Episode 33: Is your biological clock ticking?

Dr. Sophia:
Hello everyone. Welcome to the Dr. Sophia ObGyn podcast. I'm an ObGyn practicing for over 15 years in my native New York City. And I love to help women learn about their bodies, empower them, and embrace themselves. On this podcast, we talk openly and with heart about all things affecting women from pregnancy, menopause periods, sexual health, fertility, and so much more.

Disclaimer, this is general medical information based on my professional opinion and experience. For specific medical advice, please refer to your physician.

Hello everyone and welcome to the Dr. Sophia ObGyn podcast. Today we will be speaking about women and pregnancy. And when is the best time?

Touseef Mirza:
Is there a best time?

Dr. Sophia:
Is there a best time? All I know is I wanna have a baby. Okay? Not me personally, not me, Dr. Sophia. I'm talking about my patients who come in through the door and say, I wanna have a baby. And they are at all ages, at all walks of life. At all stages of life. And I figured we'd talk about it. So without further ado, I have my friend and co-host Touseef Mirza right here with me.

Touseef Mirza:
Hi everybody. So as usual, me and Dr. Sophia, we talk about a lot of things all the time since we're such good friends and she was telling me how some of her patients come to see her and they just decide that they wanna have a baby. And whether that's when they're in their twenties or whether that is in their thirties, and we start to think about that. We don't talk as much about what is really the right time to have a baby. When you're just talking about more in terms of our bodies. So we wanted to just open up that conversation 'cause we feel that's something that not everybody talks about.

Dr. Sophia:
I will say that there's a lot of things that people don't talk about when it comes to just pregnancy in general. Like the amount of times that I have to talk to a woman and ask, are you considering a family? Are you considering pregnancy? How do you feel about your future fertility? And that woman is in her mid thirties and she's like, wow, you're the first person who's ever asked me that. And I said, well, life is not all about whether or not you want birth control. What about starting a family?

Touseef Mirza:
And not because you're telling her she should.

Dr. Sophia:
No, it's just a matter of, I wanna know, well, do you even want to, so that way we can start to have the conversation about conversation. How does that happen for you? What does that look like? What are your plans? What time, when does, and how does that play into your life? Because at the end of the day, you know, when they say you have a quote unquote biological clock, that thing is real.

Touseef Mirza:
So it's not because you're trying to get in their business and try to figure out what they want, but you are really looking at it from a doctor's perspective and the implications of a woman who would wanna be pregnant and she's like 35 or 36. So let's just, let's just pull back a little bit. So when we say biological clock, I think that's something we just use all the time haphazardly. But what does that really mean?

Dr. Sophia:
It's so funny because I'm telling you the concept of the biological clock. It's like some women have heard of it and some women haven't. But when they come into my office and I actually say, yeah, no, that's real. At the end of the day, our bodies were meant to have babies in our twenties and early thirties like that is considered the optimal time, okay? And for a lot of reasons, that's when our fertility is the highest. That's when we have the best quality of our eggs. And over time that egg quality diminishes until we get to the point of what we call menopause. When we have no more eggs, where our fertility really comes to a halt.

Touseef Mirza:
So when we say egg quality, what does that mean exactly? In terms of egg quality?

Dr. Sophia:
I want good eggs,

Touseef Mirza:
Good eggs, healthy eggs,

Dr. Sophia:
Healthy eggs, eggs that are gonna withstand any kind of issues, let's just

Touseef Mirza:
Say any stress,

Dr. Sophia:
Any kind of stressors and things like that. And the reality is, is that as women, we are born with a finite number of eggs. And every time once we hit puberty, those eggs, we are losing them by the thousands.

Touseef Mirza:
Because the thing is, you talked about egg quality, I think a lot of people talk about egg quantity, right? Which is what you're talking about, too. So this is why I'm like,

Dr. Sophia:
Well, it's good that you mention it actually, because we're talking about both and both your quality and quantity of eggs are highest when you are younger. And as we age, we lose both quantity of eggs as well as high quality eggs. And so when we think of it from that perspective, that's why a pregnancy in your twenties is quote unquote ideal. Now, by no way, shape, or form am I saying that women have to have babies in their twenties. We are rock stars. We can do it anytime. But it has to be with us knowing that it's a lot easier to do when we are in our twenties. And yes, it starts to become a little bit more difficult or not as easy to even get pregnant as we age. Let's take our cycles, for example, getting our periods, our cycle is what kind of indicates to us that we are quote unquote ovulating. So for the most part, a woman who has a regular cycle where she's getting her period, let's say somewhere between 28 and 30 days every month she sees Aunt Flow, you know, whatever you wanna call her, my little red friend.

Touseef Mirza:
Or just straight up period.

Dr. Sophia:
Or just straight up period, yes. Anyway, when your period comes and you know, you ovulated that month. If you're in your twenties, you have a 20 to 25% chance of getting pregnant in that cycle. But by contrast, if you are in your forties, let's just say you're 40, that just dropped significantly from a 25% chance of getting pregnant. If you're 22, to a 5% chance of getting pregnant, if you are 40.

Touseef Mirza:
So 20% drop.

Dr. Sophia:
And when we think about the fact that a 22-year-old and a 42-year-old could still be having a period totally normal. Like it's coming every month. All right? But that 40-year-old, though she's ovulating, unfortunately, her egg quantity and quality are not the same.

Touseef Mirza:
For her to conceive?

Dr. Sophia:
Her to conceive, to fertilize that egg to be fertilized, and for that to then develop into an embryo.

Touseef Mirza:
So I think one thing that you and I were talking about, and we really wanna be clear in this podcast is that by no means we're saying that therefore every woman should have a baby and or should be having the baby at 20. What we're saying is that people should have this information and understand that if babies are really important for them, then they need to understand how their bodies are functioning.

Dr. Sophia:
Yeah. And the reason why we even started to have this conversation is because we were having the conversation of patients who come to me. And for me, at 30 years old, I see a patient, and on her chart it says, she's never been pregnant, ever. It causes me to kind of get in her business. I wanna know, well, is it because you don't want children, which is totally okay.

Touseef Mirza:
Let's just go back for a second. When you see she's 30, it just opens up all your questioning. Why is that?

Dr. Sophia:
Because our bodies are changing. You know, like, just think about it like every decade. 20, 30, 40, and beyond. Okay? But if we're talking about just in terms of our reproductive lives, the reality is the reality. And so I want to know so that I can help guide that woman in terms of real facts-

Touseef Mirza:
And give her all the information she needs.

Dr. Sophia:
And give her the information that she needs. Let it be something that becomes not necessarily top of mind, but certainly, oh, I didn't think about it. I didn't think about when I may want children. Or if I even want them. Or no, I'm clear. I don't want them, I'm just going through life, living out my career, living out my other dreams. And that's what's important to me. And I'm, I'm glad you mentioned it, but no, it's not important to me.

Touseef Mirza:
If they say, though, yes, it's important to me, but I don't want them right now.

Dr. Sophia:
Again, I love that because then that's an opportunity to say, okay, great. I want you to get that master's degree. I want you to, you know, be the powerhouse at your job. I want you to be the support person at home, or whatever it is that you are deciding to do. And let's talk about maybe egg freezing. If you happen to have a partner and you'd like perhaps to delay starting your family, well then let's talk about freezing some embryos. So that way, if you wanna think about a pregnancy or starting your family, you are now 32 years old and you're like, I have other things to do. I'll think about that when I'm 37. At 37, I want you to go and have fun. I want you to go and try having a baby the old, natural way. Okay. But at least if there's a problem, if there is any kind of issue, guess what, you now have saved those 3-year-old eggs or that 3-year-old embryo that you created and can now use that should you need to, because-

Touseef Mirza:
You might have more difficulty?

Dr. Sophia:
At age 37, 38. You may have more difficulty conceiving at age 37, 38. And moreover, for some women, they may not even have a partner. They may not even know they want children, but they're not like having a boyfriend or, or being married or having a husband is not the most important thing in their, you know, in their life at that time. And so I just wanna be able to empower women with the thought that, hey, I can really sit in my idea of wanting to be a mother, of wanting to become a mother, however way that looks and hear a couple of things I can put in place. To help myself, if that is not what I'm doing at let's say 27. Right? If at 27 I am not pregnant, I'm not trying to get pregnant, it's okay, I can think about it at 37, and I now have 30-year-old either, you know, saved eggs or like I said embryos or, you know, you can even have none of that, but at least just the knowledge.

Touseef Mirza:
To have it so you can chill out.

Dr. Sophia:
Can either pump the brakes or speed it up.

Touseef Mirza:
Right. Because there is a lot of stress with women, you know, the ones who really wanna have kids, and the clock is ticking. So, at least you're relieving some level of stress by realizing that you have that as a backup.

Dr. Sophia:
Right. That's even an option. Yeah. Like most women don't even know that that's a thing. I had the quote unquote maternal instinct when I was very young. I was about 19, and I remember going to my mom and being like, oh, I don't know, I feel like I want a baby. My mother looked at me like, what girl? You better go to school. You know? But it was obvious for me at a very young age that I knew I wanted to become a mother.

Touseef Mirza:
So just on the flip side. I was 17, went to see my poor mother and told her, ama, I'm never gonna have kids. That's what I said. So we're completely at opposite ends.

Dr. Sophia:
Opposite ends. But look at how young we were. Yeah. And we were pretty clear.

Touseef Mirza:
Still don't have kids, and I have an amazing niece and I'm an awesome aunt, and that's the way I want it.

Dr. Sophia:
And I think that's fantastic. Because you are clear, you're clear about exactly who you wanted to be in your womanhood. Becoming a mother doesn't make you a woman. But if you wanna be a mother, be a mother. And it was something that I knew that I wanted, but I also knew I wanted to become a doctor. And I find that I like that I am both. And you don't have to be one or the other. You don't have to pick your career over your family life, or, you know, so many times, unfortunately, women think they can only do one thing, or they should only do one thing, or they can't have it both ways. And you can have exactly what you want. It may not all come at the same time. But you can have exactly what you want. And it's just having the information to know how to do it.

Touseef Mirza:
It's interesting having this conversation because women, over the past like hundred years or 50 years, we've become more independent, more in control of our lives, which is obviously how we wanted it to be. And so that gave us the opportunity to do whatever we want with our lives in terms of having a career or having a family, or having both, or being a nomad, like whatever we wanna do. Yeah. Travel the world. Exactly. And that is fabulous. So we are all, God knows all about that. At the same time, by having these types of liberties, I think we have to come to an understanding also of the propensity of how our bodies were designed, and think that, you know, we can do whatever we want with our minds and all that stuff, but our bodies are our bodies. And so our bodies were actually still designed to give birth in terms of what the lowest risk.

Dr. Sophia:
Yeah. And that's in your twenties. There's no question about that.

Touseef Mirza:
When you look at potential issues that can come about, right? Like preeclampsia?

Dr. Sophia:
No, you're a hundred percent correct. At the end of the day, women who have pregnancies and deliveries later on in life do come with the complications that can arise. And these are complications that can happen at any age and with any pregnancy, but the risks are higher when you're a little bit older. I hate even saying that when you're a little bit older, because, you know, I look at myself and I'm like, huh, if I wanted another baby, no, I'm kidding. But in the sense that I don't want another child at this age. However, for so many women in their forties who are feeling so incredibly vital, living a life that is beyond their wildest dreams and having to be considered, quote unquote a geriatric pregnancy. It's so frustrating. It's just gonna be so much harder, but it's still the reality.

The increased risk of preeclampsia, as you mentioned just now, preeclampsia being a blood pressure issue in pregnancy, that can lead to many, many hard and problematic, you know, complications, gestational diabetes, diabetes occurring in pregnancy, the risk of genetic complications with the fetus are the baby having things like down syndrome, still birth, stillbirth as you know, as being something that happens higher in terms of number when you are older miscarriage. So it's not that you can't get pregnant, it's that you can't stay pregnant. There are just so many more things that happen more frequently as we get older, trying to have a baby as opposed to when we're younger.

Touseef Mirza:
So like in summary, the different areas where you have increased risk of issues is from fertility. So that's even, you know, before you're pregnant. And then actually, all the other issues in terms of gestational
diabetes and high blood pressure-

Dr. Sophia:
The actual pregnancy itself. So there's increased risk throughout the journey.. When we're a little bit older,, and when I say a little bit older, I'm talking about 35, 36, 37 years old. And for so many women, they're looking at it as if I am in my prime. I have done all these things. I feel so successful. I am financially stable. I have,

Touseef Mirza:
I feel like I'm 22.

Dr. Sophia:
So why not? My body still feels like I'm 25, so now I've met the man of my dreams. We've accomplished so many things together, and I am ready to have a baby. Right. And they walk into my office and that's exactly what they say. And then I say, we're ready to have a baby. And I'm like, okay, great. Have you been having, you know, unprotected sex? And are you having a regular period? And they said, yeah, we've been planning and trying for a baby for the last six months. And I say, okay, so at this time, if you've been trying for six months and bearing all things normal, meaning you're fe the woman's normal, her partner is normal and they've been trying for six months, it then leads me down the path of having to tell them, okay, let's start thinking about if there is, are any issues, whether that's hormonal issues. Whether that's tubal issues, like problems like actually anatomically either with the uterus or her tubes.

Touseef Mirza:
If they have been trying for six months with unprotected sex, then as a doctor, you think that there might be something else here at play that there might be some issues?

Dr. Sophia:
There's a possibility. And I don't want to wait till two years have gone by. So here we are, we have a 30 5-year-old woman who tells me, okay, it's been six months I've been doing all the things. I'm even, you know, I'm calculating when I'm ovulating, I'm having sex at the right time, et cetera. And nothing seems to be happening. I'm, that's when I'm like, okay, let's start the investigation to make sure that you don't have any reason why it's not happening. And that could be for another two, three months of trying to figure out if there are any reasons why it's not happening.

Touseef Mirza:
But when they come and see you, and they say this initially, they don't really think it's a big problem. Right. They just think, you know, like, we're just trying and it's gonna happen. Or when they tell you this, are they already a little frustrated or worried?

Dr. Sophia:
Some are worried, others are just like, okay, here's what's, what's been going on? What are your thoughts? You know? Like, okay, should I be doing something different? Is there a supplement I need to be taking? Do I need to start prenatal vitamins? Do I need to do something, change something about my diet or exercise? Do I need to sit on my head?

Touseef Mirza:
Anything.

Dr. Sophia:
Anything, anything? What do I need to do? What do I need to do? What do I need to do? And it is a little different. If I have a woman who has a regular period at 25 with very regular cycles who says, you know, Dr. Lubin, I've been with my, you know, significant other for a year and we haven't really been using condoms. I haven't ever had a pregnancy scare. And I say, okay, are you trying to get pregnant? Well, if it happens, I'd be happy.

Touseef Mirza:
Well, you're not looking every day like this is the day I need to.

Dr. Sophia:
Exactly. And so I say, okay, well here are some steps. Here are some things that you can do to help yourself if this is what you want. Et cetera. But the level of concern is just not gonna be the same until she tells me, I am actively, I, here I am, I'm 25. I've been actively trying for pregnancy for more than a year, but a woman who's 35, 36, I may say, okay, you've been actively trying for six months. You know, once she tells me it's been a year, I'm already like, okay, let's start the investigation. And even at six months, I'm like, let's start the investigation as to whether there could be a potential reason why it's not happening.

Touseef Mirza:
One of the things that when we were having this conversation that came to my mind is, where did I learn, or where was I given the information that you could not easily get pregnant but get pregnant in your thirties? Like in, in my mind, it was more like when you're literally at the end of your thirties or like beginning, like, like between 40, 45, then it gets difficult, but that in your thirties, it's still not as easy. Maybe in your twenties, but it's still fine. And I started to think, and I said to myself, I think this is all different, like Hollywood movies. I feel that a lot of times you have these characters and somebody's gonna say, oh, you have time. You know, you're only 31, you know, you have like 10 years ahead of you, you're fine. And we've heard that a lot.

Dr. Sophia:
You're absolutely right. I mean, the reality is, we get so much misinformation just from not just social media, but media in general.

Touseef Mirza:
They like Hollywood movies.

Dr. Sophia:
Yeah. They portray women, whether they're a little bit older and they portray this idea that women we can just get, have a baby anytime. And that's just unfortunately not the case.

Touseef Mirza:
Where am I getting this information? Like, where am I getting this information? And not to say I get my information from Hollywood, but it's been coming at us for so long that it just becomes a default. And I'm sure that there's other women like that, and I'm pretty, you know, like I research things and everything like that, but after talking to you and just thinking about it, just like, wow. Like I didn't want kids, so it didn't affect me, but, you know, for other women who want kids, but that don't have that information straight, that's pretty serious.

Dr. Sophia:
It's totally serious. It's so serious. Because if at the very first time you are deciding, okay, I am so excited, I'm gonna, I am ready to have a baby, and you're 39 and it's the first time you're hearing it might be harder for you to get pregnant, that's a huge blow.

Touseef Mirza:
And you can't, you can't go back in time. Like, that's it.

Dr. Sophia:
And there is no going back in time. Unfortunately, your eggs, your ovaries, are exactly who they are at 39. Your eggs are what they are at 39. And so it is, it's hard. It's a hard conversation to have if you've never heard it before. And so that's why I try to mention it at any stage. But for sure if I have a patient, we're developing a relationship and I see that she's either never been pregnant or she's had a pregnancy, and it was many years ago, I ask people, I get in their business, I wanna know, is this something that you are considering thinking about? Have you thought about it? Is it something that's important to you? And this is where we take it from there. We have to be thinking about it for ourselves. What exactly do we want? What is going to work for us?

Touseef Mirza:
I mean, I think also for some people, they don't know what they want. And that might be developed later on in life, but it's still good information to know no matter what.

Dr. Sophia:
So I fully agree with you with that, because sometimes it's just that little trigger of, huh, what do I want? You know, because otherwise we're kind of going through life and you're like, la di da, like, there are so many other things, interests, and adventures that we wanna go on that may not be top of mind. But it can become top of mind if someone is reminding you, Hey, I see you've gone, you know, scuba diving and you went to theater school in London, and you jumped out of a plane in Japan. Just a quick question. We're 33, I was just curious, were you thinking about having a family? And if you're not, that's great, but if you are, I just wanna make sure that you've thought about, you know, these three things. When would you like to have a baby? How would you like to have a baby? And the how is, because some people, yeah, I wanna have a baby, but I don't wanna have my own baby. I wanna become a mother, but it doesn't have to be biologically.

Touseef Mirza:
Like adoption.

Dr. Sophia:
Like adoption, or if not adoption, then things like surrogacy, women have options, but they don't know they have options.

Touseef Mirza:
So we talked a lot from the perspective of women who are in their thirties. So let's, let's do the flip side. So for women who are in their twenties, can you give us an example of when we say that the twenties is really a good time to have a baby? Like, how does that look for patients?
Dr. Sophia:
For me, when I see a 24-year-old come into my office and she's excited and she's pregnant, and I am like, YES. Because for the most part, their bodies are meant to have babies at that time. What does that mean? Usually, it's a beautiful, seamless pregnancy. They come in, especially if they're coming in for their visits, they're taking their vitamins, they're eating well. We're having conversations. A 20-year-old's body has the energy, the metabolism, the strength, the eggs, right? In terms of just getting pregnant and just a higher chance of going through the pregnancy, uncomplicated. It's not the same thought process for so many things. Like, could there be an increased chance of diabetes, preeclampsia? Granted, all those things are always possible. It depends on your family history, it depends on your own, like your health status. But let's just take a nice healthy 24-year-old who comes in, comes to all their visits, does all the right things, comes for a birth. It's supposed to be a beautiful process.

Touseef Mirza:
So even like labor, it's easier for them.

Dr. Sophia:
Even the labor is easier for them. Like I just had one, I literally just had a girl I delivered this morning, 21 years old, completely pushed a baby out, like got too fully dilated, had all her energy, she had an epidural, she went through the process. Like it was nothing. I mean, it was like, oh, you could have 10 babies at that rate. You know what I'm saying?

Touseef Mirza:
It was just an easy process.

Dr. Sophia:
It was an easier process. It was an easier process. Now granted, this young girl was in great shape, she was in good health. It was an easier process for her body to go through, but the majority of them look like that.

Touseef Mirza:
Right? Because if, if you're talking about a 24-year-old, 21-year-old, 24-year-old that is in good health delivering, and then you look at a woman who's like 36, 37, and she's in good health and the process is still easier for a 24-year-old.

Dr. Sophia:
Yes. Let's just say first-time mom, both sides, 24-year-old, 37-year-old, they're both first-time moms. Let's just say they're both in excellent health. Okay. I find this is just anecdotally, people, please understand this is just me and my experience.

Touseef Mirza:
For over 15 years.

Dr. Sophia:
I still find that it's easier for the 24-year-old than the 37-year-old. I still find that overall, the 24-year-old goes through the process is not a diabetic, does not have hypertension. And I'm clearly just talking about your average woman. That even includes our young black women. You have to be getting good care and you have to be taking care of yourself as well. So going into your pregnancy as healthy as possible, getting good medical care makes all the difference. That's across the board. Exactly. It does that, that goes for every pregnancy, right? Every mama, every woman who is going through the birth process. But at the end of the day, I mean, the girl I delivered today, she went according to the normal, what we call labor curve. Like every few hours, she was making change, she was making progress. And if I take the same situation, you know, maybe a couple of weeks ago, where I delivered someone who was like 39, it just wasn't as easy.

Touseef Mirza:
And this goes back to the stats that we were saying that younger mothers or mothers to be, have higher fertility, have less complications during their pregnancy, and also have less stillbirths, which is, you know, the flip side of women in their late thirties, early forties. And this basically just demonstrates that the body is just designed to deliver babies, to be pregnant, to deliver babies optimally more during the time in your twenties. And that's, that's not, you know, we didn't decide that that's just what evolution did.

Dr. Sophia:
That's just evolution.

Touseef Mirza:
That's just that it has nothing to do. That's our bodies. Yeah. And, and you know, I just want to say this, I'm 53, I've, I have white hair. This is not about ageism, 'cause I know we talk a lot about ageism, and you know, a woman can do everything she wants at any age she wants. We have the mind, the soul, the emotion, the strength, the resilience, all of it. We're just saying that the body biologically is the body in terms of how it was designed. And we also have to respect that. And we also have to recognize that. And that is also to our benefit, to recognize, to know ourselves more from the inside out.

Dr. Sophia:
The more we know ourselves, the more we talk about what we in our bodies actually want, the better decisions we can make, the more prepared we can be and the better and more beautiful the journey. So the goal here is simply to give the information, understanding that it's real. We have a clock and it's ticking. It's just a matter of knowing how you want to go against that clock. How are you moving with that clock?

Touseef Mirza:
And the great news that we do have options. Like you were saying,

Dr. Sophia:
We absolutely have options. Thank God for modern medicine and technology and all the things that are available to us. And also, let me be clear, the importance of just being healthy and how you help your own self. So by all means, this is not to discourage any woman who's in her thirties, right? From knowing that she, her body is functioning in a really great way. That she can have a baby. She should have a baby. We want you to just think about it

Touseef Mirza:
And know all the information

Dr. Sophia:
And just know the information. Like, I don't want women for the first time. It's when they're hearing, you know, after they've been trying for two years to have a baby, and they're now 39 or 41, or even 35 and they're just now getting the information, oh, maybe you should have tried that before, or that it may actually be a little bit more difficult. Let's check and see where you are in terms of your fertility.

Touseef Mirza:
Right. So, you know, if you're in your twenties and you're hearing this, I think it's good for you to know that in the back of your mind so that you are more aware of this as you are deciding what you want out of your life from that perspective. And I think in terms of, you know, if you're in your thirties, it's to think about it even more, but also if you are having difficulty recognizing that this is not about you.

Dr. Sophia:
No.

Touseef Mirza:
This is biology. Yes. So give yourself that grace.

Dr. Sophia:
Amen. Right.
Touseef Mirza:
To recognize it's not that I'm doing something wrong. My body is just like what it was 10 years ago? Like, that's where I was all like guns blazing, but that's just where we are at right now. You know? And so to recognize that, and not to put like the weight of that level of, of stress and, and, and guilt of like, you know, what's wrong with me? Nothing's wrong.

Dr. Sophia:
Nothing's wrong, this is definitely not a guilt trip. This is instead an empowerment session of, okay, let me think about this. How do I want, what do I want my life to look like, and where do I wanna be in terms of my sense of reproduction, my sense of fertility, and who I am as a woman and, and where I wanna be in my womanhood, you know? Is becoming a mother a part of it? And if it isn't, that's totally fine. Just knowing that I have a little bit more time, I'm ready to do this now. What does it look like for me? And that you absolutely have options. I just want women to walk into it armed with information. I don't want it to be that it's the first time they're hearing it may become a little tougher for you when they're 41.

Dr. Sophia:
Or when they are thinking about a pregnancy and they've missed their periods now for three or four months, and they're like, oh, Dr. Lubin, I don't know what's going on. I, you know, I realize that my periods have been missing, have been, you know, skipping. But you know, my husband and I are trying to have a baby, and it's the first time I have to describe the concept of being perimenopausal. Even, you know, one of the major concerns in perimenopause is fertility, or what we call sub fertility, or the fact that, you know, your fertility goes down so dramatically after the age of 40.

Touseef Mirza:
Which can start earlier than 40.

Dr. Sophia:
Of course, because perimenopause can start much earlier than the age of 40. So for any woman who's listening. The goal is for a woman in her twenties to know and think about what she may want for her future. Certainly a woman who's in her early thirties, and if you don't know that it's okay, but that you at least know there really is a clock.

Touseef Mirza:
And then for those of you who are later, like in your late thirties or even early forties, and you're listening to this and you're going, oh my God, I should have been like, you know, figuring this out before and all that, I mean, you can't turn back time. Well now you have that information. And number two, it's to recognize it's not about you. It's about how your body was designed. And we hope that by sharing this, it just brings a little bit more clarity,

Dr. Sophia:
Con clarity, understanding, comfort to your situation. Knowledge so that you can go and ask more questions with your provider and you still have options. As always, we are here to help you embrace your body and embrace yourself. Thank you so much for listening. Thank you Touseef.

Touseef Mirza:
Embrace your body in your teens, in your twenties, in your thirties, in your forties, in your-

Dr. Sophia:
Fifties, in your fifties, in your sixties, in your seventies. Yes. All the way, all the way through-

Touseef Mirza:
Eighties, nineties. Because we can't all the way through, we cannot forget Ms. Jane Fonda.

Dr. Sophia:
Who's in her eighties. So yes, all the way through. Yes. Yes. Until next time. See you later. Bye. Bye.

This is general medical information, based on my professional opinion and experience. For specific medical advice, please refer to your physician. Until next time, embrace your body. Embrace yourself.