What if you found a passion that not only changed your life but also aimed to change how healthcare providers treat half the population?

In today’s episode, we welcome the incredible Dr. Maria Uloko. Tune in as they discuss the glaring disparities in women's health, the systemic sexism and racism in medical treatment, and innovative solutions designed to empower both patients and providers.

Dr. Maria Uloko shares her journey from frustration over the lack of guidelines in women's health compared to men's health, to stepping away from academia to create a health tech company and a comprehensive sexual health clinic MUMD Beverly Hills. 

Her mission-driven approach seeks not only to treat but to innovate—shifting paradigms in how women's health issues are understood and addressed. One of Dr. Uloko’s groundbreaking initiatives is Vulva AI, an AI-powered tool designed to enhance diagnosis and treatment for vulvar and vaginal health issues. 

From discussing the historical absence of women in medical studies until 1993 to the importance of foundational research, Dr. Uloko and Dr. Rahman call for a systemic shift toward prioritizing women's health and well-being.

Throughout this episode, you’ll hear real stories, professional insights, and a passionate call to challenge the ingrained culture of disregarding women's pain and health issues. 

Dr. Uloko emphasizes the lack of physician training in vulvar health, often leading to misdiagnoses and prolonged suffering for many women.

Make sure to like, share, and give us a review on Apple Podcasts!

Highlights:

Turning Passion into Action: Dr. Maria Uloko describes her frustration with systemic issues in women's health and her journey to founding a health tech company and a specialized clinic in Beverly Hills.

Medical Sexism and Racism: Both Dr. Sameena Rahman and Dr. Uloko discuss the pervasive sexism and racism in healthcare, particularly in pain management and treatment of women’s health issues.

Innovative Solutions: Explore Vulva AI, a tool that allows users to get tailored summaries for vulvar and vaginal health issues through a symptoms-based quiz, guiding better diagnosis and treatment.

Educational Imperatives: Understand the critical need for more comprehensive education for doctors on women's health issues, particularly vulvar health, to avoid misdiagnoses and ensure effective care.

Empathy and Advocacy: Here, the emphasis is on believing patients' pain and the importance of medical professionals adopting a more empathetic and inclusive approach in their care.

Systemic Change: Learn about the need for foundational research in women's health and the historical context that has led to current disparities in care availability and quality.

Community and Support: Discover the powerful role community and supportive healthcare can play in improving quality of life for women facing health challenges. 

Stay informed, ask questions, and stand up for your reproductive health. Let’s work together to create a better healthcare landscape for all women.

About our guest:

Dr. Maria Uloko is aa trailblazing urologist revolutionizing the field of comprehensive sexual health. Her expertise spans across an impressive range of treatments, addressing needs of all genders with equal vigor and precision. From tackling challenging conditions like vulvar arousal dysfunction and sexual pain, to pioneering in low libido solutions, menopause management, and hormone replacement therapy, Dr. Uloko stands at the forefront. Her work in regenerative ED treatments, advanced erectile dysfunction solutions, and penile prosthetic surgery, including her expertise in Peyronie’s disease, is nothing short of groundbreaking.

Internationally acclaimed, Dr. Uloko's research in sexual health has garnered numerous awards. Among her many achievements, her pioneering research on the clitoral nerves has reshaped our understanding of human sexuality. She's a fervent believer that research equals advocacy, dedicating her career to bridging gaps in care and knowledge, particularly in under-explored areas like vulvar health.

Dr. Uloko's educational journey is as impressive as her professional feats. Before completing her fellowship in comprehensive sexual health, focusing on prosthesis and reconstruction at San Diego Sexual Medicine and Scripps, she honed her skills in urology and general surgery during her residencies at the University of Minnesota Medical School in Minneapolis. Starting medical school at just 17 years old, she received her medical degree from the six year combined BLA/MD program at the University of Missouri - Kansas City School of Medicine. She has been in the healthcare field for over 15 years.

Get in Touch with Dr. Uloko:

Website

Instagram

VulvaAI

Get in Touch with Dr. Rahman:

Website

Instagram

Youtube

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.

Let's go. Hey, y'all, it's me, doctor Saminurman. Gyno girl here for another episode of Gyneau Girl presents sex, drugs and hormones. I'm super excited today to have you guys listen to the amazing talk I had with doctor Maria Oluko. She is a board certified urologist and a sexual medicine specialist for both men and women. For vulva owners and penis owners, she is recognized as a world leader in chronic pelvic pain and vulvar conditions. She is dedicated to improving her patient's quality of life through a compassionate and inclusive approach to stigmatized subjects. She empowers her patients to take ownership of their sexual health, providing a shame free space for questions and stories.

And she actively works to close gaps in disparity of care by promoting diversity and inclusion. She started a AI empowered site called Vulva AI that is for both clinicians and for patients, building on her commitment to women's health. It's the world's first women's health search engine designed as a patient advocate tool, and vulva AI uses advanced AI technology trained on extensive databases of vulvar conditions, symptoms and treatments to offer solutions for patients. She also started her own private practice, Mumd Beverly Hills, to deliver specialized care patient centered care for chronic pelvic plan recurrent UTIs focusing on innovative and science based solutions that address the root causes of these issues. She provides compassionate, comprehensive, personalized treatments to both genders and for their sexual health and concerns. So I had a great conversation with her. You guys are going to enjoy this a lot. And, you know, as, as usual, please like and subscribe to this podcast and rate it.

And I'm here to educate so you could advocate. So let's get at it. Hi everyone. It's me, Doctor Smynarman. Gyno Girl welcome back to another episode of Gyne Girl presents sex, drugs and hormones. I'm super, super excited today to have a colleague and friend joining us today to talk all about sexual medicine and everything in between. Today we're honored to have doctor Maria Iloco. She is, as you have just heard, recent introduction.

She is a board certified urologist and one of what? Seven urologists that can treat both. I think I know all seven of them. Seven urologists who have been fellowship trained to treat both men and women and female sexual dysfunction. Trained by the OG, who. I talk about a lot on this, on my show. I talk about Doctor Irwin Goldstein and Ishwish a lot. So my listeners know. But, you know, Doctor Illoko was one of the, I guess, six that he trained so far.

She is an amazing superwoman doing a lot of stuff around the country, trying to change the narrative on vulvar health, on urinary tract infections, on sexual dysfunction, men and women. So let's just get at it with doctor Maria Loca. Thank you for coming.

Thank you so much for having me.

I'm so excited to hear about everything that you're working on, but I want to hear about your journey into the sexual medicine arena. I talked about my journey when I first started my podcast, but. And then we'll talk about, you know, you know, some of the other great stuff you're doing, but let's talk about your journey, like, what brought you into sex med? Like, not a lot of urologists or gynecologists, like, you know, tend to focus on this at all. I mean, I think it's on. It's a field that nobody really teaches you about, and we're trying to change that narrative, obviously, with issuance. Everything that I know you're doing a lot with tight lipped as well.

Yeah.

Tell me, like, what brought you to this?

Yeah. So sexual health, you know, it's so funny. I grew up the kid that was, oh, I'm not supposed to do that. Well, now I'm curious. Like, as soon as my parents or society or anyone, any, I guess I'm a rule breaker and also I'm a teacher's pet. It's a very unique, it's a very interesting, interesting dynamic and an interesting dichotomy, but, yeah. So from an early age, sex was very shamed in my family. We just never talked about it, which then made me extremely curious.

You're also the daughter of an immigrant.

Yes, exactly. Immigrant. That are both very religious. Very. Yeah, all the things and so all the things. It was always something that, like, interested me just because I was curious. It's just as soon as I. Some of someone told me, no, don't do it.

I just became even more curious. And then also just even growing up as a. As a girl, you know, I grew up as the only girl in an all essentially male family. And even, like, learning about my own body was, like, taboo and so hush hush and secret and, like, truly, I couldn't even learn about my own body. And so, you know, I became, like, even mensies, right? Yeah. Oh, my gosh. Oh, my gosh. Like, menstruation sex.

Forget it. Yeah. Oh, it was so shamed. All of that was so shamed. Full. So full of secrecy. And so I just, you know, I would used to sneak my mom's, like, red book, which was just essentially, like, cosmo for married women, and, like, read about sex and be like, oh, wow, that's so interesting. And I also, while being fully sheltered, like, I didn't talk to a boy until I was, like, 20 something.

So, like, we're, like, the same people here. And so.

Because you're not allowed to, right. Like, your whole life.

Yeah.

Don't have sex, don't talk to boys. And then at some point, hey, go get married. And, like, why aren't you married?

Yeah, why aren't you married yet? Yeah.

Context of marriage and having kids.

Yeah. Yeah, exactly. And so, you know, when I got into. And I, like, I've always had, you know, very dirty sense of mind, humor, all the things. And that was, I got into medical school at 17, and, like, all of my friends were like, oh, my God, you're going to totally become a urologist because you love telling a dick joke. And I was like, whatever, sure. What's that? I didn't even know what a urologist was. And then throughout medical school, as soon as, like, again, trying to just figure out what I want to do with the rest of my life is why you probably shouldn't be 17 and become a doctor.

But just trying to figure out what I wanted to do was really toughen because, you know, I didn't like a lot of the things. And then I found surgery, and then I found urology. And so with surgery, it was this, like, really great way of. I love problem solving. So solving a problem surgery is. Here's a problem. Here's a direct, quick, not quick fix, but you get to fix it. And then I met urologist, and I was like, oh, you're hilarious.

These people are funny and weird and, like, very, like, fun and smart and innovative and cool. And so I then took a rotation and then kept taking rotations. And then I said, this is what I want to do with my life. And then, you know, in actual urology, I liked. I liked it, but it was nothing that, like, gave me passion. And I still remember Doctor Christy Gooden, who is a transplant surgeon where I went to medical school, and it was a mentor, and she. She gave me this. She always stuck with me how much she loved her job being a transplant surgeon.

I still remember we had this, like, awful take back case, and it's like, 02:00 in the morning, and she is just, like, ready to go. She's, like, so pumped. She's like, let's save this person's life. Let's go. And I was like, oh, my God, this, 02:00 in the morning, I'm exhausted. How are you? Like, I know you've done four transplants today. Like, how are you so excited to be here? And, you know, when thinking about a career in medicine and, like, a career, like, that wasn't just a job for her. That was her life's calling and mission, and that was something.

I was like, that's what I want, where I'm just so geeked about the work that I do and feel so excited about it, and even when it's inconvenient to everything else in my life. And so urology wasn't that for me. And I was like, oh, this is kind of like, this is fine. It's good. I enjoy it, but it's not. It's a job and not a calling. And then when I found sex med, I was like, oh, this is fun. And then I found Erwin Goldstein, or Erwin Goldstein found me.

And that was, like, the first time, truly. And this is where mentorship really comes in, too, is like, that was the first time I felt like someone, as a urologist, saw me, saw me, saw me outside of just, like, you know, a standard urologist and was like, I want to mentor you. I want to train you. You are someone I am seeking. And I was like, when you're 0.02% of urologists in the world, you're like, oh, someone wants me. I don't have to. Yeah, I don't have to prove myself. You just want me.

Great. Awesome. So then I took. He's amazing. And also, I was living in Minnesota at the time, and the idea of training in San Diego for a year, I was like, say less like. Exactly. And, you know, I didn't. I did not understand how that decision was going to change my life.

And I'm so glad it did, because once I found comprehensive sexual health where not only am I taking care of men and penile sexual health, I'm taking care of everyone with genitals. And understanding the science and the research behind it. It literally, I finally understood what doctor Gooden was talking about. About making, like, finding your passion and chasing that. And now I live, breathe, sleep, sex, and sexual health and research and all of the things. I love it.

Yeah, that's awesome. I love that. I think that those of us in this realm kind of, you know, like, that's why ish wish feels like home. And that's why, I mean, I had opportunity to do a, you know, obviously I'm not a urologist. I couldn't do a fellowship with Doctor Goldstein, but I did a preceptorship with him, like, for a week.

Yeah.

Really transformative, even, just to learn how he does all the things that he does. And, you know, the gold scenes are so welcoming. It's just been great with them.

Yes, they. I mean, like, we stand on the shoulder of giants and even just understanding, you know, that this man's career could have ended with Viagra. He could have gone into retirement. Yeah. And instead, it saw a much bigger problem, a much suspicious, bigger systematic problem, and then decided to dedicate his life towards that. Like, that's. I mean, yeah.

And for the people that maybe haven't listened to some of my other podcasts, you know, you can explain Maria if you want, but Doctor Goldstein is like, the creator of female sexual medicine in essence. Right. Like, he's the OG.

Yeah. I think what he was really fundamental about was the cross collaboration and really bringing it out of, you know, even at that time, only a few handful of gynecologists were even addressing sexual health. And he. What I think his superpower, their superpower was not just. Was like, the cross collaboration that has happened. Yes. With physical therapy in so many industries. Yeah, yeah.

And really creating that space. And as someone that's in a season of creating and creating essentially across different industries, I'm just, like, blown away by the foresight and the vision to make this happen and to make it happen on a global stage. I mean.

Right. I mean, and I think that's kind of the story he tells is like, it was actually the onset of Viagra that, like, brought women to the table and being like, what's. What about us? They're having sex with us. Who's helping us? And. Yeah, it was like, aren't the gynecologist helping you? And they're like, nope, no, that's kind.

Of how, yeah, it's such a, it's, it's so, it's so because so many people could have been like, oh, oh, that sucks for you all. I'm, yeah, I'm done. I already did the thing. I've already dedicated like decades of research towards a thing and I created something amazing or aided in creating something amazing and instead he said, okay, I'll go solve that other problem.

All right, that's amazing. But yeah, it's a great field. And you know, we always say ish wish is home to so many of us that do sexual medicine and the gold students are prominent in that. But let's talk a little bit about also, like I met Doctor loco at, well, I mean, I think we met through social media initially and then I was at the ISSM slash SMSNA conference in Miami in 2021 or 2221-2222 and, okay, doctor Blair Peters and doctor Maria Loco were presented an award for this amazing research. So let's talk about it because, you know, I think what was it like 1970 something, someone investigated Cal clitoris and said they had over 8000 nerve endings and that's kind of where we, where we landed. Like, that's where it stopped and I, and had the same amount. Let's talk about your research. Amazing.

Yeah, so, you know, I think the research, so the research was that we defined how many nerves are in the human clitoris, which was significantly more than 10,000. We could only quantify over 10,000. But there's, if we just really think about it, it's just a lot. It's a lot. And really this was a crosse collaborative, multidisciplinary, meaning we had a urologist, a gynecologist and a gender affirming surgeon, plastic surgeon that did this research. And I think it speaks to the, to the wider narrative of how important cross collaboration is. And that's something that I learned also from Doctor Goldstein is that, you know, we all operate in the pelvis and yet as urologists we only know the urethra and then as gynecologists we only know the, like the vagina and then everything else is kind of just like all, just there and it's like, no, we actually all need to be learning the same thing, being trained together. And like, your skill sets are great at this and my skill sets are great at this and let's combine all of that and like, it's a fascinating thing.

And then the other thing that really, like the actual, like this research actually came from spite and frustration. I was getting one of the most fascinating things in taking care of stepping into the realm of women's sexual health and people with Wolver health was kind of this general lack of facts in women's health, where it's to go from urology, or in men's health, where we have guidelines for every single thing to the point where it's so, like, I was actually little upset because I was like, oh, there's the art of medicine, and, like, thinking and doing all these things. And it's like, in urology, it's like, no, there are guidelines, and you stick to the guidelines. And if you don't follow the guidelines, like, you know, you're not a good urologist and you could potentially get sued.

All those things.

And so I was like, oh, whatever. And then I realized why guidelines are important. Because in women's health, there's a lot of feelings over facts. And there. And those feelings are usually rooted in this typical paternalism, patriarchal, sexist lens that if we were to really boil it down, is, did you die, though? Like, that's what is always exactly.

Okay, well, you suffer. Like, you know.

Yeah, it's always, like exactly suffering. It's accepted. There's this understanding. There's this general underlying current of, you should just be excited that you didn't die. And, like, that is where a lot of decision is made, right. And a lot of decisions are made off of this underlying feeling that women do not deserve a quality of life. And that is the foundations of medicine. And when you then take that and you train, and this is like, it's a generational feeling, really.

And so then you're like, that person's training the next generation is training the next generation. And so we're building really more on feelings than we really are on facts, and that's directly harming women. And that was the point where I was just, like, so mad. I was so. I was. I still remember I was on a podium giving a lecture about pelvic pain, and someone asked a question, and I was like, well, this is what the research shows, but also, this is why the research isn't great that we have, and this is how important it is to collect data and do research. And they're like, well, I just feel a certain way. I was like, ma'am, feelings are not facts.

Like, exactly.

Exactly.

I was just like, and fake news.

Fake news.

It's like, it's crazy. And so I actually called Blair after that conference because as someone that I oftentimes, and we oftentimes are the last resort for a lot of patients. And one of the things that I often see is what I would classify as malpractice. But because women internalize the narrative of, like, oh, I'm challenging. I'm difficult. They don't say anything. They suffer in silence. They leave that doctor's office and say, well, I guess it's just me.

And then I come. They come to my office. I'm like, ma'am, no, that was bad. That's illegal. They cannot say those things to you.

Exactly.

And so. And again, when you hear those stories at least 30 times a day, you just. You can't help but kind of get angry when someone's telling you that they're refusing to give care based off of feelings instead of the actual facts. And so I called Blaire so angry and just being like, and this is why women are suffering, because doctors are just going off of feelings instead of facts. And like, I was like, and we don't even know how many nerves are in the human clitoris. Like, literally, the foundations of women's health are not known. And he was like, I. We can get those real quick.

We can count them real quick. Let's do this study real quick.

Yeah, that's amazing.

It was. It was like. It was just one of those things where, yeah, everything really clicked. And, like, he. That ragtag group of people, we were all, like, within our first year of being in clinical practice, we, like, got a very small grant. Like, it was just. It was like, we really did that grassroots work ourselves to pay a larger point and to aid to the narrative. I just never thought it would blow up to what it was, and I'm so appreciative of that.

And I really hope that the actual story behind the research gets out there, too, of, why did we do this? The reason was we need more foundational research in women's health, because that's what's going to actually lead to better outcomes clinically.

Yep. What's the statistic? That it wasn't until 1993 that women were required to be in medical studies. That was that long ago, right?

Yes, yes, yes. And I think that's such an important thing, because so many of us are leaving training, thinking, oh, we learned everything that we could ever learn about the human body. And it's like, no, we haven't. And so we. We have to start thinking more from a lens of exciting discovery, instead of just being like, well, that's just the way it is. It's like, no, we are just started.

That's why there's so many syndromes in women's health or disorders. But there's not that many disease states because we don't know, like, we haven't done the research.

Exactly. Exactly.

I mean, you know, like, just even taking care of patients with, like, endometriosis or pcos or, you know, like, some of these. And of course, sexual pain, like, you know, to tell a patient who, like, one in ten patients suffer from, like, endometriosis, up to 80% of color get fibroids and heavy bleeding. Right. And, okay, if one in ten men suffered from their menstrual cycle every month, or 80% of men suffered like that, we would have had an answer 50 years ago, right?

Yes. Yes. And I can say that because I get to take care of all genders, and that is the medical sexism that exists is not hypothetical. It is real. It is real. There is objective evidence and data to show that. And it was actually, that huge gap in care delivery actually made my job as a clinical clinician almost impossible, because I would be like, for my male patients, I'd have all these really straightforward pathways, very easy, and they're like, oh, by the way, my wife doesn't enjoy having sex with me. I'm like, great, send her my way.

And she couldn't get seen for at least a year and a half because that's how long my waiting list was. Because I was the only person, even when I would then be able to see them. Most of the medications that are life saving and evidence based aren't covered by insurance. And I'm also then spending several visits unpacking years, decades worth of trauma, because they've been neglected by the system. And it's just like, this is my men's health clinic. So well resourced, so straightforward, super fun. My women's health clinic, also very fun, but very under resourced. You know, I could even, like, dollar to dollar, I can tell you how much I was losing money taking care of women, even though it's something that I care so much about, because these are just huge inequalities, right? Like, the reimbursement rate for women is way worse than men.

That's insanity. Because women, in theory, are more complex, even though they're actually very straightforward, but the complexity of disease is actually much higher. I'm like, make any of this. You can't explain it other than it's medical sexism. That is what it is, and we just gotta start calling it.

Yeah, I always, like, I always like, sort of joke with my page. Well, that's because the government hates women. And so we don't have x, y or z research. And I joke about it, but, like, the reality is, like, if there was, like, this much support for our health and our. And our disease states, we would have answers. You know, we definitely would.

We would absolutely have answers. And it actually, like, there's just so much. If we think about how little we know, it's the. It's actually very overwhelming. And I know that there was recently that $100 million White House, you know, pledge, baby, we need billions of dollars for this. Like, this is not. Yeah. And, like.

And that. My fear is that they're going to say, well, look, we gave $100 million. Like, you guys should be good.

It's like, you know.

No, exactly. Like, exactly.

And I don't know about you, but I'll come home sometimes after, like, having a couple new patients with either, like, pgad or, like, really long, you know, sexual dysfunction issues. And, you know, you go through a whole story with them. About seven, eight years of, like, not getting the appropriate diagnoses. And sometimes I come home so, like, emotionally drained. Like, I just feel like, oh, my God, I feel so sad about the world sometimes that, like, these are. Women have suffered eight to ten years before they saw someone that had an idea what was going on with them, you know?

Yes.

And I can just. I mean, and I'm a. I'm a, like, I'm someone that takes people's emotions to heart. So I think, like, I. I have too much empathy sometimes. I'm like, oh, my God.

Yeah, no, I mean, towards the end of my, like, academic career, I would sit in my car for, like, an hour just to decompress. Like, you're really taking on a lot of trauma, right? You're listening to people unpack some of their most. They're unpacking their pain. When you're a chronic pain specialist, when you're all a women's health specialist, you're going to be unpacking not only trauma, but also medical neglect and medical malpractice, because a lot of the conditions that people have been told that is impossible to treat chronic recurrent, it's actually just misdiagnosis. That was the part that made me so mad was that, you know, this person is sitting in my clinic, has taken off work, has dedicated, has literally changed their entire life because of this disease state. They've been told it's impossible. You'll never be fixed, try some random stuff. And I'm like, baby girl, it is actually very treatable.

I can already. I already know exactly what you have. I don't even have to do an exam. Like, that was, by the end, I would have, like, medical students with me or all those things, and they would just be like, Doctor Yoko, I already know what this person has. And I was like, yes, listen to your patient.

Right?

I know, because you've seen this. Exactly. You just know. And it's just like getting the basic education. So, you know, it got just so frustrating because this work isn't hard. To me, it wasn't all that hard. It was just that most doctors aren't educated or choosing not to learn about this. And the only people that are suffering are patients.

Like, we're telling patients that they are challenging instead of actually looking and seeing that the healthcare system, ACOG, Ama, we are not training our doctors to know about women's bodies, period. And that's it. That's it. And I need every patient to know that. That, like, it almost feels like we're like whistleblowers in a way, of like, look, listen, the healthcare system is truly not training its doctors on your bodies, and you're the only one suffering. And I just would sit with that big conundrum every day after my women's health clinic. And that's actually what led me to leave my academic job and create vulva AI, my health tech company.

Oh, yeah. Let's talk about that next. That's amazing. But I do agree with you. Like, just as a side note, like, when I was a resident and, like, I remember seeing my first IUD insertion, because, like, you're like. And they're like, oh, don't worry. There's no nerve endings at the cervix. And they put this, and you look at the tenacular, and you think, oh, my God, that looks so painful.

And, you know, you see the patients are screeching, and whatever. I'm like, isn't there something we can do? I would say, isn't there something we can do? And they'd be like, well, I mean, that's why, like, you know, I use nitrous in my office. You know, I do all the things, you know, don't have that kind of pain. But, like, it's like, this habitual training that you get, you know? And it's like, well, that doesn't suggest that, you know, using lidocaine will help. Well, if it. You know, if that patient thinks it's helping her, I'm going to give it to her, you know, like, right, right.

That, like, it's. It's, it's. It's so fascinating to have taken care of men where predominantly men. I still saw women, too, but it's just a very different training. Like, even mentality of, like, who deserves comfort and who doesn't, you know, we. There was. It was never a question to do to make sure our patients were comfortable during procedures. Like, that was just never even a question.

And if your patient isn't comfortable during a procedure, that is a. You are failing as a doctor. That was. That was truly, like, I still remember my chief going through all the blocks with me, like, doing er procedures with me and, like, giving me feedback of, like, you didn't make the patient comfortable enough. Like, you know, and, like, as an intern, and I was like, you know, writing, writing things down and being like, of course I'm being trained that, like, my number one job is to make sure. It's obviously to do the thing that I need to do. Get them diagnosed and treated while making sure and prioritizing their comfort.

Yeah.

That is not what is trained in women's health. It is very much. And it makes. It breaks my heart when I'm talking to other women who are gynecologists that are just kind of like, yeah, she's complaining. It's so. She's just so complaining. And I'm like, wait, no. Yeah, they're complaining because you're harming them.

Like, they're complaining because that procedure is very painful. Like, what are we. What are we talking about?

There's no award for that. And it's like. And it's like, you know, and I don't do obstetrics anymore, but I remember, like, when I was in academics as well, and I was seeing a resident, and she was like, oh, she's only, like, 3. She's complaining about pain. I said, and at that point, I hadn't had a baby, but I was like, you know what? But it is painful. Like, this is painful.

Yes.

Like, give her the epidural. Give her the epidural, I'd say. And they're like, I don't think she needs it yet, doctor. And I'm like, you don't get to decide if she's in pain or not. You know, him saying.

Yes, exactly.

That I was shocked. That's the mentality. And even, like, among, like, you know, the, you know, when it comes to even, like, you as me, as an ob gyn, being pregnant, I remember being like, oh, I was having preterm contractions, and I, you know, other obese, like, well, I was practically, like, in labor when I had. When I did a c section. My, you know, fourth, my third trimester. And I'm like, you don't get an award for, like, endurance suffering.

Exactly. It is. It is so fucked. That's the only word. It's the only word that makes sense because it is one of the most now and again. This is, again, if you're a woman going into that healthcare system where that. That is the mentality that you're suffering is actually expected, we actually build that into our treatment and diagnostic plan. Like, that's how we learn how to evaluate patients.

If you're suffering, then we're doing a good job.

Like, what the hell is that?

You know, it just blows my mind. And it's like, how it's.

Yeah, it's speechless.

How do we fight culture? How do we fight culture? And it's. It's. We only are able to fight culture by empowering patients to know that that is not okay.

Not okay. You know, I tell this story a lot, too. Is that when I was an intern, actually, you know, like, there's medical sexism, of course. But then you. Top of that, you put medical racism in the mix, and it's really like women of color. Right? My. I remember. I tell the story a lot, but when my.

When I was an intern and there was a patient who was, you know, of my descent, I think she was pakistani as well. And she, you know, like, a lot of, you know, women of my culture have vaginismus, and I talk about it a lot. She had all the vaginismus symptoms, and she was in early labor, and she. And I remember the attending walking out very frustrated because she couldn't examine the patient. And she looked at me and she goes, what's the deal with your people? They act like they've never had anything in their vagina. Like, can you imagine being first an intern listening to something that was so blatantly racist? And then, like, this woman is suffering in pain and she has vaginismus, and you're just. You know what I'm saying?

Like, I was like, there's just. It's an ingrained general sense of humanity. Like, it's like, it's an ingrained loss of humanity. Like, that is not a person. Like, it is. And I'm so glad that you saw that and said, this isn't normal. This isn't right. Because I think this is how culture begets more culture.

Right? It's like, you set the precedence. That attending was setting the precedence for people's pain. Doesn't actually matter. We don't center their pain or their.

Comfort because she's brown, and that's what she expected from her.

Exactly. Exactly. Like, there's. There's no, your comfort doesn't matter. And even I've had some of the most. I taught gynecologists, too, and, like, truly some amazing gynecology residents and urogyne fellows. And it was always fascinating. And I also taught urology residents, just, again, that culture of acceptance and allowance and just kind of this, like, general, deep disdain for women in the gynecology field.

Like, at least, like, when I would teach.

She's complaining about this or she's complaining about.

Yes, I still remember I had one of, like, again, I worked with some of the most amazing gain residents and fellows. Brilliant. Coming from some of the best programs in the country, if they're a fellow. And then we just had a really awesome guy in program at where I was previously at. So. Top of the top. Brilliant. Amazing.

I had to literally train every single one not to, like, not to hate women and like, to really check them on this internalized bias that they didn't even see. Cause the people that were coming to my clinic already wanted to be there and, like, learn or excited and, like, clearly super passionate about giving high level care to women. But because they were trained in a system that inherently just hates women, they would say things to me that I was like, I know you don't believe that. I know you don't believe that. So let's do a thought exercise. Yeah. To break down why that thinking is very problematic and actually directly harms your patient. And a lot of it's centered around believing their patient's pain.

Exactly.

That is like your. I love what you said of, I just believe your pain. It's like, I don't have, like, I don't need to believe that you have pain. You are telling me you have pain. My job is to figure out a. What the pain is and then make sure you're comfortable. That is it. It is like, it was actually funny because so many of my patients that have been through the system would spend so much time over explaining themselves to me to the point where I was like, oh, friend, I believe you.

You don't have to. Like, I'm not. Your job isn't to get me to believe that you have pain. I already believe you could tell me anything, and I would believe you. My job is just to make sure that we figure out why and how to fix it. That is it, right?

Yes.

And it was. You don't have to exactly. I was like, I like, it was. I could almost. I already knew the energy of those patients going in, and it just made me sadder because I'm like, this is the person that needs extra love and care because the system has made them this way, has made them so distrusting that they have to over explain themselves what they're feeling in a way that's almost chaotic. But for them, that was the only way they could feel that they were being heard and listened to. And it would always be funny. Like, after they did that and, like, talked at me for like, 30 minutes, I was like, oh, I already believe you, by the way.

I just needed you to know that.

To figure out the history of why this happened.

I just, like, I already believed you. Like, I just wanted you to know that that's our only goal is moving forward, not, not you having to justify your pain.

Absolutely.

And I think that's, that's such a shit lot that women have in life and dealing with the healthcare system.

I agree. And, I mean, I, like, that's one thing I always told the residents too, is like, you know, like, let's just remember one thing. Like, especially my, you know, it's always, it was always women saying this too. You know, it was double shocking. And I'd be like, you know what? Just, you know, we have to believe the patient. And remember, karma does not forget an address. So if you're going to tell her that this da da da. When your time comes and you're in labor, you know, someone might not give you an epidural or something.

You know what I'm saying? Like, you have to think, yeah, that situation. Pretend like that's. Or your sister. I mean, if you can't, I empathize with them in another capacity. You know, put someone in there that you love and then tell me you feel the same way.

Exactly, exactly.

So it's very interesting. Okay, let's talk about vulvar ar. We were about to talk about it. And you're telling me this, the reason you brought it, you kind of developed it, but tell us what it is and how it works.

Yeah, so, you know, vulva AI was, I always say it's a love letter to my patients. And it really came from sitting and listening. I think it's so interesting when now that I've gone into this business space, a lot of people are like, well, you need to do customer discovery. And I'm like, baby, I've done over 2000 customer discovery interviews. Like, everyone's like, most people are like, oh, I've talked to 50 people, and I talked to 100 people. It's like, I have, I have treated, I have interviewed, and, like, the way that I do things is very different than other physicians. It's not a ten minute visit. It is a dedicated visit.

So I'm unpacking decades worth of trauma with every single patient that I have. So it's not just, like, in and out and so understanding those stories and understanding those backgrounds and really seeing their huge pain points, you know, the really, it really came down to, doctors aren't being trained on vulvar health and how to diagnose vulva, vaginal conditions, and urinary. Like, really actually how to do it. Women then themselves don't know about their own bodies. Like, it was so fascinating. I would, you know, I'd have a patient that was, like, suffering for 20 years. We'd do an exam, and within 5 seconds of looking at her own genitals, she was like, wait, why is it all red? And I was like, you know how much pain you've been having? That's why. So it's like, you know, the amount of women that I would have crying in my office of just, like, for many reasons.

But one of the hardest ones was they would also start crying during the exam. Not because it hurt, because I do it very differently, but they, because they could actually see what was causing their issue. And if only someone had ever, if only they had known to look, that was like, it was always, they would always be like, wait, what? I could have saved myself so much time, effort, energy, heartbreak, money, relationships, right? And so I was like, okay, that sucks. And then also, third, they couldn't even find resources to then go look up, right? So so many people would go to their doctor, they'd be get dismissed, or they get the wrong treatment, and then they would go onto the Internet to try to find solutions, and they couldn't find anything. They were, like, resorting to Reddit. When you are resorting to medical information on Reddit, we have fucked up as a system entirely, entirely. And so, you know, it was just one of those things where looking at the math just wasn't mapping. They were just, I was spending all of my time, you know, either at work doing research or trying to train other doctors to do this work, but that was really slow.

You know, we never stopped talking. We never stopped doing the thing. But that's not actually creating change, like, worldwide expansive change. And a lot of this comes down to the lack of education and lack of training on the physician side and on the patient side or user side. And so when I thought about big system problems and big system issues, I was like, tech is the way to go. And then when I thought about AI, like, right now, generative, and I, AI is having a moment. And how I think about AI and what I think about it is, is that AI is great for where humans are failing. And currently, when humans are failing in diagnosing and treating vulva, vaginal conditions, whether it's recurrent utis, recurrent vaginal infections, chronic pelvic pain, overactive bladder symptoms, iC, interstitial cystitis.

They're failing. They're failing at it. I can treat and diagnose these patients in ten minutes, 30 minutes, pending on, you know, how much we have to unpack.

Yeah.

Why is it that then they are suffering for years, decades, on average, seven to ten years, to get your. The actual right diagnosis. And so. And I oftentimes would tell my. The people working with me in clinic, they're like, this is so straightforward. How is it that everyone's missing this? And I was like, we do a whole thing.

Yeah.

I was like, oh, baby, there's a whole system. How much time do you have? And so, yeah, I thought about it of, like, there's just not enough doctors that are trained in this. And also, I want to arm my patient. I want to arm anyone with a vulva with the ability to advocate in the doctor's office the amount of women that are told the most asinine, wrong, blatantly, just wrong things, which is so much. And it only stands from, well, the vaginal health, but menopausal health, endometrial health, like anything along with the. In the. In the gyne space, there's just a lot of. There's just a lot of.

There's no standard, right? It was just like, there was just no universal standard.

I mean, half. Half. Gynecologists I know don't even examine the vulva. So sometimes I'll. I'm like, well, you clearly have lichens sclerosis in my head. I'm looking at your vulva, like, totally, like, sea flavia clitoris is gone. And I'll show them. And I'm like, they're like, I don't know.

No one's ever said this to me before.

And, like, they get so many, so many misdiagnoses. Like, just so many. And so I left my. I said, you know what? I'm gonna go. I used to say this work was so straightforward that I could train a monkey to do it. So instead of a monkey. I went to go train an AI algorithm how to do this. And so what? Vulva AI is using predictive AI to help, not only to help two people, right? So to help the physicians, because as of right now, when patients come in and says, I have chronic pelvic pain, the physicians have no idea where to start.

They just kind of start throwing things at them and just hoping something sticks. And this is why we have such poor treatments, outcome, success. I wanted to be able to create for them an algorithm that actually helps them create their own differential diagnosis and then actually walks them through the steps of how to get diagnosed and how to carry out the diagnosis and treatment. So that's one aspect, because many physicians need this training, but predominantly, this was for patients, right? So for patients, they can also do the exact same thing, but I'm also teaching them how to advocate for themselves in the doctor's office. So. So, you know, say that you're someone with chronic pelvic pain. You've seen your. Like, you've seen another specialist.

They gave you another lidocaine cream that's not working. You're gonna go see your next specialist. But before you do that, you get to log into vulva AI, create your user profile. You then take a quiz based off of your symptoms, whether it's recurring Ati's, whether it's chronic pelvic pain, whether, you know, whatever it's bringing you to the app. You take a very. Yeah, very, very tailored quiz. That quiz then creates a summary. That summary then teaches the AI model how to get you diagnosed.

It actually builds your differential diagnosis of, oh, it could be hormonally mediated vestibular dynia. It could be pelvic pain. What is hmv? What is, like pelvic floor dysfunction? What is the da da da da? So they get all the information around it. So actual evidence based information. And then we then give them the script of walking them through diagnosis. Like, so this is what you should be talking to your doctor about. These are the lab work that your doctor should be doing a lot of. And one of the fun things about this is that so much of the diagnosis, you can actually see.

And so I'm actually teaching. People also had to do their own vulvar exams because everyone's like, wait, wait, how do I do a vulvar exam? I was like, everything is on the outside, so it's actually very easy. But because there's, again, that poor understanding of vagina versus vulva, just people just in general, just don't know their own genitals. They get so shocked that they could do their own exams and actually know, like, it's kind of like if a person has a rash on their penis, they look at their penis, they say, oh, my penis hurts. And, oh, wow, there's a rash there. I should go to a doctor. That's essentially what a lot of what I was seeing was. Like, there is actual physical changes that are associated with your symptoms, and we can fix those changes.

But because so many women had never even looked themselves, they didn't even know what to. They were just like, I don't know. It hurts down there, but I couldn't tell you why. And I'm like, then they saw it, and they're like, oh, well, now I know why it hurts. But what is causing that? And so vulva AI walks you through that entire process, and it helps. It literally starts giving women a standard of care of what you should be expecting when you go into the doctor's office and how to advocate for that. And so we're starting in the vulva vaginal space. But I want to ultimately expand to all of, you know, anything with the women's health, right? Because there's just so much variability in how care is delivered.

And I want to be able to give women, people with vulvas, even birthing people, as they are going through the healthcare system, they have their own checklist of what should be happening and how to advocate for themselves, and especially because they are so vulnerable when they're going through the healthcare system. And so this is a love letter to women. This is a love letter to anyone with a vulva, anyone that's been had, any medical trauma happen to them, where we get to actually protect you through the system, by educating you, by educating you on your own body, by educating you on the process to getting diagnosis, on the process to getting treatment. And it's like having your own vulvar specialist in your pocket. And one thing I thought was really fascinating about women's health is that we have completely given our vulvas to the doctor. No one else knows about the vulva except for the doctor. But funny fact, the doctor doesn't even know about the vulva. So just no one knows how the vulva.

And it's like, it's cause, like, you know, you. You just assume that your doctor knows everything, and there's no other part of the body that is so neglected and so shamed and so tabooed that it.

Just, I mean, most people don't even know the word vulva, right? Like, if you don't know vulva. You just say down there, or my private part, you know, whatever. Like, you can't even use the terminology. Then how are you going to look at it?

Like, exactly. Exactly. And so, you know, ultimately this goal is to get people, people to quicker diagnosis, more accurate diagnosis and better treatment outcomes and really reduce harm in the healthcare system.

I love it. I think that's amazing. And I'm so glad you did that because I always say in this podcast, well, my tagline is, I'm here to educate so you can advocate. Because I feel like right the end of the day, you have to know everything that you need to know so that you can go advocate for yourself because no one's going to say, no one's going to do it for you. So I think, you know, I tell a lot. I have a lot of patients who like, you know, I help get pregnant because they can't have sex or whatever. And when they do, well, now you have, you have to go and, you know, see an ob that can deliver you because I don't do that anymore. And they're like, you know, a lot of times they're like crying, especially my women of color.

They're like my black women specifically because they're like, I know the maternal mortality rate right now. And to me, so how am I going to, how am I gonna get somewhere else? And I'm like, you call me.

Yeah, no, I mean, it's crazy how it just speaks to such a larger narrative of, like, how vulnerable almost every woman is. Like, truly, if Oprah can't even get right menopause care, what is gonna happen.

To any of them?

Right? Everyone is fucked in this system. But then you start adding intersectionalities, like, then that makes it even harder for you. And that, I mean, there's a reason we have such terrible outcomes. And one of them is the lack of training and the lack of education of the physicians out there. And so until Ama particularly. Yes. Yeah. And like, until Ama, AcoG, like, these governing bodies that are slated to be the education, who teaches the doctors and who trains the women's health specialists, they need to change their curriculum.

And that's ultimately, like, that's the biggest goal, is that now once patients understand what their standard of care should be, they start advocating, they start putting pressure on the medical system to say, we deserve better. I'm nigerian. I love a coup. I grew up when, like, my bedtime stories was that if you are putting people in power and they are no longer doing the thing that they're supposed to be doing, or it's not making sense. Burn it down and build again. And that's like, that's a weird bedtime story for seven year olds. And yet that's what I grew up on. And so it me, radical change is nothing that insane.

It's not a concept that's out of the realm of possibility for me. I feel like a lot of us in medicine learn this learned helplessness of, like, that's just how it is. That's just how it's always been. What can we do? And I'm like, we can do a lot. We can actually do so much. It just means thinking.

Start by listening to your patients.

Yes. And maybe doing a basic pubmed search. I digress. But, yeah, no, I just, I just am a big believer that we can make change, and sometimes it's going to not be as easy and straightforward as we want, but if something isn't working, you gotta change it. And I, it makes it some nonsensical to me to be like, well, that's just how it is. It's like, no, no, that's not how it is.

And I will say, like, just as a caveat, like, you know, not, we don't, we're not vilifying all doctors. We're vilifying basically because the system is rigged. And so, like, you know, the way insurance companies are, like, you know, they don't, they don't reimburse for things around sexual medicine or menopause the way that private equity groups are kind of just taking over. And then, you know, people are, like, forced to see 40 patients a day to meet their quote, like, you, you can't unwrap these issues in a ten minute visit.

You cannot. And yeah, yeah, there's, it's, and so.

Many doctors are forced into that situation, you know, luckily, and we're going to talk about your new practice, but luckily, some of us have been able to kind of spin off and try to practice medicine the way we want, but that's for the patient, but that's not the reality for so many.

And I just try to figure out a solution that worked with the current landscape of medicine. Right. That's like, I am one human being. I will not change the system. But can I start putting, can I look at the system, figure out a solution for said system, while also at the same time inspiring people to start dismantling that system? Yes, that's what I can do. And that is, it's also understanding that, like, I am one person. I am, I am this is. This is a fight.

This is a fight that everyone is going to have to get involved in. I just have been, and I think all of us, all the ish wish crew, the sexmed crew, are tackling it in just different, very different ways. But we're all.

Yeah.

Yes, exactly. We're all, we're all, I mean, truly, physician advocates trying to bring attention to this, like, glaring problem that we see every day.

Absolutely. And I mean, truly, you're a revolutionary. I'm so happy that you're doing all this. And vova AI, that's amazing. Let's talk about your new practice, though. Everyone should know how to get in touch with you, because I don't want to take all your time today, but.

I do want started your own. Yes. So on top of this health tech company, I also.

Because you don't have that much to do.

I still love seeing patients, and I still love helping, and I still love doing research. So I still have a full research team. Still have a health tech company team, and then also seeing patients again. And so I opened up a comprehensive sexual health clinic in Beverly Hills. Every Monday, once a week, I will be seeing patients. Anyone from erectile dysfunction, Ferroni's disease, anyone with menopause, recurrent I infection. So that's also my claim to fame, is recurrent utis. I'm a big believer that it's not actually recurrent utis.

We can actually fix a lot of that. And it's been so great to give so many people their life back and then long term vulvar health. And I really, so I am obsessed with the biopsychosocial approach to sex and sexuality, and I really love emphasizing the psychosocial aspects of it, partnering with sex therapists, tantra workers, sexological body workers. I think there's the science of sex and then there's the practice of sex. And so I'm able to incorporate all of those things with just kind of having a really fun and robust network in LA. And so, yeah, I want to bring people from disease states to pleasure. So whether it's like, yeah, so it's a very pleasure focused practice. We fix the disease, and then we center your pleasure as well.

Wonderful. So I love it.

And you do. You're, like, able to see both men and women, which is great. We have to have you back on because, you know, obviously, I don't see men in my office, but I do ask about patients partners all the time so that I can, you know, help them get, like, does your partner have ferronase? Erectile dysfunction. Let's get you to somebody that can help you. Because obviously, you know, if you're a heterosexual, you're having sex with and you're a female, you're likely having sex with another man who might have problems, especially in the midlife. We talk.

Yeah. Yes, yes, yes, yes, yes. My jam. That's all my jam.

Yes. So I want to back to talk about Pharone's disease or.

Yeah. Yes. I say that I can help all couples. I help all couples every iteration. If you have seven partners, I got you. If you have one partner, it's yourself. I got you. But like, that is.

That is my. That's. That is. I love to provide evidence based, shame free, fun, high quality concierge care to all my patients.

Wonderful. Well, you guys know where to find doctor Maria loco. And if. And you know, check out vulva AI. It's amazing new technology for patients and for other clinicians who are listening. So thank you so much, Adrilogo, for being on my show, and I will have you back one day when we can talk about men's sexual health a little bit more. Yeah, but, you know, thanks for joining me today for gyno girl presents sex, drugs and hormones. Remember, I'm here to educate so you could advocate for yourself.

Please tune in for my next episode and thanks for joining me. If you have a second, please subscribe to this podcast. I'd love for you to be a.

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