Marimer Pérez, gynecologist: “There are aspects that I thought about discussing with my psychologist that menopause has resolved for me”

One of the indisputable benefits of social networks is that they have become a showcase for professionals in the world of health to educate and raise awareness with their messages while making empathy a weapon (almost) as powerful as medications. Thanks to the digital universe we have met doctors who, with their didactic activity on-line They make medicine a little closer to everyone thanks to profiles full of advice and explanations in which information and proximity go hand in hand. The prestigious Marimer Pérez, gynecologist and obstetrician, is a great example of this trend of 3.0 female doctors. To the baggage and wisdom accumulated over 24 years of profession and the trust, naturalness and humane treatment that she offers her patients, we must add her closeness, sense of humor and, of course, her immense empathy. . Founder of WoMera comprehensive health center located in Barcelona born from sorority, is a well-known disseminator about menopause, a process that she herself has been going through for two years.

Expert in communicating through your Instagram profile how to live a menopause to the fullest, when a media outlet asks her to talk about her symptoms, she flatly refuses. “Let's give the subject a twist: I don't want to talk about hot flashes or things that can be read elsewhere… So many negative messages! And euthanasia, when? ”She asks us with her characteristic humor. We spoke with her to give that twist to menopause, get to know the happier side of her and try to erase the stigma that haunts the woman who not only is not a mother, but also claims that work is what makes her happiest. . On these topics, and on her particular Roland Garros, by the way… But let's not get ahead of ourselves. Let's start the match.

You talk about your menopause openly on social media. Why does this topic continue to embarrass so many women?

I don't know what's wrong with us. People are surprised by the fact that I am not ashamed to say that I am in menopause, because they think that men will not find me attractive. “Doctor, think carefully: men are not going to see you the same way,” they tell me with all their affection, making me see that they believe that menopause makes us transparent. Many women write to me saying that they are ashamed to say it, and the important thing would be to talk about it openly so that the entire male sector understands us. The problem is that since this topic has never been properly put on the table, nor have certain symptoms been described that our couples have to understand, it seems that menopause does not suit them. However, menopause is not just a concern for women: it is everyone's issue. Along with fear and shame we have to add that kind of social conviction of “we'll get through it.” This is not how it works: we do not have to suffer, endure or limit ourselves to just fanning ourselves. It seems that this suffering was part of women: we are Joan of Arc continually, and apparently, we have to be so in all the stages we go through.

Do you notice that women's attitude has changed during their first gynecological visit?

Teenage girls are much smarter than us. I have been in this profession for 24 years, and I see that now they have a very clear eco-consciousness and speak openly about contraception, STDs… It strikes me that with maturity we have not forgotten the shame. Now, younger women approach sex in a way that makes you fall off your chair. They have deromanticized it, they have relationships for pleasure and they have things clear. The word shame does not exist for them.

From what you say, as the years go by, don't we leave fear and shame behind?

I find that shame in adult women. It is not unusual for me to find myself in consultation with patients who ask me how they are going to explain to their husbands that it hurts them to have sexual relations due to menopause. In reality, it's like telling your husband that you take insulin because you are diabetic. It is a physiological process: as you have less estrogen, there will be greater vaginal dryness. If we explain the physiological process well, men will have to understand it. It is important that the male sector understands that it is bad business to live without estrogen. We are going to live a third of our lives without the main hormone that intervenes in all the processes of our life, so this cannot be a topic that embarrasses us. Women would have to talk about menopause all the time and they would have to give us a medal of honor, because without being something easy, we carry it with great dignity.

What are the positive aspects of menopause?

I have been in menopause for two years and I am not, by any means, in the worst stage of my life. As if that were not enough, on a mental level there are things that have benefited me. I am more mature and having more androgens has given me a mentality where I can easily set limits. I was a phleguma [persona floja, en catalán]; Everything affected me, and now… much less. There are aspects that I thought about discussing with my psychologist that menopause has resolved for me. Things start to matter a lot less to you. The best thing is that you don't have to do a mental exercise to think like this and face things with this attitude: you are simply in that mood.

Are the sexual problems that come with menopause addressed normally?

I think the problem with sexuality is easy to understand: estrogen increases sexual desire, so having less of it makes sense that you won't be chasing your partner. What you have to do is have nutritious conversations, one on one, and explain to your partner that they don't have to get overwhelmed, but that starting relationships is complicated for you now for these reasons. If you use the example of testosterone, it will be even clearer: if they have less testosterone, their erection becomes more difficult, right? That's why the couple has to work on it and look for spaces of intimacy. It must be made clear to the other person that it is not at all that there is no longer attraction. You are not going to stop having orgasms, but you will still have to take more care of the preliminaries. I think we have to start being more permissive with ourselves. We have to understand ourselves and take advantage of the good that can come from menopause. When you understand what is happening to you and you talk about it with your friends without hesitation, you see that we are all the same. Have I ever heard that “They are going to give me the Oscar for best actress, because if you saw how I get when she looks for me and how I make her see that I am very excited…”. I have 12 or 14 Oscar winners every year in my practice.

In Anglo-Saxon countries, hormone replacement treatment is the order of the day… Why is it still a sensitive topic here?

What is the problem with taking hormones? Ignorance causes fear. If you tell a man who does not have erections that if he takes a pill his problem will be solved, he will not ask you about a side effect. He will ask you how many pills to take a day. On the other hand, giving low-dose hormone replacement therapy to a woman costs me sweat and tears. If it were a man, the consultation would last five minutes. We have a very established culture in which we have in mind the phrase “I'm not that bad.” The problem is that it is not about not being so bad, but about “being very good.”

What happens to the aesthetic yoke aft
er a certain age?

We are perhaps no longer at an age where we want men to turn around in a bar when we enter. If we put the focus away from the physical issue and focused on all the things in which we are good, such as work, we would take advantage of all the positive aspects of getting older. The men have done it well: a man with a paunch and a bald head may appear, but if he has his shirt rolled up, his glasses and a good watch, we think it is very apparent. We, on the other hand, believe that we cannot have even half a lorza. By the way: he doesn't even see that supposed lorza. We are the ones who punish ourselves every day. Doesn't he have a belly? Can't you see his erection is different? We have a problem with ourselves

Is a gynecologist more empathetic than a gynecologist, or should there be no distinctions?

The profession has been feminized. I have a gynecologist, but with menopause I think I'm going to go for a gynecologist. Empathy does not understand gender, but there are topics, such as menopause or adolescence, in which I think a gynecologist is more empathetic. In menopause it seems to me that you empathize with the patient right away.

Are you hopeful about the male birth control pill?

I have little hope in everything that depends on men. Now that we have finally achieved that the papilloma vaccine is included in women and children, the percentage of mothers with male children who do not give their children vaccines is astonishing. “They have the papilloma,” they say. It is a culturally rooted issue. I have no hope, as happens when a man sees that his wife has had three cesarean sections and she does not want to be a mother again, and you tell her to have a vasectomy, she refuses. In this regard, he would recommend that the patient look for an empathetic urologist and make an appointment with her husband. Vasectomy rates are very low, because men believe that it is something that affects their virility.

Tell us some classics that you find in consultation when there is a man present accompanying his partner.

Let's imagine that there is a woman who has just given birth, wants to breastfeed and I don't want to hormone her… I find that he doesn't want to use a condom. In 90% of cases, an IUD must be inserted. I finish earlier. Since they are vectors, carriers of everything, they do not suffer from it. Since we have few reliable papilloma screening methods, we cannot scare them with data. Then there is the issue of male infertility. You can't imagine the number of seminograms that go wrong now, but we continue to look at women when there is infertility.

Speaking of infertility, there are more and more reproduction clinics…

There is something we are doing wrong. To begin with, the age at which we have children has changed: the normal thing now is to have the first at even 38. Let's go fair. I think we are doing well by spreading the word that fertility is not eternal. Of course: there is less and less taboo in cryopreservation. With the pace of life we ​​lead and with that well-established idea that we have to be the best mothers and the best businesswomen, it is impossible to raise your child with all the attention it requires and masterfully fulfill all the duties we have undertaken. position. In general, this pressure has repercussions on reproduction, and that is why semen has the quality it has today. That mega-executive man who has a frenetic pace of life, does not eat sitting down, faces the harmful environmental factors that exist and has the lifestyle habits that he has, will see how his semen has been affected by all of this. However, ask him for a spermogram and you will see his face. You have to explain to him why he may have altered semen. I always nail them in consultation.

Are you constantly asked why you are not a mother?

Every day, in my stories, They ask me how many children I have. Can't we talk about something else? There are more and more women who choose not to be mothers. Saying that what I am most passionate about is my work is still a complicated matter for me. It makes me choke up not being able to say it, because I don't understand what's wrong with it. They would give a man a medal! I don't have doctor parents and I am from Madrid who has opened her clinic in Barcelona: it is something that has cost me a lot. When I say that what I like most in the world is my work, since it is a delicate subject, it is an enjoyment in petit committee. This even happens to me with my mother. I ask him if he has ever considered that when I am with my patients, in my gown, that is when I am super happy. Sometimes, in heroic births, I blast Freddy Mercury and say, “We gave it our all!” I don't know: Rafa Nadal is applauded. Not me. However, I leave there as if he had won Roland Garros. In petit committee, They gave me the cup. It is an achievement that is socially difficult to share, but enjoying your work like this is wonderful. I feel very lucky.