
Tonya Lewis Lee's Hulu Documentary 'Aftershock' Investigates How To Reduce Black Maternal Mortality

Black women take center stage in April, celebrating International Black Women's History Month. In addition, April 11-17 sheds light on Black Maternal Health Week to raise awareness of the disparity of mortality rates among Black women compared to their non-Hispanic white counterparts. The discussions surrounding Black maternal mortality are becoming more mainstream with Baby Dove joining Sista Midwife Productions, "a birth advocacy, training, and consulting agency," to comprise a comprehensive list of the Black Doula Directory.
Tonya Lewis Lee has become a staunch advocate of ensuring that the American public is cognizant of alarming statistics that show "Black women are three times more likely to die from a pregnancy-related cause than White women" even though 80% of "pregnancy-related deaths in the U.S. are preventable," according to the Centers for Disease Control and Prevention. Bias, racial and gender inequities are prevalent in the American healthcare system, including other disparities such as "quality healthcare, underlying chronic conditions, and structural racism," all impair marginalized patients from having the same opportunities to receive care to uphold their "economic, physical, and emotional health," the CDC reports.
According to the organization's report, approximately 700 women die in the U.S. from pregnancy or various other pregnancy-related complications. Recently, in Detroit, Michigan, Alona White, a 25-year-old mother, died after giving birth to her second daughter; White succumbed to an emergency craniotomy that caused her brain to bleed. As a patient at Ascension St. John Moross, White underwent a C-section, a medical procedure that Lee’s documentaryAftershock also explores and shows the financial benefits hospitals and doctors reap from this particular surgery, even though it may not be conducive to the birthing process.
Lee, who co-directed and co-produced with Paula Eiselt, discusses through her documentary Aftershock about Black maternal health and places several human faces to those victimized by this growing health crisis. The Hulu doc, which is a part of the streaming service's Onyx Collective, initially premiered at the 2022 Sundance Film Festival in the U.S. Doc Competition and was awarded the Special Jury Award: Impact for Change. Aftershock follows Omari Maynard and Bruce McIntyre, who both lost their partners, Shamony Makeba Gibson and Amber Rose Isaac, during childbirth, and how the two men, along with other family members, are in the streets providing advocacy and activism to eradicate this epidemic.
Using her background as a former human rights attorney, a spokesperson for the U.S. Department of Health and Human Services Office of Minority Health, and an author of the children's book Please, Baby, Please—which she co-wrote with her Academy awarding-winning husband, Spike Lee, she uses her platform to heighten the conversation of Black maternal health.
L-R Omari Maynard and Bruce McIntyre
Photo courtesy of Onyx Collective
xoNecole: Based on your research, what are the factors causing Black women's death in most hospitals? The documentary did expound on it, but if you can say it in your own words.
Tonya Lewis Lee: First, I want to say that most of these deaths happening with Black women from childbirth complications are preventable. When we were making the film, 65% of these deaths were preventable. Since then, a new statistic has come out that says 85% of these deaths are preventable. When you asked me what we discovered in our research about why this is happening? First and foremost, what keeps coming through is very clear that Black women are being dismissed and ignored when they express pain or discomfort or something is not right. A lot of these deaths are postpartum.
It's frustrating because it's not like women aren't seeking help, as you see in Aftershock. The two families that we cover, the two women who passed away, each of them were seeking help from their healthcare providers. Unfortunately, their calls for help were dismissed, minimized, and ultimately led to their death. I will say that what tends to happen is there is either too little intervention too late, or there tends to be too much intervention done too soon, which, unfortunately, often causes these deaths.
xoN: Is this something that residents are taught in medical school because, like the doc pointed out, the founder of gynecology J. Marion Sims, believed Black women don't feel pain? Is this ideology still continually introduced in medical schools?
TLL: My understanding, and I've heard, anecdotally, that it is still taught in med schools today that Black people do not suffer or have the same kind of pain that white patients do, which is insane to me that we're still having these conversations. I empathize with doctors because I think they are trained in such a way--it's a patriarchal, technocratic system. They go through rigorous training, which is great, but they're also kind of dehumanized doctors, when they're going through a process so that by the time they get to their patients, they often inadvertently treat their patients in the way they have to rush, let's get through to the problem. What's the problem? Let's solve it.
I'll go back to the question you asked before about what's causing these deaths also, is that [birthing] is not woman-centered, and what I mean by that is, when a woman is giving birth, as opposed to listening to her desires and how she wants to give birth and who she needs in the room, what is she doing and how is it working for her? Unfortunately, a lot of times, it's more on the doctor's schedule, what works for the doctor, and what's efficient for the doctor. Why do we lay on our backs and put our legs up? Well, because it's easier for the doctor to get in there than allowing a woman to move around during her labor to help the baby work its way down. So the baby gets in position, and she's able to do what she wants to do. I think that a lot of education works against the natural birthing process.
xoN: Regarding the medical schools, is there any way we can change how they're instructed? How can we upgrade their curriculum on how they handle Black maternity?
TLL: I agree with you, and I will say, at least some of the good news; I see that with Aftershock, we've been invited by medical schools to bring the film. We were at Harvard and Columbia [to show the film] to their residents and converse with me, my co-director, and the film's protagonist. To your point, they need to be educated; differently, they're beginning to understand that and are looking at it [but] it's going to take a little bit of time to turn the ship. But at least there's a conversation that is starting to happen, but I completely agree with you that med schools need to start thinking about how they teach maternal care.
And again, even the midwifery programs, too, because I am a big advocate for midwives. Yet, they're not enough midwives in general in the United States, and they're certainly not enough Black midwives. So, to that point, we also need to work on the pipeline of doctors, obstetricians, and gynecologists, because there's a shortage of doctors. There's a shortage of nurses, and certainly Black nurses and doctors. We want to think about who's going to med school and how we cultivate them so that we have a workforce that can care for all of us.
Photo courtesy of Onyx Collective
xoN: To add to that point, maybe there should be a movement to have Black owned hospitals. Many Jewish communities have their own doctors and ambulances. Is that also something we need to start putting on our agenda to start creating Black-owned hospitals in these cities with a high Black population?
TLL: I think we can [have] Black hospitals; we're talking about education in general. Our issue as a community is whether we need more resources or we need to focus the resources in that way. It's worth thinking about. Looking to our HBCUs, our Black students, bringing them through to get us to a place where we could create that kind of thing. I don't think it's a bad thing. A study showed that when Black doctors treat Black infants, they have better outcomes. So I think a movement towards ensuring that we have more Black doctors, more Black nurses, a robust Black health care system to begin with, or at least doctors. Having an awesome Black hospital that's important for us would be amazing because we do not have the resources to do that.
xoN: How can we change policy as it relates to the health of Black women when they're giving birth? What can we do?
TLL: Well, the good news is policies are moving through Congress right now, the Momnibus bills, its pieces of legislation, a group of bills. One in particular that is great that I believe recently passed is making sure that women have Medicaid coverage through their first year of birthing; I think it's important that we deal with women a year postpartum because, again, as I said earlier, most of these deaths do happen postpartum. Many women who don't have coverage get lost, and they don't see doctors thereafter or are not seen. We need to ensure policies that make sure that women have the support they need. For example, doulas get covered by insurance companies and Medicaid as well.
I think midwives are really important to this process; the United States is the only industrialized nation that does not have midwifery care at the center of women's health care. So we need to ensure that when women go to midwives, they can get reimbursed. So those are some policies that can have an impact. I will say voting matters because our politicians, locally at the federal level, but particularly locally, and our state and local governments are the ones that drive the policies and our communities around birthing. I think, as individuals, we need to be out there voting, ensuring women can get the support they need.
Also, to the voting piece because many hospitals in the Black communities have been divested from [offering] the services, if they do have maternal health care at all. They don't have a lot of services. So we want to make sure that our hospitals and our communities are well-resourced so that they can provide the care they need for people, especially when they're in distress.
Photo courtesy of Onyx Collective
xoN: What was your experience when you gave birth to your children?
TLL: I appreciate that question. It's interesting. When I gave birth to my children, my daughter is now 27; my son is 25. I didn't know about midwives. So I had a wonderful doctor who was a friend of the family. But even then, I look back with a little frustration because my water broke, I went to the hospital, my family was there, and it was like, 'We can just move this thing along, let's get you on Pitocin get you going,' and I did that and stayed in the hospital overnight. Then the contractions were coming hard, as they do, especially when you're on Pitocin.
They suggested that I have an epidural, which I had. Then, my lips started to numb because they told me I was only supposed to be numb from the waist down. But I was beginning to feel numb over my entire body. I told my anesthesiologist to turn it down, my lips were numb, and she kept saying, 'Well, no, if I turn it down, I have to turn it off, and you're gonna feel pain.' I was like, I need to feel something because I'm now not feeling anything. I had to get nasty with her and didn't want to do it. Because you're laying there, you're vulnerable; I couldn't move. My mother and sister were there, and then they started noticing my oxygen levels were getting weird. I was like, 'You need to turn it off, and I had to get nasty for [the nurse to] finally turn down the anesthesia so that I can at least feel something. Thank God everything was fine, and my daughter was fine. Similarly with my son, a different doctor this time, by the way, both Black women, lovely people, but in a system, right?
With my son, the same thing happened; similarly, my water began to leak, and I was saved in a way by the nurse because at one point I was pushing, and the doctor was like, 'Okay, his umbilical cord is around his neck, his shoulders are stuck,' and she just stopped. The nurse said, 'This may hurt a little bit,' She put her hands on my stomach and pushed my son out. Again, I was fine, thank God, and the children are fine, but in retrospect, I wish I had allowed my body time to do what it wanted to do, and I think I would have been fine. I don't think I needed Pitocin. I don't think I needed the epidural if I had done it that way. But that's the way I did it back then.
But I joke with my daughter that by the time she's ready, I'm ready, and we're going to get it right this time because I don't think that surviving birth is what it should be. I think we should thrive in our births and be able to have beautiful birthing experiences that are not with trauma. And I'm not saying they don't have pain, but I believe that the pain that one goes through is what we're supposed to go through. I don't think women should suffer. But as Helena Grant, the midwife in our film, says that when a woman is birthing a baby, she's not just birthing a baby, she's birthing a mother, and it's a rite of passage that we have to go through to get on that other side. So we are prepared to take care of this young life we've just brought here.
xoN: How can women protect themselves when pregnant or about to give birth in this environment?
TLL: First of all, shop around for your healthcare provider. If you go to a health care provider and you don't connect with them, then keep looking for that health care provider that is right for you. First and foremost, ask as many questions as you can ask. Remember that you're in the power seat, you should be empowered; you're about to go through something amazing. Make sure you get the support you need. No [woman] can be doing everything in the moment of labor and birthing.
So make sure you have the right energy and people around you who can advocate for you and support you the way you need during your birthing process. I was with these people through the process of this documentary. I was able to be up close and personal with people grieving from a loss but activated by the loss. I was able to be up close and personal with people going through the birthing process themselves, trying to figure it out for themselves as well. So it's been quite a journey.
Aftershock is now streaming on Hulu.
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Eva Marcille On Starring In 'Jason’s Lyric Live' & Being An Audacious Black Woman
Eva Marcille has taken her talents to the stage. The model-turned-actress is starring in her first play, Jason’s Lyric Live alongside Allen Payne, K. Michelle, Treach, and others.
The play, produced by Je’Caryous Johnson, is an adaptation of the film, which starred Allen Payne as Jason and Jada Pinkett Smith as Lyric. Allen reprised his role as Jason for the play and Eva plays Lyric.
While speaking to xoNecole, Eva shares that she’s a lot like the beloved 1994 character in many ways. “Lyric is so me. She's the odd flower. A flower nonetheless, but definitely not a peony,” she tells us.
“She's not the average flower you see presented, and so she reminds me of myself. I'm a sunflower, beautiful, but different. And what I loved about her character then, and even more so now, is that she was very sure of herself.
"Sure of what she wanted in life and okay to sacrifice her moments right now, to get what she knew she deserved later. And that is me. I'm not an instant gratification kind of a person. I am a long game. I'm not a sprinter, I'm a marathon.
America first fell in love with Eva when she graced our screens on cycle 3 of America’s Next Top Model in 2004, which she emerged as the winner. Since then, she's ventured into different avenues, from acting on various TV series like House of Payne to starring on Real Housewives of Atlanta.
Je-Caryous Johnson Entertainment
Eva praises her castmates and the play’s producer, Je’Caryous for her positive experience. “You know what? Je’Caryous fuels my audacity car daily, ‘cause I consider myself an extremely audacious woman, and I believe in what I know, even if no one else knows it, because God gave it to me. So I know what I know. That is who Je’Caryous is.”
But the mom of three isn’t the only one in the family who enjoys acting. Eva reveals her daughter Marley has also caught the acting bug.
“It is the most adorable thing you can ever see. She’s got a part in her school play. She's in her chorus, and she loves it,” she says. “I don't know if she loves it, because it's like, mommy does it, so maybe I should do it, but there is something about her.”
Overall, Eva hopes that her contribution to the role and the play as a whole serves as motivation for others to reach for the stars.
“I want them to walk out with hope. I want them to re-vision their dreams. Whatever they were. Whatever they are. To re-see them and then have that thing inside of them say, ‘You know what? I'm going to do that. Whatever dream you put on the back burner, go pick it up.
"Whatever dream you've accomplished, make a new dream, but continue to reach for the stars. Continue to reach for what is beyond what people say we can do, especially as [a] Black collective but especially as Black women. When it comes to us and who we are and what we accept and what we're worth, it's not about having seen it before. It's about knowing that I deserve it.”
This interview has been edited for length and clarity.
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You’ve Got Several Sex Hormones. These Tips Will Help Make Them (& Your Sex Life) Stronger.
It’s been said that since, shoot, forever, that the brain is the biggest sex organ that we have — and to a large extent, I would agree. That’s why, whenever I tackle sex issues on this platform, it’s more as it relates to emotional connectedness, effective communication, and clearly articulating one’s needs.
That’s not to say that articles like this one aren’t, in some ways, equally as necessary too because sometimes — sometimes, there is absolutely nothing “wrong” with your relationship and still, when you think about having sex with your partner…you’re just not as “into the idea” as you usually are.
And what that could mean is there is something going on physically instead of mentally or emotionally. For example, it could be an indication that one or more of your sex hormones are a bit “off” and you need to get them back where they need to be.
That’s the purpose and goal of today’s offering. We’re going to explore how five hormones in your system play a direct role in you having a satisfying sex life, then we’re going to touch on some signs that yours may be low and what you can do about them, at home (although if these don’t work, please see your doctor), if that is indeed the case.
Ready to physically feel like having (more) sex? Awesome.
1. Estrogen
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Although estrogen is found in both men and women, there is a lot more of it in women. And since drops in estrogen can lead to things like a lower sex drive as well as experiencing challenges when it comes to having orgasms, it’s important to do as much as you can to keep your estrogen levels where they need to be at all times.
So, what aresome key indications that your estrogen levels are low? If you have super dry skin; your vagina is dry; you’re storing up more belly fat; your periods are irregular; you’re tired a lot; your sleep patterns are erratic, and/or your libido is low.
And what can you do to get your estrogen levels back on track?
Eat foods that are considered to be phytoestrogens. Phytoestrogens are considered to be plant-based sources of estrogen that could help to get your levels up. Those foods include flaxseeds, peaches, berries, sesame seeds, and cruciferous vegetables (broccoli, cauliflower, cabbage, and collards).
Take Vitamin B-Complex. The reason why it’s important to have vitamin B consistently in your system is because it plays a significant role in how your body creates estrogen. So, if you’re not currently taking a B-complex vitamin, this is as good of a time as any.
Look into Black Cohosh. If you’re someone who likes to take supplements, do some research on black cohosh. It has a pretty good reputation when it comes to elevating estrogen levels.
Drink some black tea. Are you a tea lover? If so, it can’t hurt to sip on some black tea. Although research is still ongoing, there are findings that state that some of the properties in black tea will help to elevate estrogen levels.
Live in moderation. Now this might be your “something new” for the day. Were you aware of the fact that estrogen levels actually increase in body fat? In fact,being underweightis what can decrease your estrogen. While we’re here, exercising too much can jack up your estrogen levels as well. Moral to the story with this one: stay at a healthy weight and don’t overdo it on the workout tip. When it comes to keeping your estrogen levels where they need to be, balance is key.
2. Testosterone
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Testosterone is a hormone that stimulates sexual desire in both menand women, although there is significantly more of it in men.The reason why women need it in their system is not only does it increase their libido, but it also helps to give them energy, to stay in a good mood, and it can also help to make conceiving easier.
How can you know that your testosterone levels could use a boost? If you have an irregular cycle, you’re having trouble conceiving a child; you’re low on energy; your hair is thinning; you’re losing muscle tone; you have trouble sleeping, and/or you have no real interest in sex.
If you happen to notice any of these signs, what can you do to get your testosterone levels up?
Exercise. One way to increase your testosterone levels is to exercise; however, as a woman, the key is to do things like resistance training and High Intensity Interval Training (HIIT). Both of those have the reputation for raising testosterone levels; in women, especially.
Consume more zinc. Although it’s been said for years that zinc deficiencies are directly tied to erectile dysfunction in men, there are also studies that say that many women who are postmenopausal are also low in zinc. In both cases, zinc is needed because it helps to keep hormones in balance. So, if you sense that you may be low in testosterone, perhaps take a zinc supplement or eat foods that are high in zinc, like beef, lamb, pumpkin seeds, whole grains, and eggs.
Drink less alcohol. Even though alcohol can make you feel horny for a moment, the reality is if you drink too much of it, it can actually cause your testosterone levels to tank. Bottom line with this one, pace yourself with your cocktails — especially if you already know that your testosterone levels aren’t where they should be.
Go outside. Did you know that there is a correlation between vitamin D deficiencies and pregnancy issues like preeclampsia and a baby’s low birth weight? There are also studies that indicate that when a woman is receiving a daily dose of vitamin D, her testosterone levels tend to remain strong. That said, one way to get vitamin D into your system is to take a supplement or to eat foods that are rich in them. Another is to consume foods that contain vitamin D, like salmon, tuna, and mushrooms. Still another is to spend more time outside. Definitely one of the best ways to get some “D” into you is to be in the presence of the sun. In fact, as an extra bonus, the ultraviolet radiation that comes from the sun can boost the libido of both men and women. The more you know.
Watch your stress. Two things that aren’t the best of friends are testosterone and cortisol (the hormone that creates your natural stress response). This is so much the case that when your cortisol levels are high, that can hinder your system from producing all of the testosterone that it needs. So, you know what that means, right? CHILL. OUT.
3. Progesterone
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Progesterone is what helps to keep your libido regulated. Since it also plays a pivotal role in a woman’s menstrual cycle and how her hormones respond throughout the month, women who are in the latter stages of perimenopause or who are postmenopausal should also keep their progesterone levels up in order to maintain a consistent sex life.
Signs that you need more progesterone? Trouble sleeping. Irregular cycles. Bloating. Erratic moods. Headaches.
Things that can help bring some relief to these issues?
Meditate. From what I’veread and (briefly) researched, cortisol has the ability to block your progesterone receptors, which means that it can decrease them if you are too stressed out. And that is why one way that you can boost your progesterone levels is to meditate.Since meditation can reduce anxiety, lower stress, and help you to sleep better, I’m sure you get how it can work to get your progesterone levels where they need to be.
Take Vitamin C. If you are low in vitamin C, it could impact your progesterone levels in a negative way. That’s becausevitamin C is a nutrient that actually stimulates the production of progesterone. So, if you want to get more of it into your system, take a vitamin C supplement, drink some orange juice, and/or eatvitamin C-enriched foods like cantaloupe, parsley, strawberries, papaya, and chili peppers.
Implement chasteberry tea. An herbal tea that I personally think every woman should have in her possession ischasteberry tea. Not only does it do things like reduce inflammation, bring relief to PMS symptoms, and help to improve infertility, it also helps to balance out your hormones and, yes, increase progesterone levels.
Hang out with friends. When it comes to raising progesterone levels, something that I found to be fascinating is that there are studies that say that when women hang out with each other, that can give their progesterone levels a boost. The methodology is that it reduces stress and anxiety and makes people feel more comfortable, to the point where it helps to balance out that particular hormone. Pretty cool, right?
Get on a sleep schedule. Not getting a consistent amount (preferably 6-8 hours) of rest can definitelythrow your hormones off, including your progesterone levels. That’s a big part of the reason why I once wrote “6 Fascinating Ways Sex And Sleep Definitely Go Hand In Hand.” Check it out when you get a chance.
4. Oxytocin
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Oxytocin has the reputation for being called the “love hormone.” That’s because it’s a hormone (and neuropeptide, which is a protein-like molecule) that “activates” during physical activities like kissing, cuddling, andsex.
And what are some telling signs that you are low on this particular hormone?You may feel a bit depressed;you may feel more anxious; you may notice that you don’t want to communicate and/or be affectionate with others; you may have less of an interest in sex, and/or it may be harder for you to orgasm.
Are there also things that you can do to increase your oxytocin levels on your own? Yep.
Get into some music. If you’re not in the mood for sex but you want to be, treat yourself to a long shower — and then sing in it. Believe it or not, some studies say thatsinging for 30 minutes can increase your oxytocin because it helps you to feel connected and relaxed (so can listening to music).
Hug someone. There is data all over the place that says that oxytocin is stimulated through the power of touch. That’s a part of the reason why it’s known as the “cuddle hormone.” So, just like you can get an oxytocin boost by kissing or cuddling with your partner, hugging a friend can also take your oxytocin levels up a few notches as well.
Get a massage. Sooo…when’s the last time you got a massage (check out “12 Different Massage Types. How To Know Which Is Right For You.”)? Take this as a sign that today would be a great day to book an appointment. As far as your oxytocin levels go, it’s another way that touch can come into effect while reducing stress and inflammation. And don’t get me started on where your oxytocin levels will go if your partner starts rubbing on some of your pressure points. Feel me?
Spend quality time with your bae. Speaking of partners, there are studies that also say that oxytocin levels are high when new relationships start. A part of the reason why is that there is so much intentional quality time that’s being spent, which is also good for your oxytocin levels. So, if it’s been a minute since the two of you have been on a date, plan one. Check out “10 Cheap Date Ideas For Couples On A Budget,” “15 Date Ideas Based On Your Love Language,” “10 Romantic Dates You Can Go On (In Your Own Home)” and “Dinner & A Movie Is So…“Meh.” Here Are Some Creative Takes On V-Day Dates.” for some inspiration.
Have sex. As far as physical intimacy goes, it doesn’t get any closer than sex — and here’s the thing: the more orgasms you have, the more oxytocin your body is able to produce. So, if you want more oxytocin and you’re not having (more) sex (and orgasms), that’s actually working against you… especially as far as this particular hormone goes.
5. Dopamine
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Dopamine is a hormone and a neurotransmitter that plays a role in sexual desire and pleasure.For men, it can help them to achieve and maintain an erection;for women, it can help them to orgasm (more easily).
Some indications that you may need more dopamine in your system are if you find yourself lacking drive and motivation, you struggle with concentrating, you’re moody, sleep is a struggle for you, and/or you don’t find things that you used to enjoy being very fun (including sex).
Luckily, there are things that you can even do to level out your dopamine:
Consume more protein. There is an amino acid called tyrosine that helps your body to process dopamine. That’s why it’s a good idea to make sure that protein is a part of your diet. Although you can get it from meat, there are other foods that are packed with protein as well. “Vegetarian Or Vegan? Check Out These High Protein Foods.” has a few ideas for you to consider.
Eat less saturated fat. Speaking of your diet, it’s also wise to eat less saturated fat. That’s because there are studies that say that too much of that kind of fat in your system can mess with how your brain processes dopamine. For the record, saturated fats include dairy, fried foods, and coconut oil.
Maintain a healthy gut. It has been stated that more than 50 percent of the dopamine that’s in your body is synthesized in your gut. This means that you need to be hypervigilant in making sure that your gut remains as healthy as possible. Check out “80% Of Your Immunity Is In Your Gut. Take Care Of It Like This.” for tips on how to do just that.
Take a probiotic. Speaking of maintaining a healthy gut, it’s going to be so much easier for you to do it if you take a probiotic. Plus, probiotics are known for producing the kind of “good bacteria” that makes it easy for your gut to release dopamine.
Try some oregano oil. A supplement that is full of antioxidants and may possibly boost dopamine in your body is oregano oil. Since it also helps to keep your gut healthy — hey, why not give it a shot?
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As you can see, there are so many factors that go into having a happy, healthy, and fulfilling sex life. Now that you know more about what to do for your sex-related hormones, hopefully, you can get more of what you’re looking for in your sexual experiences.
Amen? I’m saying, sis.
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