Franziska Haydanek: Have you ever asked yourself, why don't we know more about women's bodies? As a woman and as a physician who takes care of women, I ask myself this every single day. It really feels for the most part that women's bodies have been an afterthought in medicine. Don't forget, it wasn't that long ago that we were completely excluded from clinical trials. When I think about the conditions that I treat daily PMOS, endometriosis, adenomyiosis, perimenopause, every single complication of pregnancy, my complaint is always the same. There's not been enough research. In the reasons for these diseases, the solutions for these diseases, and any sort of management that I can offer to these patients. I even discussed this recently in the episode with my sister, where I was talking about people putting money into women's research and asking, where is Melinda Gates? Well, it turns out she's been here all along. Melinda French Gates is the world's largest funder of women's health research. Starting in the early 2000s with the Gates Foundation, she contributed millions of dollars to the general health and understanding worldwide. She pushed heavily for funding for maternal health, contraceptive access, vaccine access, and reproductive health in low-income countries. In 2015, she launched Pivotal Ventures, which, unlike the Gates Foundation, which had the greater global idea in mind, was solely for women's health. In that time frame, she's donated millions, millions of dollars to women's health, focusing on all aspects of the health of a woman, not just the things I had mentioned, but the larger picture, cardiovascular health, brain health. Mental health, autoimmune disease, and female-specific pathology as well. As a physician, I am frustrated every single day that I can't give my patients more. I am limited by the current science and medicine. I can't tell my patients why they have PMOS. I also don't have a single medication created just for PMOS. I can't explain to my patients why their hearts are doing what they're doing in perimenopause. I don't have a cure for PMDD. Just last week a patient told me once a month I want to off myself and I wish I had a solution. And I wish I had one for her. But the money previously wasn't there to put into research so that we understood why do our bodies do this and what can we do to help. Several weeks ago, Melinda Gates' team reached out to me and said, Hey Dr. Fran, Melinda's about to announce that she's going to donate even more to women's health research, and we'd love for you to have a chat with her. You want me. To talk to the woman who's donated more money towards women's health research than anyone else in history. I was just a little nervous, as you can imagine, because I have some, I have some gripes. I have some things I want fixed, okay? And she made no promises, but she did listen. In the segment, you're gonna hear why she feels so passionate about really supporting women throughout their reproductive lifetime. It's not just about pregnancy, it's not just about endometriosis, it's not just about perimenopause, it's supporting women. Because when they are well, they can do well. When they feel supported, they can support. When they have options, they can give options. I feel hopeful as both a woman and the doctor who treats women in knowing that someone hears us and is helping give us the thing that we've deserved all along. Welcome to I Did My Own Research. I'm Dr. Freyne, and today I'm joined by Melinda French Gates. Melinda earned her bachelor's degree in computer science as well as her master's in business administration from Duke. She's now most well known for her philanthropic work, previously co-chairing the Bill and Melinda Gates Foundation, the world's largest private charitable organization, and now works as the founder of Pivotal Ventures, which works to identify and implement solutions to problems affecting US women and families. I'm honored to have her here today as she just announced her new funding commitments to women's health. Expanding her longtime focus on contraceptive access and maternal care with investments in midlife, menopause, and mental health care. With this new funding, Melinda's commitments to women's health exceed six hundred million dollars and is arguably at the forefront of advancing women's health. I could not be more honored to have her here today. Melindo, thank you for being here. Thanks for having me, Dr. Fran. Could you tell us a little bit more about the new funding that you're putting towards women's health and really what your new focus areas and why is this now your focus? Well, I'm really doubling down on the work that I've already been doing in the reproductive health space. So contraceptive access as well as maternal care. But now I'm also adding on a new focus, and that is midlife. We know that all women basically make this transition into their reproductive years and their reproductive years into mid and later life. And yet, very little funding goes into the midlife time. And women are facing lots of issues during that time and trying to and having trouble getting accurate health information or solves for their issues. And so we really need to focus on that, in my opinion. There's something that can be done about it. You know, I say if you live long enough, all women are gonna go through menopause. And I think historically we didn't have the information both scientifically but also in our training. To know how we can appropriately take care of our patients who are going through this. And really, if you think about it, women going through menopause are at the height of their lives, right? Their children, if they have them, are starting to be at an age where they're getting out into the world. They're at the height of their career and all of a sudden they go through this life change where they feel no support. And part of that, from my point of view as a physician, is that sometimes I don't know how to help because either we weren't getting the training we needed to, or medically we don't have the tools to help our patients. And so I know all women who are in that midlife part of their life, perimenopause, menopause, are looking forward to expanding the training and the tools that we have to take care of these conditions. So I applaud you for seeing that very large group of women who so desperately want to be seen. Thank you. Thanks for saying that. You've said in the past that women need to be well to do well. And from what you've seen, how does supporting women's health translate into women having more power in all aspects of their life? When you're well. You can go on to live your full potential. You can get the education you want, you can have the career you want, you can raise a family if you choose, you can start a business. But conversely, if you're not well and you're constantly dealing with chronic issues or pain or uncertainty about yourself, you really almost at times women literally do step back from the workforce. We hear this a lot in the perimenopause time of life. Just when they are at the crux of their career and doing really well. If they don't have their health, they can't stay doing the things that they want. And so what I know to be true is that you have to have your health to be able to step into your full potential and your full power. And that's just the truth. Yeah. Is this something that you've seen in your own life with the women around you who start to enter different phases of their life and feel like I could do things better if I was just supported in my health? Absolutely. I've met women who say all of a sudden they're dealing with restless leg syndrome or they are. Chronically underslept because they have severe insomnia and it just hits them all of a sudden. They're like, What is happening to me? Why am I up at 2 a.m. and I can't go back to sleep? And they go searching for answers. And even in my group of friends, which you know, we are so lucky to have good access to healthcare, they can't find solves. They can't find solutions. And they'll go to doctor after doctor after doctor until maybe finally. somebody has a solution for them or things that they can try. And part of it, as you said, is we aren't we're graduating people from OBGON residency and only a third of them know about menopause. We're only training a third, much less primary care doctors or mental health doctors or, you know, the first provider on the line. Yeah. You're absolutely true. I mean, I've said myself that You know, I only graduated from residency five years ago. I got one lecture on menopause in my entire training. I know everything there is to know about pregnancy that we know. But menopause, I was like, I don't know a lot about anything. I really had to teach myself. I had to do courses. I had to talk to other doctors. I had to watch other healthcare professionals online to really feel now, five years later, I feel I'm in a really good spot where I can really take care of patients. I know how I can work up problems, prescribe medications, but I didn't receive that in my training and that's really unfortunate for the patients who I was taking care of before. So finding ways that we can even just expand the training for trainees and like you said, not just OBGYN, but anyone who really takes care of women should be well versed in how their field of medicine is affected by menopause. Cause it's not just hot flashes and night sweats, but you know, it's your bones, it's your muscles, it's your back, it's your kidneys, you know, all body it's your brain. All parts of your body are affected by menopause and everyone is responsible for taking care of patients in that part of their life. What is another area of women's health that you feel like has not been well understood that you're trying to clarify now for people? Yeah. For me, so I have a condition called PCOS, or we just renamed it to PMOS. It affects 20% of people with ovaries, women, right? We don't know what causes it. We don't have a single medication for this condition that affects 20% of women. And so I'm frustrated as a patient, but also as a physician, because as much as I can try to piece it together with endocrinologists and metformin and GLP ones and registered dietitians and exercise and sporanolac, you know, I piece it together in the ways that I can. But we have a condition that affects 20% of women and not a single medication created for it, not a single gene therapy that's being worked on. And that is very frustrating for me because my patients are frustrated. It affects Their ability to get pregnant, it affects their pregnancy itself, it makes them higher risk. It puts them at a five times increased risk of having endometrial cancer, their like whomorbid conditions, their lipids, their heart, everything is affected by this condition that basically has no funding and nothing behind it to help them. So for me, that's really like where my heart lies. My listeners will have heard me talk about this over and over again because I'm I'm frustrated on behalf of 20% of women with this condition. Yeah, and to have to go in search of answers. And you're a medical professional, right? But think if you're in a situation where that is not at all your background. And and I've heard so many women say exactly what you're saying about lots of things about their health. They're having to piece it together themselves. That shouldn't be 21st century medicine. Are you kidding me? And I'm I'm with you that I think we need to do far more research on. things that affect medical conditions that affect women and women's hormones, right? We should have been studying women's hormones 50 years ago. So we would have lots of different hormonal type therapies for women. Yeah. Instead, we're here in 2026 piecing it together with medications made for other conditions and other modalities and patients feel stuck, the doctors feel stuck, and we're all just like stuck in like this bad situation. So I appreciate anyone who even just like listening to that and saying, you know what, I hear you. I think that's what anyone wants when there's a problem is someone saying, I hear you. Let's see what we can do. And so I'm hopeful that for menopause, for PCOS, for PMDD, for preterm labor, for pre eclampsia, that the more we talk about it and the more we recognize that we haven't done the work that we needed to do, the more the work will eventually be done. Definitely. When you think of women's reproductive health. What things do you think of as vitally important right now? Yeah. I think the big one that I always talk about as a gynecologist is really people knowing that screening is important and vaccinations are important because these are the things that are gonna keep you healthy lifelong, right? We have these conditions that we know can lead to bigger problems down the line. And so for me, I see a lot of people who kind of avoid the screening exams. You know, I'm thinking pap smears, mammograms. DEXA scans, colonoscopies, because they hear negative things or they have a friend who have a NVIDIA experience. But I've seen the consequences of not going to get your screening. I've seen women in their 20s have cervical cancer. And so I get nervous when people don't come in for screening because I've seen the consequences of that. Yeah, you've seen it firsthand. I've seen it firsthand. I did want to talk to you about the mental health component that you're focusing on, which I think is really, really important. You know, I see it from all aspects. I see it from women in their twenties who are dealing with chronic pelvic pain, right? The mental health component of that. I see the I don't know if you know this, but the leading cause of maternal morbidity mortality is actually suicide. So mental health concerns in pregnancy, we see that a lot, and especially postpartum in the first like month postpartum, that's really the scariest time for those patients. And it's something that we don't talk enough about. But you are focusing on that. This funding that you are, you know. Putting out there is it includes mental health. It's not just like a side component, but it's a core part of that. Where is that drive coming from? And how do you see that integrated to like where what I do in my day-to-day? I see it as a core and fundamental issue, women's mental health. Because if she, if a woman is dealing with mental health, whether it's she's falling into depression, whether she's got severe anxiety, if We're seeing one in five women are affected by it during their pregnancy, either during the pregnancy or as you said, postpartum. And yet, the way many screenings work until the woman comes back in after birth, she's not seen until the six-week well baby checkup. By then, she could be in severe depression. And think about the ramifications on her. Both to pull her out is harder, but she's not been able to function well. Which means she can't be the mom she wants to be for that child or breastfeed in the way she wants. And yet, if we work upstream of that and we screen for it early, and every person screens for it, it's those screens you know better than anybody are not that difficult, right? And so you screen and you look for it, and then if you can immediately intervene with the mental health services she needs, whether that's medication, whether that's therapy, whether it's both, you will help. Prevent so much downstream pain and suffering. And so to me, it is never a separate issue. They are linked and fundamentally linked. And again, it's why you ta I love what you do where you talk about information. This is could be what's happening for you. Again, the more we know about our health, the more we can take a little bit of charge or control. I don't know about you, but if if I have something going on in my body and I don't understand what it is, it causes anxiety for me, right? Until I can get it labeled and figured out and start to figure out, ⁓ here's a path forward, right? Absolutely. And I think it's hard too because when you're in the postpartum stage, especially, you're so focused on so many different things, right? Your body is physically different in your healing. You're all of a sudden tasked with taking care of this brand new little person who needs you for every little thing. That sometimes you're almost like you forget that how you feel isn't normal. I I had a lot of what I now recognize were like intrusive thoughts in my first week's postpartum. I also have three children. And the first for my first child, I was like, why am I constantly scared that I'm gonna drop her down the stairs? Like, why is my brain doing this? And it scared me because that was a new feeling to me. And then you're right, you know, I will say I feel some of, you know, healthcare systems are doing a better job. We see all of our patients within one week of delivery, which I think is a really great change, even to just by telehealth, to touch in. How are you doing? How do you feel? How are you adjusting? Because like you said, if you get it early, if they're saying like, Yeah, it's not just baby blues, like I really am not doing well, you can intervene then rather than six weeks down the line when they've have felt alone that entire time. So I think even just the fo the understanding that we can't just let recently postpartum women just like go out into the world with their feelings and like act like that's normal will make a big difference for people. I think so too. I mean, it is such an enormous change in your life. You know, I had three children too. When you take that first baby home and you love them so much, but maybe breastfeeding's not working or you can't their baby's not sleeping through the night. So you're not sleeping through the night. I mean Just it's such an overwhelming amount of change. So we've got to catch women and give them a little bit of support. What I know about women is you support them, they support everybody else. A hundred percent. A hundred percent. With the incredible amount of money that you've put towards women's health, really, if there's one thing that you could change about how women experience their health or the healthcare system, what would be your biggest goal with all the work that you're doing? That women get the right. Care at the right time. Care can make all the difference. It can be the, you know, when these, when women, we all go through these big transitions in life, reproductive health years, and then okay, later years, mid and later years. When we can get the right care, we can zoom into whatever trajectory we want for our potential. But conversely, if you have adverse outcomes or a bad experience, it can. It can have lifelong consequences for you or for your child. And we we just that just shouldn't be. So right care, right time. Well, Melinda, thank you from the bottom of my heart. As a woman, as a physician who takes care of women, we have needed you. We applaud you for what you do. Thank you for doing this. Thank you for seeing us. And thank you for really putting, you know, your money where your mouth is, putting your heart into it. We appreciate you. Thank you so much for everything that you're doing for us. Thank you, Dr. Fran, and for all you do. Thank you.