Welcome back to another episode of MedCity FemFwd, a podcast dedicated to exploring the breakthroughs and challenges in women’s health. In this episode, we’re joined by Dr. Cathleen Brown, medical director of menopause company Winona.
We discuss the company’s new Winona Research Initiative, which seeks to fund and support menopause and women’s health research.
Here is an AI-generated transcript of the episode:
Marissa Plescia: Welcome back to MedCity FemFwd. I’m Marissa Plescia, reporter for MedCity News. In this episode, we’re joined by Dr. Cathleen Brown, medical director at Winona, a telehealth company for menopause. We discuss the company’s new initiative that aims to expand research for menopause and women’s health.
Hi, Dr. Brown. Thanks so much for joining MedCity FemFwd. Thank you so much for having me. I, I love having these conversations, so it’s nice to be invited on. Yeah, absolutely. Maybe just to start, can you tell me a little bit about yourself and what brought you to Winona? Sure, sure. So I am a board-certified OBGYN who’s been practicing, um, since I graduated residency in 2008.
Dr. Cathleen Brown: Um, and, um, what brought me to Winona was that I started going through my own struggles in midlife and, and dealing with symptoms of perimenopause. And I was actually approached when Winona was looking to expand. Um, when they first started out during COVID, um, that’s when we were born, you know, in the age of telemedicine.
We realized that in a global pandemic, that was one of the best things that came out of that, was knowing that we could improve access to care for patients through telemedicine when it wasn’t safe to go into offices. And there was a real gap in care being provided to women in midlife. And so they started in California and Texas, and then when they were looking to expand to Pennsylvania, um, they reached out to me, uh, because our chief medical officer and I both worked for the same company providing, like, OB laborist, um, backup to hospitals.
Um, and so at the same time I was also doing a deep dive and really trying to find better care for myself ’cause I was going through so many symptoms and being told I was too young, and being told that, you know, it wasn’t time yet. I needed to wait till I was suffering more before I got treatment. Um, and so I, you know, as an OBGYN, many of us, and any doctor really, you know, we don’t get a lot of training in our medical school years or even in residency.
So much of the focus is placed on fertility and pregnancy and, you know, period management and, and, you know, treatment of other GYN disorders. But there wasn’t a lot of emphasis placed on taking care of women in midlife and beyond, um, which is where we spend the bulk of our, our years as women. So I was really excited to join the workforce to help take care of patients, but also, um, you know, I had a vested interest because I was one of those patients as well, you know, also going through a lot of the symptoms.
Marissa Plescia: Yeah. Thank you so much for sharing that. Um, and I think that flows great into what we’re talking about today, which is the Winona Research Institute, which you just launched. Um, can you just talk a little bit about what this is and why you launched it? Yes. Yeah. So, you know, in women’s health, you know, globally this has been an ongoing issue, is that not a lot of emphasis and time or money is spent putting money into helping making women’s lives better.
Dr. Cathleen Brown: Even birth control pills, you know, the research done on birth control pills wasn’t actually, you know, used and researched on women themselves because so many researchers and scientists felt like the women’s hormones were too variable and throughout the different times of the month, that there were too many co-founding variables.
And so for a long time, women weren’t even included in research trials. Um, and this, you know, has been a pervasive thing in medical research for decades, for years. And now we’re, we’re really seeing that there’s a need and there’s a huge gap in getting the information that we need to reliably be able to take care of patients safely.
And so because of that gap, you know, Winota feels really strongly. Like, like one of our real, you know, founding, um, you know, tenets that we like to do is, like, really to provide a lot of education. You know, even if the patients aren’t our patients, we wanna help spread knowledge and information so that women can be empowered to take care, better care of themselves.
And we really feel like the resurs- research initiative really goes along with that too because we feel like it’s our duty to kinda help to contribute to research that could improve women’s lives and, and, um, improve women’s health, um, overall so that we can get the information we need. And, and this is not something that’s just unique to us.
Um, you know, there have been research dollars just recently donated to the Menopause Society as well to try to improve women’s health research as well. So, you know, there’s a, um, a, a recognized gap, um, as far as the information that we need, and there’s so much more research that needs to be done so that we can continue to enhance the lives of women as they go forward into midlife and beyond.
So, um, that’s really why. We, we really wanna help, you know, fund research projects that can help make lives better for women. Yeah. So well said. So what’s your, um, process for selecting scholars, and what kind of support do they get? Yeah. So right now in the early phases of this research initiative, we’re looking for, for scholars, whether they be medical students, residents, or even early career physicians who maybe already have a project in mind, have already started, but just need money to kinda help get the process going so that they can get their research, you know, presented at a, um, you know, a meeting especially.
You know, because that’s really when the data really, you know, helps make change in healthcare is when you take research and you present it to other doctors. It’s peer reviewed, um, and then we can determine whether or not, you know, the research is quality and also can help to change practice is really the goal.
Um, so we’re looking for people that already have a project in mind or have a, a goal of what they wanna study, um, and they’re just looking for, you know, someone to help back them to kinda help make that process happen. Um, and so that’s, that’s really our goal. And so, you know, patie- uh, not patients, um, the scholars that are, that are interested basically submit their information, submit their, their theories on the project, their, you know, the hypothesis that they’re working on for their research project, and those are reviewed, um, on a rolling basis.
And so the goal is to try to get a few scholars every few months that we can be actively mentoring, um, and help them with, um, you know, finishing their project and getting it presented at a, at a scientific meeting. And how is this all funded? Well, it’s funded from, from our Winona company. So, you know, basically, you know, we’ve set aside, um, a, a core amount of dollars that, you know, that we’re starting this project with.
Um, and so it’s, it’s really from the profits of the company. Um, and so… And that may change and morph over time depending on what our outcome is from this research initiative. You know, the goal would be, you know, to help improve the dialogue of more people wanting to do women’s health research. Um, and we would love to be able to contribute to some really meaningful menopause related research.
But for right now, we’re not narrowing that to just menopause related care. It’s really anybody trying to do a project to further women’s health, because we feel like that’s important globally is to improve women’s healthcare. Yeah, absolutely. Um, earlier you, you talked a little bit about your experience when you were a medical student about, um, how little training you received on issues like menopause and other women’s health issues.
Marissa Plescia: Can you just talk a little bit more about that and- Yeah, absolutely … how you hope something like this changes that? Yeah, absolutely. So in medical school, for those that don’t know someone who’s gone through it, you know, the first two years of medical school are didactic and are in the classroom, and the second two years are clinical, where each month we’re basically doing clinical rotations in a different subtopic of medicine.
Dr. Cathleen Brown: So one month you do cardiology, the next month you do pulmonology, family medicine. So in those first two years, you know, we have a core OBGYN lecture, um, you know, which is several months long, and they have to cover everything that there is to know about OBGYN in that timeframe. And so I think maybe we got one hour or two about menopause and after.
Um, a lot of the other things, you know, the other time was spent on learning the menstrual cycle, learning medications, you know, ’cause we have to learn the pharmacology, we have to learn the physiology, the anatomy. All of those things when you’re learning each system. Um, and then in, in residency, so when you become an OBGYN resident, um, that’s to be able to be a board-certified OBGYN after you sit for your board exams after your training.
The residency for OBGYN is four years. So much of that, especially in the early years of your residency training, is spent on obstetrics and fertility and, like, menstrual management, contraception, um, dealing, you know, helping patients deal with heavy periods or, you know, anatomic issues like fibroids, endometriosis, things like that.
And I remember, you know, certainly getting maybe a couple hours about menopause care. And when we were in residency training, every year we had to take in-service exams, which is when the program that’s training you really can see, you know, if their training program is giving you the adequate knowledge that you need in order to be a board-certified OBGYN at the end.
So you take this yearly exam. And so I remember our, our attendings teaching us, you know, “Oh, well, you need to learn this stuff about HRT for your shelf exam, you know, for your in-service exam, but you’re never gonna use this.” Because when I was training, it was right on the cusp, on the heels of the Women’s Health Initiative study being out in the media, and that really caused a global widespread fear of hormone therapy, and reflexively caused a lot of doctors to take all their patients off hormones because everyone was so deathly afraid of, you know, hormone therapy causing breast cancer, causing heart problems.
Um, and we’ve learned so much from the Women’s Health Initiative study. We learned good and bad. But what was really bad was back then they took that research study and it rolled through the media, big headlines, and it caused this widespread panic that has been pervasive ever since. And it’s still to this day that, you know, the outcomes and the stigma of HRT from that study that was on the news has really caused a lot of women and a lot of physicians to be very afraid of, you know, learning more about this treatment option and offering it to their patients.
So, I mean, we’re at the point now where the tide is changing and women are demanding better. Especially women like me who are female OBGYNs going through it themselves are demanding better care for patients, and women are speaking up. They’re being those squeaky wheels demanding better care. And so I think what’s gonna happen is it’s gonna drive that education process better And we hope that the pendulum’s gonna swing so that more menopause related care is in- infused into the curriculum of doctors moving forward.
I mean, ultimately, if doctors don’t get on board and then they have a large proportion of their patients that are females 40 or older, if they’re not comfortable with managing menopause and they’re not comfortable with discussing hormone therapy, the patients are gonna go elsewhere, right? So the patients a- as consumers are really gonna drive, I think, this education change.
Um, but also it takes, you know, research funding, it takes dollars to kinda help get curriculums changed and to provide the support to medical schools and residencies so that they can infuse this into the curriculum better so that, you know, future OBGYNs that are, that are graduating and future family medicine doctors and internal medicine will get more experience and more of a comfort level, um, with treating patients that are going through perimenopause and menopause.
And, and that’s really the goal, um, because it’s been, it’s been too far and far and few between that, you know, doctors feel comfortable with this. You know, you really have to have the experience to feel comfortable. Yeah. So well said. We actually, um, talked a lot about that study and, um, HRT and how that’s changing in our last episode, so thank you for bringing that up.
Marissa Plescia: Oh, great. Yeah. That’s great. Yeah. Um, well, going off of that, you also re- recently released a new report, um, on the state of menopause today. What were some of the key findings of that report? Yeah. I mean, so we really have a nice, um, you know, data bank of patients. We’ve been, we’ve been in practice at Winona since 2021, and so we felt like it was important for us to release some of the information that we have learned through taking care of thousands of patients through the Winona platform.
Dr. Cathleen Brown: And what we’ve really found that, you know, by the time women get to us, they’ve gone to several different doctors before they get the help that they need, and that’s kind of universal, that a lot of women are, are getting that closed door. They’re getting the no. They’re being told it’s a natural process, that they need to suffer.
Um, the other thing that we’re noticing, and that we put in that white paper too, is that women that are seeking care are reporting an average of, like, nine or more symptoms at once. It’s not just, you know, simple hot flashes and night sweats. This is multifactorial. So many things that are affecting women’s lives, so specifically, like energy loss, weight gain, fatigue.
Brain fog is a big one. A lot of women are starting to notice the effects of hormonal changes on their day-to-day schedule, their work life, um, their home life, their relationships. And one of the biggest problems I see in all my patients is sleep issues especially. Um, and, and most women, it takes them a while to seek the care that they need, so a lot of women were dealing with symptoms for at least a year before they found the care that they need.
And a lot of women describe, like, one to three years of suffering through symptoms before they find somebody who’s willing to help them. Um, so those are some of the big things that we found when we looked at our, our database of patients. Um, and, um, also, you know, for women that, you know, have had prior hormone therapy, they can sometimes have symptoms for a longer duration and have, you know, an overall burden.
So some women experience all the changes and symptoms of perimenopause and menopause much longer than others. Um, and so we’re seeing those kind of patterns, and we wanted to share this information with other people out there, and we wanted especially to share it with patients. So, you know, it’s available for everyone to read, um, so that they can kinda learn where they kinda fit into that overall, um, you know, spectrum of patients too.
Marissa Plescia: Yeah. Thank you for sharing those findings. Um, and just one last question for you. Based on some of those findings, what more do you wanna see, um, in the industry to improve menopause care? I really want, I mean, at a baseline, even if healthcare providers, doctors, nurse practitioners, PAs don’t feel comfortable with menopause care, like even if they don’t have the experience managing hormone therapy, I just want people to be open to having the conversation.
Dr. Cathleen Brown: I want people to listen to women. I mean, I think that’s the most important thing. Um, and unfortunately, there’s some systemic issues in our healthcare system too that limit the ability of a doctor or another type of healthcare practitioner to really spend quality time with their patients. But I also want more of the in-person doctors and, you know, medical systems to be open to allowing the infusion of telemedicine as a, as a way to kinda help balance the in-person care too.
So, you know, we have the luxury of being able to spend a little bit more time per patient than those like 10, 20-minute visits when you’re kinda rolling through and trying to get your insurance reimbursement. Um, and so really I think that telemedicine can be very complementary to in-person care. Um, but also I think it’s important for women to recognize that telemedicine cannot replace your in-person care.
You have to do both, ’cause we can’t examine you through the computer. That’s just impossible. You still need your well-woman care. You still need breast exams, pelvic exams, Pap smears if you still have a cervix. So I think those are the important things that I want people to learn, is that, yes, telemedicine can help, but you need both.
And I just want more people to have the conversation and women to have more access. Access to care is really the biggest piece of this. Yeah. So well said there. Well, Dr. Brown, um, this has been such an interesting conversation. Thank you so much for joining MedCity Come Forward. Well, thank you so much for having me.
It was great having this conversation
