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Session 205: The Connection Between Menstrual Health & Mental Health

The Therapy for Black Girls Podcast is a weekly conversation with Dr. Joy Harden Bradford, a licensed Psychologist in Atlanta, Georgia, about all things mental health, personal development, and all the small decisions we can make to become the best possible versions of ourselves.

Do you remember the conversation you had with your parents, aunties, grandma or friends when you started your menstrual cycle? Whether you’ve realized it or not, the tone and content of that conversation has likely shaped your relationship to your cycle all these years later. To help us dig into how our menstrual cycles may impact our mental health, today I’m joined by Sara Flowers, DrPH, MPH. Dr. Flowers and I chatted about how our cycle changes throughout our lives, the ways that shame often shows up related to our cycles, the importance of having conversations with one another about how our bodies change throughout life, and she shared some great suggestions for how we can talk to the younger people in our lives differently about their cycles.

Do you remember the conversation you had with your parents, aunties, grandma or friends when you started your menstrual cycle? Whether you’ve realized it or not, the tone and content of that conversation has likely shaped your relationship to your cycle all these years later. To help us dig into how our menstrual cycles may impact our mental health, today I’m joined by Sara Flowers, DrPH, MPH. Dr. Flowers and I chatted about how our cycle changes throughout our lives, the ways that shame often shows up related to our cycles, the importance of having conversations with one another about how our bodies change throughout life, and she shared some great suggestions for how we can talk to the younger people in our lives differently about their cycles.

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Read Full Transcript

Session 205: The Connection Between Menstrual Health & Mental Health

Dr. Joy: Hey, y’all! Thanks so much for joining me for Session 205 of the Therapy for Black Girls podcast. We'll jump into the episode right after a word from our sponsors.

[SPONSORS’ MESSAGES]

Dr. Joy: Before we get into the episode, I want to share a very exciting announcement with y'all. The Therapy for Black Girls podcast has been nominated for a Webby Award for Best Health & Wellness podcast. We are thrilled to be recognized for such a cool award and we need your help. Right now, we're in second place so I would love for you to help us move up in the rankings by going to TherapyForBlackGirls.com/webby and casting your vote for us. Again, that website is TherapyForBlackGirls.com/webby. Thank you in advance for your support.

Do you remember the conversations you had with your parents, aunties, grandma or friends when you started your menstrual cycle? Whether you’ve realized it or not, the tone of that conversation has likely shaped your relationship to your cycle all these years later. To help us dig into how our menstrual cycles may impact our mental health, today I'm joined by Dr. Sara Flowers.

Dr. Flowers is the Vice President of Education at Planned Parenthood Federation of America. Her research focuses on fidelity and adaptation of sex education curricula, dismantling sexual and reproductive health disparities, serving youth of color, and strengthening abortion access. Dr. Flowers holds a Doctorate in Public Health from The Graduate School and University Center, CUNY, as well as a BA in Psychology and a Master of Public Health degree, both from The George Washington University.

Dr. Flowers and I chatted about how our cycle changes throughout our lives, the ways that shame often shows up related to our cycles, the importance of having conversations with one another about how our bodies change throughout life, and she shared some great suggestions for how we can talk to the younger people in our lives differently about their cycles. If there's something that resonates with you while enjoying our conversation, please share with us on social media using the hashtag #TBGinSession. Here's our conversation.

Dr. Joy: Thank you so much for joining us today, Dr. Flowers.

Dr. Flowers: Thank you so much for having me. I'm so thrilled to be a part of this conversation.

Dr. Joy: Yes, I'm very happy to have you here to talk all about menstrual health and how that impacts our mental health. And I think that this is a conversation that is often kind of overlooked, as I'm sure you are aware in a lot of your work, and so can you really just talk with us about like the life cycle of our menstrual cycles?

Dr. Flowers: When you were forming your question, I immediately in my brain went to the way that people with ovaries actually have all the eggs from the moment they're born. Which essentially means that like I was in my mother's, who was in my grandmother's, who was in my great grandmother's, like we are all connected. There's like a power there in your history and your ancestry.

And I know we're talking about menstrual health but like when you think about the connection between these systems and thinking about young people learning about their bodies changing, learning puberty, learning about the cycle and how it works, what it means for your potential for becoming pregnant, staying pregnant, parenthood, menopause, perimenopause... All of these stages just feels like there's so much to unpack and then also like a really basic thing is like thinking about the way the uterine lining sheds every 28 days. Which on some level is very clear and concise and on some level almost oversimplifies this really complex experience that people with uteruses have. So I feel like there's a lot to talk about and I don't want to go too far in any one direction.

Dr. Joy: Well, I think you bring up a really good point around context for being in our mothers and our grandmothers and all of those things. Because I think when you think about how those conversations happen around what's happening with our bodies, it is very much connected to how that conversation has been had maybe with our mothers and our grandmothers.

Dr. Flowers: That really resonates with me. Absolutely. And we could all tell stories about what we learned. I mean, I remember my mother talking to me about what to expect about a period and really thinking about, like how do you really explain to a kid blood is gonna come out of your vagina and that's a totally normal thing that's gonna happen to you. Like that's kind of a wild concept for a kid to wrap their brain around.

I'm 42, I have an eight-year-old child so I'm in like a lot of parenting circles and I hear friends talk about some people when they're parenting, they don't get a lot of privacy in the bathroom anymore. And so like what are the opportunities to normalize menstruation in the ways that we normalize bathing and other daily self-care and hygienic acts? I've heard mothers talk about needing to change their pads or their tampons in front of their young child because the young child would not give them a moment of privacy.

But there's almost this opportunity to normalize this as a function of our lives with all children if that's what your family’s boundaries do or don't permit. There's something to explore there and I think also the conversations. As a career sex educator, I've heard a lot of stories. I've heard people celebrate periods as this gateway to adulthood. I don't know if I'm dating myself, but I remember, I grew up in the ‘80s and ‘90s and when Rudy got her period on The Cosby Show

Dr. Joy: That’s the first thing I thought about when you said that.

Dr. Flowers: Do you remember that? Yes, so I remember that but there's other stories that have happened in pop culture and how we frame it can shape our sense of normalcy. I got my period pretty young and didn't tell my friends. Two years later, my friends were talking about getting their period. One friend turned to me and said “What about you, Sarah?” And I said, oh, I got my period in fourth grade. And they were like, “What? And you didn't tell us?” But like no one was talking about it in fourth grade. I was horrified as a kid, terrified maybe isn't the right word.

Dr. Joy: It wasn’t a conversation you were excited to have.

Dr. Flowers: Absolutely not. A sidebar, Dr. Joy, is my mother finds it hilarious that this is my career of choice because, at the time, I was not talking about these things. Absolutely.

Dr. Joy: But you know, you bring up a really interesting point because I'm trying to remember like, what conversation I had with my mom around my cycle. I feel like I remember it starting, I don't remember, I feel like I was maybe 12 or 13. Then I feel like it was maybe a book she gave me and a conversation about like how to use a sanitary napkin and those kinds of things. But there definitely wasn't this like period party and make a big deal of it. You know, it wasn't this ceremonial thing and I think seeing it on The Cosby Show was my first time ever seeing a different context for how to have a different kind of conversation around starting your cycle.

Dr. Flowers: Right! No, it's absolutely right and the context is what shapes this experience for us. I don't know about you but I didn't have older siblings.

Dr. Joy: Neither did I.

Dr. Flowers: All the people where I see they had older siblings, they had seen it before. It wasn't brand new. I was the elder child and I have a younger brother. I'm a very straight shooter and I'm not trying to speak ill of my father but when you are young and get your period, the way that you're trained every 28 days–that's not the way adolescent bodies work. Your body's figuring it out. It's like a car sputtering to life so it may be that you get your period and then you don't get it for a long time. It's not 28 days in the beginning and maybe you're a person who doesn't ever have a regular period.

But I remember as a kid, maybe I was in early junior high or late elementary school, and I had gotten my period. My dad was the only person home and I called for him through the bathroom door because there were no pads in the bathroom. Then we could ask ourselves why there were no pads in the bathroom but we'll unpack that later. There were no pads in the bathroom and my dad fussed and he was frustrated that I was asking him to go to the store. And I remember his voice saying, “Don't y’all know when this is happening?” And me feeling like, was I supposed to have known? Is there some guidebook that I didn't get? Like I remember sitting in the bathroom waiting for him to come back from the store and feeling confused.

And really like how do we normalize “bodies do what bodies do” and how do we set folks up for success? How do we help young folks today know what the tools are, as you talked about, know how to use the pads or the tampons or the cup or wearable, the free flow underwear, knowing that's available to them? And knowing when this happens, wherever you are, you have these tools at your disposal so you're not left out there. Or knowing who you could go to. Like I remember in junior high going to the nurse. They had these awful pads, they were super thick, you didn't want to do that in junior high and yet you were sort of stuck if you ran out of something. And you eventually got to a place where asking a friend was embarrassing, it became normalized. I remember walking to the bathroom with a tampon in my sleeve because we didn't want the boys to see–what was that?

Dr. Joy: What was that about? Dr. Flowers, I think that this is a really interesting thing to maybe explore too, and I'm guessing that a lot of it does come from the messages that we got around our cycles from the adults in our lives. But what was the need to like hide it and pretend as if we didn't have a tampon or a napkin in our hands, as opposed to this is a very natural thing? And has some of that changed? Like from our experiences as young people to young people's experiences now.

Dr. Flowers: I want to say I hope so. For example, our experiences–when I think back to the education that I received, it was definitely they made gendered-based decisions and what we know in sex education is actually inclusive education benefits everyone. So we want everyone to learn about how bodies change, all bodies. It's really valuable to understand that people with uteruses have periods, this is a normal thing and they affect different people differently. There is much more inclusive conversation around bodies and body changing today in the field and the field continues to evolve, and so I'm hoping that we continue to see more inclusivity.

But I think, to folks who are having these conversations at home, to people who are parenting or other caring adults, I think there's a real value to thinking about how we want to (in our own modeling and conversations with young people) model the normalizing of bodily functions. The normalizing of periods, the normalizing of erections also in puberty. That these are things that bodies do. In the same way that we normalize flatulence and gas, this is a normal body thing. We have ways that we are respectful of boundaries, but these are normal parts of the way our bodies function.

Dr. Joy: Yeah, the other piece of the conversation is that I think that there's a lot around the physical symptoms that you get associated with your cycle. So cramps and maybe the moodiness and something like that. There isn't a lot of conversation around these things that we now know. Of course I think there has been these rumblings of PMS for a while, but PMDD (I think) is something that is still getting attention. Can you say a little bit more about like how that changes throughout our lives?

Dr. Flowers: I think that there's a real opportunity to also understand if the theme is going to be similar. That the hormone levels are fluctuating, that's how menstruation happens in the first place, and the impact and the experiences that people have on their emotions are real and not imagined. And that whole notion, that age-old notion of hysteria which was linked to the uterus, the hystera part (that part of the root of the word) is really stigmatizing the natural bodily functions of people with uteruses. And so I think that in this conversation around premenstrual syndrome, PMS, or premenstrual dysphoric disorder... I think recognizing and acknowledging the ways that these are normal happenings for people's bodies and that finding support to identify and manage these experiences and symptoms is important.

And if I may just share in an opportunity to just sort of be open, I myself am diagnosed with premenstrual dysphoric disorder. And my personal experience is that I was able to clock the mood changes and eventually see a pattern with my menstrual cycle, but initially I thought I was just tired, I was irritable and I wasn't sleeping well. And it was only with my physician (I had gone to her, my gynecologist) and she asked a lot of really important questions and saw the pattern and said, “You need a little extra serotonin at this point in your cycle,” and prescribed Prozac for days 14 through 28 for me. And it made a world of difference and I didn't know that was an option or a tool that I could have in my toolbox.

And I think that recognizing that these are normal parts of our experience and that our bodies are not going to be like a flatline through our lifespan. So for me, I had three miscarriages before I had the pregnancy that my daughter was born of and the hormonal changes in my body affected and changed so that I don't think I was someone who was experiencing PMDD prior to my pregnancies. And so I'm curious, I don't know this, but I'd be curious to just raise awareness for folks so they could ask their own clinicians. What changes did you see as a result of whatever your body has experienced? And how have those changes and your needs for support maybe evolved or changed? What other new different support might you need, based on what you've been through?

Dr. Joy: This is really interesting, Dr. Flowers, because I do think (to your point) there are so many changes that happen in our bodies and it feels like there is a lot of attention if you know that something is going on like related to having a uterus. But if you don't know that's what it's connected to, you might just think, oh, I'm really tired or I'm burned out or something else is going on. It is the kind of thing where you only really see your OB/GYN if you are expecting or your yearly exam, but it's not somebody that we're kind of seeing like all the time so I think there's a lot of opportunity for things to be missed.

Dr. Flowers: I think that's absolutely right and I think also legitimizing that it's not just in your head. We know our bodies, we know what feels good and right or if you feel a little off. And so I'm not suggesting that you should go to Dr. Google with every single ailment because bodies are complex, but I do think, for example, use birth control and period tracker apps like Spot On because maybe you'll see a correlation and a pattern in the ways that your feelings and your hormonal changes. That may help. I've heard stories of people going to their clinician with the data from their period tracker app and from the birth control tracker app and saying “this is what I see,” and they were able to use those data to help get more support and get some insights for how their body was functioning.

Dr. Joy: Mm hmm. You know, it's kind of interesting, Dr. Flowers. It feels like we're seeing that happen in real time right now as more people are sharing about their experiences of their cycles after getting the COVID-19 vaccine. So it sounds like there's more information coming out around how people's cycles are changing after they’ve had either one or two doses of the vaccination.

Dr. Flowers: Mm hmm, and we'll continue to get data in terms of COVID-19 and also the vaccine. We feel good about the science and where it's gotten us and we're also still learning.

Dr. Joy: To your point around keeping track of that data. Those are the kinds of things that you want to be paying attention to.

Dr. Flowers: You can actually write that down. So I think there's real opportunities for us to hold that information about ourselves.

Dr. Joy: Mm hmm, yeah. More from my conversation with Dr. Flowers right after the break.

[BREAK]

Dr. Joy: From the point at which there's this anxiety around getting your first cycle to “now what does this mean” and all the changes that kind of go throughout your body, and then there's a point of “is this my last cycle?” So the other part of the spectrum that we don't hear much about is menopause. Can you talk a little bit about like those kinds of changes and what kinds of questions I think people should be looking into there or pieces of that puzzle that we often miss?

Dr. Flowers: Yes. At Planned Parenthood, we're really talking about how we can evolve into being a sex educator through the lifespan because our sexual self doesn't sort of like kick on in our late teen years and kick off after our childbearing years. That's not it. This is an inherent part of our humanity and our sexual and reproductive health system is interwoven into the rest of us. And so how it evolves and changes and really understanding and sort of pulling back the curtain on the perimenopausal and menopausal experience... Helping people to understand that in the same way it was like a slow ramp up like I described it earlier (and I don't know if this is a good analogy or not, but I guess we'll stick with it), it's like a car sputtering to life. It also doesn't just turn off on a dime.

And so one of the things, I think for example people may not realize, is that actually, folks are not officially in menopause until they miss their period for 12 months. And so you may miss your period for 11 months and then you get your period and you restart the clock, and so that takes a while because the body is changing gears essentially. And I think thinking about all of the other changes, mental health changes, the ways that your libido may be different, the way that your body may have self-lubricated may change. It’s like all of these opportunities to really be mindful and to seek support. Keep these conversations open, referring to either your clinician or others who've been through it. A lot of resources but I think keeping the lines of communication open is really key and also going to experts who are really available to help shed some light on these new experiences.

Dr. Joy: Yeah, that is really important. I think that's why it's important to have these conversations, like we had a blog post recently about menopause. I think it is one of those things again where you may not necessarily be having these conversations with your girlfriends. Are you talking with your moms and your aunts about these kinds of things?

Dr. Flowers: Absolutely, and I think there's that piece. Like we can be the conversation starters, we can open that door is one piece. And I think the other piece is to acknowledge the complexity of our lives and all these different stages of life–through adolescence, through your young adult years, (if you choose to parent) through your parenting years, through your middle and later adulthood. There's all of these stressors. You may be a caregiver to your own parents, to a sibling, to your own children, to your spouse or partner. The stresses of life impact the way our bodies function and so not discounting but again taking note of all of the different things that impact us.

And trying to remember that our bodies don't operate in a vacuum. So thinking about, okay, what about like are doctors talking about your menstrual cycle and maybe your libido after cancer treatment? Or how are you coping after a recent separation from a partner or some other stressor? Like we've talked a lot in my career about folks really navigating life, dating life, libido during COVID. Some people are single, some people have been quarantined or physical distancing at home with their partner and you and that partner or partners may have really different responses to this experience. So recognizing that there's a lot of elements at play to what your experience may be and how you sort of feel through it, if that makes sense.

Dr. Joy: Mm hmm. I'm curious, Dr. Flowers, to hear your thoughts as things may be opening back up once people are more vaccinated and those kinds of things. What kinds of changes do you anticipate, just in terms of sexual health and reproductive health?

Dr. Flowers: I think one thing that we've learned this year is we really want folks to still maintain their preventive care. That means cancer screenings, we don't want to put those off because of the pandemic. Physicians’ offices and clinicians have really been able to put protective measures in place to allow people to continue to get the care they need. We want folks to continue to be testing for STIs and seeking care. We've really ramped up in the telehealth space and so access to care, including Therapy for Black Girls, frankly, as a platform, really has allowed folks to get the care that they need.

As I mentioned to you when we were doing our introductions, I'm not only a fan, but I'm also sort of a client. I found my own therapist from Therapy for Black Girls so like I really see the ways that we have this opportunity in this moment to lean into. It’s almost like there's some little silver linings of this pandemic and telehealth and accessing care online has allowed us to really continue that. We didn't have to put that on pause.

Dr. Joy: Mm hmm, yes, very good point. I would love to hear about how telehealth has advanced because it feels like there would be some stuff that would be difficult to do virtually. What kinds of services still can be offered?

Dr. Flowers: I would say there's other people who are much more expert in the telehealth space than I, but I think that really naming that you can, as I understand it... Maybe this is anecdotal but like most mental health care or mental health regular therapy appointment is available via a secure Zoom-like platform. I got a pandemic pup and the vet texted me. So like this opportunity to ask questions, have your questions answered and for folks to be available to you, seems to have increased a lot this year.

I do think we want to be clear that there are some in-person care modules like mammograms for example or colon cancer screenings that obviously have to be in person but the distancing practices on the clinicians’ side are in place. And I think for STI testing, you can reach out to Planned Parenthood and go on a Planned Parenthood website and certainly a local Planned Parenthood health center could help you get a sense of what's available to you, and whether or not that's available via telehealth or if it requires an in-person visit.

Dr. Joy: Got it, okay. So I want to back up a little bit when we think about like the life cycle of people who have periods. There does seem to be this rapid switch between when you first get your cycle of “don't get pregnant” to the other side of it is “when are you gonna give me some grandkids” kind of thing, right? And so I think that there's something to be discussed around how rapidly the message switches but also the difficulty that people find themselves in when they are struggling to conceive.

Dr. Flowers: There are so many points to that question, I'm trying to figure out how to narrow it in. The conversation around going from, okay, a young person can get their period and now one of the things that this means is that this person is capable of getting pregnant (or that’s what their body's telling them) is an important message. And what are the other important messages? It's not the only message that we want to be saying to young people about this stage of their lives. Like what are the other dreams that we have for young people when we think about them becoming sexually active at some point in their lives?

In the ways that we want to normalize periods, is there also a way to normalize a healthy sort of sexual maturity, if that makes sense? Like this is a thing that adults are going to do. Young people are going to become sexually active at some point so what's the ways that we frame the conversation altogether as like this is a normal, healthy way that we are developing into adulthood? Many years ago, there was something called the European Study Tour that our colleagues at Advocates for Youth and other sex education groups across the country worked to do and they took teachers and parents and teams from this country and went and did a tour.

If memory serves, they did a tour across a few European countries asking about sexual health and sexual education and young people becoming sexually active. And the theme that this American group learned was that our European peers saw becoming sexually active as a normal part of growing up. That it wasn't stigmatized as “don't ever do that” or “now just start doing it and give me grandkids.” Like it wasn't this flip. It was a recognition that this is a normal, developmentally appropriate growth trajectory and that with that developmentally appropriate runway comes responsibility.

Essentially, young people were being raised that when you become sexually active, you do so in a way where you use barrier methods to avoid pregnancy and STI, you use condoms (and at this time, I don't know if we had internal condoms). But if we were to evolve the conversation, the notion would be using methods to prevent STI transmission and pregnancy so that you can engage responsibly and hopefully in a way that both parties are experiencing pleasure.

And so recognizing that this is a complex conversation and that we have the opportunity to frame it in a way that we frame other (dare I say) rites of passage in growing up. These are elements of growing up, hopefully in a consensual experience. And I think to your other point around really acknowledging that how do we responsibly explain to people how pregnancy happens and help people also understand fertility varies and changes? And that the experience, again, is not going to be a one-size-fits-all experience. And to help people feel set up for success, about how to understand their fertility, how to understand ways to seek support if they're trying to get pregnant and they're not having success.

I'll weave into my own personal story if that's okay. I mentioned I had three pregnancies before I was pregnant with my daughter and I being someone who spent her whole career working in sexual reproductive health, when I had my first miscarriage, I really approached it in a really like distant way. I said to myself this is normal. Miscarriages happen to some whatever high percentage of pregnant people. And maybe I knew too much, frankly, because I don't think that I attached the emotional toll that it took on me.

But I think that like how do we help people to understand that miscarriage is normal and also understand that you still need support through it? How do we help people to know...? You know, when I had my experience, I didn't tell people. It was just me and my husband. I didn't seek support until I felt comfortable doing so, and I made the conscious decision after the fact to be more vocal because people were commenting to me publicly about when we were going to start a family (and that's painful and intrusive, to be perfectly honest). So also this opportunity, I saw it and continue to see it as I have an opportunity to help other people know that they're not alone.

I remember walking around having experienced these miscarriages and I felt like pregnant people were dropping out of the trees, you know what I mean? Like it felt like they were everywhere and that's all I wanted and my body was not... I wasn't able to do it. I finally got the support I needed to stay pregnant. I felt very alone and I sort of tell my story so that others will know they're not alone and that people are going through this. And I remember walking around feeling like everybody else just like looked at their partner and not only got pregnant but stayed pregnant.

And so I think another theme is this communication and this opportunity to really normalize all of these conversations because what you and I have been talking about is there's so much stigma in these normal experiences. Like I needed medical intervention, I had a blood clotting disorder that caused my miscarriages. But by normalizing it, by bringing these words out of the shadows and into the light, how I can help someone else not feel alone. Or someone else knows to ask their doctor to have their blood tested for thrombophilia. Like, those were things I didn't know to do. And so how do we bring that out to normalize it?

I mentioned that I started therapy and I normalize talking about it in front of my child. I have therapy at 10:15, I can't be disturbed. I say to my husband “can you make sure that everybody stays upstairs so that I can have privacy?” And I explain to my child this is what I'm working on, I'm working with this doctor because I want to work on these things. And so how do we bring all of these conversations–menstruation and these other pieces and whether you’re experiencing PMS, PMDD? How do we bring them into the light so that all of these experiences we're having are seen as parts of our human experience so that we don't feel alone?

Dr. Joy: Yes. More from my conversation with Dr. Flowers right after the break.

[BREAK]

Dr. Joy: I wonder if we can go back to our earlier conversation and maybe have you share, Dr. Flowers, some tips for people who are talking to younger people in their lives about like how to change some of this messaging. I mean, I think you've given us some, but I'd love to hear if there are other tips you can have for how we can really normalize this, especially for young people, so they don't grow up with the same hang ups and thinking that it's not okay to talk about this stuff.

Dr. Flowers: Absolutely. One of the things that we want from a psychoeducation perspective, we want parents and trusted adults to understand is the adults in the family are really the first people who are shaping these messages. We know our young people are watching us. We know if you've slipped up, you know that three-year-old says that curse word, exactly the same intonation, exactly the right way, you know what I mean? Used it in exactly the right context. And so we know they're listening, we know they're watching and so what are the ways that we're normalizing these bodily functions?

Is it that you're comfortable changing your pad and explaining to the kids? That may be beyond the boundaries of some folks but knowing that some folks do that may make a different adult feel like, oh, I never considered that. I always thought I should hide it, maybe I should question that and that approach. Or even just talking about it. Or when you're buying your tampons or your pads in the grocery store–as a kid, I used to want to hide it on the conveyor belt. What are those small things we can do to make this normal?

Another story I remember is I did a study abroad as a sophomore in high school. I lived with this family for three weeks and it probably wasn't until I got home that I realized every night at the dinner table, the mom and the eldest teenage daughter took their pills at the same time. I didn't know what they were doing. Why had it seemed that I did not know that that's what they were doing? But to the family, that was a normal piece of their dinner routine. And I remember the mother saying in French to the other teenager who was my age, I think she said, “Donne-moi ma pilule,” which is like give me the pills. And they were in a cabinet behind that person’s seat and she gave them to the mom and to the older sister. And that was a way that this family normalized this part of their self-care. And so what are ways in your family that you could normalize these bodily functions?

And I think you also have to understand that everybody's comfort level is going to be different–my dad would not have been comfortable with me talking about bodily fluids at the dinner table. But I think the way that I'm choosing to raise my child is different and how do we normalize this while also thinking about your own family's boundaries? So I think we, as the adults, have an opportunity to consider what do we want to take with us from the way we were raised and what do we want to maybe forge a new path?

Dr. Joy: And do you have any suggestions for resources, Dr. Flowers, that you really enjoy that might help continue these conversations? Things that people find really useful?

Dr. Flowers: Absolutely. I think there's a lot of resources on PlannedParenthood.org. If people need sexual & reproductive health care, you can certainly find your nearest Planned Parenthood Health Center on our website. You can follow us on Instagram at @PlannedParenthood. And also, we have a series of videos that are available for young people, for teens, but we also have a series for parents and for caregivers around how to have some of these tough conversations or these opportunities for teachable moments. I think there's a lot of resources that are available online.

Another resource that I’d offer is we have colleague organizations that created a series called Amaze and Amaze Jr. which is a video series also available on YouTube, which is sex education for the younger set so it's developmentally appropriate for the elementary school-aged young people. And so there's really a plethora of resources available. As well as many, many sex educators that I could name–Dr. Lexx...

Dr. Joy: Brown-James?

Dr. Flowers: Yes. You know Dr. Lexx, yes.

Dr. Joy: Yeah, she’s been on the podcast several times.

Dr. Flowers: Excellent. So Dr. Lexx is one, Afro Psychology?? *[inaudible 0:40:30] is another, there’s a lot of resources. Sex Positive Families. There's a lot of resources, depending on who you are and what you're looking for, that's available to you online.

Dr. Joy: Perfect. I appreciate that. And is there anything that we haven't covered today, Dr. Flowers, that you're like, oh, I'd be so sad if we didn't talk about this.

Dr. Flowers: I think we covered so many things. I just really appreciate the opportunity to be here to have this conversation with you. And certainly, if folks want to be able to use an app like Spot On to track their own cycle and their own birth control, that's another resource that's available.

Dr. Joy: Perfect, perfect. And Dr. Flowers, is there an age where you can start accessing services from Planned Parenthood?

Dr. Flowers: I think there may be different inclusion or exclusion criteria, not a specific age. So I think if there were a need, I would contact your local health center, explain that need. And certainly, we offer not only sexual reproductive health care, but obviously also sex education. Which again we mentioned is through the lifespan. So depending on what your local Planned Parenthood affiliate offers, I think the best thing to do would be to ask for what it is that you're looking for and we will connect you with the right resources.

Dr. Joy: Perfect. And do you have any personal social media handles you'd like to share outside of the Planned Parenthood one?

Dr. Flowers: I actually keep my social media personal. That's one of my boundaries and self-care pieces but you can definitely find me on PlannedParenthood.org

Dr. Joy: Not a problem. Well, thank you so much for that, Dr. Flowers. I appreciate you chatting with me today.

Dr. Flowers: Thank you so much, Dr. Joy. I appreciate this time.

Dr. Joy: I'm so glad Dr. Flowers was able to share her expertise with us today. To learn more about the resources that she shared, visit the show notes at TherapyForBlackGirls.com/session 205. And don't forget to share this episode with two of your girls right now.

If you're looking for a therapist in your area, be sure to check out our therapist directory at TherapyForBlackGirls.com/directory. And if you want to continue digging into this topic or just be in community with other sisters, come on over and join us in the Sister Circle. It's our cozy corner of the internet designed just for black women. You can join us at Community.TherapyFor BlackGirls.com. Thank y’all so much for joining me again this week. I look forward to continuing this conversation with you all real soon. Take good care.