10] Yes. It will be the second most common cancer among women by 2050. It's [00:00:15] already more common than colon cancer, and right now we are in a place where everybody [00:00:20] is getting hormones.
[00:00:21] Dr. Kemi Doll: And like you said, many are not getting exams and they're not getting [00:00:25] ultrasounds. I think it's reasonable to sound maybe not an alarm, but a flag- Right ... to say, [00:00:30] "Hey, if you still have your uterus, you need to make sure you had a very clear [00:00:35] conversation about what doses am I on, what is gonna protect the endometrium or that [00:00:40] uterus, and how are we gonna monitor it to make sure that there are no issues?"
[00:00:43] Dr. Taz: Dr. Kemi Doll [00:00:45] is a physician, surgeon, researcher, and advocate and coach working at the [00:00:50] intersection of health justice, reproductive equity, and personal empowerment.
[00:00:54] Dr. Kemi Doll: Right now, [00:00:55] in 2026, Black women have a two times chance higher of dying after [00:01:00] uterine cancer diagnosis. The way that our diagnostic system works is that when you come in, we're [00:01:05] supposed to do an ultrasound, and that ultrasound is supposed to tell us whether there's any risk that you might have [00:01:10] cancer.
[00:01:10] Dr. Taz: And what are you looking for historically on that ultrasound?
[00:01:12] Dr. Kemi Doll: We're looking for the thickness- Mm-hmm ... of the uterine [00:01:15] lining. Okay. So we call it the endometrial stripe. If it's under four millimeters, you're supposed to have a 0% [00:01:20] chance of having uterine cancer, except all of that research was not done on women of color.
[00:01:24] Dr. Taz: [00:01:25] Mm.
[00:01:25] Dr. Kemi Doll: Especially not done on Black women.
[00:01:27] Dr. Taz: Wow. Her groundbreaking research on [00:01:30] racial disparities in endometrial cancer has been funded by the NIH, the [00:01:35] PCORI, and the Robert Wood Johnson Foundation, and has been featured in The New York [00:01:40] Times, NPR, BET, and Good Morning America. Please join me in welcoming [00:01:45] Dr.
[00:01:45] Dr. Taz: Kemi Doll to the show. This episode is sponsored by WholePlus, a holistic [00:01:50] health platform built around education, personalization, and integrative care. [00:01:55] WholePlus blends holistic, integrative, and functional medicine clinics with [00:02:00] learning resources like blogs, YouTube videos, and of course, this podcast, so you're not just [00:02:05] treated, you're informed.
[00:02:07] Dr. Taz: The platform also includes holistic health quizzes and a [00:02:10] curated wellness shop, helping you make choices that support your body at the root level. [00:02:15] Whole Plus is holistic healthcare designed for real life. Visit [00:02:20]
[00:02:20] Dr. Kemi Doll: us at wholeplus.co to learn more about the platform. Again, that's [00:02:25] W-H-O-L-P-L-U-S dot C-O.
[00:02:27] Dr. Taz: Dr. Kemi, I am so glad you're [00:02:30] here, and I'm gonna tell you why.
[00:02:32] Dr. Taz: I have been in practice for over 20 [00:02:35] years in probably this integrative space. Mm-hmm. And I have sat with so [00:02:40] many women, especially women of color- Mm-hmm ... that are not [00:02:45] getting sort of the GYN help that they need. They are suffering from [00:02:50] all kinds of different symptoms and conditions that I don't see-
[00:02:53] Dr. Kemi Doll: Mm-hmm
[00:02:54] Dr. Taz: in our [00:02:55] Caucasian or even South Asian counterparts. Mm-hmm. And when I go to the [00:03:00] research, right, when I start to dig away and I'm like, "Okay, how can I do something? What can we do here?" There's [00:03:05] really not a lot there. Yeah. You have dedicated your career and your [00:03:10] life to helping Black women and trying to understand what's going on with [00:03:15] them-
[00:03:15] Dr. Kemi Doll: Yeah
[00:03:15] Dr. Taz: understanding what's going on with the womb, right? How did you get into this [00:03:20] space? Mm. What is, what is motivating you and inspiring you to [00:03:25] really start to turn the page on this topic?
[00:03:26] Dr. Kemi Doll: Thank you so much. Thank you for having me. Yeah. I'm really happy to be here. Thrilled to [00:03:30] have you here. Mm-hmm. Really happy to be here.
[00:03:32] Dr. Kemi Doll: There's so many things that motivated me, but I have to be [00:03:35] honest to say that probably in an unconscious way, I think my [00:03:40] grandmother, my grandmother's story and her life motivated me because I found out [00:03:45] fairly late actually into my adulthood- Mm-hmm ... that she had died in childbirth.
[00:03:49] Dr. Taz: Such a common [00:03:50] story, right?
[00:03:50] Dr. Taz: Such a common story. For previous generations of women.
[00:03:52] Dr. Kemi Doll: Exactly. Um, and then my mother almost [00:03:55] died- Mm ... um, giving birth.
[00:03:56] Dr. Taz: Which was not that long ago.
[00:03:58] Dr. Kemi Doll: Which was not that long ago, and then here I [00:04:00] am, and I survived. And so I, I just say that because I think that in a [00:04:05] way, this is exactly the work I was always supposed to be doing, and I gravitated [00:04:10] naturally to it.
[00:04:10] Dr. Kemi Doll: In medical school, I loved OBGYN. I loved everything about women's [00:04:15] healthcare. I was totally zeroed in on it. And then when I went to residency, I really just got [00:04:20] fascinated with gynecologic cancers.
[00:04:22] Dr. Taz: Mm-hmm.
[00:04:22] Dr. Kemi Doll: Um, mostly because I was just amazed that the [00:04:25] uterus could do so many different things. Mm-hmm. I thought, "This organ is, is incredible."
[00:04:29] Dr. Kemi Doll: I mean, it can [00:04:30] grow life. It can grow a cancer. It bleeds every month. It d- Like I, I was [00:04:35] scientifically fascinated with it. Mm-hmm. And then more than that, I found that- [00:04:40] Unlike any other organ, the meaning that we make out of [00:04:45] what's going on with our womb, what's going on with the uterus, the, the symptoms that we have, it just [00:04:50] impacts so many parts of our lives that it meant a lot to me to serve women in that [00:04:55] way.
[00:04:55] Dr. Kemi Doll: And so I just feel, like, so aligned with this work.
[00:04:57] Dr. Taz: There's so much, like, written in the [00:05:00] energetic and spiritual worlds- Yeah ... about the significance of a woman's womb- Yes ... and what that [00:05:05] means. You know, I have a background in Chinese medicine as well- Yes ... with our conventional training, and they talk a [00:05:10] lot about that as being the life force- Mm-hmm
[00:05:12] Dr. Taz: of a woman. Mm-hmm. Like, that entire pelvic floor [00:05:15] region- Mm-hmm ... the womb, all of it. Mm-hmm. And when it's compromised or when it is [00:05:20] not maybe working at the capacity that it was meant to work at- Mm-hmm ... that was a very important determinant of [00:05:25] not just womb health, but overall health in general. Exactly. You know?
[00:05:28] Dr. Kemi Doll: Exactly.
[00:05:28] Dr. Taz: But I wanna go back to your [00:05:30] grandmother. Sure. So what's the year? Tell us the timeline.
[00:05:32] Dr. Kemi Doll: Oh, gosh, I would have to do the math. Um-
[00:05:34] Dr. Taz: [00:05:35] Roughly. You
[00:05:35] Dr. Kemi Doll: know, we've- Roughly we're talking [00:05:40] 1950s.
[00:05:40] Dr. Taz: Your grandmother. My grandmother.
[00:05:41] Dr. Kemi Doll: 1950s.
[00:05:41] Dr. Taz: And then your mom?
[00:05:43] Dr. Kemi Doll: My mom, [00:05:45] 19- '80s.
[00:05:46] Dr. Taz: Okay. So we're, we're talking mid-ni- you know, [00:05:50] 1900s.
[00:05:50] Dr. Taz: Yeah. Now going into the later, you know, uh, 1900s. Now [00:05:55] we are in the 2000s. Yeah. Has anything changed?
[00:05:58] Dr. Kemi Doll: Very little. [00:06:00]
[00:06:00] Dr. Taz: That is what's so disappointing.
[00:06:01] Dr. Kemi Doll: Exactly.
[00:06:02] Dr. Taz: So what happened to your grandmother?
[00:06:04] Dr. Kemi Doll: So [00:06:05] nobody knows what... I mean, at that time, the story was simply that she bled too much.
[00:06:09] Dr. Taz: Mm-hmm.
[00:06:09] Dr. Kemi Doll: You know? [00:06:10] Um, now I think about the fact that fibroids run in my family, [00:06:15] endometriosis runs in my family.
[00:06:17] Dr. Kemi Doll: Um, I had issues [00:06:20] with heavy bleeding and anemia. These things all add up, and I think what we see often [00:06:25] is that we see them come to a head when a woman is trying to give birth, right? Everything comes together, and [00:06:30] there's a lot of risk there. But my work is about recognizing that that's not the only [00:06:35] time- Right
[00:06:35] Dr. Kemi Doll: that you're at risk.
[00:06:35] Dr. Taz: Right.
[00:06:36] Dr. Kemi Doll: And I want the conversation about womb health to get [00:06:40] beyond just the moment of pregnancy and giving birth, to recognize that we spend most of [00:06:45] our lives not pregnant.
[00:06:46] Dr. Taz: Mm-hmm.
[00:06:46] Dr. Kemi Doll: And every single day, a lot of us are taught, [00:06:50] unfortunately, to suffer and to just normalize the symptoms that we [00:06:55] have from these various gynecologic conditions to the point that we are vulnerable enough, [00:07:00] honestly, for it to be a life or death thing.
[00:07:02] Dr. Kemi Doll: Um, and so that's kind of [00:07:05] why I'm here. My work is about humanizing that aspect of our life every day, taking it [00:07:10] out of silence, and then asking what can we learn from what's going on, and how [00:07:15] can we heal?
[00:07:16] Dr. Taz: Why do you think there's such a gap when it comes to [00:07:20] understanding that what the ch- what Chinese medicine, Ayurvedic medicine, all these older systems of med- [00:07:25] Mm-hmm
[00:07:25] Dr. Taz: African medicine, they all already understood this, right? Mm-hmm. They already understood in their language- [00:07:30] Mm-hmm ... that the womb was a symbol of overall health for a woman. Mm-hmm. Mm-hmm. Right? It wasn't [00:07:35] this separate entity that lived over here- Mm-hmm ... and you just used it to get pregnant- Mm-hmm ... and then you took it out when you no longer [00:07:40] needed to have babies anymore.
[00:07:40] Dr. Taz: Mm-hmm. Mm-hmm. Right? So that was sort of the standard of care.
[00:07:42] Dr. Kemi Doll: Yeah.
[00:07:43] Dr. Taz: Why did we miss the mark [00:07:45] on that-
[00:07:45] Dr. Kemi Doll: Mm-hmm ...
[00:07:46] Dr. Taz: where we're not thinking about the womb, you know, not to use the word, you know, [00:07:50] flippantly, but we're not thinking about the womb in a holistic way?
[00:07:52] Dr. Kemi Doll: I mean, I think the short answer is misogyny. [00:07:55] I mean, I think- The patriarchy.
[00:07:55] Dr. Taz: The patriarchy
[00:07:57] Dr. Kemi Doll: is usually the answer. Yeah. I mean, if you think [00:08:00] about, even if you think about- The Western medicine framework- Mm-hmm ... and our [00:08:05] biomedical, like, industrial complex, which I am a part of, I believe in science, I love science. Same. Mm-hmm. Right? But [00:08:10] when you recognize that, like, we don't have an institute for women's health- Right
[00:08:13] Dr. Kemi Doll: at the National Institute of Health. Like, we [00:08:15] don't- we, we have an institute for the heart, the blood, the kidneys, everything, but we don't have anything for [00:08:20] gynecologic health. Hmm. So that alone, even though half the population has the or- these organs, and [00:08:25] these are very common conditions we're talking about, not rare.
[00:08:27] Dr. Taz: Right.
[00:08:28] Dr. Kemi Doll: So I think [00:08:30] part of that perspective that we have, that this is just for pregnancy and then we'll take it out, [00:08:35] is that we have devalued- Yeah ... the importance of the womb and [00:08:40] the uterus from a biology standpoint, from a health standpoint, and from a research [00:08:45] standpoint, and we are just, just beginning to turn the tide on that, but we have decades of [00:08:50] catch-up to do.
[00:08:50] Dr. Kemi Doll: To
[00:08:50] Dr. Taz: do. Yeah. Yeah. Well, let's first talk about the womb, and then I do wanna get into [00:08:55] some of the issues around, you know, Black women and what's happening- Hmm ... in particular in [00:09:00] that community. So the womb in general. Yeah. What are we missing when we think about overall health in the [00:09:05] womb?
[00:09:05] Dr. Kemi Doll: Yeah. So first, first is that your womb health lasts a lifetime, you know?
[00:09:09] Dr. Kemi Doll: And so I [00:09:10] think, I think even that recognition that, you know, before puberty there's not much going on, but those [00:09:15] organs are growing. And then when we get into puberty and girls have their first period, most of us were [00:09:20] just taught how to keep it quiet. I mean, succe- a successful period was one where [00:09:25] nobody knew that you were bleeding, right?
[00:09:26] Dr. Kemi Doll: You're- you get taught to manage the blood, but you don't really get taught [00:09:30] what are these organs and what are they doing. So I always start with reminding people that, you know, the [00:09:35] uterus is just one part of the reproductive health system. You have fallopian tubes, ovaries, et cetera, [00:09:40] but it's a very critical part.
[00:09:42] Dr. Kemi Doll: And the way that I think about [00:09:45] menstruation is, obviously, you know, we bleed every month. There's cramping involved. It's not great [00:09:50] sometimes. But from a medical standpoint, it's something really incredible. Hmm. And I think this is what you're [00:09:55] talking about, about the other systems understanding something more deep than we have.
[00:09:59] Dr. Kemi Doll: From a [00:10:00] biology standpoint, it's the only place in the body where you have a wound with a [00:10:05] scarless repair.
[00:10:06] Dr. Taz: Fascinating.
[00:10:07] Dr. Kemi Doll: Yes, and talk about the metaphor- That's so true. I never thought about [00:10:10] that ... already. Yeah. Yeah. So every month, right, this wound forms on the surface, on the inner [00:10:15] lining of the uterus. You have the shedding.
[00:10:16] Dr. Kemi Doll: You have everything that's supposed to happen, and then there is [00:10:20] this beautiful repair process with no scarring.
[00:10:22] Dr. Taz: Hmm.
[00:10:23] Dr. Kemi Doll: And so even [00:10:25] giving women that imagery and that understanding starts to shift how you think about what's [00:10:30] happening, and then it can help us understand why it's starting to go wrong.
[00:10:34] Dr. Taz: Hmm.
[00:10:34] Dr. Kemi Doll: [00:10:35] What's wrong with the shedding process- Hmm ... or what's wrong with the repair, and how that's leading to [00:10:40] potentially too heavy cycles or too much pain, and then we can start to get into the biology [00:10:45] of it and what works and what doesn't. So, um- That's how I would start with [00:10:50] saying, like, what's going on with the womb.
[00:10:52] Dr. Kemi Doll: Um, there's so much more, but- Scarless
[00:10:53] Dr. Taz: recovery, I love that. Yeah. That's something [00:10:55] that all of us should remember. We're capable of scarless
[00:10:57] Dr. Kemi Doll: recovery.
[00:10:58] Dr. Taz: Right. How is that for meaning? Who
[00:10:59] Dr. Kemi Doll: knew? Yeah. [00:11:00] Yeah, it's like, you know, yeah, I think about that a lot actually. Like, how can we think about that in the [00:11:05] rest of our lives too, right?
[00:11:06] Dr. Kemi Doll: Right. Right. Like, we are all wounded in some ways, um, [00:11:10] and I think we're all looking for a scarless repair, you know?
[00:11:13] Dr. Taz: I love that.
[00:11:14] Dr. Kemi Doll: Yeah.
[00:11:14] Dr. Taz: What [00:11:15] has your work... And I know you're doing a lot of research around the womb. Mm-hmm. You know, what has your [00:11:20] work sort of focused on- Mm-hmm ... when you're doing research, you know?
[00:11:23] Dr. Taz: Mm-hmm. And how does that translate [00:11:25] clinically-
[00:11:25] Dr. Kemi Doll: Yeah ... to a certain extent? Yeah, so two things. So I'm, I tend to research actually how health [00:11:30] systems and how our, how, um, our communities and our belief [00:11:35] systems interact with the health system- Mm ... to create, unfortunately, a lot of delays in care. And [00:11:40] then I also do a lot of work on how our technologies like ultrasound- Yeah
[00:11:44] Dr. Kemi Doll: and our diagnostic [00:11:45] systems do or don't work- Ooh, that's gonna be interesting ... especially for women of color. Yes. And so, um-[00:11:50]
[00:11:51] Dr. Kemi Doll: One of the things I think we can start with is this idea [00:11:55] of, um, uterine cancer and diagnosis. Okay. And so, um, I'm a gynecologic oncologist- Mm-hmm ... so [00:12:00] I spend most of my time taking care of women with, with gynecologic cancers, the most common of which is [00:12:05] uterine cancer- Mm-hmm ... which, you know, most people don't realize.
[00:12:06] Dr. Kemi Doll: They think it's cervical, but it's not.
[00:12:08] Dr. Taz: Right, right.
[00:12:08] Dr. Kemi Doll: Um, [00:12:10] uterine cancer is diagnosed through post-menopausal bleeding. So a woman is done with menopause, and then she [00:12:15] starts to have a few drops of blood again. And we have an assumption in medicine that if that happens, a [00:12:20] woman would run to the doctor.
[00:12:20] Dr. Taz: Mm-hmm.
[00:12:21] Dr. Kemi Doll: That assumption does not take into account a lot of women have [00:12:25] negative experiences when they go to the gynecologist. Right. A lot of women don't even have a gynecologist anymore after [00:12:30] they've had a baby. And we are taught, again, to just manage things- Mm ... that [00:12:35] go on down there.
[00:12:35] Dr. Taz: Mm-hmm.
[00:12:36] Dr. Kemi Doll: So if you have a little bit of bleeding and you're not cramping, you're not in pain, [00:12:40] you might just keep moving with your life.
[00:12:41] Dr. Taz: Right.
[00:12:42] Dr. Kemi Doll: So the way that our diagnostic system works [00:12:45] is that when you come in, we're supposed to do an ultrasound, and that ultrasound is supposed to tell us whether there's any [00:12:50] risk that you might have cancer.
[00:12:51] Dr. Taz: And what are you looking for historically on that ultrasound?
[00:12:53] Dr. Kemi Doll: We're looking for the [00:12:55] thickness- Mm-hmm
[00:12:55] Dr. Kemi Doll: of the uterine lining.
[00:12:56] Dr. Taz: Okay.
[00:12:57] Dr. Kemi Doll: So we call it the endometrial stripe, the thickness of [00:13:00] that. If it's under four millimeters, you're supposed to have a 0% chance of having uterine cancer, [00:13:05] except all of that research was not done on women of color.
[00:13:07] Dr. Taz: Mm.
[00:13:08] Dr. Kemi Doll: Especially not done on Black [00:13:10] women.
[00:13:10] Dr. Taz: Wow.
[00:13:11] Dr. Kemi Doll: Exactly. So you know what should-
[00:13:12] Dr. Taz: Wait, who is the sample size then?
[00:13:14] Dr. Taz: Who are they [00:13:15] looking
[00:13:15] Dr. Kemi Doll: at? It was done in Scandinavia- Okay ... primarily, so mostly Caucasian women. Okay. And there was one study from [00:13:20] Hong Kong. Wow. Think about how many people that leaves out. Right. They also excluded women with [00:13:25] fibroids.
[00:13:25] Dr. Taz: Why? Okay. Why would you do
[00:13:28] Dr. Kemi Doll: that? 70% of Black women have fibroids. They're the [00:13:30] highest risk.
[00:13:30] Dr. Kemi Doll: 80%. Yes. So, um, and it was really oriented time [00:13:35] towards a certain kind of uterine cancer, not to get into the weeds- Right ... that is less common in women of color.
[00:13:39] Dr. Taz: [00:13:40] Right.
[00:13:40] Dr. Kemi Doll: So what happened was over time, over and over again, even [00:13:45] when coming for care, Black women would get these ultrasounds and then get reassured- Mm
[00:13:49] Dr. Kemi Doll: that everything's [00:13:50] fine. You don't have cancer. And then take years to come back after now I'm really bleeding, now I'm having a [00:13:55] lot of cramping. They'd be diagnosed at later stages, and they would die.
[00:13:58] Dr. Taz: Mm.
[00:13:58] Dr. Kemi Doll: And so this is why right [00:14:00] now in 2026, Black women have a two times chance higher of dying [00:14:05] after uterine cancer diagnosis, and this is the number one climbing cancer in this [00:14:10] country.
[00:14:10] Dr. Taz: Wow.
[00:14:10] Dr. Kemi Doll: It is more common than colon cancer among women. So I'm not trying to scare people, but I'm, I'm [00:14:15] in... I'm giving you a picture of what happens when we forget womb health. [00:14:20] Most people don't know that uterine cancer is more common than colon cancer. Why is that?
[00:14:24] Dr. Taz: I don't know, [00:14:25] but I will tell you this just from practice.
[00:14:26] Dr. Taz: Yeah, go ahead. Well, this has bothered me, and you probably have a better [00:14:30] answer to it. So we have this checklist, right, of preventive screenings. Yes. Like we're set up as like whole family- Yes ... so we do [00:14:35] whole family care. So when women come in and I'm going through the list of preventive screenings to make sure they've [00:14:40] had everything like colonoscopy check, mammogram check- Yes
[00:14:42] Dr. Taz: you know, all that other stuff, there's no standard of care [00:14:45] that I'm aware of- Yep ... unless I'm behind, of screening the uterus. Correct. [00:14:50] So what I'm having women do, which you can probably correct me on if it's not the right tool- Mm-hmm ... what I'm having women [00:14:55] do is that minimum every three years- Mm-hmm ... I don't care if you're [00:15:00] 40, 50, 60, 70- Mm-hmm
[00:15:00] Dr. Taz: I'm sending them in for a pelvic ultrasound- Mm-hmm, mm-hmm ... if they still have their uterus. Mm-hmm, mm-hmm. You know? That's [00:15:05] just sort of an arbitrary thing I brought up on, you know- Yeah ... I kind of made up on my own- Yeah ... just watching women and [00:15:10] watching what we were dealing with. Yeah. What would you say to that?
[00:15:12] Dr. Kemi Doll: I would say I don't think it's crazy. So, um, [00:15:15] I, so, so this is what I would say, a few things.
[00:15:18] Dr. Taz: Okay.
[00:15:19] Dr. Kemi Doll: One [00:15:20] is that a lot of women go undiagnosed for a long time with conditions because [00:15:25] they think everything's normal. Right. They have learned a standard of normal that is wrong, [00:15:30] right? So they don't realize that their pain or cramping is to the extent to which [00:15:35] there sh- this should be evaluated, or they don't realize you are bleeding so much you might be anemic.
[00:15:39] Dr. Kemi Doll: [00:15:40] So I think it is actually incumbent upon us doctors to take a further step instead of [00:15:45] waiting for somebody to say, "Hey, something's wrong." The second thing is that, um- [00:15:50] You know, my, honestly my very, um, peer rev- [00:15:55] like peer reviewed, very scientific- Yeah ... very like traditional- Yes ... colleagues might get upset with me [00:16:00] about this, and I think that's okay because- They always mad at me, it's all
[00:16:02] Dr. Taz: right.
[00:16:02] Dr. Kemi Doll: Okay. It's, I think, I think- I think we have to figure out- You're in safe [00:16:05] space. We have to figure out how to bridge the gap- Yeah ... is what I'm saying. Yeah. And we're in a time where [00:16:10] people want information about their bodies. We, people are really, really [00:16:15] motivated right now- Right ...
[00:16:15] Dr. Taz: to understand like what's going on with their-
[00:16:17] Dr. Kemi Doll: Right.
[00:16:17] Dr. Kemi Doll: They want information, right? And we have to [00:16:20] get away a little bit from this idea of, well, when we studied looking at ultrasounds in [00:16:25] 50-year-old women and we could not detect that we found anything, that's one thing to say [00:16:30] maybe it doesn't decrease uterine cancer rates. But that's not the same thing as somebody having a better [00:16:35] understanding of what's going on.
[00:16:35] Dr. Taz: Right.
[00:16:36] Dr. Kemi Doll: Maybe they understand, you know that you have a polyp, and it's probably [00:16:40] okay, but if you ever have this symptom, then we should do something about it. Or maybe they learn you have a two centimeter [00:16:45] fibroid and it's asymptomatic. That's great, right? Right. However, if it's that way now, [00:16:50] you might decide to start taking vitamin D.
[00:16:52] Dr. Kemi Doll: You might decide to do things that you know are [00:16:55] helpful to halt fibroid growth before it gets symptomatic.
[00:16:58] Dr. Taz: Right.
[00:16:58] Dr. Kemi Doll: That is reasonable. Yeah. [00:17:00] I think that we need to be in a place where we're more in partnership with [00:17:05] patients, and sometimes that means offering them information even if we [00:17:10] think this isn't telling me anything.
[00:17:12] Dr. Kemi Doll: So that's what I would say to you. I think every three years is totally [00:17:15] reasonable. I mean, that doesn't sound crazy to me at all.
[00:17:18] Dr. Taz: If you're listening to this [00:17:20] and thinking, "I know something is off in my body, but I don't know where to [00:17:25] start," this is for you That's why I created the Circle. The [00:17:30] Circle is my private community where I and my team focus on understanding your body [00:17:35] from hormones and stress to metabolic health and longevity with real-life guidance [00:17:40] that you can actually use.
[00:17:41] Dr. Taz: This is about clarity and consistency and support [00:17:45] beyond the exam room, and maybe outside of all the different appointments and [00:17:50] experts that you've been running around to. You can try the Circle with a one-month trial [00:17:55] using the promo code podcast at [00:18:00] wholeplus.co/circle.
[00:18:00] Dr. Kemi Doll: Again, that's Whole Plus, [00:18:05] wholeplus.co/circle.
[00:18:05] Dr. Kemi Doll: All right, let's jump back into the episode.
[00:18:08] Dr. Taz: Well, I'm glad, and then the [00:18:10] other thing that sort of I've noticed, and I'm sure you have too, is that with this explosion around [00:18:15] HRT, right? Yes.
[00:18:17] Dr. Kemi Doll: Okay. Like hormones for everybody. Let's talk about that too.
[00:18:17] Dr. Taz: Like-
[00:18:18] Dr. Kemi Doll: Another reason to do ultrasounds. Yeah ...
[00:18:19] Dr. Taz: [00:18:20] why would you do hormones for everybody at some of these doses, right, when you have a [00:18:25] thickened endometrial lining to begin with?
[00:18:26] Dr. Kemi Doll: Okay. Or fibroids. Dr. Taz, I keep bringing this up.
[00:18:28] Dr. Taz: No, I'm just saying. [00:18:30] This is so- I mean, like- No, this is so important ... right now it's like, "I got that patch. I got..." I'm making fun of this. I do not mean... I'm all about hormones. No, [00:18:35] no, we all... Okay. I am all about hormones. 100%. I'm on hormones. Listen. I love 'em.
[00:18:38] Dr. Taz: Hormones for
[00:18:38] Dr. Kemi Doll: everybody.
[00:18:39] Dr. Taz: Hormones for [00:18:40] everybody. However. However. Not where you, like, type in something and then get your [00:18:45] prescription in the mail without a proper screening.
[00:18:46] Dr. Kemi Doll: I'm very concerned about this. I just wanna say, [00:18:50] again, as a gynecologic oncologist, and I wanna be really clear about this, 'cause I agree with you, I am not [00:18:55] anti-HRT.
[00:18:56] Dr. Kemi Doll: I think people should be on hormones. I do not think women should suffer through menopause. [00:19:00] And we are missing the conversation about the womb and menopause. Yes. I am [00:19:05] not hearing people talk about the fact that- 100% ... uterine cancer is absolutely a risk when you're [00:19:10] on HRT if you're on estrogen without progesterone.
[00:19:13] Dr. Kemi Doll: Right. Yet women are being [00:19:15] given estrogen without progesterone who still have a uterus.
[00:19:18] Dr. Taz: Mm-hmm.
[00:19:18] Dr. Kemi Doll: I'm talking to women who [00:19:20] say, "Well, I was given both, but the progesterone gave me some side effects, so I dropped that one." Mm-hmm. They have no [00:19:25] idea that it's there to prevent cancer.
[00:19:27] Dr. Taz: Right.
[00:19:27] Dr. Kemi Doll: And I don't think I'm being, [00:19:30] um, I don't think I'm being fear-mongering when I say- If uterine cancer is on the [00:19:35] rise, and it is, it's the number one cancer on the rise.
[00:19:38] Dr. Taz: Interesting.
[00:19:39] Dr. Kemi Doll: It's one in [00:19:40] 32 women, and it will be one in 17 by 2050.
[00:19:43] Dr. Taz: Wow.
[00:19:43] Dr. Kemi Doll: Yes. It [00:19:45] will be the second most common cancer among women by 2050. It's already more common than [00:19:50] colon cancer, and right now we are in a place where everybody is getting hormones. [00:19:55] And like you said, many are not getting exams and they're not getting ultrasounds.
[00:19:59] Dr. Kemi Doll: I think it's [00:20:00] reasonable to sound maybe not an alarm, but a flag- Right ... to say, "Hey, if you still [00:20:05] have your uterus, you need to make sure you had a very clear conversation about what [00:20:10] doses am I on, what is gonna protect the endometrium or that uterus, and [00:20:15] how are we gonna monitor it to make sure that there are no issues?"
[00:20:18] Dr. Kemi Doll: 'Cause I, unfortunately I have [00:20:20] heard stories. My gynecology colleagues are telling me-
[00:20:21] Dr. Taz: Mm-hmm ...
[00:20:22] Dr. Kemi Doll: listen, women are coming in with estrogen levels at [00:20:25] 100-
[00:20:25] Dr. Taz: Right ...
[00:20:25] Dr. Kemi Doll: no progesterone- Right ... and a thickened stripe at 62. Yeah. And I'm like, oh my [00:20:30] gosh.
[00:20:30] Dr. Taz: And I'm seeing that in practice too, by the-
[00:20:31] Dr. Kemi Doll: You're seeing that too ... by the way.
[00:20:32] Dr. Kemi Doll: So yes, thank you. I'm seeing the exact same thing. Yep. So I just, again, [00:20:35] it's about the balance of things and about, um About bringing the womb back into the [00:20:40] conversation.
[00:20:41] Dr. Taz: Well, let's go back to the womb- Yes ... for a second.
[00:20:42] Dr. Kemi Doll: Yeah. I
[00:20:43] Dr. Taz: have so many questions. Okay. But going [00:20:45] back to the womb, you talk about there's a crisis- Yeah
[00:20:48] Dr. Taz: when it comes to the womb [00:20:50] of Black women. Yeah. Right? I think you, uh, you have a term for it as well. But, you know, in [00:20:55] general- Mm-hmm ... when we look at the stats on h- the health of Black women across the board, right? Yeah. They [00:21:00] have the highest sort of morbidity and mortality when it comes to childbirth. Yeah.
[00:21:04] Dr. Taz: They ha- [00:21:05] they're very behind when it comes to many of the other markers around women's health in general.
[00:21:09] Dr. Kemi Doll: Yeah.
[00:21:09] Dr. Taz: You [00:21:10] know, we know in the research and we know clinically that they're suffering from fibroids- Yeah ... and, you know, [00:21:15] a lot of issues with endometriosis. Yes. Ovarian cyst, you know. Yes. A lot of these different [00:21:20] conditions.
[00:21:20] Dr. Taz: And the answers for most of them that, at least again I'm [00:21:25] aware of, is take it out. You know, uh, myomectomies take the fibroids [00:21:30] out. Yeah. Hysterectomies take the uterus out.
[00:21:32] Dr. Kemi Doll: Yeah.
[00:21:32] Dr. Taz: So let's go back to what's happening with the [00:21:35] womb of Black women-
[00:21:36] Dr. Kemi Doll: Yeah ...
[00:21:37] Dr. Taz: today.
[00:21:37] Dr. Kemi Doll: Yeah.
[00:21:38] Dr. Taz: Why are they having such an [00:21:40] issue-
[00:21:40] Dr. Kemi Doll: Yeah ...
[00:21:40] Dr. Taz: in comparison-
[00:21:41] Dr. Kemi Doll: To others
[00:21:42] Dr. Taz: to the others?
[00:21:43] Dr. Kemi Doll: Let's take fibroids.
[00:21:43] Dr. Taz: Okay.
[00:21:44] Dr. Kemi Doll: Okay. [00:21:45] So fibroids, um, fibroids grow because of actually a single [00:21:50] cell. There's a s- a single cell will be mutated. It's a muscle cell in the uterus. It'll have [00:21:55] a number, there's a number of different kinds of mutations that can happen, and once that muscle stem cell [00:22:00] changes, it will start to grow basically out of proportion and create a fibroid.
[00:22:03] Dr. Kemi Doll: Okay. That's what happens. [00:22:05] Fibroids in most women start in the 30- in their 30s and grow [00:22:10] from there. In Black women, fibroids start as early as the late teens- Mm ... and early 20s [00:22:15] years. Yep. So it's actually true that, like, 80% of women will have fibroids at some point in their life [00:22:20] because again, these little mutations happen, they grow, and then they go away.
[00:22:23] Dr. Kemi Doll: So half of fibroids will [00:22:25] grow and disappear, grow and disappear. This is why I tell people, "Don't freak out- Right ... if you see one." For Black women, [00:22:30] they start earlier. Why? They grow. We don't know.
[00:22:33] Dr. Taz: Okay.
[00:22:33] Dr. Kemi Doll: We don't know why they start [00:22:35] earlier.
[00:22:35] Dr. Taz: Mm-hmm.
[00:22:35] Dr. Kemi Doll: But if you think about the fact that they are basically random mutations that are [00:22:40] happening, there's probably an element of environmental influence there.
[00:22:43] Dr. Taz: Mm.
[00:22:44] Dr. Kemi Doll: As [00:22:45] well as a predisposition, because we know fibroids tend to run in families as well. [00:22:50] And so when that happens, you have Black women who now have larger fibroids that started [00:22:55] earlier that are now more symptomatic earlier, except they're [00:23:00] not seen as vulnerable. They're not going to the doctor, or when they're going to the doctor they're getting [00:23:05] dismissed.
[00:23:05] Dr. Kemi Doll: So paradoxically, they're getting treatment later.
[00:23:08] Dr. Taz: Mm-hmm.
[00:23:08] Dr. Kemi Doll: So by the time somebody is really [00:23:10] taking them seriously to say, "Oh my gosh, there's a problem here. Let's do something about it," there's only the option of [00:23:15] hysterectomy. Mm. Or there's only the option of myomectomy. So I want the awareness to [00:23:20] recognize that if this is a problem that's happening in young Black women, we're s- we see these s- asymptomatic, [00:23:25] they start off with no symptoms fibroids in Black women in their early 20s, that's when we should be paying [00:23:30] attention.
[00:23:30] Dr. Kemi Doll: That's when we should be starting the therapies that we know can halt fibroid growth-
[00:23:34] Dr. Taz: Right ... [00:23:35]
[00:23:35] Dr. Kemi Doll: and give them more options instead of waiting until things are symptomatic. [00:23:40] Um, so that's, that's like one of the... That's like, I think, a really good example. [00:23:45] There are a lot of hypotheses about, like, what's going on, and I'm gonna do a little bit of, like, science plus woo woo.[00:23:50]
[00:23:50] Dr. Taz: Okay.
[00:23:50] Dr. Kemi Doll: I love it. Right?
[00:23:51] Dr. Taz: You, you know that's me.
[00:23:52] Dr. Kemi Doll: That's right. That's, we, we love this. That's my
[00:23:54] Dr. Taz: jam.
[00:23:54] Dr. Kemi Doll: That's my jam. [00:23:55] Right. Yeah. Okay, so, so for example, there are things that we know that are associated with [00:24:00] fibroid growth. One of the things that's associated with fibroid growth and m- women with more [00:24:05] fibroids is chronic stress.
[00:24:06] Dr. Taz: Right.
[00:24:06] Dr. Kemi Doll: We also understand that Black women experience a different kind [00:24:10] of chronic stress in this country because of the intersection of racism and sexism- Mm-hmm ... that we deal with. Mm-hmm. And that happens from [00:24:15] an early age. Right. Another thing that's associated with fibroids is something called [00:24:20] anger squelching.
[00:24:20] Dr. Kemi Doll: Have you heard about this?
[00:24:22] Dr. Taz: No, but I'm gonna go on a rabbit hole with you in just a [00:24:25] minute, so I don't wanna- Okay ... interrupt you 'cause you're gonna- So- ... you're gonna die in a second, but keep
[00:24:28] Dr. Kemi Doll: going. Okay. [00:24:30] So anger squelching, it's come from the psychology literature. When you, and when instead of releasing [00:24:35] your anger, instead of expressing your anger, you suppress it.
[00:24:38] Dr. Taz: Yep.
[00:24:38] Dr. Kemi Doll: Right?
[00:24:39] Dr. Taz: Yep.
[00:24:39] Dr. Kemi Doll: Think [00:24:40] about the angry Black woman stereotype. Yep. You're not allowed to be angry. There's lots of consequences if people [00:24:45] feel like you're doing too much. Women with high levels of anger squelching have more [00:24:50] fibroids. Associated with more fibroids and fibroid growth. So [00:24:55] what we don't know yet, 'cause I wanna be really clear, I can't trace to you right now yet the [00:25:00] mechanism of, like, this emotion, this neurotransmitter, this molecule, this fibroid.
[00:25:04] Dr. Kemi Doll: But you start [00:25:05] to see those patterns, and then it's not shocking to me that 80% of Black women have fibroids, and that they're [00:25:10] bigger, and that they're more intense. Yeah. So I like to open up the conversation to just [00:25:15] say, "Listen, there's a lot of science going on in how to treat these. There's a lot going on in figuring out how to stop, [00:25:20] stop growth, and I love that work, and th- we can get into that.
[00:25:23] Dr. Kemi Doll: And we have to [00:25:25] acknowledge that the data shows that these are not, this is not just [00:25:30] a unilateral, like, scientific condition that is not connected to our envi- our [00:25:35] environment.
[00:25:36] Dr. Taz: Okay.
[00:25:37] Dr. Kemi Doll: Okay. Are you ready? Okay, I'm ready.
[00:25:38] Dr. Taz: All right. [00:25:40] Anger squelching. Yes. We gotta talk about anger squelching. Okay, let's talk about it.
[00:25:43] Dr. Taz: All right. Because get ready.
[00:25:44] Dr. Kemi Doll: [00:25:45] Okay.
[00:25:45] Dr. Taz: In Chinese medicine-
[00:25:46] Dr. Kemi Doll: Okay ...
[00:25:47] Dr. Taz: the liver-
[00:25:48] Dr. Kemi Doll: Yes ...
[00:25:48] Dr. Taz: holds anger-
[00:25:49] Dr. Kemi Doll: [00:25:50] Mm ...
[00:25:50] Dr. Taz: and is the seed of anger. So people with repressed anger- Wow ... or anger that's developed even [00:25:55] intergenerationally- Yes ... that's held, according to Chinese medicine, which is- Yes ... a more energetic system of- Yes ... [00:26:00] medicine, right?
[00:26:00] Dr. Taz: Sure. That's held in the liver.
[00:26:01] Dr. Kemi Doll: Yes.
[00:26:02] Dr. Taz: Now, when you apply kind of the chemistry and the physiology [00:26:05] to this-
[00:26:05] Dr. Kemi Doll: Mm-hmm ...
[00:26:05] Dr. Taz: when the liver get, and this is again still in the Chinese medicine world-
[00:26:09] Dr. Kemi Doll: I'm
[00:26:09] Dr. Taz: listening ... when the [00:26:10] liver gets stagnant-
[00:26:11] Dr. Kemi Doll: Yeah ...
[00:26:11] Dr. Taz: or sluggish- Yeah ... it cannot metabolize the hormones well. They call [00:26:15] that liver stasis.
[00:26:16] Dr. Kemi Doll: Listen.
[00:26:16] Dr. Taz: That liver stasis-
[00:26:18] Dr. Kemi Doll: Look at
[00:26:18] Dr. Taz: us ... leads to estrogen [00:26:20] dominance, I don't know how you feel- Mm ... about that theory- Mm ... which is a stored form of estrogen. Mm-hmm. Essentially, you're holding [00:26:25] onto the metabolites of estrogen. Mm-hmm. You're not able to metabolize them effectively. Mm-hmm. Which then in turn [00:26:30] triggers the mutations that cause fibroids.
[00:26:32] Dr. Taz: Interesting. That's the Chinese medicine interpretation- Interesting ... [00:26:35] of fibroids. So- So they have a lot of herbal formulas that would, like-
[00:26:38] Dr. Kemi Doll: Yeah ...
[00:26:38] Dr. Taz: target this, but [00:26:40] then the Chinese medicine practitioner would be like, "Okay, take this herb."
[00:26:43] Dr. Kemi Doll: Mm-hmm.
[00:26:44] Dr. Taz: Right?
[00:26:44] Dr. Kemi Doll: Mm-hmm. "[00:26:45]
[00:26:45] Dr. Taz: Follow this diet- Mm-hmm ... to help improve- Mm ... the health of the liver- Mm-hmm
[00:26:48] Dr. Taz: to improve your fibroid."
[00:26:49] Dr. Kemi Doll: Mm-hmm. [00:26:50]
[00:26:50] Dr. Taz: Please also, let's work on your shen or your anger-
[00:26:54] Dr. Kemi Doll: [00:26:55] Yeah ...
[00:26:55] Dr. Taz: to help release that to really bring about a healing response.
[00:26:58] Dr. Kemi Doll: That is so [00:27:00] fascinating to me. I have so many things I wanna say. Yeah. So several... First of all, I love this. I
[00:27:03] Dr. Taz: know.
[00:27:03] Dr. Kemi Doll: Because I can't- Science with a [00:27:05] little bit of woo Yeah.
[00:27:05] Dr. Kemi Doll: I can't, because that's me. I love it. I love it. I literally, I literally said in my book. Yeah. I'm like, I'm like a woo woo [00:27:10] girl- Yeah ... with a scientific heart of gold. Uh,
[00:27:11] Dr. Taz: same.
[00:27:11] Dr. Kemi Doll: But like, and we have- 100%. 100%. And don't you think we need, we have to have [00:27:15] more conversation? You have to have that. That's
[00:27:15] Dr. Taz: the purpose of this show.
[00:27:16] Dr. Kemi Doll: And-
[00:27:17] Dr. Taz: That's the purpose of all of it,
[00:27:18] Dr. Kemi Doll: yeah ... and yeah, also, you ostracize people. [00:27:20] Right.
[00:27:20] Dr. Taz: And I'm like,
[00:27:20] Dr. Kemi Doll: we,
[00:27:20] Dr. Taz: everybody actually wants the same thing.
[00:27:21] Dr. Kemi Doll: Right. Everybody wants good
[00:27:22] Dr. Taz: health. We're on the same team.
[00:27:23] Dr. Kemi Doll: We're on the same team. Yeah. Different [00:27:25] ways to get there, and I think we can unite, and that we don't wanna cause harm.
[00:27:28] Dr. Kemi Doll: Right. That's the main thing. So these are the [00:27:30] things that come up when you say that. One is that, um, one, I think that's fascinating.
[00:27:33] Dr. Taz: Yeah.
[00:27:34] Dr. Kemi Doll: Two, [00:27:35] I always wanna say, I wanna be careful to say I don't think this are women, this is women's fault.
[00:27:38] Dr. Taz: No.
[00:27:38] Dr. Kemi Doll: This is not me saying- No, no, no, no, no ... [00:27:40] you're angry. If you were just less stressed, go meditate, and these will go away.
[00:27:43] Dr. Kemi Doll: But it's actually [00:27:45] recognizing that, can we be empathetic to like- Yes ... it's not easy to be a woman in this society. No. [00:27:50] It's not easy to be a woman of color in this society, and that has [00:27:55] physiologic and biologic consequences. We already know from heart disease.
[00:27:57] Dr. Taz: Right.
[00:27:58] Dr. Kemi Doll: We know from hypertension. [00:28:00] There, we, we can trace these things, um, like from start to finish in some [00:28:05] diseases, and we're working on the other ones.
[00:28:07] Dr. Kemi Doll: So I wanna just make sure that people listening know [00:28:10] that this isn't about blaming individuals. No, no, no, no, no. 'Cause I think sometimes that's the pushback. It's actually to me about saying it's blaming [00:28:15] society, like this is part of the soup that we swim in. The second thing I wanna say is about [00:28:20] estrogen dominance a little bit, and this is where I'll push back a little bit-
[00:28:23] Dr. Taz: Mm-hmm
[00:28:23] Dr. Kemi Doll: is just to say that- [00:28:25] We see fibroids develop, large ones, horrible ones, in women who have, like, never taken [00:28:30] birth control. They've never done any, they've never taken any- Right ... exogenous estrogen. And we d- we, so we [00:28:35] see women with no fibroids ever who've been on birth control, like, every day of their life since they were 12.
[00:28:39] Dr. Kemi Doll: [00:28:40] So I wanna be careful about people thinking, like, estrogen, me taking estrogen or estrogen- [00:28:45] No ... equals fibroids.
[00:28:45] Dr. Taz: Yeah.
[00:28:46] Dr. Kemi Doll: Yeah. Fibroids are actually, they grow from this very complex [00:28:50] interplay between estrogen and progesterone. Estrogen kind of primes the fibroid [00:28:55] to receive progesterone as a growth stimulant, is kind of how it works.
[00:28:59] Dr. Kemi Doll: Interesting. So it's the two of them [00:29:00] together. Okay. Um, and it is true that when we've measured levels of [00:29:05] estrogen and progesterone in women, they don't correlate to fibroid growth, size, or [00:29:10] anything. Mm-hmm. So it's something... What that means is that it's not that those hormones don't matter, but it's [00:29:15] actually about how the fibroid receptors are interacting with your hormone levels.
[00:29:19] Dr. Kemi Doll: With those hormones. [00:29:20] Okay. So somebody who has really sensitive fibroid receptors might have super low estrogen and [00:29:25] progesterone, and the fibroid is like, "Give it to me." Exactly. "I'm growing." Yep. And I've seen that. And somebody else- Yep ... has super high levels, and they [00:29:30] might have one fibroid that has, like, one receptor, and it's, like, barely impacting it.
[00:29:34] Dr. Taz: Do we have a [00:29:35] test to test fibroid receptor sensitivity?
[00:29:36] Dr. Kemi Doll: No, girl. Okay. So this is what we have to work on, right? I just asking. So it's like, I [00:29:40] know.
[00:29:40] Dr. Taz: Asking for a friend.
[00:29:40] Dr. Kemi Doll: I know, asking for a friend, right? Yeah. But it's, I say that not, like, it's like, [00:29:45] it's, like, all the yes and, which is that this is why we need these, we need these [00:29:50] systems so people can feel like, "Okay, what can I do?"
[00:29:52] Dr. Taz: Yeah.
[00:29:52] Dr. Kemi Doll: And I start to say, like, I put in my book, one of [00:29:55] my things is, like, eliminate stress. Yeah. Like, we gotta work on that. I'm not gonna leave that off the list when I [00:30:00] know that this is associated.
[00:30:01] Dr. Taz: Right.
[00:30:01] Dr. Kemi Doll: And then also, there are some, there are [00:30:05] some medications, and there are some, um, vitamins that [00:30:10] we do know can halt and slow down fibroid growth.
[00:30:13] Dr. Kemi Doll: And so,
[00:30:13] Dr. Taz: like- Well, let's talk about those.
[00:30:14] Dr. Kemi Doll: Oh, okay. Yeah.
[00:30:14] Dr. Taz: [00:30:15] Yeah. Vitamin D. Vitamin
[00:30:15] Dr. Kemi Doll: D.
[00:30:17] Dr. Taz: Vitamin D is that girl we all- You know, vitamin D- Yes ... is chronically low in a lot of-
[00:30:19] Dr. Kemi Doll: [00:30:20] Yes ...
[00:30:20] Dr. Taz: my, uh,
[00:30:21] Dr. Kemi Doll: Black women. Your patients. And Black women. Yeah. Yeah. Yeah, it's chronically low. Why? And, um, the [00:30:25] theory, and I will say that I'm kind of, like, sometimes I get a little suspect- Yeah
[00:30:28] Dr. Kemi Doll: suspicious of this, and I'll tell you why. Yeah. The [00:30:30] theory is that, you know, we have more melanated skin.
[00:30:31] Dr. Taz: Right, so we don't
[00:30:32] Dr. Kemi Doll: absorb the sun. So we absorb less. We absorb- I
[00:30:33] Dr. Taz: never really bought that theory.
[00:30:34] Dr. Kemi Doll: Thank [00:30:35] you. 'Cause first of all- Yeah ... like, so you're telling me that all my ancestors- Right ... had the vitamin deficient for the last 2,000- Right
[00:30:39] Dr. Kemi Doll: you know, thousands and [00:30:40] thousands of years? Right. Like, that makes no sense to me. But-
[00:30:41] Dr. Taz: Yeah ...
[00:30:42] Dr. Kemi Doll: I acknowledge that's the theory. Um- [00:30:45] Dietary things can also, as you know- Right ... like, depending on, like, the quality of your diet and stuff, it [00:30:50] can be low. So that's not my area of expertise. I'm not sure why it's low.
[00:30:53] Dr. Kemi Doll: But I know that the studies [00:30:55] looking at vitamin D and fibroids, fibroids do not... I mean, vitamin D does not [00:31:00] shrink fibroids, but it halts growth.
[00:31:02] Dr. Taz: Mm.
[00:31:02] Dr. Kemi Doll: So it's very... I s- I spoke to [00:31:05] many phys- gynecologists who only do fibroid care, 'cause I wanted to really get this right. Right, right, right.
[00:31:09] Dr. Taz: Yeah.
[00:31:09] Dr. Kemi Doll: [00:31:10] And they were saying yes.
[00:31:10] Dr. Kemi Doll: Like, they tell all their patients, "Listen, while we're figuring out what to do, at least get your [00:31:15] vitamin D levels up because we can s- we can slow things down." Right. And we've seen that in studies. [00:31:20] So that's really important. Okay. And any woman that has concerns about that, I would say get that vitamin D going.[00:31:25]
[00:31:25] Dr. Kemi Doll: Another, um- When we think about actual fibroid growth, there's kind [00:31:30] of two medications and, um, I'm forget- the generic names are very [00:31:35] long. I, I'm literally forgetting them right now. No, no, it's- I feel really bad. No, but- Oh, we have rigolix and something else anyway. Oh, God, I [00:31:40] forget that too. I forget. Like-
[00:31:41] Dr. Taz: Rigolix
[00:31:41] Dr. Kemi Doll: maybe?
[00:31:41] Dr. Kemi Doll: There's ... But they're combination. Okay. And they're a co- and there is actually a [00:31:45] very specific targeted combination of a certain type of [00:31:50] progestin that's kind of like more of an androgen- Mm-hmm ... estrogen. And then another [00:31:55] medication that kind of halts fibroid, um, vascular growth. Mm-hmm. Like it stops them from growing the blood [00:32:00] vessels- Right
[00:32:00] Dr. Kemi Doll: that they need to keep growing. And those are both oral medications that do a very good job of- [00:32:05] They do ... halting and shrinking fibroid growth. So there are options that aren't just [00:32:10] surgery.
[00:32:10] Dr. Taz: Yeah.
[00:32:11] Dr. Kemi Doll: But the issue is that when you show up and your fibroids are already eight, [00:32:15] 10 centimeters- Right ... or you already have 35- Right
[00:32:17] Dr. Kemi Doll: of them-
[00:32:17] Dr. Taz: Yeah ...
[00:32:18] Dr. Kemi Doll: that's where it gets difficult, [00:32:20] and that's where, as a physician, I do say like, "We can do the teas, and we can do all these other, and we can [00:32:25] do the supplements." Right. But at this stage, we're beyond- I said the same thing ... right, we're just beyond where ... And it's [00:32:30] like, what can we do to either, like, do a myomectomy or, like, bring things back and then [00:32:35] start from there?
[00:32:36] Dr. Kemi Doll: Um, because once, once they're at a certain size, [00:32:40] unfortunately, that s- that original stem cell, you're not gonna get to it. If you think about- That's been- ... a stem cell in the [00:32:45] middle of ... Like, you're not gonna get to it anymore. That's
[00:32:46] Dr. Taz: been my clinical experience. Like- Right? ... you know, patients come in all the time wanting a [00:32:50] more holistic approach to- Yeah
[00:32:51] Dr. Taz: managing fibroids.
[00:32:52] Dr. Kemi Doll: Yeah.
[00:32:52] Dr. Taz: And we, we are [00:32:55] successful as long as those fibroids are under about six-
[00:32:58] Dr. Kemi Doll: That's
[00:32:59] Dr. Taz: right ... you know. So to- Four [00:33:00] to six is what we usually say. Four to six. Four to six centimeters. We're
[00:33:02] Dr. Kemi Doll: successful.
[00:33:02] Dr. Taz: Yeah. But the minute you've got like, you know, 10 [00:33:05] centimeters- Exactly ... you have multiple ... I had one patient describe her uterus to me as like a, like literally an [00:33:10] apple sack- Yes
[00:33:10] Dr. Taz: is what she described it as. You know, I'm like, at that point-
[00:33:14] Dr. Kemi Doll: It's too late ... [00:33:15]
[00:33:15] Dr. Taz: it's, like, very difficult- It is ... for these things to turn it around and for you to maintain the quality [00:33:20] of life that I know you wanna maintain. That's exactly right. Yeah, so that's where this, like, middle road is so important, [00:33:25] right?
[00:33:25] Dr. Taz: Like-
[00:33:25] Dr. Kemi Doll: It is, and that's why we need to work together.
[00:33:27] Dr. Taz: Right,
[00:33:27] Dr. Kemi Doll: you know. Because it's like ... And this is why I ... [00:33:30] Again, I might get in trouble. This is why I'm not opposed to a woman at 22 being like, "I would like [00:33:35] an ultrasound just to see where I am." Yes. Why not? Because why not empower
[00:33:38] Dr. Taz: her? Yeah. Yeah,
[00:33:38] Dr. Kemi Doll: exactly. Um, you know, [00:33:40] like, why not?
[00:33:40] Dr. Kemi Doll: It's something at least she knows about
[00:33:41] Dr. Taz: it. Well, that was gonna be my next question. Like, if you're saying this is showing up [00:33:45] as early as your late teens- Yeah ... why are we not doing routine ultrasounds on young [00:33:50] girls after they turn about 16 or so?
[00:33:52] Dr. Kemi Doll: I have two theories.
[00:33:53] Dr. Taz: Okay.
[00:33:53] Dr. Kemi Doll: So one is that [00:33:55] doctors don't like to find things that we feel like we can't do anything about.
[00:33:58] Dr. Taz: Ah.
[00:33:58] Dr. Kemi Doll: And a lot of the ... [00:34:00] Like, even the s- the studies I just shared with you, like, a lot of these things are- [00:34:05] Uh, most of the treatments are developed for people who are symptomatic and severely symptomatic.
[00:34:09] Dr. Taz: [00:34:10] Right.
[00:34:10] Dr. Kemi Doll: So- Not
[00:34:10] Dr. Taz: preventative ...
[00:34:11] Dr. Kemi Doll: not preventative. And so I wanna, you know, especially things are [00:34:15] different in internal medicine.
[00:34:16] Dr. Kemi Doll: I just, I don't wanna paint all physicians- Right, right,
[00:34:18] Dr. Taz: right ... with one
[00:34:19] Dr. Kemi Doll: brush. No, no, no, no, no. But I just think- We're just talking
[00:34:19] Dr. Taz: about [00:34:20] the
[00:34:20] Dr. Kemi Doll: established standards ... I think it's fair to say in gynecology we have not had a very [00:34:25] strong focus on prevention outside of things like the HPV vaccine, which is great.
[00:34:29] Dr. Kemi Doll: You know, like- Mm, mm-hmm ... and [00:34:30] Pap smears. Like, it's not like we don't do it at all. But when we think about endometriosis, fibroids, and stuff, there [00:34:35] has not been as much research and clinical focus on preventing those things. Right. [00:34:40] We focus on treating severe disease. And so I think that's part of it too, is that just, like, as a [00:34:45] physician culture- Right
[00:34:46] Dr. Kemi Doll: right, we don't like to find things we can't do anything about. Mm-hmm. And what I used to learn [00:34:50] is that, like, well- That doesn't, like there's no reason to find that because it's just [00:34:55] gonna make somebody anxious. There's nothing you can do, right? And it [00:35:00] probably isn't gonna bother them anyway. But as a Black woman, I have to say, I [00:35:05] started to shift on that 'cause I'm like, you know what?
[00:35:06] Dr. Kemi Doll: We say that, but then when they come in bothered, [00:35:10] we don't believe them until they're severe.
[00:35:12] Dr. Taz: Right.
[00:35:12] Dr. Kemi Doll: And then once they're severe, we have one solution. Right. [00:35:15] Take it out.
[00:35:15] Dr. Taz: Right.
[00:35:15] Dr. Kemi Doll: So there's something wrong with this narrative. Yeah. And I am challenging us to say that's not [00:35:20] quite the right, the narrative, and it makes sense, especially that women of color feel so neglected.
[00:35:24] Dr. Kemi Doll: [00:35:25] Absolutely. And it makes sense that they want to turn away to something else, and we [00:35:30] can do better. So, um, so yeah, it's... I'm passionate about it. And, and [00:35:35] then, well, I, we can keep going later, but I'll stop there. But yeah.
[00:35:37] Dr. Taz: No, I mean, it's, that's just interesting that you say [00:35:40] that, and I guess I have the luxury of kind of setting up my own ecosystem when it comes to how we take care [00:35:45] of patients- Yes
[00:35:45] Dr. Taz: and all that other stuff. But I'm actually challenged [00:35:50] by the thing I don't know.
[00:35:51] Dr. Kemi Doll: Me too.
[00:35:52] Dr. Taz: You know what I mean? Mm. The thing I don't know has driven me for all [00:35:55] these years. Yes. You know? It's what drove me into the journals when Black women are coming in- Yes ... you [00:36:00] know, with these sort of- Yes ... very similar patterns, you know?
[00:36:02] Dr. Taz: I agree. So the thing I don't know does not scare me, [00:36:05] and maybe it's a problem with our education system that we- we've been sort of trained to fear [00:36:10] that, but we should embrace the thing we don't know.
[00:36:12] Dr. Kemi Doll: Yes.
[00:36:12] Dr. Taz: Because it's going to lead to the next frontier, [00:36:15] you know?
[00:36:15] Dr. Kemi Doll: Yes. And also, that's where the best ideas, scientific insights come from.
[00:36:19] Dr. Kemi Doll: Like, I [00:36:20] think s- I think there's nothing better than biomedical science for a mechanism. Right. Like, I think there's just... [00:36:25] It's something so cool to be able to understand, like something from like the DNA strand to the protein to the this to the [00:36:30] that. I try to remind people that takes decades and decades and decades.
[00:36:34] Dr. Kemi Doll: So when you just [00:36:35] start, like last year- Yeah ... when we just started- Right ... it's gonna take a while. However, [00:36:40] I would offer that the ideas that [00:36:45] drive what the question is often come from the outside.
[00:36:48] Dr. Taz: Yes.
[00:36:48] Dr. Kemi Doll: You know what I mean? It's like- They always [00:36:50] do ... it's a both/and, yeah. Right. And so that we need to have more of an integrated [00:36:55] approach even when we think about research, because we'll get really interesting [00:37:00] ideas to follow, and then we can see, okay, what does the science show?
[00:37:04] Dr. Kemi Doll: And [00:37:05] sometimes we'll research something and we'll be like, "Oh, well, the science shows there's nothing there." And it's like, well, [00:37:10] then we need... I always go, "Okay, well then, what is another way to ask the question?" Mm-hmm. Or like, [00:37:15] what was it about this group where everything, you know, we didn't see what we expected.
[00:37:19] Dr. Kemi Doll: Like, [00:37:20] it's al- there's always another interesting question.
[00:37:22] Dr. Taz: Right,
[00:37:23] Dr. Kemi Doll: right. Um, and so yes, I don't [00:37:25] believe that we should continue. We should do things that we know, like, don't work, you know? And I do... [00:37:30] It's like in both areas that we've kind of set up here that we're saying are integrated, but, you know, [00:37:35] we've set them up as like Western biomedical framework.
[00:37:37] Dr. Kemi Doll: Yeah. And, uh, in both areas, I think the [00:37:40] practitioners that have ethics and that really want things to go well, they're [00:37:45] not interested in giving you things that don't work. Right. And however, [00:37:50] there's a lot to be explored about how things work, why things work. The placebo [00:37:55] effect, I'm sure you are very familiar with.
[00:37:57] Dr. Taz: Oh, yeah.
[00:37:58] Dr. Kemi Doll: I, I was always [00:38:00] taught that as something, like, very denigrated. Oh, negative. Like, "Oh, that's just placebo." Right, right. It's very negative. And I'm like, "Wait a minute." So by [00:38:05] placebo, meaning, like, the person basically got better on their own because they believed they could, that [00:38:10] is-
[00:38:10] Dr. Taz: That's enough
[00:38:10] Dr. Taz: that's huge.
[00:38:11] Dr. Kemi Doll: That's
[00:38:11] Dr. Taz: enough.
[00:38:12] Dr. Kemi Doll: And also- Yeah. It is enough ... if I can tap into [00:38:15] the placebo effect- Right ... isn't that a good thing?
[00:38:17] Dr. Taz: That's a good
[00:38:17] Dr. Kemi Doll: thing. Isn't that am- Like, I think that's an amazing thing. [00:38:20] And how long has the tradition, how, in how many different cultures is the [00:38:25] idea of laying hands on somebody healing?
[00:38:27] Dr. Kemi Doll: Is that not the placebo effect? Right. [00:38:30] Is that not... So even that, I feel like as, for [00:38:35] me, I identify as a scientist, and I'm like, "That is so interesting." And yes, of course, I'm [00:38:40] interested in things that outperform the placebo effect, but I'm not gonna denigrate it as a [00:38:45] problem.
[00:38:45] Dr. Taz: Well, the placebo effect is simply the body's capacity to self-heal.[00:38:50]
[00:38:50] Dr. Kemi Doll: Exactly.
[00:38:50] Dr. Taz: And self-healing is really what all of our [00:38:55] ancient, you know- Yes ... medicine people- Yes ... any culture, any tradition, any religion really [00:39:00] advocated for. Mm-hmm. That it's within you. Yes. You know, go back to The Wizard of Oz. It's within you. Yes, yeah. You know, the [00:39:05] answer's within you.
[00:39:05] Dr. Kemi Doll: Yeah.
[00:39:06] Dr. Taz: So I mean, I think, you know, we got really, really far away from [00:39:10] that.
[00:39:10] Dr. Kemi Doll: Mm-hmm.
[00:39:10] Dr. Taz: We also don't wanna re-correct to the other side. We don't wanna go all the way to the other
[00:39:13] Dr. Kemi Doll: side,
[00:39:13] Dr. Taz: right. But I think the physician [00:39:15] community would serve everybody really well to be a guide in that. Yeah. Right? To be a [00:39:20] sound, trusted best friend guide. Yeah. You know, which is different. Here
[00:39:23] Dr. Kemi Doll: are all the tools.
[00:39:24] Dr. Taz: Correct.
[00:39:24] Dr. Kemi Doll: [00:39:25] I think about it that way, yeah. Yeah. It's like, listen, we certainly ... I tell people all the time, the biggest [00:39:30] red flag for anybody that you go see is that they have all the answers.
[00:39:32] Dr. Taz: Right.
[00:39:33] Dr. Kemi Doll: That is, I s- it's like- Right ... [00:39:35] I, like, regardless of whatever the background training is, because the body is way too complicated for [00:39:40] that.
[00:39:40] Dr. Kemi Doll: Life is way- Too individualized ... it's too individualized. Right. There's, like, too much going on. However- [00:39:45] The another, like the green flag is somebody be able to tell you, "Listen, these are the tools that I have."
[00:39:49] Dr. Taz: [00:39:50] Yeah. "
[00:39:50] Dr. Kemi Doll: This is how I've seen them work. This is what that is based on, and this is why I think [00:39:55] it's worth you trying it, and this is how we're gonna reassess if it doesn't work."
[00:39:59] Dr. Taz: Yeah.
[00:39:59] Dr. Kemi Doll: Because [00:40:00] that's the other piece is that, like, I think, again, in all different types of clinics, environments, [00:40:05] people can get gaslit. "Well, if it's not working, it's you." Yeah. It's like, okay, hold on.
[00:40:08] Dr. Taz: Yeah.
[00:40:08] Dr. Kemi Doll: The patient is the [00:40:10] expert, and so in that sense, I, like I would ... I, why would I be against anything that's [00:40:15] working for somebody?
[00:40:16] Dr. Kemi Doll: Um, so when I was practicing, I would say that all the time. I would say, "First of all, let's talk [00:40:20] about ... I want you to know I'm curious about all the things you wanna do." Like as a cancer doctor, most [00:40:25] cancer patients are accessing some kind of alternative medicine in some way. Mm-hmm. Mm-hmm. If y- [00:40:30] especially if you define that as like acupuncture- Oh, yeah
[00:40:31] Dr. Kemi Doll: everything, right?
[00:40:32] Dr. Taz: Yeah. Yeah, yeah.
[00:40:32] Dr. Kemi Doll: So I'm like, I want to know, one is [00:40:35] 'cause I wanna make sure nothing you're doing might be interacting with what we're giving you, and then [00:40:40] two, if it works for you, I wanna know that. If another patient asks me, like, "What can I do?" I can share with them [00:40:45] like, "Listen, I don't know if this will help you, but this pa- this helped this patient."
[00:40:48] Dr. Kemi Doll: A place that's [00:40:50] open like that is a place where people feel empowered and where we give the best care.
[00:40:54] Dr. Taz: I love that, and [00:40:55] I hope that model is gonna be there for the future. I know I'm trying to build it. I know. And so many people are trying to build it, you [00:41:00] know, moving forward so that people have more options, more choice, more dialogue, right?
[00:41:04] Dr. Taz: More [00:41:05] dialogue. And we have to have a system of medicine that, that actually rewards dialogue at the end of the [00:41:10] day. Yeah. It'll save so much money on the other end- That is so true ... if you could have these [00:41:15] conversations.
[00:41:15] Dr. Kemi Doll: And they're rewarded.
[00:41:16] Dr. Taz: In a relaxed manner- Oh my gosh ... and then make the right- Not time pressured
[00:41:19] Dr. Taz: set of [00:41:20] choices, right? So-
[00:41:21] Dr. Kemi Doll: Correct ...
[00:41:21] Dr. Taz: but going back to the crisis of the Black womb-
[00:41:24] Dr. Kemi Doll: Oh, yes ...
[00:41:24] Dr. Taz: [00:41:25] I have two questions there. Mm-hmm. One, I read a study not too long ago, you probably saw the same one, that [00:41:30] talked about the chemicals- Mm-hmm. Yes ... in relaxers- Yeah ... some of the products [00:41:35] in makeup. Yes. Where, what's the story on that study?
[00:41:38] Dr. Taz: Yeah. Is that, is that a link [00:41:40] to maybe some of this?
[00:41:40] Dr. Kemi Doll: Yeah. I think, um, yeah. It cer- first i- it certainly is. [00:41:45] So in, let's take hair relaxers. So in hair relaxers there's kind of like- [00:41:50] There's two different angles of concern about beauty products- Right ... we'll say [00:41:55] broadly, and, like, the reproductive system. One angle of concern are the [00:42:00] endocrine-disrupting chemicals.
[00:42:00] Dr. Kemi Doll: Right. So things that might mimic, in some way, hormones or might be [00:42:05] blocking hormone action in some way. And then the other category are just things that are [00:42:10] harm- like, cellularly toxic or harmful. In the hair [00:42:15] relaxer, um, conversation, it is mostly the latter category. So it's mostly, like, things that are just, like, [00:42:20] toxic in, in some way, shape, or form.
[00:42:22] Dr. Kemi Doll: And what we found looking [00:42:25] specifically at women with regard to fibroids and with regard to [00:42:30] uterine cancer.
[00:42:30] Dr. Taz: Mm-hmm.
[00:42:31] Dr. Kemi Doll: Um, we-- There is a link between the specific [00:42:35] kinds of chemical hair relaxers that Black women are more likely to use, 'cause they're for very tightly c- [00:42:40] curled and coiled hair.
[00:42:41] Dr. Taz: Okay.
[00:42:42] Dr. Kemi Doll: So they're very strong relaxers.
[00:42:44] Dr. Kemi Doll: I think that's [00:42:45] very important. They're also more likely to cause burns on the scalp-
[00:42:48] Dr. Taz: Oh,
[00:42:48] Dr. Kemi Doll: wow ... because they're so [00:42:50] strong, and so they're easy to seep in through the skin barrier. Oh. So the exposure level [00:42:55] is higher. Is systemic. Yeah. Yes. Okay. So a very good study. This was actually done by the National, [00:43:00] um, Institute of Environmental Studies Found that Black women who had relaxers [00:43:05] more, six or more times a year, so they're going like every other month they're doing their chemical hair relaxing, [00:43:10] had a higher risk- Mm
[00:43:11] Dr. Kemi Doll: of uterine cancer.
[00:43:12] Dr. Taz: Mm.
[00:43:12] Dr. Kemi Doll: And it was very well done. This was like... [00:43:15] And then another, there was another group that runs something called the Black Women's Health Study. I talk [00:43:20] about this study a lot in the book, 'cause it's the only study we have with over 50,000 Black women. Oh,
[00:43:24] Dr. Taz: wow.
[00:43:24] Dr. Kemi Doll: Okay. Yes. [00:43:25] And it, I, I recommend everybody go look it up because it's not talked about that much, but it's a huge [00:43:30] study.
[00:43:30] Dr. Kemi Doll: They followed them for over 20 years, and they collected a lot of information about [00:43:35] fibroids, cycles, all this stuff. So the Black Women's Health Study went back to their data, and they [00:43:40] asked the same question, and they found the same link. Mm. So there's clearly, it's about a 17% increased [00:43:45] risk of uterine cancer with the use of hair relaxers in Black women, especially frequent [00:43:50] use.
[00:43:50] Dr. Taz: What's the dominant chemical in the hair relaxers?
[00:43:52] Dr. Kemi Doll: I don't remember.
[00:43:52] Dr. Taz: Okay.
[00:43:53] Dr. Kemi Doll: So is there a- Um, because they're all... [00:43:55] Yes, also, sorry, I'm, I didn't mean to in-interrupt you. Yeah, yeah. There are several different ones. Okay. And I just can't [00:44:00] remember, but there's a few that are, like, probably the most, like the agents of most concern.
[00:44:03] Dr. Taz: Are there new products on the [00:44:05] market that-
[00:44:05] Dr. Kemi Doll: Yes ...
[00:44:05] Dr. Taz: are a little bit gentler?
[00:44:07] Dr. Kemi Doll: Yeah. Okay. So like, you know, a Black woman, like a silk [00:44:10] press. Yeah. Like a keratin treatment. Like these things are different.
[00:44:12] Dr. Taz: Okay.
[00:44:13] Dr. Kemi Doll: Um, and they're used. And also a lot of [00:44:15] women do, um, they, they end up with, um, what we call mechanical straightening, right?
[00:44:19] Dr. Kemi Doll: Right. Right. [00:44:20] So like, and it kind of gives you the same look. There's no concern with that.
[00:44:23] Dr. Taz: Okay.
[00:44:23] Dr. Kemi Doll: So we're really talking about [00:44:25] classic chemical no-lye relaxers. That's what we're really talking about.
[00:44:29] Dr. Taz: Got [00:44:30] it.
[00:44:30] Dr. Kemi Doll: Um, and so I tend to say, you know, I feel comfortable now saying, recommending Black [00:44:35] women avoid those.
[00:44:35] Dr. Kemi Doll: It doesn't mean you can't straighten your hair- Right ... but just don't do it that way. That
[00:44:37] Dr. Taz: way.
[00:44:38] Dr. Kemi Doll: That way. Gotcha. Yes.
[00:44:39] Dr. Taz: [00:44:40] Okay. And then the other question I had, just more of a curiosity- Mm-hmm ... for me, a lot of my patients will go [00:44:45] get myomectomies- Yeah ... but then they're right back in the- Yeah ... same spot. Yeah.
[00:44:48] Dr. Taz: What's happening there?
[00:44:49] Dr. Kemi Doll: Yeah, so with [00:44:50] myomectomies, thank you for asking this question. So it's when you [00:44:55] have, um, myomectomies are most successful- About half of people who [00:45:00] have a myomectomy will have their fibroid grow back. So I try to make people clear about [00:45:05] that, 'cause I'm like, so that's half that don't and then half do.
[00:45:07] Dr. Kemi Doll: Mm-hmm. So what, how can we know which half you're gonna be [00:45:10] in? There are a few ways. One is myomectomies are most successful when you have [00:45:15] one dominant fibroid.
[00:45:16] Dr. Taz: Mm.
[00:45:17] Dr. Kemi Doll: So it's like it's one fibroid, it's six, seven, eight, nine, [00:45:20] 10 centimeters. You don't have a uterus riddled with fibroids. So that's more [00:45:25] successful.
[00:45:25] Dr. Kemi Doll: When you have multiple fibroids, multiple large and small fibroids, it's [00:45:30] much less ... It's much more likely they're gonna grow back, 'cause remember why fibroids grow, one [00:45:35] single stem cell.
[00:45:35] Dr. Taz: Mm.
[00:45:36] Dr. Kemi Doll: So when you have like 10 fibroids, you're banking on you're [00:45:40] removing every single one of those stem cells. Those individual different mutations that created each one of those [00:45:45] fibroids.
[00:45:45] Dr. Kemi Doll: It's a lot less likely that's gonna happen. It's a lot more likely that you have small [00:45:50] fibroids that aren't actually removed, and so you haven't removed all of the stem cells. Interesting. Does that make sense? Yes. So that's a [00:45:55] big reason why it grows back. That's an important
[00:45:57] Dr. Taz: differentiation there,
[00:45:58] Dr. Kemi Doll: yeah.
[00:45:58] Dr. Kemi Doll: Yes, and why it's not [00:46:00] unreasonable to pursue a myomectomy potentially if you have one [00:46:05] dominant fibroid that is not responding to medical treatment. Gotcha. 'Cause you're actually in the group that's most [00:46:10] likely to succeed- Mm ... with the surgery, right? Um, so I ... [00:46:15] One of the issues with that, with that regrowth, and I get why women would choose it.
[00:46:19] Dr. Kemi Doll: I'm, [00:46:20] I understand-
[00:46:20] Dr. Taz: Yeah,
[00:46:21] Dr. Kemi Doll: yeah ... is that we have women that are doing myomectomies with lots of fibroids, [00:46:25] and the success rate is gonna be lower. The second, um- [00:46:30] The second, um, issue around myomectomy is what happens [00:46:35] afterwards.
[00:46:35] Dr. Taz: Right.
[00:46:35] Dr. Kemi Doll: So what we also want is if your fibroids are gonna grow back, we would at [00:46:40] least like to give you several years.
[00:46:41] Dr. Kemi Doll: You know what I mean? Like, we want it to be like 10 years. We want it to be a long time before you [00:46:45] have to deal with it again. So what's happening in that intervening time? Are those things that [00:46:50] we talked about happening? Are we getting vitamin D supplementation? Mm. Mm-hmm. Are we on, preventatively on [00:46:55] the medications that I said sh- actually shrink fibroids?
[00:46:57] Dr. Kemi Doll: Shrink it. So it's like, hey, listen, just in case, you know what I'm [00:47:00] saying, there was a one centimeter fibroid we didn't find or a stem cell left behind, let's do some [00:47:05] preventative treatment. So are you on things that we think are gonna prolong that time, or [00:47:10] is it we took the fibroids out, fingers crossed?
[00:47:13] Dr. Taz: Hmm. [00:47:15] Is there not any, with all the work on stem cells right now, is there not any evolving [00:47:20] therapies with stem cells to-
[00:47:21] Dr. Kemi Doll: In progress ... get rid of this? Yeah. I mean, they're working on it. They are working on it. We have, we now [00:47:25] have in the last five years, um, the NIH, just in the last five years, actually funded large [00:47:30] centers of fibroid, centers of fibroid excellence and research.
[00:47:33] Dr. Kemi Doll: Mm-hmm. It's like a specific kind of NIH [00:47:35] center where- Right ... you get- I think
[00:47:36] Dr. Taz: I saw that.
[00:47:36] Dr. Kemi Doll: Yeah. Okay Yeah. Mm-hmm You get, like, molecular biologists, geneticists, [00:47:40] like, you get every kind of- Right ... kind of discipline all working on the same problem.
[00:47:44] Dr. Taz: Mm.
[00:47:44] Dr. Kemi Doll: So we've [00:47:45] got a few of those now, right? So it's gonna take time.
[00:47:48] Dr. Kemi Doll: Take time. I know, y'all. [00:47:50] Okay. But we are gonna get there, so it's frustrating- Okay ... 'cause we're behind, but I never want the narrative to be like, "We [00:47:55] don't care. There's no research," like nobody... Like, it's not true we're not doing anything, but it does take time.
[00:47:59] Dr. Taz: Time. What [00:48:00] about PRP? Have you seen those uterine washes with PRP?
[00:48:03] Dr. Taz: I'm just curious. I'm just [00:48:05] asking. I- I'm just curious. So
[00:48:06] Dr. Kemi Doll: okay, did you see the recent, um, [00:48:10] oh wait. Okay, I, I just saw this about the plasma. It was [00:48:15] a negative study, and I now, I just cannot remember what it was about. Oh, that's bothering me. It, [00:48:20] um- It was for, um, pelvic floor. That's what it was for. Okay. It was [00:48:25] for, uh, pelvic floor issues, like a urogynecology issues, [00:48:30] and people doing PRP for urinary incontinence- Mm
[00:48:33] Dr. Kemi Doll: and weakness in the pelvic floor. Okay. It did [00:48:35] not
[00:48:35] Dr. Taz: work.
[00:48:35] Dr. Kemi Doll: Do anything? It did not help. Okay. No. So my thought... So I really don't like [00:48:40] it.
[00:48:40] Dr. Taz: Okay.
[00:48:40] Dr. Kemi Doll: And I'll explain why.
[00:48:41] Dr. Taz: Okay. It's- And maybe explain what PRP is too, just in case someone [00:48:45] listening
[00:48:45] Dr. Kemi Doll: does not know. It's a plasma rich- Yeah. Okay ... um, I forgot what the third P stands for.
[00:48:48] Dr. Kemi Doll: Platelet. Plasma-rich platelet [00:48:50] infusion. Right. Okay. So here's a few th- reasons why I don't like it. One is that the [00:48:55] endometrium, so that's the inner lining of the womb, is a very tightly controlled space. It's one of the most protected [00:49:00] spaces in the body actually, right? Because, because to [00:49:05] grow a life, it has to be, like, immunologically protected, so there's a lot of...
[00:49:08] Dr. Kemi Doll: That's actually why it's difficult to [00:49:10] develop treatments- Mm-hmm ... 'cause the uterus is like, "Don't come in."
[00:49:12] Dr. Taz: Right.
[00:49:12] Dr. Kemi Doll: Right? Like- Right ... you are not allowed in here. Yeah. [00:49:15] Okay. So menstruation, going back to the wound with the scarless repair, is [00:49:20] this very tightly regulated system of, um, the [00:49:25] hormones and then the inflammatory system, which includes platelets, right?
[00:49:28] Dr. Kemi Doll: Macrophages, [00:49:30] prostaglandins, that all come in, and they grow these spiral arteries. This is actually [00:49:35] really beautiful architecture, and then those arteries unwind, and it's this very tightly regulated [00:49:40] system. I do not like the idea of inserting more [00:49:45] platelets, plasma-rich platelets, into that system for growth reasons- Mm-hmm
[00:49:49] Dr. Kemi Doll: when [00:49:50] actually growth factors are never a problem in the uterus. That's not the problem [00:49:55] that we have. Hmm. Interesting. It's not an area where it's like, oh gosh, we just, like, need more. We don't [00:50:00] ever need more of that.
[00:50:01] Dr. Taz: Yeah.
[00:50:01] Dr. Kemi Doll: Most of our conditions come from too much of that. So it's like I [00:50:05] just... Again, this is not my scientific opinion from the mechanisms, but this is my [00:50:10] scientifically informed perspective, that when I think about PRP, I think about, like, [00:50:15] aging.
[00:50:15] Dr. Kemi Doll: Right. I think about, you know, like- Right ... places where you're trying- Yeah ... to, like, get more, and that's not [00:50:20] the condition of the uterus.
[00:50:21] Dr. Taz: Interesting.
[00:50:21] Dr. Kemi Doll: So I don't like it.
[00:50:22] Dr. Taz: You don't like it. All right. So no to that. [00:50:25] All right. What I'd love to do, I'm thinking about my patients, I'm thinking about- Yeah ... our [00:50:30] listeners and viewers, and they're hearing this conversation- Yeah
[00:50:33] Dr. Taz: around the womb- [00:50:35]
[00:50:35] Dr. Kemi Doll: Yeah ...
[00:50:35] Dr. Taz: around fibroids, and they're like, "Well, what do I do?" Yeah. So [00:50:40] can we just go down the arc of being a woman? Mm-hmm. If you're a teenager- Mm-hmm ... if you are [00:50:45] a young Black female teenager-
[00:50:47] Dr. Kemi Doll: Mm-hmm ...
[00:50:48] Dr. Taz: what would you have them do?
[00:50:49] Dr. Kemi Doll: Oh my [00:50:50] gosh. Okay. Um, I have... Okay, so a few things. [00:50:55] One is I would have you establish care with a gynecologist that you trust, that you really [00:51:00] like.
[00:51:00] Dr. Kemi Doll: I promise you they exist. They are, there are... Especially we [00:51:05] have this whole huge crop of new generation- Yeah ... holistic- Yeah ... minded, um, [00:51:10] gynecologists. I say that because you should have a gynecologist before there's a problem. [00:51:15] A lot of times, and I am completely part of this problem- Yeah ... and I'm working on it, we [00:51:20] only go when there's a problem, but now that person does not know your normal.
[00:51:23] Dr. Taz: Right.
[00:51:23] Dr. Kemi Doll: That person is starting from [00:51:25] scratch. To know
[00:51:25] Dr. Taz: your normal.
[00:51:26] Dr. Kemi Doll: Yes. So you need to know your normal, and then you need a doctor to know your [00:51:30] normal. I encourage everybody to do a three-month symptom journal.
[00:51:33] Dr. Taz: Mm.
[00:51:33] Dr. Kemi Doll: It doesn't take that much [00:51:35] time. It's like just a quick every day, bleeding, cramping, anything going on down there.
[00:51:39] Dr. Kemi Doll: You will now [00:51:40] know this is what is normal for me. First of all, what you write down might surprise you. You might be [00:51:45] like, "Actually, I bleed and cramp a lot."
[00:51:46] Dr. Taz: Mm.
[00:51:47] Dr. Kemi Doll: And that's a sign to go in. Secondly, you now [00:51:50] have a record of normal. And Dr. Taz, you know how physicians are. Yeah. It's totally different to [00:51:55] say like, "I think something's been a little different for a little while," than to come in and say- "What's next?"
[00:51:59] Dr. Kemi Doll: from January [00:52:00] to March- Right. ... this is what it was. Right. And then this, it- Right ... 'cause it already starts us, we already start [00:52:05] going, "Okay, it could be this." Right. It like- Right ... it turns on our- Instantly ... differential diagnosis. Yeah, yeah. So I tell [00:52:10] people, speak that language. So do a symptom journal to know your normal.
[00:52:13] Dr. Kemi Doll: If everything's fine, put it [00:52:15] away, now you have it. If it's not, you are already collecting data for that future appointment. [00:52:20] Get a gynecologist so that you have somebody who knows you- Mm-hmm ... and you don't have to [00:52:25] convince them when something has changed, 'cause they already know your baseline.
[00:52:28] Dr. Taz: Okay.
[00:52:28] Dr. Kemi Doll: Number three, in terms [00:52:30] of womb health, know your family history.
[00:52:33] Dr. Kemi Doll: Does endometriosis run in your [00:52:35] family? Do fibroids run in your family? What are periods like in your family? Um, we don't have these [00:52:40] conversations often. We need to. Get a blood count and an, uh, an iron level. [00:52:45] 30% of Black women with heavy periods are anemic.
[00:52:48] Dr. Taz: Mm.
[00:52:49] Dr. Kemi Doll: 30%- Wow ... [00:52:50] are walking around without enough oxygen in their blood as a norm.
[00:52:54] Dr. Kemi Doll: Wow. [00:52:55] Get those labs tested. Um- And then you said young Black women.
[00:52:59] Dr. Taz: Mm-hmm.
[00:52:59] Dr. Kemi Doll: [00:53:00] Oh my gosh, healthy, healthy, encouraging, positive relationships [00:53:05] in your life. Mm, love that. It is not too young- Yeah ... to demand a [00:53:10] high standard for people who interact with you, for your romantic partners, for your [00:53:15] friends. Like, I love that people are, like, reclaiming themselves, but aren't you tired of the re- [00:53:20] reclamation happening at 45?
[00:53:21] Dr. Taz: Right.
[00:53:22] Dr. Kemi Doll: How about 25? I
[00:53:24] Dr. Taz: love that.
[00:53:24] Dr. Kemi Doll: You know what I [00:53:25] mean?
[00:53:25] Dr. Taz: Yeah.
[00:53:25] Dr. Kemi Doll: Um, and lastly, I talk a lot in the book about womb sisters, which is that we've gotta break the [00:53:30] silence and say, we need a sisterhood where we can talk about these things for real, for real.
[00:53:34] Dr. Taz: [00:53:35] Yeah.
[00:53:35] Dr. Kemi Doll: I understand what it means to ask Black women especially to go to the doctor when they've had such [00:53:40] negative experiences, and I don't ask them to go alone.
[00:53:42] Dr. Kemi Doll: You don't need everybody in your friend group to know your business. Right. But [00:53:45] you should have one friend- Who's an advocate ... that you ... Yeah- Yeah ... that, who's an advocate, that can, that doesn't care about all the [00:53:50] details, that can be an objective ear for you, and in a very vulnerable [00:53:55] exam and environment, be an anchor.
[00:53:57] Dr. Taz: That's a really great tip, actually. I love that. [00:54:00] Let's move on to the woman now entering her 30s- Yeah ... and going maybe into [00:54:05] her childbearing years- Yes ... coming right out of it. What would you tell her?
[00:54:08] Dr. Kemi Doll: Yeah, so I would tell her that, [00:54:10] um, it is really easy in your childbearing years, after you have kids, you're chasing your [00:54:15] career, all those things, it is really easy to literally disassociate- Yep
[00:54:17] Dr. Kemi Doll: from what's going on down there, right? You're just like, [00:54:20] "I don't exist below the belly button." Right. I only exist here. I'm like, I am right here. Right up
[00:54:23] Dr. Taz: here.
[00:54:23] Dr. Kemi Doll: Right. Yes. And you're going, 'cause [00:54:25] I do the same thing. Yep. Go, go, go, go, go. Yeah. It's very, very easy to disassociate, and that is actually where we [00:54:30] see the most severity of symptoms during that time- Interesting
[00:54:33] Dr. Kemi Doll: that are untreated. Okay. It is [00:54:35] in the 30s. It's like everybody is just go, go, go. They're taking care of their kids. They're taking care of their parents, all this stuff. [00:54:40] And especially for Black women, like, this is the time when we could actually [00:54:45] intervene.
[00:54:45] Dr. Taz: Mm.
[00:54:45] Dr. Kemi Doll: And often, you know, if you look at the hysterectomy rate, it's like [00:54:50] low in the 20s.
[00:54:51] Dr. Kemi Doll: There's a little blip in the 30s, and then you look at Black women, and it just, like, [00:54:55] skyrockets. Wow. 'Cause that's when women ... You know, their kids graduate. Everybody moves out, and they're finally like, "Okay, let [00:55:00] me take care of myself." Yeah. And now there are no options.
[00:55:02] Dr. Taz: Right.
[00:55:02] Dr. Kemi Doll: So this is the time where we have to [00:55:05] make a specific point to say- I have to prioritize my womb [00:55:10] even when it is inconvenient to other people.
[00:55:13] Dr. Taz: Mm.
[00:55:13] Dr. Kemi Doll: If something has changed during [00:55:15] this time, I have to put something aside in order to take care of this for myself. [00:55:20] And also, I start thinking about, um, screening for cancers, right? So we start thinking about, [00:55:25] oh, I should tell the young people to take the HPV vaccine.
[00:55:27] Dr. Taz: Yes. Sorry.
[00:55:28] Dr. Kemi Doll: HPV vaccine. [00:55:30] Youngsters.
[00:55:30] Dr. Kemi Doll: Please. Yeah. Okay, so this is when you start thinking about, um, you know, 7% [00:55:35] of uterine cancers happen under 45, so we start thinking about talking to your doctor about your risk factors [00:55:40] for uterine cancer. You start thinking about optimizing your heart health, 'cause almost everything that you do [00:55:45] that helps your heart helps your womb.
[00:55:46] Dr. Kemi Doll: Mm-hmm. That's another thing I tell people. Anything you hear about heart health helps your womb. [00:55:50] Um, it's when we start thinking we have to be a little bit more careful about- Yeah ... dietary things. We have to start being careful [00:55:55] about high processed sugars and, um, high, um, what do [00:56:00] you call- you know this better than me, Dr.
[00:56:01] Dr. Kemi Doll: Taz, the high glycemic index- Oh, yeah,
[00:56:03] Dr. Taz: yeah ...
[00:56:03] Dr. Kemi Doll: foods- Inflammation and all- ... and diets and [00:56:05] inflammation. Right. Mm-hmm. That drives fibroid growth. It worsens endometriosis. We know that for a fact. Right,
[00:56:09] Dr. Taz: [00:56:10] right.
[00:56:10] Dr. Kemi Doll: So you have to start paying a lot more attention to that. And then also, I have to say alcohol.
[00:56:14] Dr. Taz: Oh.
[00:56:14] Dr. Kemi Doll: [00:56:15] Alcohol increases fibroid growth, y'all.
[00:56:16] Dr. Kemi Doll: I'm sorry. I'm just- It's the truth ... I'm telling you the truth. It's the truth. [00:56:20] So I think the 30s are a time where there is a deliberate [00:56:25] effort to carve out a piece and say, "What am I doing that I'm s- to make sure that my [00:56:30] womb and the rest of my body health is as optimal as it can be, even if it's inconvenient?"[00:56:35]
[00:56:35] Dr. Kemi Doll: Now we get into... Oh, sorry, go ahead.
[00:56:37] Dr. Taz: Well, no, I was gonna say, now we move into- 40s, 50s ... 40s [00:56:40] and 50s. Okay. I believe we're- Peri-menopause years ... peri-menopause and menopause. Yes. And I have a [00:56:45] visual of a couple of women who've come, lots of fibroids- Yes ... kind of an angry uterus- Yeah ... [00:56:50] asking me if they can save their uterus.
[00:56:51] Dr. Taz: Yeah. What would you tell these women?
[00:56:53] Dr. Kemi Doll: I would say maybe, maybe [00:56:55] not. Yeah. And I would say, and I would be really honest, and I tell a story in the book of, like, [00:57:00] honestly having to tell a woman in her early 40- she was, she was actually- Mm ... just, [00:57:05] she had just turned 40, and I had to tell her- Some of them haven't had children yet
[00:57:07] Dr. Kemi Doll: "You need a hysterectomy." Oh, yeah, she had not had children.
[00:57:09] Dr. Taz: Yeah. I
[00:57:09] Dr. Kemi Doll: said, "You need a [00:57:10] hysterectomy." Yeah. And so I'm honest about that because I don't want [00:57:15] you to live a life of anemia, of pain, of cramping. At, you're 40, I assume [00:57:20] you've got 50 more years, girl. Right. Good point. So we are not gonna suffer through that.
[00:57:23] Dr. Taz: Yeah.
[00:57:24] Dr. Kemi Doll: Um, so if [00:57:25] we haven't done that priorit- prioritization in our 30s, right, and you're just coming in, one, [00:57:30] it's It is, one, seeing a, [00:57:35] seeing a holistic doctor, a specialized gynecologist so that you can walk through [00:57:40] all your options and your fertility options. So surrogacy might be an option for you, [00:57:45] harvesting eggs might be an option for you, all of these things.
[00:57:47] Dr. Kemi Doll: Um, two, it's recognizing [00:57:50] that you are about to enter the menopausal years, and it's probably going to be very helpful [00:57:55] for you to get an assessment of whether menopause hormone therapy is gonna be helpful for you, and [00:58:00] protection for your womb-
[00:58:01] Dr. Taz: Right ...
[00:58:01] Dr. Kemi Doll: during that time. Mm. For everybody, because there's women who are listening who are like, "Well, [00:58:05] I haven't really suffered from fibroids, endometriosis, anything."
[00:58:07] Dr. Kemi Doll: True. Mm-hmm. You're still at risk for uterine cancer, [00:58:10] especially if you're on estrogen-only therapy.
[00:58:11] Dr. Taz: Right.
[00:58:12] Dr. Kemi Doll: So I think I talk about that a lot. [00:58:15] And then, um, making sure that you stay in care during [00:58:20] menopause, because especially for women of color, what can happen is a [00:58:25] lifetime of fibroids, a lifetime of heavy bleeding means that as they go through menopause, [00:58:30] Dr.
[00:58:30] Dr. Kemi Doll: Taz, they actually don't have that 12 month without bleeding- Right ... because they're [00:58:35] symptomatic from other things, and it can mask uterine cancer bleeding. So you need to [00:58:40] be in routine care with somebody who's watching that pattern, because your [00:58:45] periods should always be getting farther apart and lighter, farther apart and lighter, farther apart and [00:58:50] lighter.
[00:58:50] Dr. Kemi Doll: But what happens, especially with Black women, is that that starts, but then maybe they start bleeding more, and [00:58:55] they start bleeding more. Mm-hmm. But it's all just perimenopause. Right, right. And we miss those signs.
[00:58:59] Dr. Taz: Miss the [00:59:00] big things.
[00:59:00] Dr. Kemi Doll: Yeah. Right. Interesting. And so staying in care is really important. And then post-menopause, [00:59:05] it's just making sure you still get that annual exam, 'cause you know, there are vulvar, vaginal cancers, other things that can happen [00:59:10] that are more common 60s, 70s, 80s.
[00:59:12] Dr. Taz: So a lot of women aren't going after 60.
[00:59:14] Dr. Kemi Doll: I know. [00:59:15]
[00:59:15] Dr. Taz: Do you want them to go?
[00:59:16] Dr. Kemi Doll: Yes. Okay. I want you to go. Sorry.
[00:59:18] Dr. Taz: No, that's important.
[00:59:19] Dr. Kemi Doll: I want you to go [00:59:20] because it goes back to what we talked about. Yeah. Are we just child bear- I mean, are we just- Right ... here to child bear?
[00:59:24] Dr. Taz: Right.
[00:59:24] Dr. Kemi Doll: So [00:59:25] vulvar and vaginal cancers are most common in women in their late 60s, early 70s.
[00:59:29] Dr. Kemi Doll: Mm. And you know what would [00:59:30] happen? We would see women with literally masses on their vulva, [00:59:35] on their vagina, that nobody had bothered with, women in nursing homes or not, women who [00:59:40] otherwise looking great, because the thought was, "Oh, I might have a UTI," or, "Maybe [00:59:45] I have, like, an STD or something. There's noth- like, there's nothing-" Right
[00:59:47] Dr. Kemi Doll: "to really worry about down there." Right. And [00:59:50] as gynecologists, it's so frustrating. I'm sure. Because it's like, why? These organs still exist. [00:59:55] Why do we have this paradigm where we just- act like they're not there anymore Right Like, is there any point [01:00:00] where somebody goes like, "Oh, we don't worry about your heart anymore"?
[01:00:02] Dr. Kemi Doll: Is there any point where we're like, "Kids-"
[01:00:03] Dr. Taz: Good point. Your bones don't matter.
[01:00:04] Dr. Kemi Doll: Oh, yeah, [01:00:05] your bones don't matter. You know what I'm saying? Oh my God. Like, even your teeth. Like, every- Yeah ... it's like the uterus is the only [01:00:10] organ, misogyny-
[01:00:11] Dr. Taz: Right ...
[01:00:11] Dr. Kemi Doll: where it's like, "Oh, you're not producing babies. Probably fine.
[01:00:13] Dr. Kemi Doll: Don't worry about it." Yeah. What? Like, [01:00:15] what... How did this happen?
[01:00:16] Dr. Taz: You said it.
[01:00:18] Dr. Kemi Doll: Okay.
[01:00:18] Dr. Taz: Misogyny.
[01:00:18] Dr. Kemi Doll: So, yes. Well,
[01:00:18] Dr. Taz: your book is out.
[01:00:19] Dr. Kemi Doll: It [01:00:20] is.
[01:00:20] Dr. Taz: Talk to us about the book. Oh my gosh. What can we find in there? What do you want people to walk away with?
[01:00:24] Dr. Kemi Doll: I want people to [01:00:25] walk away so informed that they never feel intimidated by going to seek women's healthcare [01:00:30] again.
[01:00:30] Dr. Taz: Mm.
[01:00:30] Dr. Kemi Doll: I want them to feel informed so they actually, they can look towards any [01:00:35] type of practitioner they want to and feel like they can understand what that person is saying through the lens of the [01:00:40] biology. I promise you it's not too scientific. I promise you, you can follow it, and there are [01:00:45] incredible stories in this book of women, not just enduring womb suffering, but overcoming it, including [01:00:50] my own story of my own journey to endometriosis- Yeah
[01:00:52] Dr. Kemi Doll: and my own journey with fibroids. And [01:00:55] ultimately, it is an empowering book. You're gonna wanna give it to your friends. You're gonna wanna take it to your [01:01:00] doctor. Um, the entire third part of the book is just how we can heal, and as we talked about, [01:01:05] through many ways. So I wanna bring these worlds together, and it's why I include information about [01:01:10] vitamins, supplements- Amazing
[01:01:11] Dr. Kemi Doll: emotional management, and- Love it ... medicine- I love it so much ... and surgery. It's like- Yeah ... 'cause that's [01:01:15] the world we live in, so please pick it up wherever you find books. Give it to your mother for Mother's Day. [01:01:20] I don't know- Mother's Day is right around the corner ... if you're, if you're late or early- That's right
[01:01:22] Dr. Kemi Doll: you know what I'm saying? Um, and I think it will [01:01:25] definitely serve you.
[01:01:25] Dr. Taz: Well, I am so honored to have you here. We have a crisis when it comes to [01:01:30] Black women's health. We both know that.
[01:01:31] Dr. Kemi Doll: Yeah.
[01:01:32] Dr. Taz: I've sat with so many women, both in our [01:01:35] clinics, and then prior to my clinic life I was in the ER. Yeah. Yes. So, you know, got to witness [01:01:40] firsthand kind of some of our breaks and, and how women are not served well.
[01:01:43] Dr. Taz: So I'm gonna [01:01:45] encourage everybody watching and listening to please, please share this episode [01:01:50] with at least two to three other women in your life, and I don't care if they are [01:01:55] 12, 13, 14, or they're 70, 75, or 80. I feel like we have to get this [01:02:00] message out there. So please share it. Let's get educated. We can take care of the body.
[01:02:04] Dr. Taz: The body's [01:02:05] incredible. Yes. We're both fascinated by it, but if you don't know, then you don't know what to do.
[01:02:09] Dr. Kemi Doll: [01:02:10] Yeah.
[01:02:10] Dr. Taz: And Dr. Hemy, thank you so much. Thank you. I love this episode. Thank you. Well, before [01:02:15] I let you go- Okay ... and unleash you to the world, uh, what makes you whole?[01:02:20]
[01:02:24] Dr. Kemi Doll: [01:02:25] Um, I can say more than one thing?
[01:02:28] Dr. Taz: You can say more
[01:02:29] Dr. Kemi Doll: than one thing. What makes me [01:02:30] whole is remembering that I come from amazing people, [01:02:35] and that my life is like a blessing-
[01:02:37] Dr. Taz: Mm ...
[01:02:37] Dr. Kemi Doll: um, to be able to live this life. I'm literally [01:02:40] grateful. I'm, like, grateful to God, the divine, for trusting me to, like, be alive. [01:02:45] Um, what makes me whole are my kids.
[01:02:46] Dr. Kemi Doll: Yes. They're so
[01:02:47] Dr. Taz: sweet.
[01:02:47] Dr. Kemi Doll: Yes. They're seven
[01:02:48] Dr. Taz: and 11. Family.
[01:02:49] Dr. Kemi Doll: And, [01:02:50] like, they are adorable. I love my husband still, so that's always great. That's always good. We have a good time. [01:02:55] Um, and, um, and really just feeling... It's like we talked [01:03:00] about this before we started recording. There's nothing like feeling like your work has meaning beyond you.
[01:03:04] Dr. Kemi Doll: [01:03:05] Yeah. I am so renewed by that, so yeah.
[01:03:08] Dr. Taz: We're changing generations. Thank you.
[01:03:09] Dr. Kemi Doll: So
[01:03:09] Dr. Taz: that's [01:03:10] huge. So thank you again for joining us. For everybody else, please remember, [01:03:15] another little plug to first of all, get the book. Secondly, share it. I go deeper on all these [01:03:20] topics, including fibroids, women's health, Black women's health, and more in my private community, The [01:03:25] Circle.
[01:03:25] Dr. Taz: So if you've not joined yet, now is the chance. Just go to [01:03:30] wholeplus.co/circle and we will see you next time. Before you go, take a second to [01:03:35] reflect on what stood out for you today. Then, if you can, leave a quick review [01:03:40] wherever you're listening. It really helps other people discover Whole Plus and start their [01:03:45] own healing journey.
[01:03:46] Dr. Taz: And don't forget to follow me on Instagram at drtazmd. I [01:03:50] love hearing how these episodes are supporting you.