Women’s Health for Better Sex with Erkeda DeRouen
In this episode of The Better Sex Podcast, I talk with Physician Healthcare Consultant, Keynote Speaker and Best-Selling Author, Dr. Erkeda. Dr. Erkeda brings us their wisdom related to sexual health and wellness, particularly women’s health issues and how to advocate for oneself with healthcare providers. We touch on the struggles women have in the healthcare system due to poor education in women’s health as well as getting support around sexual disorders. We explore pelvic floor health and how physical wellness plays a major role in our sexual wellness. Dr. Erkeda speaks about her commitment to provide more community access to wellness as it relates also to food security, financial ability and social determinants of good health. This is a valuable conversation filled with tips on how to manage women’s health issues and get the help you need when you need it.
Connect with Dr. Erkeda
Website: https://www.drerkeda.com/
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Stay Connected Pillow Talk
In our commitment accessibility, help make this podcast more accessible to those who are hearing impaired or those who like to read rather than listen to podcasts. The transcription is far from perfect, and in some cases quite amusing. As we grow edited transcripts are on the list in the meantime please enjoy.
Deborah [00:00:10]:
Welcome to the better sex podcast. My name is Deborah Kat and I am your shameless host. This is the Better Sex podcast where we have unfiltered conversations about sex and relationship and what matters in them. This show is about the many possibilities of sex and relationship and helping you figure out what works for you so that you can have the sex and relationship that works for you on your terms. I truly believe that a sexy world creates a happier and a safer world. And if you want to do your part in creating a safe and sexy world, please hit like subscribe and leave a comment. Today we are going to dive into the world of my guest, Arkita Rowan. She is a triple board certified healthcare technology expert.
Deborah [00:01:11]:
She does consulting and executive coaching, and her Ted Talk on using the power of imagination to change healthcare is off the charts. She's the founder of Pacemakers, an organization working to combat the inequities in healthcare. And I am so thrilled to have her as a guest. She is somebody who is new to me and I am excited to learn more about her. So where to start?
Deborah [00:01:45]:
How did you get here?
Deborah [00:01:46]:
What are you passionate about these days? Sorry, that's like ten questions all at once.
Erikda [00:01:50]:
I'm so excited to be here and we have time. I'm Erketa De Rowan and I'm thankful that you invited me on the show because I think that these are conversations that we need to have. And unfortunately, with all the taboo things, a lot of stuff people don't talk about, so we should talk about it. So, a little bit about me. I am from the DC area. I am a physician who's board certified in family health and community medicine and diversity medicine and lifestyle. So I love all the things that we're talking about and they all kind of relate to sex because we have to have a healthy life and kind of live to enjoy. And then there are diverse people out there, so we have to be culturally competent.
Erikda [00:02:37]:
So I got into healthcare because my family members, they had health conditions. And unfortunately, in America, there are health care disparities and things that aren't necessarily due to genetic causes and all of those kinds of things. So I'd always kind of had a little passion for learning more about merging my interests of being a science geek, in addition to just like, loving to talk with people. And I'm sure you guys will see how chatty I am. So I went into medicine, and after that I worked in community health clinics and then I discovered the fantastic world of healthcare technology. And I transitioned into telehealth before it was cool, about six years ago when they said that no one would see a doctor online. And then the pandemic hit and we kind of proved them wrong. So since then, I have been working at different levels of leadership in different organizations.
Erikda [00:03:35]:
And now I am a healthcare technology consultant. Otherwise, just to go back to my passions of just being involved in the community and helping to kind of advocate for people who can't necessarily advocate for themselves, I've started an organization called the Pacemakers, which kind of dives into those social determinants of health that they love to call it, which I think is a buzword. But what that basically means is only about 20% of your health is due to your interactions with the healthcare system. When you see a doctor, when you go to the hospital, the emergency room, all of those things. The other 80% is all affected by your living environment and what happens in your zip code. So the education that you're allowed to have, the economic status that you have, your neighborhoods and how safe they are, and all of those kinds of things. So with the Pacemakers, we're working to kind of give you resources to help navigate those things, where to find jobs, how if you need help with your utility bills, where to get that, because it's hard out there. As well as how to navigate the health care system.
Erikda [00:04:43]:
So a lot of people may not know if they go to the hospital and they need financial assistance. Sometimes times are getting harder, especially with the economy. So you may not have the best insurance or any insurance at all. So how do you not avoid going to the doctor and letting stuff brew, but knowing that there's a social worker that can help you with financial assistance or if you've been admitted to the hospital, that there is a person that can be a patient advocate if you feel like you're not getting the care that you deserve. So I want to just help educate, help people advocate, and then build a community with that so that we can kind of make it a healthier world for everyone.
Deborah [00:05:23]:
That's so good. And I'm really struck by the idea that only did you say 20% is health care oriented and the rest is social. Would you say social determinants?
Erikda [00:05:41]:
Social determinants of health. So things like your neighborhood, your safety, your environment, all of the things that kind of go in those zip codes. Because if we've been doing studies over time and it's shown that zip codes really matter. So in DC. There's an area, it's a very small city, but, you know, everything's packed in here. You can live in one part of town, like Capitol Hill, and then kind of one of the more underserved areas that are like 6 miles apart, and the life expectancy is a 30 year difference.
Deborah [00:06:11]:
Wow.
Erikda [00:06:12]:
Males who live in one part that was called Berry Farms lived on average to be in their fifty s. And then if you live near Capitol Hill, they're like in their eighty s and the same thing they've seen in Baltimore and other areas. So these disparities, of course, aren't necessarily all due to health care. Of course, there are people who have different habits and that could be due because they don't have food security. Where there are grocery stores, if you're in a certain area, you may only have access to corner stores or convenience stores, whereas other areas may have whole foods and farmers markets and things like that. So a lot of this is determined by zip codes. It determined really is the political determinants of health. But people hate to combine politics and health care, and we need to, because what you're voting for is affecting your health that we've seen with women's health and our rights to our body.
Deborah [00:07:06]:
It's something that we really need to address and advocate for.
Deborah [00:07:12]:
Wow. Gosh. I am rarely speechless, but I know one of the things that's, like, a big topic these days is the idea of food deserts and the idea that there are whole neighborhoods that don't actually have even a grocery store. I was actually listening to I believe it was NPR, and they were talking about a town I want to say it was in Alabama, where it was a very small town. The last grocery store was about to leave, and the town actually decided that it was enough of a priority to have it there that they actually went ahead. And now the town owns the grocery store.
Deborah [00:08:08]:
Wow. Yeah.
Deborah [00:08:09]:
And what's so fascinating to me about this is that if you talk to the folks who are part of that town, they're like, socialism bad, but we're owning this grocery store because we want to take care of each other. And I'm really struck by this idea that we have these labels that stop us from taking care of each other. Another thing I'm really struck by is that it's almost like GoFundMe has become the new insurance, and that's just devastating. Like, an illness or a trip to the hospital can actually change your wealth bracket. That's crazy to me.
Erikda [00:08:55]:
Absolutely. I think you said so many good things about, number one, how one illness that will happen to all of us. All of us are going to be eventually involved in the health system, just depending on what part phase of life you're in. But one particular illness can financially devastate someone, and it shouldn't be that way. Like, we put all of this money into the military, and we put all of this money into other different things, banks and all of those bailouts. Why can't we put money into health? And a lot of that, like I said, goes back to what are we advocating for? Why aren't we standing up for our communities like that community did, to say, like, okay, we don't want to be a food desert. What can we do about it? So that's the education that we need to put out and empower people to do, because like you said, we label a lot of things as, like, socialism, and we don't want this and of course, everyone has their own beliefs. But I think at the core of most Americans, it's more about community.
Deborah [00:09:57]:
So how do we push that over the narratives that are on the news? And how can we create healthier environments that you're living in and your neighbors are living in? Because we all want everyone to be healthy for the most part.
Erikda [00:10:11]:
And so I'm curious, what have you found that actually works?
Deborah [00:10:18]:
Works in terms of building communities and.
Deborah [00:10:21]:
Things like that, that works in terms of building communities and supporting health. In your Ted Talk, you were talking about expanding and allowing the imagination to create different alternative ideas. And I'm kind of curious, what are some of the things that you've had the opportunity to put into play?
Erikda [00:10:48]:
So I think, number one, I keep saying it, voting works. We see what we've gotten into from these last four, six years where we're living with the repercussions of taking away women's right to have an abortion in some states. Now they're trying to take away diversity and all of those kinds of support. So voting works. So number one, talk to everybody about 2024, but more active things that people can do, like you said, are starting at the grassroots organizations. A lot of times we focus on working in the national initiatives and going to the HHS and the Department of Health and all of these kinds of things which really work to help. But sometimes we have to start where we are and try to go to your county level and talk to those people and see what kinds of initiatives you have. If you're living in a food desert, can we advocate and partner with someone more in a rural area to bring out the farmers market? Can we partner with the hospital systems and the community health centers to give out instead of tickets to go get a medicine which still take your medicines? But can we also incorporate, like, here's a coupon to go and get some free fruit at the place and have a partnership in place for that and developing grants and stuff? A lot of it is kind of working with the community and working with the leaders there to talk and discuss and then bringing people on board.
Erikda [00:12:12]:
Because a lot of people, when you're in your free time, people work, people have children, people have partners, people have lives. They don't necessarily want to be like, okay, let me go to a meeting and learn about the health care I can't even afford. So how can we make it exciting? How can we make it accessible? In my realm of healthcare technology, I think that there is a lot of promise. There are a lot of organizations that are coming there to meet patients where they are. So I still see patients to a certain capacity, not full time, but when I'm seeing patients in the telehealth app, different ones, you'll have patients who come in, and they say, I'm so thankful for this. I work at Walmart, and I work the night shift. So I haven't been able to see my primary care in three years. This is what I'm going through.
Deborah [00:12:56]:
How do you help me navigate that? So being able to explain that, especially through the pacemakers, like, how do you navigate the system? Step one, I have a lot of family members and friends who will call, and they'll be like, I'm having this issue. What should I do? Or what specialist should I see? So everyone doesn't have that. So the pacemakers wants to be kind of like your doctor in your pocket or your social worker in your pocket so that you can have that access as well. Because we are kind of gatekeeping the things that are important to people and letting people kind of figure out how to navigate it. It shouldn't be this hard, but because it is, we need more organizations coming together to make it a little easier for people to just figure out how to get the things that they need.
Erikda [00:13:40]:
And I'm curious when so going back to the 80%, what are some of small things that an individual or a couple or a small family can do to improve their health care?
Deborah [00:14:04]:
There are so many things to do. Number one is kind of put it at the front and center. I definitely notice, especially working in the telehealth space, that a lot of patients, they wait. America is a place where we have sick care, not a lot of preventative care. You wait, and you don't cover things, and people don't go whether or not if they don't want to go and they don't think they need to, versus my insurance won't cover it. It's too expensive. So we wait until you're sick, and you're like, oh, God, my kidneys are failing. I got to go to dialysis, or, oh, my goodness, I had a heart attack.
Deborah [00:14:42]:
I guess I need to start seeing my doctor to see how I can get better. But how do we work on that prevention aspect? So doing the things, like, from the principles of lifestyle medicine, like getting enough sleep, is important, and it affects how your body and your energy works, how your organs work, and all of those things working to eat a healthier diet like the American diet, isn't the best. And I'm not perfect, so I'm living there right along with you and having these plans to make these small changes, but they matter. So studies have shown that plant based diets improve diseases. They can reverse them, and they can add many years onto your lifespan. So if you can't go 100% plant based, I'm not there yet. One day I will be at least 80%, but I still like chicken and things like that. But how about implementing it for two meals a day or 40% of your week or something to help you get healthier? How about doing things like going for a walk.
Deborah [00:15:41]:
Like a lot of people don't take time to exercise because life gets busy. But you don't realize that you can wake up maybe 15 minutes earlier and do some jumping jacks. And it may look silly in the house, but you're getting that heart rate up. And then when you get home, you can go for a 15 or 30 minutes walk before dinner, after dinner or something like that. And that adds up because we recommend about 150 minutes of exercise in a week. So if you're doing that, it's adding up and even if you aren't hitting those exact numbers, it's getting you a little bit closer. So doing things to kind of prioritize your physical health, prioritizing your mental health, like taking time to kind of evaluate things, seeing a therapist, unfortunately the system is set up where you can't necessarily afford it all of the time. But there are definitely some resources that are popping up to help people be able to get with someone to help talk about it outside of your social circle and your family.
Deborah [00:16:43]:
Other things I would say is getting in to see a primary care at least once a year. People always think that I sound a little crazy because I preach the gospel of telehealth, but I will say that it should be used as an adjunct or alongside regular in person care because I don't think that anything can replace that. Like you can't touch someone through telehealth. At this point, who knows where tech is going to take us? But I think at least checking in like once a year with your primary care doctor and they know all of the specialists that you're seeing, what medications you're taking, all of those different things. I've written a few articles on the different questions and how you should prepare yourself to go to a primary care visit. But bringing those things there and sharing what you've seen, if you have gone to these online doctors that aren't connected with your health system, letting people know because they don't get alerts. Unfortunately, in the US. We have all this technology, but we don't have a universal electronic medical record.
Deborah [00:17:39]:
So those are some things we need to push for. So it's crazy that you have to remember what your medicines are and what you take them for when we could just kind of put them in the system. But hopefully we're getting there. I think the last thing I'll say on this component, because I know I'm chatty, but the last thing I'll say about this is especially in women who, women who are listening to this, I think a lot of times between the late forty s, fifty s, we always go to our GYN. And GYNs are amazing. Like these doctors, they definitely prioritize your women's health, but there's more than you, than your vagina. So yes, you want to prioritize that and all of that kind of stuff and you're going to them for some of the basic things. They can check your thyroid, stuff like that, but they're not looking at your whole body.
Deborah [00:18:29]:
So you have to see your primary care, even if you're going to get your PAP smears or have your babies and all of those kinds of things at your GYN, because they may miss things that you may not even think about. So, for instance, my cousin has given me permission to share her story. She's going through a pretty tough time right now because she's 30. She had been having some issues with endometriosis for the past few years and seeing GYN after GYN after GYN. She had started a few months ago to get more short of breath and having a cough. She went to the emergency room, the urgent care. They kept trying to say it's like bronchitis, bit of pneumonia. Her mom has a medical condition, an autoimmune disease, car, sarcodosis.
Deborah [00:19:16]:
So they tried to start working her up for that. And when they took a biopsy after they saw a mass in her lungs, they realized that she has stage four lung cancer.
Erikda [00:19:26]:
Holy moly.
Deborah [00:19:27]:
Crazy. Yes. She's never smoked all of those things. 30 year Old Woman so we're helping to navigate that and we can talk a little bit about why that frustrates me, that I have to help to navigate that. And it's not because I don't love my cousin, but it's because it's ridiculous the way the health care system treats you until you have a doctor intervene and everyone doesn't have a doctor in their pocket. So that's why we're fighting. But my whole purpose with this is she's been going to GYN and not a primary care.
Erikda [00:19:58]:
For just a second and maybe we'll step into this in a moment, but I know I'd love it. For those that don't know what endometriosis is, if you could just say a little bit about what that is, because I know that's a very common thing for women, and it is very common as something that makes sex uncomfortable. And it often comes with this idea that I'm broken. I just want to make sure that for people listening that they know what those things are.
Deborah [00:20:40]:
I love you for calling out these big words because that's one of my pet peeves. And I'm starting a little Instagram series on this because it's national at this time of recording. It's October and it's National Health Literacy Month. And one thing that people hear when they hear the word literacy is, I know how to read, I'm literate. Yes, you can be a lawyer, you can be a judge, obviously the Supreme Court, and not necessarily know how medicine works and what medical terms mean and all of those kinds of things. So I think that we need to speak in plain language or at least explain what we're saying. We're just throwing out these medical words. So I'm starting a little series on Instagram where I'm going to try to take some big words and should just tell you what they mean in regular people talk.
Deborah [00:21:29]:
So my instagram is dr. D. Graham doctor the letter D. Graham. Gram so. Dr. G. Graham but endometriosis.
Deborah [00:21:41]:
So it is a disorder where the tissue that normally lines your uterus grows in different places. So it can grow outside the uterus, it can grow in your ovaries, it can grow kind of in your abdomen, different places, and it causes severe pain in a lot of women. So women are coming, they're having really bad periods, really heavy, really crampy, lots of pain even outside of your period. And it can be devastating because it's kind of hard to diagnose sometimes. You can't just do a PAP smear or do some imaging and see that you have endometriosis. You can get a sample of the tissue by doing the surgery, but it can sometimes take women years to get a diagnosis. It can cause very painful sex and it's something that can be life changing and devastating to people. It can also cause some fertility issues.
Deborah [00:22:33]:
So it's something when I always tell women when they're having very painful periods, it's something to bring up. It's not normal to have painful periods. You can have cramps or something like that, but it shouldn't be debilitating or take you away from your day if you're starting to do that. Or you're starting to have very heavy periods where you're going through more than four or five pads in a day, or tampons and you're bleeding through things, go and get help and get checked out because a lot of times you are dismissed maybe for those kinds of things. So definitely bring it up in your appointments because you have to sometimes advocate for yourself, because there are some things that can help you feel better, like birth control pills, heating pads. Some people do get surgeries and things. We're not going to push all of that extremism, but sometimes you need it. But just figuring out what's going on is important.
Erikda [00:23:24]:
I just want to take a moment because you said something about what you should expect with a normal period. And I think that we don't always know. Even just hearing you say that, I was like because growing up, it would often be like, oh, I've got my period. And I would actually be like the idea of being so cramped out or in such pain that it's almost a badge of honor. And so it's interesting hearing you say that. So what would you say? And I know normal and average are hard words to define, but for an average period, what should that be like? How many days?
Deborah [00:24:22]:
So it's different for every person. There are definitely extremes, but it should be about 24 to 30 ish days in between, like counting from the first day to the next one. On average, most women's is 28. But it can be on either edge of the spectrum. If it's less than 21, it's too short. It can last usually about three to five days for women. Sometimes people last a week, sometimes very lucky, blessed women, they get it for a day, but on average, it's usually about three to five days. You should go through about four pads or tampons in a day.
Deborah [00:25:03]:
I know some women, of course, change them a little more frequently if they're going to the restroom more often and things like that. But you should never be bleeding through tampons or pads. Of course, we have more devices now, like menstrual cups and things like that. But you shouldn't be overflowing. You should not be in debilitating pain. There are some people that do have cramps. One technique that I would recommend that you do if you are routinely having cramps is to premedicate with insaid. So an anti inflammatory medicine.
Deborah [00:25:38]:
So like aleve, motrin, ibuprofen, naprosin, that kind of medicine, maybe two to three days before. Just take it twice a day just in anticipation, and it can help soothe some of the cramps. Some people love more natural products like ginger or peppermint. You can do that in the teas and things like that. Some people do have additional symptoms like nausea or feeling very sad and things like that. Keep an idea. I would say keep a log of that and track it just to see if this is a pattern or something like that, because you can bring that up with your doctor and they can talk to you. So they may be able to give you some anti nausea medicine or give you some tips like I just did, or investigate and see if there's something else going on.
Deborah [00:26:26]:
If your periods are irregular or too heavy. Or you may be able to start a birth control pill to help regulate that. So it's always important to kind of track and monitor what's going on and know what your body rhythm is.
Erikda [00:26:43]:
Beautiful. Thank you. That makes me curious. Generally speaking, one of the things that I often hear is that for many women, there's times in their cycle where they are most amorous or when they most want sexual connection. Can you talk a little bit about women's cycles?
Deborah [00:27:12]:
So we have different hormones in our body. Like, we've all heard of the estrogen. We have progesterone. They kind of fluctuate depending on what day in the period you are. So there's one that goes up and then there's one that goes down. As it goes more down, that's when the lining of the uterus is doing the opposite. And eventually, when it's time for the cycle to end, that's when you start to bleed from your uterus. I know I was just doing hand motions, but I was kind of like, envisioning the little chart that we see in medical school when I was learning that.
Deborah [00:27:47]:
They were like, what is she doing, a roller coaster? But these hormones affect your emotions, they affect your sex drive. There are some other hormones as well, like oxytocin, which can affect not only things like your hormones and your sex drive and things like that, your attachment to people. They also affect when you're pregnant, like when you're delivering. They can even affect orgasms and stuff like that. So it can affect a lot of different things. So these hormones can sometimes get out of whack and cause you to be more sad and things like that. So a lot of these things, when they say hormonal it's yes, but it's more than that. Okay.
Erikda [00:28:31]:
And I'm curious, have they started tracking men's cycles yet? Because I know they have them.
Deborah [00:28:40]:
I wish. I agree. I can't say that scientifically. Like, I haven't read any papers on it, but they have some feelings as all humans do. But I haven't seen any research or literature about that.
Erikda [00:28:54]:
I'm sure they're it's so interesting the places where we have a lot of interest or data around what happens for the masculine body or the feminine body and then places where we don't. I find that really interesting just to.
Deborah [00:29:14]:
Say something on that. I think a lot of it is because health care and research and all of those things are very male dominated and honestly, women weren't even allowed to be in scientific medical trials until the lot of these studies are based off of men. What they wanted to study, what outcomes they saw and they didn't even include us.
Erikda [00:29:39]:
Got it. Well, that makes sense then because I as somebody who's interested in male sexuality and definitely interested in figuring, I mean, anecdotally I definitely see men have their cycles for sure. I'm wondering I've got so many questions. One of them is in the world of relationship, in the world of dating, we often use the term there was chemistry, there was no chemistry. So I'm kind of curious on what the medical take on attractive chemistry is.
Deborah [00:30:29]:
Curious about that too. But I'm going to be honest, I am not familiar with that. That's something I would like to look into though, because I do believe that there are the different hormones and stuff. Like I mentioned, the oxytocin and stuff makes you more so I'm sure there's evidence and things out there, but I haven't researched it.
Erikda [00:30:49]:
Thank you for being honest about that. Would you say that bringing it back to sort of the relational sexual experience, I'm wondering if you can talk a little bit about some of the issues that come up for people around what makes sex easy and painful and then what makes it more painful. And I'm wondering if you could speak a little bit about some of the talk a little bit about what problematic, what can be problematic for women in sexuality. And I'm wondering if you can talk a little bit about what can be problematic for men in sexuality.
Deborah [00:31:45]:
Okay, so I will start with. The men because of course they're most researched and all of those kinds of things. So I think a lot of men have problems with erectile dysfunction or sometimes when they have different hormonal issues like thyroid problems or low testosterone and things, there are some underlying issues that may be causing that. So they also can be some medical issues or physical issues that men experience where their erection might not happen. So if they have diabetes, they may not necessarily the vessels that are lining the penis. Sometimes the blood flow doesn't work as well. So those types of things can affect it. Of course, depression and the mood and all of those hormones can also affect it.
Deborah [00:32:40]:
But they've studied men, so of course they have Viagra and that's what they teach us in medical school about. We've had whole sections and things on it, but we don't honestly have much on women's health, especially like women's sexual health. So that just shows where the priorities are in health care. Women, they usually come in with and I'm not going to try to label people, but there have been some women I would say that usually when people have issues with sex, they don't love, I don't know why, but they just don't love bringing it up with their doctors. It usually is one of those issues where you are just leaving, you talked about your blood pressure and all of those things and you're walking to the door and I'm closing the computer and they're like, oh yeah, by the way, sometimes it hurts when I have sex. Or by the way, this and this and that. So one thing I would encourage people to do is if you're having the issue, don't be shy. Like there's nothing we haven't usually heard.
Deborah [00:33:50]:
Women can definitely they'll tell you that they have issues when it's time for a pelvic exam or something like that, but they tend to keep it to themselves. Or if you come in and you are depressed or anxious and you're kind of pushing a little more to see what may be caused, and then they're like, oh, I haven't had sex with my husband in three years. And you're like well, why? Why didn't you say anything? And they're like, oh, I have pain. I have fear, I'm depressed. Because there are some things that we can kind of talk about that will help. So some things that cause sexual disorders in women is the medications they may be taking or like antidepressants or other medicines, some blood pressure medicines can cause that. So talking through them, there are some women who may have structural problems. That meaning the physical body has maybe some strictures there's something called vaginismus where it really hurts to have sex.
Deborah [00:34:50]:
So there are some things that we can do to help that. So you can go and you can get pelvic floor therapy. There are devices that they can use to kind of help you kind of open up the vaginal canal more. Other diseases that women may have kind of in the pelvic area that they may not want to talk about, like after childbirth, sometimes they may have of course my mind goes blank now and say what it is but can't think of the name. But sometimes they may have some prolapse vaginal prolapse, that's what I meant, where it kind of like it's falling through the vagina and stuff like that. So there are other things that we can do to kind of split that up. There are other things where you would need to do like kegel exercises and stuff like that. So bringing it up with your doctor can kind of help you kind of go through like is it a pain disorder, is it a structural thing? Are you having mood problems? And all of those kinds of stuff.
Deborah [00:35:53]:
So if we can't help you, like a primary care doctor, who would probably be your first line, unless you go to an OBGYN, they may be able to refer you to someone. So even going from a traditional general OBGYN, they may be able to send you to an OBGYN that does sexual medicine, or someone who does reconstruction, or someone that does sexual health. Or even another big issue that women may have is when they hit menopause, because that's another thing that we often forget and we don't talk about. All you talk about is hot flashes and things like that. But there is so much more to menopause. I think there are like 30 symptoms or something that women go through when they are going through a change in life. In menopause isn't just one day I'm in menopause. It's kind of a longitudinal thing where you have perimenopause and then you have to wait twelve months.
Deborah [00:36:42]:
Like you cannot have your cycle for eleven months and 20 days, but if you have another period, you better start counting again. So twelve whole months and then you're in menopause. Another thing you want to talk about with women that they may not know is if you've gone through menopause and you haven't bled in twelve months, if you bleed again, run to your doctor because that's concerning and it can be a sign of cancer. There are a lot of older women who have post they call it postmenopausal bleeding. There are a lot of older women who may be in their 60s or 70s. They're like bleeding again. I haven't had a period in 20 years. And you're like, why are you telling me you need to get some samples tested and things? Because it can be a sign of endometrial cancer or uterine cancer, because that's a part of the lining, is endometrium of the uterus.
Deborah [00:37:36]:
There's a lot to talk about and it's a big range of sexual conditions that can affect women. I've only kind of touched the surface. But as we see, we always hear about the men and their erectile function or sometimes they can have other disorders too with pain. They can have also things depending on if they're circumcised or not that can cause some issues as well. So I won't give them too much like, oh, they're just talking about the erections. There's more to men as well.
Erikda [00:38:04]:
Beautiful. Thank you.
Deborah [00:38:06]:
Yeah, I just want to hit back.
Erikda [00:38:07]:
On pelvic floor therapy for just a moment because I am in the Perimenopausal Menopausal journey and there's a big change. I mean, for me, my desire spiked, which was like, oh gosh, really? War. Thank you though. But one of the things that came up for me is I definitely had different experiences with having sex and my desire for it. And I worked with a pelvic floor therapist for a while and that was really helpful because not only was it affecting my sexuality, it was also affecting my posture because the muscles that are in the pelvic bowl, they're around your hips, your butt, the whole nine yards. And so it was a really helpful thing for me personally. So I definitely will second that. Gosh.
Erikda [00:39:29]:
So I'm really curious about what you are up to in the world and if you could just talk a little bit specifically about I know that you are heading out on a speaking tour and I'd love to hear you touched a little bit on Pacemakers. But really my imagination is that it's a nationwide is that accurate? So tell me more.
Deborah [00:40:02]:
I'll start with the pacemaker. So it's an organization that wants to help patients kind of navigate that healthcare system. And how we're going to do it is partnering with community based organizations, health systems, health departments and all of those different things to kind of help them improve patient outcomes. So how we're doing that is by education. So doing things like this where we're explaining how the system works and how we can make it better. Advocacy where we're working to kind of push our legislature to make changes and things like that. Also working through education to do things like workshops and team building and all of those kinds of things to kind of help organizations because we can't do it alone, come together and advocate for these things and then community building. So just like we're talking about what's happening with menopause, a lot of people don't talk about these things.
Deborah [00:40:58]:
They kind of keep it in silence. So how do we bring these communities together? So if we're on the app, you can have a forum and we can talk about like, oh, I'm going through this. Did you hear that pelvic therapy helps? Oh really? Oh, I live in Maryland. Me too. Where did you go? Or how do I find this out, how do I navigate that? So like you were saying earlier, we can build a community and help one another and that also helps the health systems kind of see where the needs are. So we're working to do partnerships with that. And we're going to be nationwide. We're starting more in the more larger cities where there are more opportunities for developing grants and things to work with this.
Deborah [00:41:38]:
So like DC, perhaps Houston, those kinds of things. But we're going to be accessible. I know in the show notes I'm going to share with you guys a opportunity to sign up for our newsletter because in terms of the resources, there is a wealth of them. So I know a lot of things that people care about are like, okay, we're both wearing glasses. A lot of people may not know because glasses are so expensive, that if when you go and you get your yearly or every other year eye exam, you can ask them to add the pupillary distance to your prescription and you don't have to buy it from them. You can go on one of these sites, put in your email account and get free glasses at some of these places. So that can definitely save you things we're going to have on there where you can get cheaper medicines because a lot of times, even with your insurance or if you're getting it out of pocket, you may not know that your out of pocket expense may be cheaper than using your insurance. So if you go check your medicine on the Target or Walmart list or you go on GoodRx, you may be able to get your medicines for cheaper.
Deborah [00:42:43]:
And that can help you kind of do things like build up your refrigerator if you're having food insecurity or something like that, or put that money elsewhere, because everybody can do that whether or not they have insecurity or not. So that's what's kind of going on with the pacemaker. So we're going to put a link to sign up for the newsletter because every week I'm going to send out a new resource and then when the app goes live, I'm going to send out a blast to you guys to join it so we can start that community engagement and knowing where the events are. The other exciting thing that you mentioned was the Speaking Tour. So I love speaking as you can kind of hear, I love kind of teaching and educating as well as just starting conversations because I think that we're not starting conversations enough. A lot of people are kind of living in their little boxes and the more we talk and connect with each other, I think the more change we can make. So this fall, starting in November to about March or April, I'm going on a Speaking Tour. So I'm going to be talking about overcoming obstacles.
Deborah [00:43:44]:
So that's something that everyone probably goes through. Everyone has a story, everyone has a background. But I want to share a little bit about my story and then my approach to overcoming obstacles that can lead to your glow up. So it's called the Glow Up Tour, and if anyone wants to reach out to me, we'll have that, and you can sign up and have your organization or your school system or something do that, and I can come and talk with you guys. So it'll be exciting to kind of connect with the community in different areas.
Erikda [00:44:17]:
Beautiful. And do you talk to kids? Do you talk to adults? I know that you are open to talking to everyone, but is there a particular group that you are really wanting to connect with to get the message out to?
Deborah [00:44:39]:
So I think that it's translatable to everyone. So I think I'm not going to say it's a tour and it has a theme of overcoming obstacles, but it's tailored towards different things. So I am going to be speaking at some colleges and some school systems to kind of talk about that story and then also kind of have a Q and A and not have it just as a speech, but like as a conversation. So meeting them where they are at that level. So if it's a high school student, you're going to overcome obstacles if you haven't already. Some people have had some already, but how do you fix yourself up to get on the other side and keep leading and keep shining? And then of course, in the corporate world, there's an obstacle every day because everything is an emergency when you have these different things. So how do you meet those barriers and how do you become resourceful and figure it out? So it's translatable into different ways. So there's no one particular group.
Deborah [00:45:35]:
It's just when they look at the site and they kind of see what the theme is, see if it's a good fit for you, and we can have a conversation before it's booked to see if it's a good fit.
Erikda [00:45:48]:
Beautiful. So can you please speak your Instagram and your website so people can find you?
Deborah [00:45:58]:
Of course. So my website is just my name. I kept it simple. WW dot drurkeda. Drerkeda.com. So, Drurkita.com, you go on there. You'll see information from some of my past speaking engagements. You'll see things from my podcast.
Deborah [00:46:20]:
I have a podcast geared towards premeds and medical students that talks about kind of the obstacles that they're facing, as well as it brings in some pretty cool doctors to talk about the things that they're doing outside of healthcare. It also has a link to my TEDx that we kind of mentioned, which kind of talks about if we lived in a utopia, like how could we merge tech as well as thinking outside of the box, to use the Disney method of imagineering, to imagine something better, like the Pacemakers, which is mentioned in there. And for my instagram, it is Dr. Dgram. Doctor? The letter Dgram. And if you guys message me, I can talk about different topics and things on there. I love to do education, so I'll have some of the little fun ones where you kind of point and talk about what is reflex, how to make it better, and those kinds of things. The questions that patients come in with.
Erikda [00:47:20]:
So freaking good. I know this is a trick question here, but if there is one thing that you want people who have been listening to walk away with, what might that be?
Deborah [00:47:34]:
I would say the one thing is to keep advocating for yourself and don't be afraid to ask questions. I think a lot of times when you go to the doctor's office, you may be a little nervous to talk about certain things, especially in the sexual realm, but we're here to help you. So if you don't feel comfortable enough talking to your doctor, then you need to find a new one, because I think finding the right doctor is like dating. You got to kind of kiss a few frogs before you find the right one. So if you're not in alignment, ask around and find someone else, and I think that the Pacemakers can help you with that. So definitely sign up for the newsletter, because we'll be sending things like, who's the best doctor in the LGBT community to do a surgery because we don't want it to be, like, some of these stories that are coming out where they have lawsuits because they've been recording people and stuff like that. So we want to find people who are safe for you, and we have a lot of resources there, so I would just sign up for that. If you follow me on Instagram, you can always send a DM.
Deborah [00:48:35]:
I usually will answer back. It may not be the same day, but I get back to you.
Erikda [00:48:42]:
So good. Thank you, Dr. Akita, for your time, for your energy, for what you're doing out in the world. I'm so thrilled to have you here on the Better Sex podcast. So, again, thank you all for listening to this episode of the Better Sex podcast, where we have unfiltered conversations supporting sex and relationships on your terms. If you have questions, please reach out. Deborah Tonchakat@gmail.com if I don't have the answer, I would be thrilled to look around and help you find it. So, on that note, thank you so much.
Erikda [00:49:24]:
Please do your part, like comment and share this podcast. If you know somebody who would benefit from any of the things we said here today, please help spread the help spread the news. Get the information out there. Thank you again, Dr. Akita. And for all of you out there listening.