The Menstrual Mentor: Niko Gaffga Discusses Women's Health and Menstruation

The following is an excerpt from an interview between Niko Gaffga, MD, FAAFP, MPH (NG) and Holly Tanner (HT) about why he is interested in women’s health and the menstrual experience. Niko and Amy Meehan, PT, DPT, MTC have co-authored a specialty course for H&W all about Menstruation and Pelvic Health – to learn more join us in the upcoming remote course on July 16th-17th, 2022. You can watch the full video interview below, or on the Herman & Wallace YouTube Channel.

HT – So menstruation as a topic, what is it that got you so passionate about this particular topic?

NG -Throughout my career and my training, women’s health and OB have been one of my favorite parts of my job. In recent years there was a patient who really inspired me. I came into the room, and she was sitting in the corner in the exam room of the clinic where I worked and she was crying. I came in and I asked, she only spoke Spanish…and  I asked her “ How are you doing? What’s happening?” and she was very reluctant to say anything.

I found out through a little bit of discussion that she was feeling pain, and she couldn’t make the pain go away. That she had seen many doctors about it and no one had been able to help her. She was reluctant to show me where on her body – maybe it’s because I’m a man, or maybe it was because she was from a different country – she didn’t feel secure. So I drew a little picture on a piece of paper, and I said “Just point to me on this paper where you feel the pain.” After a while of pointing, talking, and smiling I got to a point where she could explain to me what was happening.

 It turns out that she had painful bladder syndrome, or interstitial cystitis, and we worked over the months to get that better. And I have to say, that the next time that I walked into that the next time that I walked into that same room and she was there – she was smiling. She stood up and she gave me a hug – and I said to myself, “This is why I do medicine.”

I think really the breakthrough came when I met her where she was. I took the time to talk to her in her language, show her a piece of paper, and wait for her to say what she felt. Cause many doctors, you know how they only have two or three minutes to talk with their patients. When I met her halfway, she was able to talk to me about the pain she was feeling, about her menstrual cycles – which I don’t think she had ever discussed with any doctors before.

So that started me down the road in being interested in what can I do – what more can I do to help women. When I see women in the clinic a lot of them don’t want to say anything about their menstrual cycle, and again maybe it’s because I’m a man. Maybe it’s because it’s just a difficult topic to discuss, but I realize that in society we don’t have a lot of chance as men or women to talk about the menstrual cycle.

I feel that it is a disservice to women that they don’t have a chance to talk about things that genuinely interest them, are concerning to them, or have questions and are curious about. I feel that there is a stigma, and I think that this course will begin to address it within a small group. But I think eventually, training and working with healthcare providers is one step in making that message available to other people, and to other patients all around the country. So that is how it evolved for me.

One of the most important things for me is that talking about the menstrual experience and women’s health, in general, allows me to change, to give people information, to make decisions in their life that are in alignment with the way that they see the world. I think that not many professions can say that. You know medical professions, physical therapists, doctors, and many other professions - we help people do what they want to do for themselves, and that’s powerful. That’s very powerful.

I think that the most important thing is that I can make a difference in someone else’s life. I’ve seen it when talking to women in the clinic who I’ve seen before. Discussing their menstrual cycle and having them tell me this is the first I’ve spoken about to anyone, much less to a female or a male provider. Hearing someone say that is meaningful. It is a lot of trust that they place in someone to tell them these kinds of things because they are difficult topics. Seeing that you can make a difference in someone else’s life...it means a lot to me, and this is the reason why [I’m so passionate about women’s health and the menstrual experience].

Menstruation and Pelvic Health - July 16-17 2022

The Menstrual cycle is one of the most natural of all human processes and is experienced by half of the population of the world. At any given time, 800 million individuals are menstruating. The Menstrual cycle occurs roughly once a month for roughly 35 to 40 years in a lifetime. That ends up being almost 3000 days, or about 8 years of menses. Many menstruators experience “period shaming” and other forms of socialized stigma around the menstrual experience. It is therefore important to become familiar with this experience and provide care to patients that takes into account their Menstrual Experience.

This two-day remote continuing education course is designed for clinicians who want to obtain advanced knowledge and skills to educate patients on non-hormonal, non-surgical, and non-prescription interventions for improving the Menstrual Experience. Developed by Nicholas Gaffga, MD, MPH, FAAFP, and presented together with Amy Meehan, PT, DPT, MTC, this course is geared toward the pelvic rehab provider looking to impart Menstrual Interventions that:

1. Put control in the hands of people who menstruate to identify and carry out the interventions that are appropriate to them
2. Use a holistic approach and advanced knowledge and familiarity with body and mind
3. Emphasize healthy practices that can positively impact the Menstrual Experience and beyond, in areas such as mental health and chronic diseases
4. Discover root causes of issues, rather than quick fixes, to have benefits that are sustainable across the lifespan.