Natalie Bulger

0:06

Hey everyone, welcome to another episode of Motivation N'at. I'm Natalie, your host, and today I am joined by someone who is just — she's probably not even aware of everything I'm gonna say about her in this quick engagement that we have, but Priya Patel is my guest today and you're gonna know about her in just a second. But about a month ago — we're releasing this early December, so it was early November — I made my way to Nashville, as did Priya.

We're seated back to back in this education room, so we never really get a chance to look at each other unless we're the spokespeople — which, shocker, we both were the spokespeople for our table, which tells you about us. We're in this session that's all about Not Impossible. We'll touch on it as we go along, but it was a group of healthcare leaders, folks that were being challenged to look at the problems they faced in a different way,

​

and then to share stories and to know why do we wanna make change? Why do we wanna do things a little bit differently along the way? And in a day and a half, I think it impacted all of us immensely and gave me a lot of hope in a world that sometimes doesn't have a lot. But it was on day two in the morning that we were challenged to

stand up and share a story that we had. Why did we get into healthcare? Who was our person that motivated us? Was it ourselves, was it someone else? And at this point, we had an inkling of who was kind of in the room. I went around a circle and then Priya, you raised your hand and walked to the front of the room and shared something that I think none of us expected. And we'll go through what that story is in a second. But in that instance, it was like,

I always say we get grounded, but that just kicked the chair out from under me and plopped me real hard on the concrete for a second. And it's a reminder that even when we're leaders in this industry, we're patients too. And we're going through a lot of things that no matter how much we know, we're still learning more and more every day. And then we become advocates ourselves.

​

And so the topic that we're gonna be talking about today is women's health. And it's gonna be probably one that — if you're listening to this and you don't like the word cervix, vagina, uterus, any of those things — just turn it off, because we're gonna be talking about that stuff. And as uncomfortable as that is, it is the reality of the world that we live in. And it's also the reality that because we don't talk about those things, sometimes they're not taken seriously. And it's really

really important stigma that I think we need to overcome. And when Priya and I chatted right afterwards — she told the audience of 70 people, most men — she said, I've never talked about this really. I've never shared this story before. And I'm like, no, this sounds like the confidence that came forward. And immediately it was like, we're having you on the pod. We're gonna talk about this. We're gonna give space for this conversation.

​

And so without any further ado, I'm gonna hand it over to Priya to introduce herself, talk a little bit about why the heck were you at a Not Impossible conversation and what inspired you to be like, okay, this is the moment. I'm gonna take that leap and break down those unseen walls and barriers that so often constrain us into kind of staying in our little space that we feel safe in. So Priya, over to you.

 

Priya Patel

3:41

Natalie, that was so beautiful. I want to mention — we're talking about women's health — I think there's something so profound in you opening your space and sharing your platform to allow us to come on and speak about these things. I think it's one thing for us to be advocates, but it takes a different type of being to be like, hey, take my platform and speak about it, share your story. And I thank you for that because so often, like you mentioned that stigma, we are dealing with this in silence. We're dealing with it privately and quietly because — I think it's something cultural. I think it's also something first generation people deal with. I think it's people of color. I don't even want to profile that. I think it's just this culture — women, we're just told to deal with it privately and quietly. So I want to take that moment to first thank you. I thank you from the bottom of my heart.

​

I'm already emotional. I'm choking up as you were sharing that. I just thank you for opening up your space and your heart to have this conversation. That session with Not Impossible Labs — I say this very dramatically, but I mean it — it changed me. And it changed me because I'm here today because of it. Their premise is help one, help many. If you

challenge the status quo, if you challenge what is and what has always been and think about what needs to happen — what changes need to be — and you dive in, you share your story, you're able to help one, there's a chance you're able to help many. And I think that's what that force was — I was on such a subconscious level. I didn't even know what I was doing. I was like, raise my hand, take the mic, I'm gonna share this story. So when you say it was a level of confidence that you saw, I think that was just me channeling this fuel that I had been harnessing for so long to be able to just use it, to share it. And with that, maybe I'll give a little bit of an introduction of who I am and why and where I came from. By training, I'm a pelvic health physical therapist. I studied my doctorate to receive that degree and that training, and then I went on to receive my MBA. And so that's kind of been my career — sharing healthcare and making healthcare accessible. That's really been what I would consider where all my time and energy has gone. It's been my life's work. And it was great — I was helping people understand their bodies, helping people on a patient-to-patient basis, but also on a grander level, helping healthcare improve in America. About three years ago, my husband and I decided that it'd be nice to start trying to have a family. You've lived the DINK lifestyle — dual income, no kids — your friends are having kids, you've done all your travel, and you're like, this sounds really good. I feel like that's something we can take on. Well, you're sold this story of like, track your ovulation, time it, boom, you're pregnant. For some it works, and for some it doesn't.

​

Unfortunately for me, there was a series of unfortunate things that happened. Essentially what I walked away from in just the first two months of trying to get pregnant is — I found out I have two uteri, two cervixes, and two vaginas. And for context, the average woman has one of each.

​

Yeah, you're born with one. This is something that I was born with. And when I got that diagnosis, I thought — first, there's so much anger and there's so much confusion and shock and fear. What does this mean? How did I not know? How did my doctors never tell me? Why didn't I tell my doctor some of the things that I was dealing with? Why did I deal with it in silence?

​

And I think about when I talk about it with my mom — there was no talk about sex. There was no talk about hormones. The most we ever talked about in terms of period was like how to use a pad. And so in that moment, when I received that diagnosis, a flood of emotions — like your world just comes crashing down.

​

You think about — my goodness, I've been treating pelvic health and I've been studying healthcare and I've been a clinician and I've been in the system. How did I not know what was going on in my own body? And when you mentioned going from clinician or being a healthcare provider to being a patient — that transition.

​

Natalie Bulger

8:57

Well, and I think part of that is like a self expectation, right? I'm in the industry, I should know some of this stuff — like you mentioned, how did I not know? Ironically, I would say it feels like you got into pelvic health because you were drawn to that part of the body somehow, some way. And then it becomes this — well, how smart do I act when I'm with my doctor? Because I do kind of know some stuff, but not everything.

​

How much do I defer? Are they still the expert? It's a very weird dynamic. And I'm the worst patient that exists. If you prescribe me something, I'm good for two days. And then I'm like, I didn't do my therapy today. Or, I didn't take that med, it'll be fine. And you don't even realize it, but because you're in it all the time, it just tends to have this weird kind of dulling feeling on you until then you're crisis level almost. So let's talk a little bit about that moment — you mentioned why haven't I talked to my doctors about this in the past, how did no one catch it. When you look back and reflect on that, was there ever — what kind of signs were there that maybe didn't get discussed to the extent they should? Is that something that's changed over the last 10, 15 years? Like if you were 15 now and going through that adolescent hormonal phase, would it be a little different? I'm not really sure it would be, but let's talk about it.

​

Priya Patel

10:40

The most obvious sign — Natalie, I cannot believe I'm even saying this and that I didn't catch it before — is I had two periods. I was bleeding from each uterus and I didn't know. I thought I was just one of the rare few who couldn't wear a tampon. I thought I just had to wear two tampons or a tampon and a pad. And I just thought I was unlucky. I thought it's normal to have pain with sex with your partner. It's not. I thought pelvic pain — random pelvic pain — was okay. And because a lot of times when you go to the OB and you say I'm hurting, I have cramps — yeah, that's common. But just because things are common doesn't make them normal. And I think we have blurred that line.

​

There are so many signs. When I think back to what my blood looked like — again, we're going into it, we talk about it — my blood looked very old. And the reason is because I have a septum, a wall that kind of goes through the top of my cervix down through my vagina. And that's how I end up with a double. I have the septum that goes right through it. And so when you're bleeding, your uterus lining is shedding — it was getting caught in that tissue, in that wall. And so it was just pulling and pulling. And then eventually it would fill up so much that it would have to come out. And that's why the blood looked dark and it looked stale and old and smelled foul — and I just thought this is what periods were. Because how often are we talking about periods?

​

Even at girls' nights, we don't talk about periods. Maybe you'll be like, I have a cramp, I just started, but that's the extent of it. And so girls and women are just going through it. There's no conversation around it. You meet with your OB once to do your annual and you say, hey, this is what I've experienced. And they say, that's fine, that's just your period. And that's it.

​

My hope is that girls — like you mentioned, in adolescence, when they start their period — that's when they start paying attention. Not when you're trying to have a baby, not when something is wrong, but when you first start your period. And that's when your mom, your friends, whoever your support is, you come together and you say, is this normal?

Not just is it common, but is this what I should be feeling? I think we are getting more involved and more people are talking about it now, but for our generation, we weren't. That wasn't the conversation.

​

Natalie Bulger

13:46

No. And I feel for OBs, right? They've got some of the hardest malpractice situations to be in on the birthing side of things. But on that gynecological side, there is a component — and this is across all health, primary care, preventative health — there's like this competition to go in and be perfect, have no issues. I want to get in, I want to get out. I don't want to be told that I have something wrong with me.

​

The running joke that we hide our underwear when we go to the gynecologist, and then they're in there with the speculum — and it's like, they're up in our business and I'm worried they're gonna see my underwear. And even the way the questions get asked — have you had any smell, any discharge, any — and it's like, I don't wanna feel not normal. This comes to the STD conversation. I love when they ask, well, how many sexual partners have you had since you came last time? And I'm like, you're going to judge me when I give you a number count? And then they're like, men or women? And it's like, again — it's a patient education component. Well, why are you asking that question? Because risks may go up with this or that. And when you're young and that's your first instance of walking in there, that is the time to really start having that conversation. I will never forget, I had a male gynecologist who high-fived me one time over one of the hardest conversations I think I've had with a doctor. And he was just like, he wanted me to know everything would be okay. And I was like, you're the best doctor I've ever had — to want me to walk away feeling okay. And I laughed because his replacement — I went in and was spotting during my appointment and he was like, you're spotting, you shouldn't be here. And I was like, I'm sorry. Am I dirty to you?

​

So it's this component of — if we could flip seats. If we could flip into that OB-gynecologist role and we're looking at early women having periods, teenagers, young girls — because we're in preteen world now where that's happening at age 10 and 12 — having these discussions, how can we reframe the conversation to ask questions that get at what you were talking about, and do it in a way that's not there's something wrong with you, but more — you might have a unique situation that we want to look at.

​

Priya Patel

16:38

That's a really great question. I kind of want to zoom out a little before I get into that. I think what's so important for everyone to understand is women's health is very, very new. We think about medicine in this country — even out there, civil rights — we think, oh my gosh, that happened centuries ago, that's not my time. That's not the case. For context, the first IVF baby just turned 47. That's only 10 years older than my husband. These innovations, these breakthroughs are happening in real time.

​

And so when we frame it to your question — if you were the OB, how would you frame it? You frame it as, if you tell me what you're feeling and what you're going through, we are going to help you make an informed decision. We are still learning women's health. We are still understanding female anatomy, still understanding female hormones. And when we think of textbooks, we don't realize a lot of that is based on male anatomy.

​

And so I think framing that to — I believe in science, of course, I'm a physical therapist — so I had to flip that in my head to be like, I can't possibly experience shame and fear and guilt because I am actively contributing to advances in healthcare. And me telling my doctor, this is what I'm feeling, this is week two, and I'm not ovulating on time —

those are things that will help our doctors add things to their toolkit and improve their care plan and their decision making for that next patient. So I think if we were to have that level of understanding between the OB and the patient, the gyne and the patient — that alliance of tell me everything you're going through, because with you sharing, I can learn and I can help make this a tailored experience for you.

​

Natalie Bulger

18:49

And it leads me to think about the component of pain management in women's health. We're talking about periods, we're talking about cramps. We've all seen the videos where men have simulators put on them and they can't handle level three — they're losing it. And we're at a level eight for at least two days every month. And you wonder why we're cranky. But the component of also having a conversation simultaneously about pain management during those discussions. You mentioned pain with sex. I had an IUD to the point where I couldn't function and had to have it removed a year later. And the response was, we don't know why that happened, there's no indication you should have been in pain. And I'm like, well, I'm telling you — in 40 years of life, I've never had an issue. The component of physicians, especially those dealing with pelvic health — you go through these cycles, one month it might be fine, the next might be horrible. How do we discuss pain with those patients in a world where we're not doing opioids? I'm wondering if you have a thought from a functional, pelvic health standpoint — I'm sure there are muscles we could be working with or activating more. Is there more partnership we could be doing beyond just your OB-GYN's office, but with other providers to address some of those components in ways that make sense for patients early on, so they can know how to manage that going forward and what really is weird pain that warrants asking more questions?

​

Priya Patel

20:28

Certainly — I may be biased here, but I say this with full intention: every girl, every woman needs to work with a pelvic health PT. You need to find a pelvic floor PT, a pelvic health PT, a women's health PT — whatever they're called. They're there. We're here, we're around.

​

You need someone to go in and evaluate your pelvic floor.

​

Your pelvic floor is a web of muscles that sits in your pelvis. And like any muscle in your body, they activate, they rest, they relax — like your bicep. You use it when you need it. If you don't use it, you're going to lose the strength in that muscle. Your pelvic floor is responsible for supporting your organs, for sexual function, for sphincter control — so it's how you urinate and how you hold in gas. Your pelvic floor is working all day, every day. Except when you're sleeping — it should be resting. Oftentimes when we are stressed, if we have high cortisol or just have so many things on our plate and we store that tension — we'll feel it in our jaw, we're on the computer and our shoulders are shutting up and our toes are curling or we're squeezing our legs together.

​

Oftentimes that tells you that you have a very tight pelvic floor. You have tension. You are storing tension in your pelvic floor and that oftentimes leads to pain. So when a girl goes into her OB or gyne and says, I'm having this pain —

we don't need to jump to opioids. We also don't need to jump straight to urinary frequency questions. Oftentimes we just need to evaluate the integrity, the strength, the condition of those pelvic muscles. That is often the culprit. And more and more people are now understanding that — because people are experiencing leakage with exercise, with coughing, with sneezing, sudden sharp pain. There's a lot of information out there now about the pelvic floor and it's gaining traction. But the missing piece is girls need to go in and actually get it evaluated. Because a lot of times, sometimes all it takes is exercise, sometimes all it takes is some stretching, sometimes all it takes is a pelvic PT to go in, physically do an internal exam, massage out some of those muscles and trigger points that are causing that pain. The options are out there.

​

Natalie Bulger

23:23

I love it — and it makes me think I probably have some follow-up for everyone here, because as you were talking about shoulders being high I was like, okay, pull my shoulders down, unclench my toes. We did a little mid-episode relaxation. But I want to shoot back. We've acknowledged your knowledge in this area was probably higher than a lot of people's. And yet you still had that initial reaction of, I've gotten this diagnosis, my world's been turned a little upside down, I've got all of these emotions — and now you're probably immediately flipping into, what's the next step? And it's not only what's next step for the ultimate goal of having a family, but now you've got this whole other health conversation even outside of pregnancy. So how did you start organizing your thoughts forward while also dealing with the emotional component and learning how to be confident going to those next steps? Because it's just a frightening place to be in the unknown. Walk us through what that's been like — because this is still pretty present and new for you. I know you're still in it.

​

Priya Patel

24:41

The reason I'm reacting so dramatically is because your questions are so spot-on, Natalie. I'm just so grateful that you're asking these tough questions because there's a level of realness to them. There is something so important you mentioned. This is a health issue. Whether this is pregnancy or there's a kid or a baby — we need to step back. And that is a very stark realization.

​

Oftentimes women aren't looking into their pelvic floor or their hormones or regulating any of that until it's time to conceive — which is such a disservice because we have our pelvic floors our whole life. We're going through puberty, menstruation, labor, perimenopause. Our pelvic floor is with us through this entire journey. Why are we only starting to pay attention in our thirties? It just makes no sense. And I think that was a really dark realization that I had — I need to not focus on the fertility piece. I need to focus on what is going on in my body. I need to heal. I need to understand. I need to make informed decisions for me.

​

Only once I get that down can I think about bringing a child into this world. I need to resolve some pretty major things. And that — in hindsight I can talk about it like that, but no, that was a very long process of grief. You are forced into it. I'll mention I had a handful of surgeries — I'm going to get into that later in this conversation — but to kind of resolve the issues that were going on. I went through IVF. I unfortunately had a couple of miscarriages. And through that, that realization hits you — are you doing this for me, or am I doing this for my future baby? And first and foremost, you have to do this for you.

​

You have to face the pit. You have to go through that grief. You have to go to that very dark part and say, what am I going to do for me? What am I going to do to get informed of my body? And how am I going to help heal myself moving forward?

​

Natalie Bulger

27:39

And that's where I want to take it. It's that piece of — and I love how you said it — you have to do it for you in order to fully be in the right place. I know friends who found out they have endometriosis when going through this process and the immense amount of surgeries and processes it takes to get to being healthy and pain free. And I think along with that — and I'll connect here — is the community, the family support. You've got a husband, a partner. And I can only imagine for some partners how helpless it can feel to be watching someone you love go through not only the feeling of — and I'm not placing this on anyone — the feeling of, it's my fault that I can't conceive or give us this family, but then also I've got this unique situation that you'll never understand because you don't have the same body parts. So it goes back to that — how do you build confidence in engaging in this path? Because you're relying on a support team who may not fully understand. They're along for the ride in the best case and trying their best to support you. That was the second part of the question we got back to — build the confidence to go forward, and doing it with someone else that you're probably educating along the way. So you've got this dual role — what do we share? How do we share? What are they involved in? What are they not?

​

Priya Patel

29:36

I think something that was really important to highlight is that in a perfect world, our partner is there with us. They understand everything we're going through. Our parents — in American culture, our mom is our best friend. She's gonna be there, she's gonna hold your hand, cry with you, laugh with you, go through the journey with you.

​

And what I realized is that is an expectation. And a lot of this experience is very isolating — but it almost needs to be done in isolation to begin. Because the more you rely on other people to tell you everything is going to be okay and someone else is making your decisions for you, the less you're listening to yourself, the less you're going inward.

I want to take a brief moment to mention — it got to a point where I was so unsure of my own voice and what I needed and who my support was that I was relying on social media. Like, hey, how do I make this decision? Can you help me make this decision? And I was so lost. I didn't have my own inner voice. And that can be very distracting. You have to develop your own opinion and your own POV. Because as much as other people will try to understand, they will not. You have to go through the struggles and face it yourself in order to make those decisions. So what I did was I got off of social media, I got rid of my iPhone, I switched to a Google phone. Because the less I was in it with people and the less distracted I was, the more time I had with myself. And so I want to emphasize that while we're talking about building community, you do have to start inward. You have to start with finding your spiritual guide. Building community is tough because I went into this experience thinking I have my mom and she is going to help me and I have my girlfriends. And it's so interesting because my mom, being an Indian immigrant, this stuff was more than she could handle. These were conversations she just didn't have the capacity to take on. I think she felt so much anger at why her daughter is going through this. She felt guilt — I gave this to my daughter. And so when I would share things like, mom, I had a miscarriage, she didn't know how to handle it. It was a very irrational reaction.

​

To the point where I was more upset about my mom's reaction to my miscarriage than about my own miscarriage. And that shifted our relationship. And I think that's so important to recognize — these things that are embedded, like your mom and your best friend — we have to break those expectations and open ourselves up to other opportunities. And so from all of that, with relationships changing and a lot of shift in expectations, I now have a community where my acupuncturist is like one of my best friends.

​

People I've met along the way who've also been diagnosed with didelphys or complete septate uterus. I have my best friends who've been there for me, ride or die. My husband is a rock. Without him, I would be completely lost. He taught me how to believe in God, how to trust God, how to trust this process. My point is — be open, number one, to understanding that the community you have before is not going to be the community that takes you through and sees you at the end. And be open to that shift because relationships will change. And two, get really comfortable with your inner dialogue. Find your North Star. Find your source. Find what you believe in — the universe, God, manifestation, whatever it is. Find that and then use that to start conversations.

​

I mentioned my acupuncturist, I have a therapist, I have an IVF support group that I love attending. And the reason I have this community is because I spoke up. None of these people came from Google reviews. None of them came from things I saw online. They all came from I met someone who introduced me to someone else who introduced me to someone else. And now I have this network of people who I can say, hey, I just had my second miscarriage, what do I do? Hey, I need to decide — do I go in for a third surgery or try for another pregnancy naturally? And so things like this that you want to bounce ideas off of — I think that's so beautiful. You have full choice of who you allow in, as long as you're open to speaking up.

​

Natalie Bulger

34:49

Yeah, it's that old saying, right — a reason, a season, or a lifetime that people are around for. And even when they're around for a lifetime, it doesn't mean that relationship is static. And you touch on something that probably deserves its own episode, which is the cultural, racial, and socioeconomic differences that overlay all of this — that are hard to think about and prepare for, especially when you're part of a multicultural set of friends. And your point about speaking up is really powerful because we tend to think of speaking up on very divisive topics or ripping the bandaid off — the MeToo movement, other things like that.

​

And in reality, there are so many underlying conversations that fail to happen because one, maybe we just don't think they're worth time and energy, or we think no one's going to get it. But when you mention the IVF support group — not everyone in there is probably from the same background, right? You're handling a similar difficulty and situation, but the cause for it still differs. So that ability to have the kind of cohesive ribbon that ties things together while still allowing space for those different moments and reactions and elements. But how common is what you have? Because I can only imagine when people get really rare diagnoses it's like — do I even have a doctor who knows how to treat this correctly? Am I going to have to travel? So what have you learned about your diagnosis and the path forward? Because no one is alone. There's nothing that's a one-only situation. If we talk about it, we'll find someone who has it too.

​

Have you found there's more information out there than you expected? If there's not enough, are you going to trailblaze and put it out there for everyone?

​

Priya Patel

37:08

God willing, yes. Okay, so I was originally diagnosed with a condition called uterus didelphys. When we are in utero — in mom's belly, developing — all females will have two Müllerian ducts, and these two ducts will come together and fuse and become one uterus, one cervix, one vagina. Mine came together and was like, okay, I'm done. We're just going to stay here and hang out and be attached to each other. So uterus didelphys is by definition two full sets of uteri. You have a normal number of ovaries, but you do have two systems. Now on imaging — I had a series of MRIs, pelvic studies, many appointments where you're in the doctor's room with the speculum — I had so many of those where you have like three or four providers in the room. One is going in with the spec, one with the camera, one with the tool. And mind you, you're doing all of this without anesthesia. You're just laying there watching these people be like, whoa, what is that? Is that normal? And they're having this interaction in front of you of just sheer confusion and shock. And you're trying to maintain your cool. And so that was the original diagnosis.

​

Then one thing led to another and I ended up going in for an appointment for IVF — with your REI, your reproductive endocrinology and infertility specialist. They're the ones that talk about advanced treatments. If you're struggling to conceive, you might need IUI, IVF, some sort of reproductive assistance. And when she went in there, she said, wait a second — this doesn't look like didelphys. And I said, no, you must be mistaken. I've had three or four MRIs at this point, I've got all these pelvic studies. I have didelphys. She said, I think this is a septum. I think you actually have one uterus with a wall going through the middle, separating it in half. I said, well, what's the difference? And she said, that wall

is unviable tissue. There's no blood flow. This tissue needs to come out because if you do get pregnant and the placenta starts growing on tissue with no blood flow, that's not going to survive. This is very unsafe. So she referred me to a surgeon. I had a series of three surgeries where they started from the bottom, removed the vaginal septum, then went in and removed half the uterine septum, and then removed the rest.

​

And when you ask how rare it is — it is very rare. A very small number of women actually know they have it. How many women are undiagnosed? Probably hundreds of thousands. And I want to make a very important point — I mentioned earlier that women's health is so new.

​

A lot of this stuff hasn't been researched. There aren't many journal entries you can read. There are some that will tell you the risk of pregnancy and the risk associated with conceiving — things like growth restriction, your baby doesn't have enough room to grow, preterm loss. But in terms of what to do in these situations, there isn't much out there.

Except for public forums. Because women don't have research — we're going off anecdotal evidence. There are forums on Reddit and on Facebook. Some have a couple thousand people now, so it's grown. But it's like, hey, I did this and it worked for me. Maybe it'll work for you. This is the symptom I have — is anyone else feeling this?

​

And a lot of my decision making came from other women around the world talking about what they experienced and what decision they went with. And I realized how privileged I am to live in a city like Chicago that has access to care, to a facility like Northwestern with some of the most leading providers in the country where people fly in to see. There are women in rural Idaho. There are women in rural Africa who are dealing with this and just bleeding and feeling the relentless pain and grief who don't have access to care. And so we're relying on things like Facebook and community forums to help inform our decisions. Women's health is so new. We're relying on storytelling. But I'm hopeful that the more women come together and start talking and sharing, there will be more research, more clinical trials, more treatment options.

​

But that won't happen until more people speak up.

​

Natalie Bulger

42:51

Yeah, and I think it's a — and one of the areas we touched on was what other adjacent areas could things like this impact. You've got autoimmune, you've got hormonal. The big thing right now is there's not enough conversation on perimenopause. I'm like, why don't I sleep normally anymore? I went through a phase where four months I sweated through my clothes every night in bed. And then one day I was like — it's perimenopause, it's okay, it's just something women go through. And overall sexual health, because so many people go undiagnosed. It's the same thing with sexually transmitted diseases — you don't wanna talk about it, so you don't get diagnosed. And then you think about all of the later-on comorbidities that can happen. And I've always found it funny — it only takes one person at a party to say something and then everyone's like, oh, we've been there too.

​

And I think overall the stigma associated with anything that feels scary or under-researched — we just look back to the AIDS epidemic. When it's new, when people haven't focused on it, when you're relying on stories that can be biased or infiltrated by people with an agenda, it becomes questionable who you trust. And then the big question — who becomes the case studies? We've seen things like Tuskegee. Cases where people weren't told they had cancer because of their socioeconomic class. And I'm curious your thoughts as someone who's vocal and understands this.

Are you okay with being one of the case studies? What does that look like? How do we find research and advancements when we're dealing with something so human-centric? And human-centric health care should be low risk in a lot of people's eyes. How do we learn more? How do we challenge this more? Where's your line going to be?

​

Priya Patel

45:29

I think all I really have to base my answer off of is how much my perspective has evolved. We all have that line in our life — that before and after — the event where everything split. Before, I was never sharing anything about my private life.

​

A little background — I grew up in the spotlight. I was a dancer, my parents put me out there, I was always center of attention. And then I met my husband and he was as private as can be. And I was like, wow, privacy, this is great. No one knows anything about me. I like this.

​

And so I swung that pendulum hard into private mode and really enjoyed the quiet and the peace of that. And so when I think of that before and after — the before was, I'm not sharing anything about what's happening in my life. I'm handling this privately.

​

Since then — and I mean just in the last 30 days, this is all still very new, that conference was the first time I ever spoke out about this — my perspective has changed drastically. And I think it's because I remember I woke up one day and

the sadness was gone. Like I didn't have any more sadness left in me. I had fuel. You say it was a calling — no, mine was a collision. It was like, it's time. You need to do something about this. You have this set of energy. You either put it towards the sadness, the grief, the pain — or you go and do something purposeful with it. And just how quickly that shifted in my mind, how right it felt.

​

To answer your question — I am going to lean into this and I'm going to let that perspective continue to evolve. I know deep in my gut that I am here to change women's health. I know that so clearly. I am steadfast in that. And I know that when I leave this earth I will have made a difference in how women receive care. So when you say, am I gonna be a case study? Sure. Am I going to be someone that rallies all these women together? Sure. Whatever it takes — I don't know what that will look like, but I know that I will be the one to make a change.

​

Natalie Bulger

48:29

I always say in every episode there's a moment where I know the hook hit. And it's not a calling, it was a collision — that's the thing. Because I've never felt power behind a calling. I'm like, what is that? You just hear a little voice in your head when you wake up in the morning. But that feeling of there being power and fuel behind whatever change will happen. And it's a great segue into our wrap-up on Not Impossible conversations — because the idea of how many things in this world were once dreams, once not even remotely reachable. And there's still a lot out there that feels that way. So there are so many layers and phases of what change can look like. And it's exhausting sometimes to be that constant voice for change. I had Dr. Ackerman on talking about being an advocate for Parkinson's and how exhausting that can be over time. And so it has to be something more than just wanting it. It has to be a true, I go down fighting with this no matter what comes of it. What are some of the changes that you hope will be seen — things that were once potentially impossible, now they're not? Let's channel Mick Ebeling, the CEO of Not Impossible. We were coached to not keep it too realistic, because realistic is only the constraint that we tend to put on things.

​

So what does that not-impossible look like for you? What does that help-one, help-many dream really look like in this space when it comes to women's health?

​

Priya Patel

50:46

I think the biggest, the loudest voice in my head when you ask this question comes back to IVF. There are so many changes I'd like to see. I want to see women speak up. I want to see community. I want to see women who have PCOS and endometriosis get the care they need — not just band-aid care, but address their liver, their organs, understand their whole body.

​

If I were to dream so big, I would say that the way women and families grow through IVF — we're inundated with toxins, with lifestyle factors, with a Western diet that's not conducive to women and fertility. And I'm so drawn to the idea of advanced reproductive technologies. Considering that IVF is only 50 years old, what change do I want to see? I want that process — the egg retrieval, the injections, the hormones — I want that process to be so smooth. And gosh, I wish I had a straightforward answer, Natalie. I think I'm still in the status quo. I'm still in that bridge right now.

​

I don't know. I have to be completely honest with you.

​

Natalie Bulger

52:46

Well, you touch on things that people can grasp. IVF is not always a covered service. It's not just can you get to an IVF clinician — it's do I even have money for it? Egg retrieval is not often covered. I had a good friend who went through rounds and rounds of it. It was everything she worked for — she worked 80 hours a week to pay for that egg retrieval.

It doesn't always work. You don't get time off for it. This is on top of everything else you are dealing with. And if we want to be a world that continues to populate and continues to have the next generations, it's a conversation we need to have. Because we don't have the lifestyles that we had 50 or 60 years ago. And while the technology improvement is great and the empowerment of what women are allowed to do now that they weren't once allowed to do — we haven't balanced out the fact that they are the ones who give birth and have these systems that don't always cooperate.

​

It's not to downplay any prostate or testicular issues for men. We hear you, we see you, we know you've got your stuff going on. But it should be treated equally. You get down to pads and tampons — we pay for those. If you want the good ones, you pay a lot for them.

​

And it's become marketing and sales when really, if I could just not have a period until I want one for actual reproductive reasons, I'd probably do that. So that comes back to the speaking-up part. You hear movements — let's get to a world where sanitary products are free. Where pelvic floor therapy is part of PCP work. I think you're on the right track. It's just being able to see — what does shooting for the stars look like?

​

Priya Patel

55:13

Yeah. And I think that's my answer. My confusion is the answer. I feel like we're so behind, and women have just kind of dealt with the status quo. We've accepted it, myself included. So when you ask what is dream state, what is not-impossible-now-that-will-be-possible — God, I hope a lot.

​

Like I hope that 20 years from now, I will have a doctor who specializes in menopause. I will have a PT who works with me on my pelvic floor regularly — not just an annual checkup when something goes wrong, but someone to help me tailor my pelvic floor to my lifestyle, my day to day. I hope I will be able to talk to my mom about things that are hurting me. I hope first generation girls will be able to speak up without shame and guilt.

​

I feel like women become very passive. We're understanding beings. We're so used to kind of being second tier — like our healthcare will always come second. I hope that women in rural Idaho and rural Africa who have didelphys and have a complete septate uterus will get the care that they need.

​

I really am hopeful and I really know that women's health will improve. I just hope it happens sooner than later and I hope we can leave healthcare better for the girls and the women who come after us.

​

Natalie Bulger

57:25

Yeah. And I'll go a step further. I hope it's a world where women's health is just health.

​

Priya Patel

57:31

Health. Yes.

​

Natalie Bulger

57:34

It's a part of health. And even removing that label can give it more power. It needs to be specialized right now for sure, but toward a world where it's just like — all right, you've hit a certain point, here's what the next steps are and here's what comes with it.

​

A lot of people are probably sitting here right now thinking about their own journey, thinking about what they should ask at their next checkup. If any men have made it through this whole episode — power and kudos to you. Go talk to some women around you. Encourage them to have open conversations with people they trust.

​

Priya, how can people reach out to you? If they're like, wow, this is someone I trust to talk to about my own journey — keeping in mind we all have compassion limits, and you're still going through your own treatment and process. How can people get in touch with you?

​

Priya Patel

58:41

Reach out to me on social media — that's going to be my platform and my outlet. Full transparency, I just started. I just put out my first post last night. And yeah, it's very exciting. Thanks to Not Impossible Labs for helping me share my story that one day in Nashville, and then a few weeks later being comfortable enough to share it on the internet.

​

I welcome DMs. I will have a link on my profile if you want to schedule a conversation with me — not necessarily to give treatment options, but sometimes we have something that sits deep in our gut, and on top of it we layer the fear, the confusion, the mistrust, and the guilt. And sometimes we just need someone to talk it out with, to bring that up to the surface. Let me be that person. Reach out to me, shoot me a message. If we connect and you'd rather a phone call, message me, I will give you my number. I don't care. We just need to start the conversation. I'm also on LinkedIn as Priya N. Patel — I'll link that here as well. But most importantly, my biggest takeaway from all of this is women need community.

​

And I want to help bring that community to you. Please reach out to me. Natalie, thank you so much for giving me this space and this platform. I'm so grateful. I'm indebted to that day sitting side by side with you in Nashville. That week changed my life in so many ways. And for this connection and this friendship, I'm so grateful.

​

Natalie Bulger

60:28

Well, I look forward to in 10 years being able to look back on this little starter podcast and saying — hey, that was the first time she got her story down for people to listen to and build off of and really create what this future movement looks like. And I am so grateful to be a part of the journey. Whether it's two listeners or 200 or 2,000, all it takes is one. It's help one, help many.

​

Shout out to Not Impossible Labs. I'm bringing someone in at some point, so that'll be great. I hope as you've listened, you've taken away some really good knowledge you can apply to other areas of life. And as I always do at the end — we're going to take a deep breath because this is a heavy conversation. It's a lot.

​

Priya, you're probably up here after sharing everything, so we'll decompress for a second. But as we close up and we go into whatever our days might have ahead of us — deep breath in and out. Relax those shoulders, relax those toes, that jaw, those fingers. I can't wait to talk again on the next episode of Motivation N'at and to follow up on your journey. Priya, thank you so much.

​

Priya Patel

61:46

Thank you.