Reframing Menopause: Gabriella Espinosa on Stepping into Your True Power

Dr. Sameena Rahman [: 00:00:01

Hey, y'all, it's doctor Samina Rahman, Gyno girl. I'm a board certified gynecologist, a clinical assistant professor of Ob GYN at Northwestern Feinberg School of Medicine, and owner of a private practice for almost a decade that specializes in menopause and sexual medicine. I'm a south asian american muslim woman who is here to empower, educate, and help you advocate for health issues that have been stigmatized, shamed, and perhaps even prevented you from living your best life. I'm better than your best girlfriend and more open than most of your doctors. I'm here to educate so you can advocate. Welcome to Gyno Girl presents sex, drugs, and hormones.

Dr. Sameena Rahman [: 00:00:47

Let's go. Hi, guys. It's me, doctor Samin Rahman, Gyno girl. Welcome to another episode of Gynel Girl presents sex, drugs, and hormones. I just recorded an awesome podcast with Gabriela Espinoza, who is a sexual wellness and midlife menopause coach who has done a lot for different women. She talks. In this episode, we talk about her experience in perimenopause and being dismissed, her journey into finding something that inspired her and that angered her so much that she decided to pivot in her life and start something in the realm of coaching and wellness. She is pretty remarkable at the things that she does and helps patients and her clients with really helping them to change their mindset on a lot of things when it comes to midlife and the journey that we're on.

Dr. Sameena Rahman [: 00:01:44

So I think you guys are gonna enjoy this. And if you ever wonder what a health coach does, this is a great example of using your own experiences and trying to get make the best of it and trying to actually improve the lives of others. And she does a great job at it. So please enjoy this podcast with Gabriella Espinoza, and I will link all of her information in the show notes. And remember, I'm here to educate so you could advocate. So let's go. Hey, y'all, it's me, doctor Samina Raman. Gyne girl.

Dr. Sameena Rahman [: 00:02:16

So happy to present you with another episode of Gynell Girl presents sex, drugs and hormones. Welcome to my podcast. If you haven't been here before, in my podcast, we explore a lot of patient journeys. A lot of experts come to speak about it, a lot of people in the wellness space. So I'm super excited to introduce to you guys today a new friend of mine that we met a few weeks ago at the Menopauseum, and we're going to talk in detail about her journey and discuss everything when it comes to what she does in this space of menopause and sexual health. This is Gabriella Espinoza. She's a women's health and sexual wellness coach and the host of a wonderful podcast. We're doing podcasts which she and I was just on.

Dr. Sameena Rahman [: 00:03:03

Her podcast, Pleasure in the Pause, which is dedicated to empowering midlife women to own their pleasure, power and purpose through menopause and beyond. Her work lies at the intersection of embodiment, eastern traditional wisdom, female sexuality and menopausal health, and is informed by 15 years of guiding women to know, trust and appreciate their bodies through one on one and group coaching programs, online courses and international retreats. Learning from her own experience of perimenopause with the lack of knowledge about her body changing hormones and what to expect, Gabriella developed a holistic educational and coaching program incorporating yoga, breath work, mindfulness and sex education to support other women to demystify and navigate the transition into perimenopause and menopause. Gabriella believes menopause is an invitation to know ourselves better and upgrade our physical, mental, and emotional selves to the best version possible. Her guidance takes women on a journey of self explanation, trust and knowing, and we do get to the other side wiser. I, stronger, sexier, and more empowered. I love that. That is awesome, Gabriella.

Dr. Sameena Rahman [: 00:04:15

I wish I had a live audience. I'd have them give me applause.

Gabriella Espinosa [: 00:04:20

Thank you. Thank you, doctor Roman. Thank you. It's such a pleasure to be here with you today.

Dr. Sameena Rahman [: 00:04:25

Yeah, you know, I'm so excited because, you know, you and I, as we've learned, you know, we have a lot in common, actually. We're both like children of immigrants who came here in the sixties, who landed in the south. Like, we had parents who really emphasized education over, like, you know, marriage or anything like that. And we both, I think, got married late in our thirties, right? Like, we got married in our third late, mid to late thirties and had kids. My last kid, you know, I stopped having children at, you know, 43. So I think we all, you know, like, you know, we have very similar background in that. And then, of course, I'm in the thick of perimenopause right now. But why don't you tell our listeners about your journey into perimenopause and menopause and sort of how our culture sort of impacts that? I also want to get into a discussion around, like, you know, you and I are both involved with Liberty Road, which is like a group that by Nada Jones, and it's really a great forum where they talk about women in the middle third of their life and shifting into new types of career or, you know, social or whatever stuff that's going on.

Dr. Sameena Rahman [: 00:05:33

Some kids. Some people have kids that are grown up and done, and other people are still in the thick of it, like me. But you know, how you, you know, and I want to talk about how you kind of transitioned into, you know, the work, the amazing work that you're doing right now. But first, tell us about your journey into perimenopause.

Gabriella Espinosa [: 00:05:49

Yeah. Well, thank you so much for inviting me. You know, I'm such a huge fan of yours, and you were on my podcast, and we had a wonderful discussion about the experience of women of color navigating menopause. So, yeah, my. I often reflect about the time I spent in perimenopause and say it was like the light switched off, especially with regards to my libido. I was left totally in the dark. And that time period lasted a good seven years. And I realized, you know, that.

Gabriella Espinosa [: 00:06:24

That darkness, that, uh, place is a place that I really, um, needed to go to. It's a place, you know, you. You hear it a lot, right? It was that place where I just did not feel like myself anymore.

Dr. Sameena Rahman [: 00:06:39

Right.

Gabriella Espinosa [: 00:06:39

What you hear from so many patients.

Dr. Sameena Rahman [: 00:06:41

There'S a whole study on that about perimenopause and how it's a major, major, major complaint, is not feeling like myself. Yeah.

Gabriella Espinosa [: 00:06:48

Yes, I heard that. I heard that study. Yeah. Yeah. The fatigue, the anxiety, the overwhelm, the just not being able to cope with day to day life. And I realized, you know, that place, when I got to that place and started experiencing all those symptoms, I really took time to get to know myself and collected all these tools to rise and come out of the other side. Like I said, feeling stronger, sexier, and more empowered. Like you said in my bio, I do feel that's possible, but you can't just patch it up and expect to move forward without making any changes.

Gabriella Espinosa [: 00:07:30

There's a lot of inner work of acceptance and compassion towards ourselves that's necessary to stepping into midlife. And, yeah, I followed, you know, the traditional path of womanhood, not thinking that I would. You mentioned. Yeah, I didn't get married till my. Till I was 35, started having kids at 36, and kind of. Yeah, we started following that traditional path of womanhood because that's what I saw. My parents, my mother, my grandmothers, all doing that. Right.

Dr. Sameena Rahman [: 00:08:01

Yeah. It's like the clock is ticking, and you gotta go with the children next, you know?

Gabriella Espinosa [: 00:08:05

So the being the perfect mother, the beautiful wife, people pleaser. You know, I. My husband and I had a very short course courtship. We went from that fiery, passionate desire that you often experience when you fall in love to getting married and going straight to having children. Three children and a span of five years. I wanted it to happen quickly because I was. The clock was ticking, as you said. I was in my forties.

Gabriella Espinosa [: 00:08:29

I was in my forties when I was done, went straight from childbirthing to breastfeeding to play dates to. Into perimenopause.

Dr. Sameena Rahman [: 00:08:37

Play dates to perimenopause. I love it.

Gabriella Espinosa [: 00:08:39

But I had no idea what was happening. You know, it was the anxiety that came out of nowhere that hit me. Like when I was driving with my kids in the backseat of the car. Insomnia, low mood. And of course, this had a knock on effect on my intimate life. And I had no understanding at that time. It was like 2018. Perimenopause wasn't being spoken about.

Gabriella Espinosa [: 00:09:08

I hadn't even heard of the word. I had no understanding or language to communicate with my husband, with my doctor, or even my girlfriends. I went from doctor to doctor to doctor. They told me, you're just tired, stressed out, mom, you're feeling a little bit of anxiety. Here's some beta blockers or some antidepressants. Yeah. And there was just this enormous sense of shame that I was getting old and you. It had a big impact on my intimate life.

Gabriella Espinosa [: 00:09:35

I felt my sex life was over. So I decided that was when I decided to dive into this inner work, take pleasure into, literally into my own hands. And I spent the following 15 years traveling the world. I was already living in Europe at the time. I was living in London. We were there for work, and I just traveled to study with different experts in Spain and Amsterdam and France. I learned from and in London. I went back to school and got a degree in nutritional therapy.

Gabriella Espinosa [: 00:10:09

I studied yoga and meditation. I trained with renowned sexuality experts, just researching and exploring powerful mind body tools to form a deeper connection with my body, to awaken pleasure and sensuality. And that is what has led me to where I am now as a women's health and sexual wellness coach. I want women to get to know themselves better, to feel connected to their bodies and really embrace midlife as a new stepping stone for living their best lives. So that's what my work entails.

Dr. Sameena Rahman [: 00:10:51

That's wonderful. Did you, like, we've talked about this from, you know, from your podcast, but, like, how, you know, how much information we got from, you know, siblings, parents, whatever, you know, culture around menopause and perimenopause. It was like, mom's the word, right?

Gabriella Espinosa [: 00:11:06

Exactly. I think the only sex talk I received was from my grandmother, and I think she still is with me today. She's my guardian angel. She would say to me when I would visit her, your body is a temple. Respect it and don't let anyone in. That's all she told me, and that's all. And I understood. I was in my.

Gabriella Espinosa [: 00:11:30

Was a teenager by then, so I knew. I understood. It's like, don't have sex. But sex was first spoken about in my family at all. But you know what? It was all around me. I mean, I was very aware from a young age that sexuality was a natural expression of being female.

Dr. Sameena Rahman [: 00:11:51

Because everyone else is talking about it, right?

Gabriella Espinosa [: 00:11:53

I come. Well, everyone else else is expressing it in some way. My family is from Latin America. We love color, we love music. We love dance. My parents divorced when I was young, and so my mother, she. My mother belonged to, had a group of friends that were all divorces, and they discreetly took on lovers and boyfriends, and my father did, too. I went to late night parties where, you know, they dressed in, you know, very sexy dresses and danced all night.

Gabriella Espinosa [: 00:12:26

So I just got all these messages, right, that this is what being feminine is about. It's about expressing your sexuality. But, but, but, you know, don't you have to be a nice girl? Don't have it, though. Save yourself from marriage. Don't be a slut. Because what are people going to think? And I sense this really intense fear over accessing any kind of knowledge that would bring me closer to my sexuality. So there was a lot of silencing, there were a lot of secrets all around me, and I think that silencing, I think a lot of us, I think. I think what we're seeing now is a lot of unmuting of that silence that has to do with that sexuality.

Gabriella Espinosa [: 00:13:08

Menopause and aging. Thanks to doctors like you and advocates, there's this collective unmuting from this silence around what it's like to be a midlife woman, especially stepping into very powerful time of life and owning her sexuality, owning her power, owning her purpose. I don't think patriarchy wants us to step into this part of life feeling this way. So I love that you're talking about it, and you have this podcast, and you're empowering women with. With knowledge. So, yeah, I.

Dr. Sameena Rahman [: 00:13:44

That's.

Gabriella Espinosa [: 00:13:45

That's kind of been my mission, too. I is to unmute that silence. That's why I started my podcast. That's why I talk so openly about sexuality and menopause in midlife, because I really do. It's a new feel. It's a new chapter in our lives to embrace our lived experience, our wisdom and our sexual selves and our power.

Dr. Sameena Rahman [: 00:14:12

No, absolutely. And that whole idea of what the community will think about you is very pervasive. There's a whole idea. They say, we call it Loki hange, which is like, what will people think if they see you acting like this or behaving like this? Or, you know, how it reflects its negative reflection on. But I think that inhibits a lot of people from, like, really even educating themselves. Right. Like, nobody's telling you, go do stuff, but at least know your body and educate yourself on what's happening. And so I think that's been a driving force for so many of us that we were muted for so long, like you said.

Dr. Sameena Rahman [: 00:14:49

I mean, look at Halle Berry on Capitol Hill screaming.

Gabriella Espinosa [: 00:14:52

She's.

Dr. Sameena Rahman [: 00:14:52

She's in menopause.

Gabriella Espinosa [: 00:14:53

I love that.

Dr. Sameena Rahman [: 00:14:54

You know, it's like. That is. I love it. It's like pure unmuting. You're right. But you would say that's part of, you know, the culture that you grew up with as well, that this, like.

Gabriella Espinosa [: 00:15:02

Definitely wondering what people.

Dr. Sameena Rahman [: 00:15:04

The shame around what you're doing and what people think.

Gabriella Espinosa [: 00:15:07

Exactly. I mean, yeah, I heard. I used to hear that all the time. What will people think? And it took me a lot of work, a lot of work with therapists and my own inner work to let go of that language, because when I had. When I started being a parent, a mom, I didn't want to pass that on to them. I just didn't. And so it took a lot of work to undo a lot of those cultural narratives and limiting beliefs, so. And I have a daughter.

Gabriella Espinosa [: 00:15:33

I have a daughter, and I don't want her to grow up with that same feeling of shame around her sexual expression. And I know you posted the other day you had a podcast about, how do we teach our kids about sex? I also have boys, and so, yeah, I want to be really open with them, and my husband and I are totally open with them about sexuality, and we do the sex talks, and they don't want to hear it from us.

Dr. Sameena Rahman [: 00:16:01

But you'd rather them come to you than tell some.

Gabriella Espinosa [: 00:16:05

Yeah. And you know what? You know what, Samina? They. They do. It's funny, because my boys, now that they're dating and they're having relationships with. With women, they. They call us. They call us from college. They're all in college, and they talk to us about it.

Gabriella Espinosa [: 00:16:20

My daughter isn't yet. She's still very independent. She doesn't want to. She wants to be her own person. But they, they call us and we talk to them about it. And it's so wonderful that they feel comfortable enough to come to us and talk to us about the emotional aspect. My daughter still hasn't come forth with sharing anything about her dating life. But, yeah, our boys are very open to receiving advice from us because they want to understand what's happening.

Gabriella Espinosa [: 00:16:49

It's such an intense period when you meet someone and you fall in love and you feel all these endorphins and hormones racing through your body and you're trying to make sense of it, right? So it's very real, and I'm so glad that they come to us and talk to about, to us about it.

Dr. Sameena Rahman [: 00:17:05

I agree. And I think it's just like, you know, we do the same. We just want to make sure they know the right language is the right terminology. Like, I think I've told you that I've done the puberty talk at my kids school, and I take my, my vulva puppet with me and I tell the. It's so funny because there was, at 1.1 year, there was a teacher that was, like, in her forties and was like, I had no idea that it was called it vulva his whole life, you know? So it's very interesting because, you know, the education needs to be done, but I think that, you know, just making sure they have the right language to talk about it even is important and not to shame them around. It's something that, it is our job because, you know, that kind of stuff leads to. Leads to health problems, honestly, like, I see patients who hold a lot of sexual shame and negativity towards sex who end up with these involuntary contractions of their pelvic floor vaginismus sometimes related to that, and anxiety. And when they want to have penetrative sex your whole life, you're told not to have it, and then it's finally time for you to do it, and you can't do it.

Dr. Sameena Rahman [: 00:18:07

That's what a lot of my women of color experience, that grow up within an environment that's kind of had more sex shaming than nothing. So hopefully, we can prevent that for future future girls and women.

Gabriella Espinosa [: 00:18:20

Definitely. Definitely. And even when it comes to. I was actually having a conversation yesterday on my podcast with someone around breast health. We don't even talk to our daughters about breast health. Or about their breasts until they become mothers and start breastfeeding. Right. Or when they, or when it has to do with a partner and giving pleasure to a partner or when we have to think about breast cancer as this thing, you know, it's like we don't own our breasts.

Gabriella Espinosa [: 00:18:48

Our breasts belong to cancer, to babies and to our partners. And so, so really, you know, having this relationship with our breasts from this place of love, tenderness and even pleasure. Right. And as not easy, not even as a means of connecting with yourself from pleasure, but also as a means of checking, self checking for anything, you know, sinister that might be coming up because I know, you know, that more and more younger women are being diagnosed with breast cancer than ever before. As, as are younger women potentially stepping into premature menopause. Those, that's a whole sector that we don't even talk about. So that's why I want my daughter.

Dr. Sameena Rahman [: 00:19:30

Yeah. And they, they're the most, they're very traumatized.

Gabriella Espinosa [: 00:19:33

I want my daughter to be aware of those things. Yeah. About sexuality, about breast health, about menopause, all those things, because it's really so, so important that they are armed with that knowledge before they step into other responsibilities and it hits them or comes out of nowhere.

Dr. Sameena Rahman [: 00:19:51

My five and twelve year old girls call it scary Perry in my house, they're like, wait, is this mama or is this scary Perry? Like, what's happening?

Gabriella Espinosa [: 00:20:03

So cute.

Dr. Sameena Rahman [: 00:20:04

Well, I want to get into like what brought you into coaching and what that entails. You know, I talk to obviously, a lot of different experts in the whole, you know, field of coaching is really blooming in different ways. And I think that, you know, a lot of people in the medical profession or, you know, even like psychologists sometimes question, you know, the merit of coaching. Where I've seen that it's actually like, you know, a really important part of, you know, an integrative program to get you to a better place. Right. Where I think that, you know, if there weren't these gaps in healthcare, right, if we had, like all the time in the world to speak to patients and to educate them and to rerewire their brain, which I think a lot of what coaching is about, is rewired. You let me know what you, what, you know, what you do in that respect. But from my understanding, it's kind of rewiring and interpreting, like how you sort of view things so that you can embrace things better.

Dr. Sameena Rahman [: 00:21:01

But obviously, there are so many gaps in, you know, medical care and health care and in the wellness arena that this is an area that is needed for so many women. So, you know, tell me how you got into the coaching arena and tell me, like, and then we can talk about what sessions are like and how you approach coaching.

Gabriella Espinosa [: 00:21:22

So I spoke about earlier about the inner work of menopause. I think with all the awareness and education going on about menopause by amazing doctors like yourself, of course, I understand you have to focus on the physical symptoms and how to manage and alleviate them. And it tends to lead to women searching for a quick fix. It's almost like putting a band aid on it and hoping they'll carry on like normal. And hormone therapy is great for that. It does help alleviate symptoms. But the truth is, I do feel while menopause is life altering, it can also be a life affirming transformation. And this transformation is uncomfortable, not only because of the changes that are visible on the outside, but because of who we're becoming on the inside.

Gabriella Espinosa [: 00:22:18

So I feel menopause is a transformative process. It's an invitation to get to know ourselves better, to empower ourselves with knowledge, to upgrade our physical, mental, and emotional health to the best version possible, to really embrace it as a new chapter in our lives. And so while the medical aspect is great for addressing the physical symptoms, I work with women on the psycho emotional aspect mindset, right? My mindset shift around stepping into this new stage of life. And so what I find that, and this was my case, too, it also happened to me, right. I thought, okay, I'll just put a patch on it. I believe in hormone therapy, by the way. I will never let go of my estrogen patch till the day I die. But I do feel there's a lot of kind of psycho emotional stuff that happens that changes when we step into midlife.

Gabriella Espinosa [: 00:23:14

Our bodies are changing, our hormones are changing, our sexuality is changing, and how do we deal with all of these changes? And so it really takes a mindset shift, and it takes, so I guide women to really embracing this new stage of life, making peace with their bodies, and really shifting their mindsets to see what they want more of, not less of. What do they want more of? Do they want more strength? Do they want more fitness? Do they want to feel more pleasure? Do they want more, you know, more purpose? They want, do they want to pivot and find a new sense of purpose or a new passion project? So I help women really sift through all the limiting beliefs that are out there around aging, around midlife, around menopause, and set goals in terms of their health, in terms of their purpose, and in terms of their sexuality. And so when it comes to sexual wellness, it includes, you know, how you care and for and speak to your body, includes body image, body literacy, how do you connect to your body, the narratives we carry around sex and pleasure, shame that we talked about, and really getting to know ourselves in a different way. So I take women on this journey of self exploration and self destruction, discovery, and really getting to know themselves better, really getting them to listen to their bodies. You hear so much about listen to your body. What does that really mean?

Dr. Sameena Rahman [: 00:24:51

What does it mean? Yeah.

Gabriella Espinosa [: 00:24:52

It means. It means slowing down and adopting certain mindfulness based practices that create this lens of awareness, of tuning in to your body. So, you know, what your messages that your body is sending to you, what is your body asking of you in terms of rest, connection, movement, nutrition. And so I work with women to set goals around those main pillars of their movement, nutrition, sexual health, and mental and emotional health as well. And so we work on setting goals and establishing new habits and shifting pre existing attitudes and perceptions and really getting them to make healthy and informed decisions so they can be the best versions of themselves, physically and mentally. And I feel that a lot of women need some hand holding through this midlife process.

Dr. Sameena Rahman [: 00:25:52

Oh, absolutely.

Gabriella Espinosa [: 00:25:53

I certainly did. I mean, you know, I consider myself a pretty educated woman. I went to. I got an undergraduate and graduate degree. I traveled the world. I'm pretty open minded, but I rely on coaches. Because sometimes you need someone walking alongside you. Because, again, I had no role models.

Gabriella Espinosa [: 00:26:15

We don't have role models of midlife women stepping into midlife being their most powerful, sexy, and empowered selves. We have role models that say, you become invisible. Your wisdom isn't of value. You know, you're not a value anymore. So it's really about giving women a new template for midlife. And so that's what my coaching is involved in doing with women.

Dr. Sameena Rahman [: 00:26:47

That's wonderful. Yeah, we're more than our. Some of our reproductive parts. So when you decided, like, okay, this is something, like, you want to help other women do, you know, it takes a lot of intestinal fortitude to kind of put yourself out in the world and, like, you know, get out there and do all this stuff, did you need coaching yourself? Because I, you know, one of my good friends is a coach for professional women, and I often call her all the time and, like, what? Help me. And did you feel like you needed to be coached into that as well?

Gabriella Espinosa [: 00:27:16

Well, I started. What I started doing was, you know, I started as, first, a yoga and mindfulness teacher, and I started sharing my story in my workshops, in my retreats, in my events, and women were coming up to me and saying, you know, what you're saying resonates. It's my story, too, and no one is talking about this. So I think I just felt like there was not enough normalizing of these conversations and this sort of internal fire, this fire in my belly of like, gosh, this stuff has been silence for so long, what we talked about earlier. And I just, yeah, I don't know, something kind of just like, the lid was just blown open. I'm like, I just need to start talking about this. So something within me just said, you need to talk about this. You need to put yourself out there.

Gabriella Espinosa [: 00:28:09

So I didn't really need so much coaching around that because I just, it was just something that came from inside me and some, maybe some anger. Anger.

Dr. Sameena Rahman [: 00:28:18

It was a dry, it was internal drive.

Gabriella Espinosa [: 00:28:20

It was a drive. It was anger from just feeling this part of our lives, you know, sexuality, menopause, just being silenced for so long. So I felt I had to help women, you know, unsilence that part of themselves and really be able to, like I said, embrace menopause and their sexuality. So I didn't need coaching so much for that. But I did train as a coach. I did take a, I did certify as a women's health coach. I certified as a life coach. You're taught certain skills in coaching in terms of how to engage in active listening with a client, how to guide a client through setting new habits and setting new goals.

Gabriella Espinosa [: 00:29:06

I don't prescribe or give a diagnosis. I like to work with experts like yourself, doctor Rahman. So I will give women, you know, referrals to gynecologists, to pelvic health, pts if they need to get physical or medical support. So I don't diagnose. I help women set goals, establish new habits, and if there's something that they really want to do, for example, sometimes I do talk them through the pros and cons or I give them information about menopause hormone therapy. They're on the fence about menopause hormone therapy because they want to do things naturally. Actually, most women come to me because they want to do things naturally. They don't want to do hormone therapy, so they want to do the psycho emotional, the holistic stuff first.

Gabriella Espinosa [: 00:29:59

They want to try that. And if I see that they're having a really hard time, they're experiencing all these symptoms of not feeling like myself. I will say hormone therapy can be considered as part of your toolkit. And this is who you can reach out to. This is where you can get information if you want to consider that. And if they want to start hormone therapy and there's so much fear and shame because they've been taught by either their culture of origins or by their wellness circles that natural is best, then I talk them through that. We talk through the limiting the shame around, straying from the natural is best and going and trying something more, you know, medically based, like hormone therapy. So, you know, there are a lot of different things that women come to me with, but that's one instance where I would probably talk them through a medical option so that they can feel comfortable.

Gabriella Espinosa [: 00:31:02

I'm doing that. And then I tell them, you know, these are the questions you want to ask to advocate for yourself. Yes. This is what you want to take in to your doctor's appointment. This is the homework you need to do, and these are the different options you have. So go and talk to them about them with your doctor and get the, don't leave until you get the answers you need. And if you don't get the answers you need, go and get a second opinion. So women don't know these things.

Gabriella Espinosa [: 00:31:27

You know, they don't know these things. Like, you know, we talked on, on my podcast how there's this reverence for doctors and you just don't question doctors, but we have to empower ourselves with knowledge. And like you, you said, yourself said, right, you're not handed these things on a silver platter, right? You have to advocate for yourself in the doctor's office because it's just not going to happen.

Dr. Sameena Rahman [: 00:31:48

I mean, all of us do. I mean, I'm in the thick of it. I'm a medical, you know, clinician, I'm a doctor. I'm in this field. And I still, you know, when I, when I, when I have to seek help for myself, I have to like, push the envelope to, like, I have to really advocate for myself, too.

Gabriella Espinosa [: 00:32:03

So, and sometimes seek second and third opinions, and sometimes that has to happen out of pocket, unfortunately. But you know what I, what my attitude is right now, doctor Aman, okay, I'm midline. I'm in midlife, okay? Some of us in midlife have come here. We have perhaps our savings for retirement. We're thinking about that. My savings, everything, my savings are going to go towards my health and living the longest, healthiest life I can go. I rather put all my savings into that than picking a luxury resort holiday. So I'll pay the extra $100 extra dollar 200 for a telehealth consultation with a doctor.

Gabriella Espinosa [: 00:32:50

I'll pay out of pocket for an extra second or third opinion because that's more important to me than sitting at a resort.

Dr. Sameena Rahman [: 00:33:00

There's nothing more important than your good health and to have that doctor, Mary Claire says about her nursing home prevention program, it's really about getting to a point where you're not that person that has to be so dependent on others. Right. You still want to live independently, and you want to. You want to be able to be with your friends. You want to be able to think and not have cognitive, you know, distress. Whether or not that's dementia or anxiety, you know, whatever the case may be, you want to try to prevent that. And the best way to do that is to use all these tools in our toolkit, you know, to improve our diet, exercise, to get the right medications if you need it and to get that mindset shift. I think you're totally right.

Dr. Sameena Rahman [: 00:33:46

Like, some patients don't take hormones because their mindset is still back from the two thousands or their parents. Their mom didn't take it, and their mom says, why would you take it? I went through it without a problem, but they're actually suffering in silence, and there's no reward for that. You don't get a badge of honor for suffering, definitely.

Gabriella Espinosa [: 00:34:08

And I. And I think some of us grew up with those narratives, right. That to be a woman, you entail suffering. I definitely got those messages so often from my mother. You know, I would come to her feeling stressed and overwhelmed with three little kids, and she would just say, you know, that's. That's it. She would just, you know, look at me, you know, sympathetically. She, of course, would try to help out, but, you know, that's.

Gabriella Espinosa [: 00:34:34

That's. That's it. You got to suffer.

Dr. Sameena Rahman [: 00:34:36

You got to push through.

Gabriella Espinosa [: 00:34:37

Yeah.

Dr. Sameena Rahman [: 00:34:37

You just got to put. No, it's not okay. We shouldn't suffer like that. Tell me a little bit about your retreats and stuff that you have done or that you're involved with, because I know that you mentioned that you have some of that, and I'm just curious to know what those are like for. For my.

Gabriella Espinosa [: 00:34:51

So I lead long weekend retreats, three or four day retreats. Sometimes I lead seven day retreats. And it's a really an opportunity for women to go to a beautiful surroundings, beautiful location, and totally check out of their busy day to day lives and do something for themselves and to do it in community with other people. So I include wellness talks where I give information on menopause what is menopause? The menopause transition. So it's their educational talks about hormones, about menopause, about sexual health. We do yoga, we do mindfulness practices, and I talk to them about if it's more focused on sexuality, we talk about sexual wellness, what that means, and have open and honest conversations about sexual wellness and what that means. And so I find when women gather together, it's incredible. They just let down their guards, right? It takes maybe a day or so, but they let down their guards.

Gabriella Espinosa [: 00:35:59

And when they're in the community of women, they're so open and honest about sharing their experiences, and they learn from each other, and they realize that they're not alone. And they leave feeling more empowered, ready to take this information and apply it into their own lives, ready to bring these conversations into their families, into their partnerships. We do workshops, we do little kind of, I call dyads, where I bring women together and have them practice speaking or communicating what they're feeling to a partner. Right. How would they talk about, oh, wow, that's wonderful, what they're experiencing with a partner. And it's very vulnerable. It feels very awkward, but that's part of the process of being able to open up and normalize these conversations with family members. So, yeah, they're just really empowering opportunities for women to connect with other women, to kind of do that mindset shift and really connect with their bodies, deepen their knowledge, and really take this work into their real lives and step into this new chapter of their lives feeling more empowered and armed with knowledge.

Dr. Sameena Rahman [: 00:37:17

That sounds wonderful to me. Tell me some of the places you've been. Let's entice. Let's entice our listeners.

Gabriella Espinosa [: 00:37:24

Well, I. Well, I. You know, I was living in Europe for 16 years in the UK, so I did a few retreats in the countryside of England in the Cotswolds. I did one in the south of France. I'm planning one soon in Costa Rica. So now that I'm in the US, living in the US, I'm hoping to plan one in Costa Rica. And I'm looking for a location here in Austin where I live, actually. So I'm planning on doing for anyone who's local or anyone who wants to come and spend the weekend with me.

Gabriella Espinosa [: 00:37:58

Me. There's a beautiful little hotel nearby, and then I hold the workshops. They can stay in the hotel, but they can come to my home. And because I don't have enough room to house that many people, but I do have a beautiful property with a yoga studio. And a yoga deck and a swimming pool and a hot tub. And you can't live in Texas without a swimming pool or a hot tub. So we. I hold the workshops in my home, and so women come to my house and spend the day here, and we connect here as a group, and then we go out to some fun places in Austin for dinner or dancing or enjoying the music scene, and then.

Gabriella Espinosa [: 00:38:38

Yeah.

Dr. Sameena Rahman [: 00:38:39

Oh, my God. I'm gonna come.

Gabriella Espinosa [: 00:38:41

Leave one word with me, doctor Aman, please. I'd love for you to come.

Dr. Sameena Rahman [: 00:38:45

Oh, my God. It sounds like so much fun. I have never been to Austin, but I hear great things about how, like, it's, like, fun for you.

Gabriella Espinosa [: 00:38:54

You have an open invitation, doctor.

Dr. Sameena Rahman [: 00:38:56

Oh, okay. I'm down for that. Well, that sounds great. I wanted to, you know, as we conclude, because I want to be mindful of your time when I, you know, my whole tagline is I'm here to educate so you could advocate for yourself. How, if you had to tell our listeners, like, the best way to advocate for yourself when you're in a medical scenario, you know, how have you done it in the past? How do you coach your clients to do it? Give us a few tips for our listeners.

Gabriella Espinosa [: 00:39:25

So when I coach women, I really. I guide them in this kind of somatic experience. Somatics means tuning into your body and being able to name and identify sensations and feelings. Really, really put a label on them. So it's not so much I'm feeling stressed and overwhelmed. It's more of like, I'm feeling this sense of kind of stuckness or coldness in my belly or I'm feeling this sense of burn. We take it a little bit deeper when it comes to sexual wellness. We'd say, I'm feeling this burning or itching sensation here and being able to name exactly where on their vulva or where, you know, in their pelvic area they're feeling it.

Gabriella Espinosa [: 00:40:13

So being able to develop the language of sensations. So sensations, I say, is the poetry of your body. Being able to have a vocabulary to name what you're feeling. Hot, cold, burning, itching, tingling, you know, so instead of just saying it hurts or it's uncomfortable, having a broader language and vocabulary of sensations is going to empower you to have that conversation with your doctor. So I guide women to develop that language of sensations and then to write it down. Come in with a list of sensations or things that you're experiencing. Come in with a list of questions. Sometimes I'll help women develop that list of questions.

Gabriella Espinosa [: 00:41:02

Right. We won't make it too long because we know your time is precious. But say, you know, these are the questions. I want to go into your doctor's office and say, these are the questions. I have a list of questions here I want to address with you. I hope we have time to address all of them. And the doctor may say, well, we may have to make a second appointment, in which case you say, okay, we'll make a second appointment, but I want to get through this list of questions. Yeah, these are the priorities.

Dr. Sameena Rahman [: 00:41:25

This is the priority kind of thing. Yeah. I love when patients have those lists and they actually come in and to notice.

Gabriella Espinosa [: 00:41:32

And to notice. Right. When we do some of the mindfulness practices that I teach, this has to do a lot with nervous system regulation. If you feel a doctor is, and I know you wouldn't do this, doctor Armand, if you feel a doctor is dismissing you or making you feel less than or less, you know, feeling you're not feeling good about what the doctor's telling you, you're going to feel that, right? You're going to feel that in that appointment, you're going to feel that is like a lot of women feel it like a stab to their heart or like a sinking feeling in their throat, throat or like a knot in there. They feel it in that appointment.

Dr. Sameena Rahman [: 00:42:07

Yeah.

Gabriella Espinosa [: 00:42:08

So to be aware of that and to speak up and say, you know, I don't appreciate the way that you're speaking to me, and this is not helpful to me, speak up in the appointment.

Dr. Sameena Rahman [: 00:42:18

Right.

Gabriella Espinosa [: 00:42:18

So. And women, most know it. It usually happens when they leave the appointment. They're like, I left that appointment. I don't feel good about it, you know? So, learning. Yeah.

Dr. Sameena Rahman [: 00:42:27

I should have said something. I should have said something.

Gabriella Espinosa [: 00:42:30

I should have said something. I should have said something. So getting women to connect, have that bodily connection to their emotions, to their sensations. So they say something in the appointment. And again, if they don't, if they felt the appointment didn't go well, say, thank you very much. Be respectful, be kind to the doctor. Right. Because, you know, the doctor probably doesn't know.

Dr. Sameena Rahman [: 00:42:53

Sometimes they're not aware of their own.

Gabriella Espinosa [: 00:42:55

Right. Maybe they're not aware. Maybe they haven't been. They're not aware and then go and make another opinion with. Get a second opinion. I also recommend that women collect all their blood tests or ultrasounds. I have like a whole folder, a binder of blood tests I've had over the years of tests, ultrasounds, bone density scans, so that you can go in and say, well, you know, last year it was this. And you're telling me this year, it's this.

Gabriella Espinosa [: 00:43:28

What can I do about that? So make sure you collect all of your paperwork, take it into the office with you, come in armed with a set of questions, and really come in with that self, knowing that you can speak up to what you're feeling in your body in that moment.

Dr. Sameena Rahman [: 00:43:45

That's wonderful. I think that's great, because I feel like, you know, I. I feel like patients get the most out of their appointments. Some doctors are like, oh, I hate when they google stuff or whatever. I mean, if you're googling the right information, it's great. Obviously, there's a lot of misinformation on the Internet, and that's what we worry about. And on TikTok and on social media, there's a lot of misinformation where people are pushing their own narratives. But when you have the correct information about how these medications and how these processes work, I think that it's wonderful when a patient comes in knowing exactly.

Dr. Sameena Rahman [: 00:44:19

I mean, I have patients that come in with all the books, like, oh, I read Doctor Mary Claire books, or I read Doctor Sharon Malone's book, and I know exactly what I want. And then we talk about it if it's a right fit for them, and then we talk about if their, you know, insurance will cover it or whatever. But I love when they come in so empowered, because it makes for a very smooth appointment.

Gabriella Espinosa [: 00:44:37

Yeah. And I think. And again, not. Not to be disrespectful, but I think if a doctor says, you can't do this, and you feel that maybe you can or you've heard from someone else, that you can then go and get a second opinion. I was. I just have one quick story. I was in. I went to my doctor's office, a really great.

Gabriella Espinosa [: 00:44:58

I have a great ob gyn here in Austin, but I went to see her nurse practitioner because my doctor was so busy. I wanted to. I use a progestin IUD, and so I. It was time to have it taken out and put a new one in. She took it out and told me, I can't put a new one in. You're too old. And I'm sensitive to. You can't take systemic progesterone.

Gabriella Espinosa [: 00:45:27

I have a long history of progesterone sensitivity. I need that IUD. And so I left the office without the IUD and without it prescription. I'm saying I'm coming back and having an appointment with the doctor. And so I came back and had an appointment with the doctor, and I said, your NP told me that I couldn't get an IUD based in, and she put it in. She's like, okay, when do you want to make an appointment to put it in? So this was the same practice.

Dr. Sameena Rahman [: 00:45:52

And not to. Not to bash, like, nurse. There are a lot of great nurse practitioners out there that, you know, have the knowledge and the fund and all. I think that just like any clinician, sometimes they just don't know or they're.

Gabriella Espinosa [: 00:46:03

Going by the, you know, what's been written up in certain studies and they maybe don't have a broader knowledge or they don't have. So, no, not to bash MP's. I'll go and see an MP again. But I'm glad that I left that appointment with saying, you know what? I'm going to go and talk to the doctor about this. I want to get a second opinion.

Dr. Sameena Rahman [: 00:46:23

Absolutely. And that's pure advocacy right there. Like, you're like, I think I've read better, and I know that this is a possibility. I mean, there are some cases, I think, where, like, IUD's are not covered by insurance in certain age groups, which is very upsetting. But I've actually fought many battles and gotten them covered through their pharmaceutical plans. But sometimes we've run into that hiccup where, like, if someone is actually in menopause, but the perimenopausal period, usually you don't have trouble getting it covered for the most part. But I think that, you know, that's the only way I could see someone not getting an IUD. For some reason, this didn't get covered by insurance.

Dr. Sameena Rahman [: 00:47:03

But then you either pay out of pocket or you try to defend or you try to get a prior authorization or try to speak to the insurance company to get it covered. And I actually feel like that will probably change, too. I mean, one of the indications for the progestin IUD is not only contraception, it's actually heavy or irregular bleeding. And so sometimes it's a matter of just knowing that that's the reason.

Gabriella Espinosa [: 00:47:25

Yeah. And I had a history of that. I had a history of that, and she knew that.

Dr. Sameena Rahman [: 00:47:30

Yeah. So yours should have been easy.

Gabriella Espinosa [: 00:47:32

So. But, yeah, I was sitting there half naked, and she's like, I'm not putting a new one in. I'm like, oh, my God, wait, let's.

Dr. Sameena Rahman [: 00:47:42

Talk about it before you get into a half naked position. At least, you know, like, then you're very vulnerable. You're like, well, I guess I can't say anything right now.

Gabriella Espinosa [: 00:47:51

I quickly got dressed and I'm like, I'm just coming back. I'm making an appointment. So I did that.

Dr. Sameena Rahman [: 00:47:56

Well, good for you, because you knew better. And hopefully, hopefully that nurse practitioner learned something at that day. But, you know, that is exactly what we try to recommend is just advocating for yourself, because sometimes, you know, we all, no one's like, you know, a lot of my colleagues say this, no one's going to come save you. You got to really do it yourself.

Gabriella Espinosa [: 00:48:16

Absolutely.

Dr. Sameena Rahman [: 00:48:17

So, you know, I think that. I think that, you know, that that speaks volumes to, you know, to your ability to advocate for yourself. So I'm glad.

Gabriella Espinosa [: 00:48:26

And going back to some of these events that, where we've met, we've met at. Right. We met at the let's talk menopause event and this Liberty road event where women are coming in. These events are selling out, right? These events are selling out. And. Yes, and it's so wonderful to see that women like droves. Like, they're just want to receive this information. I mean, women, you know, Gen X women are smart women.

Gabriella Espinosa [: 00:48:52

We're smart. We're intelligent. We know we're resourceful. Right. We've been through a lot of shit. We want to get the thoughts and to think that we're the first generation of women receiving this groundbreaking information that's coming out. All this education that you're doing, Doctor Aman, that all the doctors and menopause. Menopause doctors, Doctor Haver, I love Doctor Jessica Shepherd, Doctor Kelly Kasp.

Gabriella Espinosa [: 00:49:17

All of you are bringing this information, and we're the generation that's listening to it for the very first time. And you know that we're going to do something with that information.

Dr. Sameena Rahman [: 00:49:27

Yes. Yeah. I mean, you see it with all these, like. Yeah. Like, even the creation of Liberty Road was, you know, really? Because, okay, now we're going to pivot and, you know, do something else with the middle third of our lives. And so I think that, you know, that speaks volumes to our ability to transition and to adapt and to fight for ourselves.

Gabriella Espinosa [: 00:49:46

Exactly. And to know that we're still a value to our society and to our communities and to our workplaces. We have so much to offer, not only our lived experience, but like I said, our resourcefulness.

Dr. Sameena Rahman [: 00:50:01

You know, it's funny, you know, I'm Julia Louise Dreyfus, you know, from, like, Seinfeld and I veep and all those. She started a podcast, and that's what she says. Like, she interviews people that are wiser than her because nobody listens to, like, older women, right. Like, they just get put aside in media, they get put aside. And so I love that she does that, too, because you do. You learn a lot from these people who have been through.

Gabriella Espinosa [: 00:50:23

So I love that podcast. I've listened to a few of those episodes and.

Dr. Sameena Rahman [: 00:50:27

Yeah, beautiful. All right, well, thank you so much, Gabriella. It's been my pleasure to have you here, and I hope to have you back in the future. Future. I will, in the show notes, put all the information to how you can get in touch with Gabrielle and do some one on one sessions with her. And then also, like, if there's any new retreats, we can all sign up and go to Austin for fun.

Gabriella Espinosa [: 00:50:49

Yes. Come to Austin for my next retreat. I'll let. I'll let you know about it. You'll be the first one to know, doctor Amon, and hopefully you can come down and help me and be a part of it.

Dr. Sameena Rahman [: 00:51:00

Oh, that would be wonderful. I love to just, you know, spend a little time on myself. All right, well, thank you so much and I appreciate you. And thanks for tuning into Gynell girl presents sex, drugs and hormones. I'm Doctor Samina Arman, sex gynecologist and menopause specialist in downtown Chicago and a clinical assistant professor of Ob GYN at Northwestern Feinberg School of medicine. I'm here to educate so you can advocate for yourself. So please take notes and join me for my next podcast. And you can join me on YouTube and also Instagram.

Dr. Sameena Rahman [: 00:51:35

But hopefully you guys gained some information that you can take back to your clinicians, to your husbands, to your wives, to whoever else, so that sisters, brothers, mothers, so that they can learn to advocate for themselves as well. Thank you very much. If you have a second, please subscribe to this podcast. I'd love for you to be a.

Dr. Sameena Rahman [: 00:51:53

Follower and learn as much as you can about the things that we're going to talk about with all the people on our journey. Please review us on Apple or Spotify or wherever you listen to podcasts.

Dr. Sameena Rahman [: 00:52:03

These reviews really help review us. Comment.

Dr. Sameena Rahman [: 00:52:06

Tell me what else you want to hear to get more information. My practice website is www.cgccago.com. my website for Gynel Girl is www.gynewtv.com. my Instagram is Gynell Girl so please follow me for some good content. Additionally, I have a YouTube channel, Gynell Girl TV, where I love to talk about all these things on YouTube. And please subscribe to my newsletter, Gyno Girl News, which will be available on my website. I will see you next time.