← Culture Apothecary with Alex Clark
Culture Apothecary with Alex Clark
A Deep Dive on PCOS, Endometriosis and Birth Control | Dr. Jolene Brighten
01:47:33
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- [00:00]
A
When women are on the pill, they're attracted to genetically someone who's more like their cousin than being as different from themselves. They gravitate towards male faces that are more feminine.
- [00:12]
B
If a woman suspects that her hormones are totally out of whack and imbalanced, what are the first steps she needs to be doing to get them figured out?
- [00:18]
A
First thing is track your cycle, track your symptoms, quantify that. Then I would start looking at what is your stress, what is your sleep, what is your diet, and saying what is the smallest thing that I can do right now to implement change? The number one place that we all have to focus if we want hormone health for life is insulin and cortisol. Looking at adrenal function and looking at blood sugar regulation. Because if those are not right, none of your hormones will be right. Foreign.
- [01:08]
B
Are you struggling with hormonal issues like endometriosis, pcos or fertility challenges? Or maybe you're curious about the real impact of hormonal birth control? Today's guest is Dr. Jolene Brighton, a trailblazer in women's health and hormones, here to shed light on all things hormonal imbalance. With her extensive expertise in naturopathic endocrinology, Dr. Brighton has empowered thousands of women to take control of their health and hormones. She's a certified menopause specialist, podcast host of the Dr. Brighton Show, a best selling author of beyond the Pill, one of my favorites, and Is this Normal? And the founder of Dr. Brighton Essentials, a supplement company focused on science backed solutions for women. I ask her everything today from what to do if you're experiencing acne flare ups, getting off the pill, to struggling with having no libido, healing pcos and endometriosis, and how to best support your circadian rhythm postpartum when you're up at all hours of the night. Watch this episode on the real Alex Clark YouTube channel or culture Apothecary on Spotify. Are you constantly learning new things while listening to my show? Well, I certainly hope so. If so, please consider leaving a five star review right now, sharing how it's impacted your life for others and potential guests to read. You can also become a financial supporter of the show because a nonprofit produces it. Leave a tax deductible donation through the link in the show notes. Please welcome Dr. Jolene Brighton to Culture Apothecary. As a doctor doctor is saying hormonal birth control is poison a fair or unfair statement?
- [02:36]
A
Oh, I would say that it's an unfair statement to say that it's outright poison. However, I don't think it's without its flaws. And I think that if you make a statement like it's toxic, it's poison, some people completely shut down and then we cannot open up to a real nuanced discussion about hormonal birth control.
- [02:56]
B
When you say that there's like some things to be discussed around it, what would that be?
- [03:00]
A
There's the pros and cons. If any medication that you enter into, you need to have an informed consent. And that means looking at what are the benefits and what are the risks and through the lens of specifically what is true for you. And I think that's some nuance that gets lost in the conversation. With women. It is often this study says this. There's no study that exists on this, or why are you even concerned about that? I'm literally offering you something that will make your skin glow and, like, you don't have to have your period. And it's essentially your savior. So when we talk about, like the nuance, we have to talk about how does birth control work, what does it do to the body and what could be the potential side effects that you should look out for? We often hear that women are never told about side effects or they're told they're so minimal they shouldn't even worry about it.
- [03:50]
B
If we were given true informed consent in America, within our 10 minute wellness checkup, when we're being prescribed birth control, could you demonstrate what that would look like?
- [03:59]
A
10 minutes? Yeah. So I wrote this whole book, beyond the Pill. I would definitely say, take a look at that. So if I'm sitting down with a patient and we're talking about birth control as an option primarily, about 60% of women are using birth control for symptom management, not for primarily pregnancy prevention. So the conversation can look different. If we're talking about pregnancy prevention, I'm going to go through all of the options with them. So we're talking about, there is the combined oral contraceptive pill that has a synthetic estrogen and progestin, not to be mistaken, for progesterone, which your ovaries make. Or, you know, are we going to use something like the mini pill, which is progestin only. We're going to talk about IUDs. The different IUDs are out there. There's several that have progestins, there's one that have none. So, for example, if you say to me, I need contraceptives, and then I go through your whole history, I want to know about your family history, I want to know about your personal medical history so they can understand what the risk factors are. If you say to me, I have very heavy, painful periods, copper IUD is immediately out. Okay. We can't go down that road because it causes heavy, painful periods. Really?
- [05:07]
B
I didn't know that about the copper iud.
- [05:09]
A
Yes. So if you, if you have ever had a copper IUD and you're like, that was the worst pain in my life, friend, I want you to get checked for endometriosis or adenomyosis, because that can definitely be a sign of it. So we have to. We have to look at this individual. We have to ask them. So. But I think you're probably more interested in, like, the pill specifically, like, how do we have that conversation? So if we're having the conversation and it's like, I have heavy painful periods, I want to know why. Is there a time and a place for the pill? Absolutely. If we have somebody who is severely anemic and they're bleeding seven days or more, they're changing a tampon or pad every hour. Like, sometimes we do have to shut things down to rebuild the iron stores and figure out what is going on. So that might look like a three months of the pill to stop the bleeding. Right. That's how we're losing all this blood. This is the cause of iron deficiency anemia. But we don't stop there. We want to go one layer deeper now. So in that instance, if I'm going to prescribe the pill, I'm going to let them know this is for symptom management. This is not treating the cause of what is going on. We're going to use it for a short period of time. This is what that will look like. So that's if they're electing to go that route. It's always the patient's choice. Now, if I'm going to prescribe the pill, I'm also going to tell them about the different side effects. So I actually prefer to do testing ahead of time. This is very controversial to test for something like blood clotting disorders.
- [06:31]
B
Why is that controversial?
- [06:33]
A
Because anything that could be seen as putting a barrier from you getting access to the pill is anti woman. Right.
- [06:39]
B
Okay.
- [06:40]
A
You know, because I've talked about birth control for so long, I have had so many parents of daughters who have died, like, from birth control. Side effects of clots, having a clot in their lungs and pulmonary embolism, having a clot in the brain, these kinds of things. If I know you have a clotting disorder, then we're not going to use this oral contraceptive pill in you. Let's not do that. Why people also say it's contro controversial is because in the United States healthcare is expensive and getting access to these tests may prove to be a barrier. But while statistically speaking, the risk in when you're like in your 20s, right on the pill for a clot is very low, the consequence is very big. So the other things we're going to talk about is the adverse effects on mood. If you're going to start hormonal contraceptive of any kind, because it's the progestins we know that are really implicated in some of the mood issues. We want to talk about what you should look for. And I also think it's important to tell a friend. So having a woman know that she should talk to her friend, this is especially important for teens. Like if I start ignoring your talks, I'm not interested in the things I used to be interested. Maybe you're a volleyball player now, you could care less. You don't care about going to practice. You're missing missing practice. Things like that can start. They're early signs that we're having adverse mood changes, which we know can happen in the first few months of taking hormonal birth control. So if we can follow up on that, so two months in, how you feeling? Follow up on that individual, make sure things are going well. I'm also going to talk to them about nutrient depletions because if they're looking at this is my long term contraceptive of choice. The pill is known to deplete nutrients like vitamin C, vitamin E, B6, B12, folate, magnesium, zinc, selenium, coffee. That's a lot, right?
- [08:26]
B
So when you're deficient on those nutrients, how could that look like playing out in your health?
- [08:31]
A
Well, the nice thing is we're not pirates, okay? So we don't get scurvy. We're not going to see like we're not going to see scurvy coming up. And this is the thing I think is important to understand is that in the United States we have the rda, right, the Recommended Daily Allowance. We are told this is the gold standard of what your intake needs to be. But in reality it's, it's the floor and is the bottom of it that you have to have this coming in in order to avoid diseases like rickets and scurvy, these severe nutrient deficiencies showing up in your body. Now when it comes to depletions with hormonal birth control, by the way, we've known about this since the 70s. But most providers aren't talking about their patients. I actually get hit back by providers all the time who are like, well, I just tell my patients to eat a standard diet and I'm like the standard American diet. Yikes. The most nutrient devoid, like the diet that we use in studies to say this is like the worst of the worst. And now we're going to compare.
- [09:27]
B
Yeah. 70 ultra processed.
- [09:29]
A
Yeah, yeah. And like, you know, very devoid of nutrients or the nutrients that are there are being put back in because they didn't exist to begin with. So things that can show up. So, you know, we talked a little bit about depression. I brought that up. That is something that can show up when our nutrients are not optimized. So if we don't have enough B6, we're not making serotonin, melatonin. That pathway is not running optimally. So we might see mood symptoms are starting to come up. If we're not having enough vitamin C and vitamin E, you're not going to probably notice that right now, but you are under oxidative stress. That means free radicals are winning. So free radicals, here's my nerdy little chemistry side of me. They are missing an electron. They're going to grab one off your cell. That makes things unstable. And so that's how we get cellular D damage. We also know nutrients like magnesium. I mean, what isn't magnesium not involved in? I don't know. I have an answer for that. But we can see mood symptoms with that. There was an interesting recent study showing that people who have an intake of 550mg daily. That doesn't mean you have to get all in a supplement, but food as well. They have brains that appear younger than their cohorts. So if we're on a medication that's depleting a mineral like that, well, what's the long term implications? And that I think is the biggest problem with the pill. It is not me who said it first, but I will parrot it, that we are in the largest uncontrolled experiment in human history of giving women the pill for decades on end and having no idea how that impacts them in the long run and how does it.
- [11:00]
B
Affect who you're attracted to?
- [11:03]
A
That's another controversial, fascinating. What's really interesting is that we're essentially animals. And I think people don't like to recognize that. I also think that women don't like to believe they're not completely in control of everything on a conscious level. And I don't like, blame them for that. But what we do know from the research, there's been very interesting studies. One is we pick up on people's scents, and what we are smelling is telling us information about their immune system and genetic compatibility. So when we go to mate, we want someone as different from us as possible. That way, basically, you shake all those genes together and you get the baby right. The organism that comes from that is going to be robust and viable and best suited for the environment that they're in. When women are on the pill, they're attracted to genetically someone who's more like their cousin than being as different from themselves. People hate it when I say that, because, one, it feels like ick. Secondly, certainly, you know, the other thing is there have been studies, women on the pill being they gravitate towards male faces that are more feminine. Yes. That I find fascinating.
- [12:20]
B
So juicy.
- [12:21]
A
I want so much more research in this, like the. The pushback. So researchers, they sometimes get penalized if they want to investigate a negative aspect of the pill. But also, as soon as they come out of the study, you know, you see things like, of course, like, a man must have come up with that, or. Or, you know, that that can't be true. And yet we have to ask questions because we are seeing women telling these stories of, like, I come off the pill, I'm no longer attracted to my partner, or I wasn't into this person until I started the pill. We have to ask why. There's also been studies where they look at strippers. We probably should have prefaced, like, don't have your children listen to this. So women who are stripper strippers, when they're ovulating, they get tipped more, they make more money. There's something that men are also picking up on when we are ovulating. And so it's just a really interesting topic that I think should be met with curiosity and less of, like, you know, repulsion of, like, this. This can't be true. There's a great book by Dr. Sarah Hill called this is your brain on birth control. And because she's a psychologist, I think she is really well suited to do this research. And it's so interesting because my book beyond the pill, it came out the same year hers did. I think we were, like, six months apart. We were just kind of floored because we weren't sharing our work really, with, like, anyone that we came to the same conclusions from the research. So my book came out, and then I read her book. I was like, oh, my gosh, yes, this is the same stuff that I'm finding. And so it was like instant friendship based on the fact that we both were, like, doing this independent work, yet coming to these same conclusions that the Pill does not just alter how our ovaries function, it alters how we function.
- [14:07]
B
When I'm looking into the Pill, does it increase or decrease rates of cancer? I feel like I see both. I see both things. That it helps decrease your risk of cancer and that the Pill helps in. It increases it. So what is the truth?
- [14:22]
A
This is something where is very important part of the informed consent, because is it true that the Pill decreases the risk of ovarian cancer or, like, endometrial cancer? Yes, of course. If your ovaries are not functioning and you're not building up your endometrium and then shedding your endometrium, women who are have pcos, then yes, it certainly can help. But there's other ways to prevent cancer, and I think it's a disservice to tell women, just take the pill and it will decrease your cancer risk. Well, what about your nutrition and your lifestyle, which we know are some of the biggest factors in the development of cancer? Now, when it comes to breast cancer, there is a slight increase in that. And it's so interesting because when you talk about birth control pills and cancer risk or clot risk or a lot of things, anything negative, women are told, no, no, no, no. It's the Pill. It's mostly safe. Like, don't worry about it. Don't ask questions. If you are in perimenopause or menopause, and you want to start ahrt, which is a far lower dose than the oral contraceptive pill that we're giving you topically. So we're not giving. Getting the first pass through the liver and the clotting issues going on, you're scared. You're told, like, you're gonna get breast cancer. Like, this is. You know, this could kill you. Like, we see people out there saying that. Yes. And what's interesting is if you look at the studies, when we see the cancer risk, when we see the problems, it comes down to using progestin, not progesterone, which is the same thing that's in the pill.
- [15:52]
B
Can using birth control actually make your hormones worse in the long run?
- [15:57]
A
So that's a really great question, and it is, again, very nuanced and depends on the individual. So. And when we talk about hormones, it's like, well, we got, like, 50 plus hormones. So, like, what hormones are we talking about? So there's been some studies that show that insulin dysregulation can come about after pill use. There was one study showing that women who use the pill and then subsequently enter into menopause, they have a higher risk of insulin resistance. We get these studies, and then nobody is like, go deeper and replicate and look into that. When it comes to thyroid hormone, that is something that I've certainly seen get worse when women are on birth control. So when you go into a birth control trial, they, a lot of people like to quit it or lie about taking it because of the side effects. They know this, so they validate it by testing binding proteins. Sex hormone binding globulin is one, cortisol binding globulin is another, and thyroid binding globulin. These do exactly what they sound like. They are binding hormones. So when you're on the pill, the pill is depleting nutrients that you need to make thyroid hormone to activate thyroid hormone to use it at the cellular receptor. So that's three steps that have to happen for you to have optimal thyroid health. In addition to that, it's raising thyroid binding globulin. So it may be grabbing on to the, the, the hormone that you should have. You can only use free, Any. Any other hormones. Just basically in jail. Can't. Can't do anything. Can't be out there misbehaving or helping you in any way. So there's that mechanism in place. And then we know that for some people, hormonal birth control can impact the gut in a negative way, so leading to dysbiosis. So you're not. Just because you take it doesn't mean you absorb at all. In the small intestine, it can make its way to large intestine and cause an imbalance in the flora there. That's the seed of your immune system. What is the number one cause of hypothyroidism in the United States? Hashi boros, an autoimmune thyroid condition. Do we have studies that say, without a doubt, birth control is causing autoimmune disease and leading to Hashimoto's? We don't have that. The studies haven't actually been done. So right now it's a question mark. We have so many question marks.
- [18:06]
B
I heard that if you are on the pill for 10 years or more, your risk of developing an autoimmune disease goes up like 230%.
- [18:16]
A
So this is what's really important for women to know. Anytime you have hormonal changes, you're at risk of developing an autoimmune disease. So Dr. Fasano came up with the theory of how autoimmunity is developed. I'm going to explain that, but what I want everyone to know is that you must have the genes. So if you have the genes for Crohn's disease, the pill may put you at a 300% increased risk of developing Crohn's disease. However, if you don't have those genes, that's not the route your body's gonna go. Now, the other two things that we need to develop autoimmunity is intestinal hyperpermeability or leaky gut. The pill, like ibuprofen, like other medications, can induce leaky gut. For people who don't know, that is you have these tight junctions inside of your gut, and, like, very, very small things should get through when they separate. Large things get through, and the immune system gets mad.
- [19:10]
B
This is what happened to me. I'm telling you.
- [19:11]
A
Yeah, this is the birth control.
- [19:12]
B
For so many years, my primarily only eating ultra processed food for.
- [19:17]
A
Yeah, I mean, that definitely wasn't doing any favors for your gut. So the other. The third factor is you have to have a triggering event. So having a baby, perimenopause, menopause, starting, stopping birth control, like, all of these hormonal changes can be a triggering event. And so I always, like, want people to be cautious because people will say, well, the pill causes autoimmune disease, therefore don't take it. And then people are like, all I have to do is not take it. I'm like, whoa, whoa, whoa, whoa. No, but if you have a baby, we know Some studies estimate 1 in 12 will develop postpartum thyroiditis. What is that? It's like the mini version of Hashimoto's. It might go away in a year, but it might not. That's how I got Hashimoto's. I had a baby. And then, surprise, I got an auto. So I have it too, though. Most women do. It is the number one autoimmune disease, and women are most impacted by autoimmune disease. On my podcast, you and I were talking about, what should RFK and Maha be looking at in terms of women's health? Autoimmunity. Why in the heck.
- [20:16]
B
Yeah.
- [20:16]
A
Are so many women developing autoimmunity? I need to know. Like, we all need to know. Why is it so disproportionately affecting us? It's going to be multifactorial for sure. But if we want to prevent this, and we have to in future generations, like the Numbers that are climbing are scary. If we want to prevent it, we've got to figure out what's going on.
- [20:36]
B
What is the real reason women have hormonal imbalances after getting off birth control?
- [20:41]
A
Here's the thing to know about birth control. A lot of people use it for symptoms, and that is often masking what is going on. People will often ask me, does birth control cause infertility? And my answer is, the way medicine uses birth control leads to infertility. The reason for that is you go to your doctor and you say, I have acne. I have heavy periods. I have painful periods. I have irregular periods. And they say to you, do you want to have a baby? No, not right now. It's not in the cards. Okay, fine. Go on. Birth control. If and when you do want to have a baby, then come back and have that discussion. Well, will I be able to get pregnant? Sure. As soon as you come off birth control, you can get pregnant. Because, I mean, if you're giving the pill at 14, yeah, you could probably get pregnant pretty easily. But if you wait until you're 28 and what's really going on is PCOS, or endometriosis, your disease has not been treated and managed right. And so you come off the pill expecting, you can get pregnant right away. The problem is PCOS has progressed, endometriosis progressed. Maybe your fallopian tubes are now scarred. You can't get pregnant. And so we have to look at how the pill is being used and really question, is it always right to chase just symptoms? I think the answer is no. Or is it right to tell the patient, here's the option for your symptoms, but we need to figure out what's going on.
- [22:08]
B
If birth control is supposed to help regulate our hormones, why do we see it often mess up our cycles?
- [22:16]
A
Okay, everybody needs to explain, like, have explained to them how the pill works. That's part of the informed consent. You take the pill, it's large enough amount of hormones that it goes through your liver. Your liver is like, you don't need all of this. Let me sort it out. But it's still enough that it gives this feedback to your brain and says, we have more than enough hormones. Don't talk to the ovaries. So the brain stops talking to the ovaries. Really great if you want to stop ovulation. But how does something that stops your ovaries from working actually regulate how well they're working? It doesn't. It just stops them. So women are told, this fixes your hormones or it fixes your period. Yeah. Then when they come off, they're like, I have all these hormonal issues. My period is gone. And unless you want a baby. And this is what really irks me about women's medicine is that is always reduced to reproductive capacity. And not looking at quality of life, not looking at the fact that polycystic ovarian syndrome, which I called PCOS earlier, sorry, I didn't define that. But PCOS is a complex endocrine and metabolic disorder. You're not just staring down infertility, you're staring down heart disease and diabetes as well. You're staring down Alzheimer's, you're staring down depression, you're staring down eating disorders because of the way that we treat these women. And so with that in mind, it's very short sighted to just hand you the pill with no explanation about what's going on.
- [23:39]
B
This whole idea of like taking the pill, it's too complicated to understand your cycle. You don't need to worry about that. Wouldn't it be nice to not have a period? And it's like, we almost need this total re education for women of understanding that our periods are really such a gift. Like, this is another vital sign that tells us all these cool things that are going on with our body. Like it's this extra window into our health that we as women have the privilege of experiencing. And I don't understand how we got from like treating that as a gift to like, oh, you just, you don't need your period. It's useless. But our periods are actually amazing.
- [24:15]
A
This is such a good point. And for anybody listening, if you are like, no, but I dread my period and I, I hate it. Let's talk. Because it doesn't have to be that way. There's myths, myths that we have really normalized in society that periods are horrible. Hormones make you crazy, they work against you. It's your body's way of betraying you. If you have symptoms, your symptoms is your body's way of communicating with you. It's never betraying you. It's not just like trying to get you closer to death. That is not your body's goal. It's in it with you. But you're so right. It's a vital sign. If you lose your period, we have problems. Something's going on. It could be primary ovarian insufficiency. It might be early signs of autoimmune disease. It might be a sign that you have a rare autoimmune immune condition called Addison's disease, you could end up in the hospital with an Adizonian crisis and potentially die. And your period could have told you that in advance. So there's a lot of ways that period problems show up and they are really signs. I mean it's such an opportunity. Like men don't get this kind of feedback. They have these like really boring hormones. That's why I don't do men's health, because they're just like, they're like the sun. They're up and they're down.
- [25:23]
B
It's like 24 hours, right? And then we have 28 days and.
- [25:25]
A
Yeah, well, I mean like let's than 30% of us actually do 28 day cycles. Most of us are, are having, you know, anywhere from like 24 to maybe even 35 day cycles. I just say that because if you don't have a 28 day cycle, you are normal. If you never know when your cycle, you know is going to be, where it's going to be at, or when your period showing up not normal. So there's definitely differences and certainly from ovulation to your next period, if it's less than 10 days, that's also not normal. Which is why tracking your cycle is super, super important. I agree with you on that. And I think at some point it got twisted in women's medicine. So you'll see a lot of gynecologists who say, I'm a fan of menstrual suppression. Why? Because I'm a fan. You don't need a period. How do you know? There's no study that says there's no negative impact if you don't have your own progesterone for the rest of your life. Like the progestin that they give you in the pill does not have the same benefits of your natural progesterone. The only way you make progesterone is via ovulation. You must ovulate to get to progesterone. There's never been a study that shows that it's totally fine to be without progesterone for like what happens 40 years on the pill, no progesterone? We have no idea. Right? So we have these claims that are made, but we don't actually have evidence to back it up. And it's kind of funny sometimes because it's the same people who are like evidence based medicine all the time and it's like, well hold up then why are you refuting every bit of evidence that comes out about side effects with the pill and not asking for more Evidence.
- [26:59]
B
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- [30:11]
A
So I outline this in beyond the Pill and what I say to people, this is what I do with my patients. If you started the pill for symptom management, let's work on your body for the next three months. Let's make sure we get your nutrient stores up. Let's figure out what was going on ahead of time and start troubleshooting for them that then have you come off the pill. If you started for just, you know, pregnancy prevention and you're like, which, by the way, if you do want to get pregnant, you don't just stop the pill and then try to get pregnant. You want to give yourself more time. It's so interesting because your average gynecologist will be like, just stop. It's fine. Your reproductive endocrinologist, who is a fertility specialist, will tell you, no, we want you to get off. We want to, you know, make sure that you are having regular cycles. We want to build your nutrient stores. We want to do all of these things. So. So if you come off the pill, I will tell you the last thing to go away is almost always acne. And that is the worst. You all can see my skin. I had never had skin issues. I came off the pill, I had deep cystic acne all along my jawline. It's what a friend of mine, Dr. Lara Bryden, coined the term androgen rebound, where basically your ovaries are like, yeah, we're back. And they start with androgen, so you start getting all of this testosterone going. So, so acne is the one you have to be patient with. You have to recognize that your skin and your hair, as much as you love it, you're attached to it. Your body's like, it doesn't really matter if we have hair. Like, it doesn't really matter. Like, what matters is our heart's okay, our lungs are okay. So with that, you know, it depends on what's going on, but you want to be as targeted as quick as possible. So I bring up the acne, cuz that's the number one I see drives women right back on the pill. We generally have to look at things like, like dairy and sugar as an influence because that can raise things called IGF1. That hormone can drive acne. We know having more omega 3 fatty acids in your diet. So salmon, mackerel, sardines, those are going to be some of your best sources. The cold water fish people have higher omega 3 fatty acids, they have lower incidences of acne, they have lower IGF1 level. So they're not getting the, the same skin breakouts. And then we have to look at things like, like how is your liver detoxifying? Are you giving it everything you need? How is your gut functioning? There's a big push back right now where people will say, oh well, your body detoxifies itself. And it's like, well, if you give it what it needs, like your kidneys aren't going to work without water. Like your liver needs amino acids, it needs certain nutrients. You, needs you to be eating cruciferous vegetables.
- [32:42]
B
Also pro tip on the tin fish. Well, getting your Omega 3s for mackerel. So this is, they're not a sponsor of the show, but if they want to be. Holler at your girl. I love the, the Fish wife brand tin fish and it's the most beautiful packaging and they only use like olive oil that they're, they're putting their fish in. And the best, like, like red chili flakes and I lemon and it's so good. So if you're like weirded out by tin fish or you want to get those up and you're like, how can I incorporate this into my lunch or whatever. I'm telling you, just try the fish wife brand tin fish. It's incredible. And so much protein.
- [33:17]
A
So beautiful. I actually put them in stockings for stocking, stuffing. My kids get them for stocking stuff.
- [33:22]
B
Literally. I need them to become a sponsor because I talk about them all the time. It's my favorite.
- [33:26]
A
The first time I saw it, I was like, this is the most beautiful fish I've ever seen. It's gorgeous.
- [33:30]
B
They have brilliant branding. But that was just like a sidebar. Pro tip. Are there any other lesser known side effects of birth control that, like, nobody ever talks about?
- [33:37]
A
Oh, gosh. So we talked about the thyroid piece. We talked about, like, who you're attracted to. We've covered clots, we've talked about the gut, we've talked about thyroid. The other thing that I would talk about is a lot of women start the pill so that they can have sex and not worry about an unintended pregnancy. And the pill will absolutely tank some people's libido. And beyond that, some studies have shown that there can be clitoral atrophy. So what's that? The clitoris shrinks? Yes. And so is this true for everyone? No, but it is a side effect. Who, like, who has ever, like, heard this or when I found that I was like, my lady parts.
- [34:16]
B
Yeah.
- [34:16]
A
What was I doing? So there's also increased, you know, incidence of vaginism developing. That can be. So that's basically where the, the muscles are basically shutting down. It's a very scared vagina. It will. Does not want to have sex and it can be very, very painful. So that's not to minimize that for anybody. I had vaginismus while I was on the pill. I also had chronic east vaginitis, which I'm like, which came first?
- [34:41]
B
Chicken Or a question about the vaginismus. This is fascinating to me. Does that immediately go away once you get off of the pill, or can it sometimes stay and it's a long term side effect?
- [34:51]
A
It can be a long term because of how the nervous system has been trained.
- [34:57]
B
Oh, my gosh.
- [34:58]
A
That is something where every woman in the United States. We should normalize pelvic floor physical therapy for everyone, not just if you've had a baby and not just if you're having dysfunction. But this is where pts can really help with that, as can mind body exercises. What a lot of women are told when they struggle with low libido or pain with sex, they're like, have a glass of wine and get some lube and it's like, well, hold up, there's a lot more going on here. We know that women's pain, when they're having a heart attack, when they're having a stroke, when they're having severe GI issues, they go to the ER and they are dismissed. I wrote all about this in my other book. Is this normal? If you think that, like, reproductive health or sexual pain is not dismissed. Like, you need to wake up to the fact that we die of heart attacks at a higher rate than our male counterparts because our symptoms go ignored.
- [35:49]
B
What is post birth control syndrome?
- [35:52]
A
So post birth control syndrome is a collection of signs and symptoms that can come up after you stop hormonal birth control. For some women, they'll see the return of symptoms they have, but other women can have brand new symptoms that they've never had before. I was one of them. I'd never had acne before. And my doctor convinced me that it was just me. He also was like, you must have pcos. I'm like, no, I don't have pcos. Like, my periods have always been regular. Trust me, I counted down, I dreaded them, I was scared of them. Like, they caused me tremendous pain. But, like, you can have this new onset of symptoms coming about. So you can have the acne. Some women start losing their hair. So you can have hair loss that's transient or continues. You can have cycle irregularity. So when it comes to the pill, we expect, if you had a regular cycle, once you stop the pill, know that that's a pill bleed. That first period, it could be three months before you get it back. If you have pcos, it might be six months. If it's longer than that, that that's a problem. The other thing that I think is just really important for women to know is that when they come off the pill, they may also have adverse mood symptoms. So their ovaries don't always come back online. So saying the the pill, you could have three months till your period comes back. If you're on Depo Provera, it might be 18 months. This is why you can't just tell women. Like, you'll just get pregnant right away, right? You have to plan for that. So I think it's just really important to understand there can be this delay and then there can be hormonal chaos as your body figures out how to communicate to your ovaries and your brain how they do that dance. And what's interesting is there have been researchers looking at the fact that there's a maturation period so you're 14, you get your period, it's irregular for a couple of years. Yeah. Because you have an immature hypothalamic ovarian access. So the hypothalamic pituitary ovarian access, that's brain and ovaries, how they talk to each other, other, that can be awful. It's maturing. But researchers have asked the question, if we interfere with the pill, then do you then also have to go through that process again when you come off 10 years later because you never fully matured? The brain isn't really meeting its maturation goals until like 25 years old. What happens when we put you on the pill and we, we interrupt that we don't actually know.
- [38:12]
B
Is it actually possible to track your cycle accurately if you're on pill?
- [38:16]
A
No, you don't have a cycle. So you're not ovulating and you're not menstruating. How we should really talk about the menstrual cycle is that ovulation, that's the main goal. Right. But we always talk about the period. Why? Because that's really easier to track and understand. You know, when you're having a period. So often people are like, okay, periods, normal cycle, pill bleeds, normal cycle. And why it's really important that I think we use that language is because women will start the pill because they had a regular periods. They think, I'm having a regular period for like the last 10 years, so I'm just gonna be able to get pregnant, like everything's fine. They come off and they're like, well, where's my period now? And we have to explain to them, you weren't actually having a period. Yeah. You were having a medication induced withdrawal bleed. And as I said, like with endometrial hyperplasia, preventing endometrial cancer has utility. There's a time and a place for that. That. However, I feel it is misleading not to use accurate information and for women to understand a menstrual cycle is not a flat line of hormones daily, which is what the pill is. You take it every day. You don't. Okay, hormones drop, you get a period.
- [39:24]
B
Out of all of the different types of hormonal birth control, which one do you think? Like, I would avoid this like the plague. If you were talking about side effects on side effects and side effects. I wouldn't touch it with the 10 foot pole.
- [39:35]
A
This is always going to be very individualized. And you know what's going to be true for people? For me, Depor Provera. I don't like something that would go in and I can't get out of and I would never use it long term because of the possible implications on bone health. I also know myself and when I get on progestin, I'm not fun to be around. So I have very adverse mood issues. You know, we were talking on my podcast going through ivf, there was like to time things right, I was like, okay, I'll just try the pill. And it's so funny cuz everyone's like, she's anti pill. And I'm like, like really like. Because here I am going to take the pill for this thing. It was five days in, I'm raging, I'm crying, I hate my life. I'm like having an existential crisis. So like, do I add any value to this world? And my husband is like, this is the pill, it's not you. And I'm like, no, it can't happen within five days. And he's like, you went from like awesome to like killjoy, like what is happening here? So you know, for me personally, knowing that I'm like, okay, we're just based only not going to work for me me. The other thing is the implant and this is for me personally, I don't like anything that goes in that I can't get out. These things are not working with the pill. I stop that right? But like, you know, and even IUD is really easy to go get pulled. But like once you have the shot in you that's gonna be with you for the next 90 days, once you have that bar put in your arm, you've got to go get that taken out. So that's, that's what I look at. And then for me now knowing what my clotting factors are, so, so one of the benefits of getting a full fertility workup is that they're going to look at clotting factors that no other doctor is looking at. And to find that I had these clotting factors, I'm like, I am so glad I stopped the pill in my 20s and didn't continue on it because now if I take oral estrogen, I have to inject myself with a low molecular weight heparin to keep my clotting factors down because they go up. Yeah. I'm like, yeah, I think you're on.
- [41:31]
B
To something about saying that we should really, it should be regular practice to test women for that risk factor before prescribing the pill. But I understand why people would say no to that and how, you know, it's Anti woman or whatever. But I'm like, I feel like that's the most pro woman thing possible. You're saving a life potentially.
- [41:45]
A
And it provides that full informed consent. And again, people will say the risk is minimal. And that's true, but we have to weigh it with what is that risk? Yeah, a stroke where you stop talking to your family. Family. Like, yes, it's small, but we have to look at what the impact is. And factor five, light in is one of the most common that we will see in clotting factors. You can test for that. And if you see that someone is heterozygous, it's probably not a good idea to be using the oral estrogen. If they're homozygous, they have two copies of the genes that are misbehaving. That's a no. And you literally saved someone's life by giving them an alternative.
- [42:24]
B
Is it possible for somebody diagnosed with severe endometriosis to heal and have a baby?
- [42:29]
A
Let's talk about endometriosis is. Because not everybody knows this. So endometriosis is endometrial, like cells outside of the uterus. So you have your uterine lining. That's the endometrium. This is not the same. Some doctors are like, oh, same same. Because they might even make their own hormones. So this is why, like, the pill is not a treatment for endometriosis. Will it help some people with painful periods? Yes, but it is not treating the condition. And this lie is not only costing women fertility, but their quality of life. Now, with endometriosis, it's going to depend on where it is. So if it's in your tubes, that has to get removed because that is where conception happens. So the egg is fertilized in the tube, but if the sperm can't get there, then that's never going to happen. So it is possible to treat your endometriosis. However, a lot of times we're going to be looking at things like excision surgery. I think it's really important for women to understand because you might be in your 20s now hearing this, and your doctor's like, you might have endometriosis. Like, don't worry about it, we'll deal with it in the future. It's compromising your egg quality. So this is a systemic inflammatory condition. I had a brilliant endometriosis specialist on my podcast and. And she brought up the research that is 70% of women with endo have period pain, but 98, depression, anxiety, like they're having mental health issues. Why Inflammation.
- [44:00]
B
Wow.
- [44:01]
A
We have to be really expanding our knowledge on endometriosis. We need a lot more research, but we also need to be considering the implications for quality of life, life and for fertility. If you're someone with endo, you have excision surgery. There's this really cool procedure called plasma platelet rich plasma prp. They take your blood, they spin it down, there's growth factors in there. Bonus pro tip, if you have this done, make sure you're taking a prenatal bump, up your CoQ10 to like 800 milligrams, get your antioxidants up, because all of that is going to be in there, and then they can inject that into your ovary. What happens when you do that is you can increase the quality of eggs that have been being hurt by that inflammation within three months. Some women are able to conceive naturally. Other women, because of how long the disease has gone untreated. They do need to go the route for like ivf. But I think it is a major disservice to jump to IVF in women with endometriosis. 50% of infertility cases is, can be attributed to undiagnosed or maybe even silent endometriosis.
- [45:12]
B
So when you're going through that process, are they doing like, are, are they looking into all these different things before having you do IVF or even the IVF clinics or not?
- [45:20]
A
This is where you and I are on the same page of taking issue with ivf. Many IVF clinics are not. And they will tell you, keep going, keep going, keep going. Just collect eggs and transfer. Collect eggs and transfer for that makes them a lot of money. And that I think needs, needs to be looked into because there needs to be a standardization of giving women a full workup. A lot of doctors are under the impression, because they haven't educated themselves on endometriosis, that the only way to diagnose is through surgery. I tell everybody, no peekaboo surgeries. Do not let a doctor say, I'm just going to go in and take a look if there's endo there or not. If they're going in, they better be getting everything thing. You can actually have imaging ahead of time. Very skilled and trained practitioners can do ultrasound. And then there's something called a gel MRI that you do endo mapping. It's not fun because you have to have gel inserted in the rectum and the vagina, it expand. I mean, yeah, it sounds, I had it done. I was like, this is not fun. However, like the vagina is this amazing organ. Right. It's like an accordion. I mean, a human passes.
- [46:26]
B
Also, that pre nouveau scan that you and I both did, checks for endometriosis.
- [46:30]
A
Yes. But it can't map it, so. So 29 years for me to get my endometriosis diagnosis. And it was incidental on a pre nouvo where they were like, oh, you have adenomyosis and an endometrioma. And I'm like, what? So I had endometriosis. I. They saw cyst in my ovary. That wasn't enough to diagnose it, so I had to get a gel mri. And with that, because you insert the gel, it expands the tissue so they can visualize it so much better. Better. I had very extremely painful periods as a teenager, figured out how to manage them. I studied nutrition, went to naturopathic medical school, and fixed my period. I didn't have painful periods, which everybody was shocked by because I went through excision surgery, and I had stage four endometriosis. My bowels were glued to my uterus. My ovaries had endometrioma. I had to lose two ligaments because they were so infiltrated with it.
- [47:27]
B
Whoa.
- [47:27]
A
And you want to know what's crazy is that my doctor, he had said to me, I love him. Rom Cabrera. He's amazing. He was like, your energy is going to be up. Absolutely. It was. I didn't expect that in two weeks. I lost so much weight. My face changed, my shoe size changed. Everything changed because all the inflammation dropped.
- [47:48]
B
So what is, like, the number one symptom that you have? Endometrium.
- [47:52]
A
So there's the pain. Right. So like, 70 of women have period pain.
- [47:55]
B
Okay.
- [47:55]
A
They might have pain with ovulation, so you might not have period pain.
- [47:59]
B
So horny it hurts.
- [48:02]
A
Yeah, Right. Like, I'm so into you that I'm gonna throw up. So the other thing is that you might have what people call crotch lightning or butt lightning. So where you feel an electric shock through the rectum, through the anus, or in your crotch or down your thighs because of what's going on with the nerves. But like I said, you might have mood symptoms, but certainly if you are somebody struggling with fertility and they say to you, we don't know. Unexplained infertility. Wrong. Unless you've checked for endometriosis, you can't call it that yet. You need to dig deeper because, like I said, so helpful. 50% of infertility cases that they're like, we don't know. It's likely endometriosis.
- [48:46]
B
What about tips and tricks for ovarian cysts?
- [48:49]
A
For ovarian cyst, that's where doctors will, like, immediately be like, let's just put you on the pill when it comes to ovarian cyst. Like, sometimes we're like, we have no idea what's going on or what's happening. We want to make sure it's not endometriosis, but making sure that you're. You're doing some of these basic things that are going to support your estrogen level. So making sure that you're eating enough fiber, 25 grams of fiber every day as a minimum. If you're like, I eat, like, no fiber right now. Start with five grams a day. Day, do that for a week, another 5 grams. So now you're 10 grams the next week. Because if you are like, okay, Dr. Brighton said 25 grams, and you start that tomorrow, you're going to be gassy, bloated, constipated, you're going to be in pain, you're going to hate me. So go slow. We want to make sure we're eating our cruciferous vegetable. So that's going to be things like broccoli, cauliflower, cabbage, kale, Brussels sprouts. Making sure that you're eating those, because that's going to help with your estrogen metabolism as well. And then we also want to look at, like, what nutrients are we bringing that are just going to be supporting overall our menstrual cycle. So, like, vitamin B6 from avocados, vitamin C, strawberries, bell peppers, and your citrus fruit. Looking at ways that you can help support your hormones and how your body is functioning. But if you're having ovarian cysts and they're rupturing, and they might have said, like, it's a chocolate cyst. Chocolate cyst, yeah.
- [50:12]
B
That doesn't sound appetizing.
- [50:13]
A
I know it sounds like way to ruin chocolate for me. What is that? So that's an endometrioma that ruptures, and then you'll have, like, this, like, brown blood that's there. What's so interesting is doctors will say, oh, just take the pill for ovarian cysts. There's actually not good evidence that that's gonna actually treat and prevent these ovarian cysts. And I had this happen. I ended up in the ER in my 20s, and now here I am in my 40s, and I'm like, that was endometriosis. That was endometriosis. And no doctor said anything to me. They just said stay on the pill.
- [50:49]
B
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- [53:36]
A
Figure it out fast. So we need to know why.
- [53:39]
B
Because.
- [53:39]
A
Because one of the drivers might be a form of testosterone called dihydrotestosterone or dht. DHT is going to cause the follicles to get small, small, small until the hair follicle is done. It doesn't come back out. It's irreversible hair loss. And if that's what's going on and you're in your reproductive years because, you know, we talk about like finasteride and spiralactone and minoxidil for hair loss. You can't take that if you want to become pregnant. And I think like, you could start it at 25, but you're going to lose all your hair when you go off of it because you can't be on it if you want to be pregnant if you're 45. Okay. Totally different story to like use those things, but something like saw palmetto, which is an herb. I have a product called saw palmetto plus in my supplement line that we use for that reason. I brought you some today. Yeah, I'm excited because it's been shown to be beneficial with dht. What's interesting is all the stuff, studies they look at, like how DHT is affecting the prostate. It's the same hormone that's leading to hair loss. They find that it's very effective for men. It works in women as well. The other thing that can always help if you're dealing with testosterone issues, it's too high, it's too low, is zinc. I always like to joke, like, you know, are oysters really an aphrodisiac? Because, like, maybe, maybe it's the slurping, maybe it's like how mindful you have to be to eat them. Maybe it's the restaurant, the ambience. Or maybe it's the zinc because Zinc can really help with testosterone levels in both men and women.
- [55:07]
B
Oysters are my favorite food. Everybody knows what.
- [55:10]
A
That's my very favorite man. You're like checking all the boxes because I talk about like, oh, cold water fish people are like, yuck. I'm like, oysters people like, no, they're not going to do it.
- [55:18]
B
I don't know how you don't like. I think you've just never had a good one is what I think.
- [55:21]
A
I agree.
- [55:22]
B
Can postpartum trigger pcos?
- [55:25]
A
If you have pcos, pcos, it's going to look like irregular periods from the onset, or maybe you didn't get your period until you were 16, so significantly delayed. So those periods are going to be unpredictable. Why? Because ovulation is unpredictable. So pcos, there are, as of right now, the Rotterdam criteria is like, there's three ways, you know, three things we have to check off to diagnose it. So firstly is the most useless one, which is polycystic ovaries. They're not cyst on your ovaries. Ovaries, they're follicles. They're your body trying really, really hard to ovulate. You're young, we're gonna see them. You're like 35 plus. We're not, we're not going to catch those, most likely. So not totally useful. And you have to do a transvaginal ultrasound, which for all intents and purposes does look like a penis. And not everybody wants to have that done. You don't have to have that done. The other two that you can meet is the ovulatory issues, which is going to show up as, as my period just goes missing or it's really irregular. And, and that's how you'll notice that this is where tracking your symptoms is helpful. And then excess androgens we can test, but we don't have to test. If you have oily skin, acne and hair loss and you're growing hair on your chin, chest, abdomen, we can check that box. But I do think some women do need to have that tested. And then this being recognized now that anti malarian hormone or amh, which in the fertility world, everyone knows it, it's checking ache resistance reserve. If it is very high, this is not a good thing. So if it's passing 4, that's suggestive of PCOS. And I think that we're going to see that gets adopted as one of the criteria we can use to diagnose this. And I want everybody listening to know, just because you have a high ovarian reserve does not mean all those eggs are going to be high quality and you're going to be able to get pregnant. And I think that's a big misunderstanding in the PCOS community where they're like, we have so many eggs, like we're going to be able to get pregnant. It's like, well actually because of the excess androgens, it can impact your egg quality because of the underlying inflammation that can impact your egg quality. And in pcos, excess insulin stimulates the ovaries to make the androgen. So you've also got insulin dysregulation influencing your egg quality.
- [57:40]
B
What are the best natural game changers for healing PCOS and fixing the insulin problems?
- [57:46]
A
Well, it's diet and lifestyle. Like I will tell you that when.
- [57:49]
B
So this is a diet and lifestyle disease.
- [57:51]
A
Yes. Okay, so it's not that your diet and lifestyle cover cause this. Okay, you had the genetics and you're predisposed. Not every ovary gets excess insulin and is going to make testosterone. Your genes are running it that way. But what's really cool is that the 2023 I believe guidelines came out on PCOS and they said nutrition and lifestyle need to be first line interventions for this. So what do most women with PCOS get? Spiral lactone. Let's drop your testosterone, let's give you birth control pills. But who is talking about the inflammation? They might also get metformin which can give you tummy troubles. Not everybody loves that. For that when you know you could use things instead like myoinositol bring in chromium. So myoinositol 2000mg. Couple that with D chyro inositol 50mg. This is how I formulate my myonosital plus because all of the research is there for not only egg quality but for helping with insulin and helping with androgens as well. You have to do this is non negotiable, high quality protein, fat and fiber at every single meal. Carbohydrates are not bad, refined carbohydrates, you are not genetically set up to process those.
- [59:04]
B
Well, do you like keto for pcos?
- [59:06]
A
So the thing about keto for PCOS is that there are some women it works really well for, but then there's some women that they'll just lose their cycle altogether. Okay, I would love to see more research on this so that we can understand like who does this work for, who doesn't work for. The closer you are to menopause, the more that like keto and fasting and all these things that, like, you know, all the biohacker men are like, this is the best thing ever. It will work for. Because you're no longer in those reproductive years, you're not cycling anymore in the way that your 20 something, 30 something self was. So with PCOS, we need to strength train because we've gotta gobble up that glucose. There's something called the soleus push up. I love this. So you put your feet flat, you got heels, but you lift your heels and then you just drop them abruptly. And you want to try to do this every second. So 60 in a minute. And there's researchers, brilliant, who are like, perfecting this. But the soleus muscle, I call it the glucose goblin because it will gobble up all your glucose. So you can do that after meals as a way to start optimizing your blood sugar. So building muscle mass, soleus pushup. So when I set up a plate for people, I think this will be helpful for people to understand, right? Because always, like, eat fat and protein. What does that look like? You take a plate. Half your plate is vegetables, okay? Half of it is plants, fruits, vegetables. This is where a lot of your fiber is going to come from. The other half, cut it in half again. A quarter of that is your protein. We want to aim for like 25 to 30 grams of protein at each meal for like everybody, but especially pcos. Now the other half, that's going to be your carbohydrate source. Maybe it's brown rice, maybe it's quinoa, or maybe it's sweet potatoes, carrots, squash, things like that. And so that's how we want to structure a plate to optimize our blood sugar. This will help. If you have pcos, if you have endometriosis, if you're somebody with adrenal issues, you have hypothyroidism, you have an autoimmune disease, you have perimenopause, you have menopause. Like, literally everything can be helped by structuring your plate in that way. And then he said, strength training, definitely gotta have that on the bill because muscles are so, so good at helping you sensitize to insulin. And then we have to start looking at all the mind body aspect of, like, how do you live your life? Negative selft talk alone. So saying mean things to yourself can raise inflammatory cytokines. If you already have a condition where inflammation is up, it's where I tell people you have to talk pretty to yourself. Get in from the mirror. You know, there's that little girl who went viral. She's like, I'm the best. I'm a rock star, buddy. Do that. That. Because they have. They've tested people's blood and they've shown that they can decrease inflammatory markers just by being super positive and nice to themselves. Like, I love that. How amazing is that?
- [61:47]
B
Do you like strength training for Hashimoto's?
- [61:49]
A
I like strength training for everything.
- [61:51]
B
Okay.
- [61:51]
A
When I was studying for my master's in nutrition, it was. My research was in sarcopenic obesity. This is the one thing like, okay, mama, nature gets some stuff wrong. And this one definitely wrong, because you start deleting muscle cells, which is super lame, because as we start losing muscle mass, we're not only going to see increased visceral adiposity. So that's when fat packs around your organs that's inflammatory in itself.
- [62:14]
B
Yeah.
- [62:14]
A
We also start to see the risk for Alzheimer's and dementia go up. Something that like 66% of women are within that population. Like, again, disproportionately affecting us as well. So when it comes to thyroid, really important for everyone to know. Even if you need a thyroid medication, you still have to move to activate T4 to T3. It is one of the ways we get to that active thyroid hormone. So butterfly shape on your neck, there's is a little gland. It is going to produce T4, a little bit of T3. But the conversion to the active form and T3 is like our mood, our mens, our metabolism, motility for our gut. That is all that T3 goodness. It has to be converted out in the peripheral free. Your gut's going to do it, your liver's going to do it, but also movement is going to help.
- [63:02]
B
You know what's weird is that one of the symptoms of this condition is that it's like it makes you more tired to work out. It's hard to get moving and you.
- [63:10]
A
Don'T recover as fast.
- [63:12]
B
But you still say, push through it.
- [63:14]
A
Where I'm going to nuance that. But what I want to say is one of the symptoms that no one talks about with thyroid disease. When your thyroid hormone is low, you step out of bed in the morning and your feet hurt so bad first thing in the morning, you're like, why are my feet, like, in this searing pain? Because those muscles that are supporting you all day, they didn't have thyroid hormone to help them recover. So we have to be optimizing the thyroid hormone. And this is where people will take issue with me because, like, people take issues with everything. But I'm like, you have to slow the workout. Okay. You can't just be like, I'm going to go to CrossFit, right?
- [63:45]
B
Oh, horrible. What I say, I think, okay, hot take. I think those hit workouts and CrossFit, whatever, I think that's just terrible for women in general, but maybe that's just me.
- [63:52]
A
I'm going to say, I think CrossFit is terrible because it is so prone. You're so prone to injury when they're like, do as much as you can in the short period of time. I'm like, form first, movement second. Always, always, always. Okay. Yeah. This is how you know you do too much in your workout. If you have, if you're healing your from anything really, but especially when you have Hashimoto, if you work out and three to five days later you're still sore, like, you're like, I can barely move you. You did too much. And that's good data. You didn't do anything wrong. You experimented. Now you know that was a little bit too much. Know that when you first start working out, if you haven't been strength training like the doms, the delayed onset muscle sore is going to hit you. You're going to be like, I hate life right now. This was so bad. That's normal. That's your inspiration not to stop because it will come back like, bad. But I'm talking about like, you can't do your activities of daily living because you're in so much pain. So maybe it looks like walking and you're doing 10 minutes three times a day and that is where you're starting. And then may, maybe you're like, hey, I work an office job. Every hour I'm gonna, I'm gonna sit down and stand up for my chair 10 times. Like, and you're just starting to incorporate more movement before you ever pick up a weight. Because if you, if you haven't been lifting weights, like going from like zero to like, you know, here I am in the gym, strength training. That might discourage you, but it also might injure you. And I also want people to know they're not alone in that because. Because I remember when, before I got my diagnosis, I was like pushing my son in a stroller and just like up the hill, like, no big deal. And I like, the next day was like, I can't move my body. Oh my God, what's happening to me? And like five days later I'm like, why is I am in so much pain? Like, I was working out every single Day, like, I was a really fit person, and I'm like, something else is going on here. And so understand you have to have that thyroid hormone. And I also want people to understand it actually has a time and a place. Because when you pulse that cortisol like that, it actually puts your immune system in check.
- [66:02]
B
So maybe certain parts of your cycle and not others.
- [66:04]
A
I do think we have to pay attention to how we feel in our cycle. I think we, like, try to make too many rules about, like, if you're in this phase of your cycle, like, you can't do this, and if you're in this phase, you can't do that. The U.S. soccer team, they won the cup because they trained with their cycle.
- [66:20]
B
No way.
- [66:21]
A
Yeah.
- [66:21]
B
I didn't know this.
- [66:22]
A
Oh, my gosh. Yeah. What most coaches do, and this is like, to me, as a doctor, I have boys, but as a mother, if I had a daughter, this would be a huge red flag to me is when they're just like, we're just going to put you on the pill, so we don't have to worry about it. And then we're just going to train you, train you, train you. Oh, what do they. They don't want the report card saying, I've lost my period because you're abusing my body, because you're underfeeding me and you're over training me. So these coaches were like, what if we work with their cycle? We don't just put them on the pill. We're going to work with them. They won.
- [66:50]
B
Were all those girls synced up?
- [66:52]
A
No, I don't believe they were. But I believe, and I hope I'm not wrong on this because I think it's fantastic, the person who kicked the winning goal was actually on her period. And so, you know, we often hear things like, oh, well, you're on your period. You just have to rest. If that's true for you, absolutely rest. But if you're like, oh, no, because progesterone's taking a backseat, I'm less prone to injuries now. I. I'm not as, you know, super hungry and I'm not overheating, and, like, I feel super strong, like, do it. Go for it. With hit exercises, we do have to be mindful that, like, if you're struggling with a chronic condition, if you've had an injury, like, if your estrogen is super low for whatever reason, maybe you're postpartum, or maybe you're in menopause, like, your joints are going to hurt more. This might be more painful. For you? Yeah, it's very, very nuanced. And we have to respect that everyone knows their body and help them feel like they're an expert in their body, because I think when we make too many rules or too many generalizations, we start disempowering people and they forget that, like, they know they're normal. They know their body. They know what's true for them.
- [67:58]
B
Can you explain each of the four phases of a woman's cycle and the hormonal changes that happen with each phase?
- [68:05]
A
Okay. Women like to break up their cycle into four phases, phases with the period being a distinct phase. But what I want everyone to understand is it's all the follicular phase, because the goal of the menstrual cycle is ovulation, and that is what the follicular phase is doing. So I will explain, like, you know, when the period is and everything, but I want to explain the follicular phase. So that is the day you start your period until you get to ovulation. So even while you're bleeding, so you might be on day two of your period, your ovaries and brain are already conspiring to ovulate. So estrogen is already rising. Fsh. Follicle stimulating hormone from the brain is telling the ovaries, let's get an egg ready. We're about to do this all again. So you may be bleeding. And that's what people will call the, you know, the first phase in some instances. And that period should ideally be about three days to seven days, less than three. We don't have enough estrogen over seven. We got a problem here. Like, we either got, like, too much estrogen, we got fibroids, endometriosis, adenomyosis. Like, something's going on that's too much, too long to be bleeding. That's what people will call the. The period now. So your o. Your ovaries are doing something totally different than your uteruses. Your ovaries are already, like, we're on our way. So we've got estrogen rising. There is no progesterone happening, but testosterone is. Is there? Okay, there's some. There's like, a little bit of progesterone, but nothing to write home about. So FSH is going along. Ovaries are getting that egg ready. So you've got all of these follicles being recruited and when that egg is ready, so the ovaries have to choose a winner. LH surges luteinizing hormones. So this is for people who want to get pregnant. This Is what you're peeing on every day, like in the. Usually in the early afternoon to be like, is there an LH surge? This is how body so coolly designed, when the egg is ready, tells the brain. The brain is like, and. And via a spike in estrogen, the brain says, luteinizing hormone. I love to think of it like, release the Kraken, like release the egg and then the egg is released. So in that moment, we're now in the ovulatory phase. What's interesting about this is that ovulation is a one day event. You only have one day to sync up with sperm if you want to get pregnant. That's it.
- [70:18]
B
I thought it was five.
- [70:18]
A
Sperm can live five days. They're loiters, they're just like hanging around. Little troublemakers in there. You don't want to get pregnant. So sperm can live five days, ovulation one day.
- [70:28]
B
And how do you know which of those five days is the one day? Like, is it the first day of ovulation?
- [70:33]
A
The day you ovulate, that egg lives 24 hours. And so that's where like, if you're wanting to get pregnant, we're like three days before you, you think you're going to ovulate. Best time to have unprotected sex. And then the day you ovulate, like those are like key days three days before. Yes. So because it might live five days, or maybe like the uterus is not, not as loving and comforting and nurturing as it should be. Or maybe like the sperm is not as healthy as it should be. So we want to get like, bet your best chance in the, in that three days. What's really interesting is that that's ovulation, right? It's just one day. But within the follicular phase, there's something that in the research they've called it the sexual phase of the cycle, which as soon as I read this study, I was like, oh, that's ovulation. So what's happening? Pre ovulation, estrogen is up and testosterone's up. So everybody, like, if I ask, like, oh, what's the main hormone that you think's involved in sexual desire or libido? People are testosterone. I'm like, but it needs estrogen. Estrogen actually puts sex on our brain. It makes us think more about sex. Like, we are like thinking about our partner. We're fantasizing more. We're like at work being like, I can't wait to get home. Mother Nature doesn't get a lot of things wrong. And this one definitely got right. And so that's what the research is saying. Like this is the sexual phase. And I'm like, that's, that's gearing up to ovulation. And it's because that's your body by design saying I'm about to ovulate. That's also when you'll see more fertile cervical mucus. And it's also the time in your cycle where like if you are sexually active, you self lubricate more easily. That self lubrication goes away as you pass ovulation and enter into the luteal phase. And that is because estrogen now takes a back burner turner to progesterone. And it's just really important for every woman to understand that like lube, needing lube is super normal during this phase of your cycle, but also not being in your into your partner as much super normal. So you will see men on the Internet being like, what's up with women? One day she's totally into me and the next she wants nothing to do with me. I'm like, she ovulated. Then progesterone came online. And I like to say progesterone is like, we would rather get into sweatpants than get into your, your pants. Thank you very much. Because you had the opportunity to capture some sperm. We passed that, we're done. So once you ovulate, the what's left behind, and this is, I think is so cool, a temporary endocrine structure that means a hormone producing structure called the corpus ludium. And that's going to produce progesterone that's going to take us into our luteal phase, which at minimum needs to be 10 days. But we really want to be getting like closer to 12, maybe even 14. And this is why it matters less. Like in the whole thing of like, oh, you ovulate on day 14. Like I want everyone to understand that the way we count pregnancy, it's imprecise. So because they say for based on your last menstrual period, you weren't pregnant and did you ovulate? And it's based on a myth that we all ovulate on day 14. No, we don't. Maybe you ovulate like day 20.
- [73:33]
B
Yeah.
- [73:33]
A
So if we say day 20, then you're essentially three weeks from your period. And then we know that implantation. So if you do become pregnant, pregnant. So fertilization happens in the fallopian tube. Implantation might not happen for another 8 to 10 days. Then we gotta wait for beta HCG to rise before you can take a pregnancy test. But at this point, you might go to your doctor and you're like, oh, yeah, well, my period was like, five weeks ago. And they're like, well, then you're five weeks pregnant when in fact, you're only, like, two weeks pregnant. And this matters greatly when it comes to how we estimate due dates in this country and being like, oh, we have to jump in and we have to, like, make sure you're induced because, like, we're. We're assuming you're five, six weeks pregnant. And it's like, well, actually, at the time, I was only, like, two weeks pregnant.
- [74:17]
B
Oh, wow.
- [74:18]
A
Yeah. It's just important for, I think, women to understand that piece and understand that tracking from ovulation to when your next period is that ludal phase is so helpful. Because if it's, like, only getting to, like, seven days, we probably have an issue with how the ovaries are producing progesterone. We have to work on that because if it's less than 10 days. Days, then we're compromising the ability to have implantation. Uterus bleeds, sheds the lining. Because we went through the whole ovaries. The. The estrogen is going to get the endometrium ready, and it's going to help it proliferate and grow. I just think of, like, the softest, like, most wonderful, comfortable bed ever. That's what you're making for babies. I want to snuggle right in. And so it has to grow, develop. It gets these three layers, layers to it. Like, it's so cool and complex. And then once we get into the luteal phase, we have to have enough progesterone stimulating the receptors, getting ready so that it can basically. And what's really cool is that when implantation happens, that little embryo is secreting enzymes. It basically, like, chews into your uterus, but the uterus is like, we're ready. Like, we'll. We'll welcome you in.
- [75:29]
B
This is what health classes in school should be teaching. You know, middle school school girls and high school girls.
- [75:34]
A
You know, I very much am. Like, if every single state had medically accurate health education, not one of us would be like, yeah, of course our only option is the pill. Like, we would be like, I know my body. This is what I think's going. And I also think it would change everything. You can troubleshoot so much stuff on your own. Like, there's a time and a place to go to the doctor. It's what I try to outline in my books is like, here's the DIY part, because absolutely, stuff has to happen on your own. Like, your doctor's not there when you're at the grocery putting stuff in your cart. Like, you have to be doing things on your own. You also have to know what to track, what data to bring to them and know when to see them. I think we get lost on that, too. Like, when do I actually even need to see a doctor? Is it for every little thing, or is it just for the big, scary things?
- [76:16]
B
How can we feel less crappy during our luteal phase?
- [76:20]
A
Oh, yeah.
- [76:20]
B
I can always tell when I'm on my luteal phase at work, everybody's on my nerves. I am so irritable. I can always tell with my boyfriend. The only time we fight, it's when I'm on my ludal phase. Like, just the worst. Just, I do not want to leave the house. Just irritability. That's, like, my biggest thing.
- [76:41]
A
So I think we need to not only normalize health education for women across the board, but also men to understand us and for us to be in communication. Because there's not only the, like, we're irritable. And then they're like, why do you hate me? But there's also the, like, I just. You know, I'm about to start my period. My progesterone says, I'm less into you, and they're feeling rejected. They're like, why don't. Why don't you love me? What's happening? It's like, it's my hormones, and they're supposed to do this. This is, like, normal. But when it comes to pms, which is what you're likely talking about, that's typically like, three to five days before your period. If it's more than that, if it's hijacking half of your month, we're looking at pmdd. If that's half happening month after month, and that's extreme. That's where you're having suicidal ideation. Your moods are just all over the place. You're having all kinds of physical symptoms as well. And pain, that's a different story. We have to look at that a lot more closely and try to figure out, like, you know, what is going on in those instances. We also have to make sure that there's not a concurrent ADHD or autism diagnosis being nist, because in those women in particular, there's a way that they're not utilizing progesterone that makes them more susceptible to that.
- [77:54]
B
Oh, wild.
- [77:54]
A
Yeah. Yeah.
- [77:55]
B
Mine definitely is five to seven days out, like, and I, and if I like have not paid attention really to where, where I'm at my cycle for a couple days and then I'm starting to feel this way and I'll look and I'm like, it says period, you know, five to seven days. I'm like, yep, this is about right.
- [78:07]
A
And especially when your progesterone's not right. Now if it is right, you're like, like, you know, I want to just cuddle with my partner, right? No sexy time. But if it's not right, you're like, if they even breathe or chew in the wrong way, like I'm going to lose it on them. And that's normal if you don't have like optimal progesterone. So we have to support progesterone number one. We all have to understand that by way of being born with ovaries, we were designed to be super sensitive to the environment because you gestate, grow a human, feed a human. And those things are very energetically expensive for all my mamas out there, they're like, I know I don't sleep. And like, like, you know, they, they take like all of this stuff. They're totally worth it. Love my kids. But because of that, your body being really wise, it's like, look, if we're running from a tiger, right? Because your body doesn't know what the stress is. Is it your boss or is it actually a bear? You know, if you are not eating enough. So do we have a famine going on? If your body is receiving negative input in the way of too much stress, it will compromise your ability to reproduce. You might lose your libido, you might not ovulate, or you might just have trouble making enough progesterone cuz you're making cort cortisol.
- [79:17]
B
So, so what I'm hearing is during the luteal phase, it is the most important time of your cycle to do activities that help lighten your load, stress wise, supporting the body with the stress response. I mean, would magnesium during the luteal phase be a good idea?
- [79:31]
A
Is magnesium ever bad? No, no, no.
- [79:33]
B
So, but definitely during, I want to.
- [79:34]
A
Talk about that nuance of magnesium. But also in your luteal phase, more sleep. So the studies that have told us all eight hours a night on men, then they just tried to apply to women. Nice try. Doesn't work during your ludal phase. Like if progesterone's right, it's, it has a metabolite that stimulates gaba in your brain. Gaba makes you feel chill, calm. Love in your life is like, oh, you're just like, everybody's great and I'm sleeping like a champ. If it's not right, sleep is getting disrupted. We're feeling irritable, we're feeling anxious. So specifically things that can help with progesterone, so you have them in a bottle right there actually. So Vitex is one of them. Chase tree berry vitamin C. So we want to bring that in via foods. But also it helps to take a supplement if you are somebody who's struggling with progesterone. Progesterone, vitamin B6 as well. This is one that I just want to caution people because sometimes people are like, if a little is good, then more is better. If you're taking a lot of vitamin B6 and you do that for a long period of time, you might get numbness, tingling in your fingers and toes, which is scary, it goes away, it's reversible. But we just, you know, with vitamin B6 we're talking more like 25 milligrams, maybe like 50 milligrams we might use if somebody has like nausea in pregnancy. But we're not doing super high dose. So those things can really help the corpus ludium function. So those nutrients decreasing stress, making sure you're getting enough sleep. Now to your point of magnesium. Magnesium is going to help with your stress response. I like magnesium glycinate specifically because it'll also help you sleep and then bringing in adaptogenic herbs. So things like holy basil, Ashwagandha, rhodiola for every mom. Rhodiola is our endurance herb. Mental and physical endurance. I have a toddler and I have a 12 year old. So I'm like in the middle of things and I'm like that's my bestie right now. So those kinds of things can help you with your stress. Cuz you can meditate and you can go for walks and you can do all this stuff. But like if you're primed for stress, it's nice to have some herbs that are just like sh. Cortisol, it's okay, go to sleep, be cool. So those things can help. Magnesium I especially love because if you are somebody who has painful periods, kids, I recommend, you know, magnesium, 300 milligrams, typically magnesium glycinate. You take daily omega 3 fatty acids. Please, please, please look for a quality supplement. It's actually why I started my supplement line because I was so appalled by like what people are doing with supplements. Like sometimes Cutting canola oil with fish oil.
- [81:58]
B
Oh, it's like not regulated at all.
- [82:01]
A
Yeah, we do third party testing because I'm like, if I'm gonna put it in my body then and my husband's body and my kids. Kids. But, like, are we gonna know what's in it? Like, without a doubt. With the omega 3 fatty acids, I just, I always want you to do food first, but if you're going to Costco, trust me, you are not getting your money's worth there. You're like, I got a deal. No, you didn't. No, you didn't. So. But omega 3 fatty acids, quality ones that are also checking for like heavy miles, things like that, that can help a lot.
- [82:26]
B
So alternating in the luteal phase between, see high quality seafood and maybe steak, red meat.
- [82:32]
A
Oh, yeah. Like, I mean, somebody's gonna, some vegan's gonna hate me. But your period's coming. You're about to lose iron. You absolutely are. So replenishing that we also know that's gonna have your B vitamins in. It's gonna have zinc. Like, really quality. So. But with the Omega 3s and the magnesium, this helps something called prostaglandins. I will always ask people when they're like, I have period pain, I'm like, do you also get like period poops? And they're like, yes. I'm like, prostaglandins. So prostaglandins, anyone who's ever have a baby, you're very intimate with them, they cause the uterus to contract. We why everybody also poops when they're having a baby. And anyone who says they didn't bless their nurses for lying to them, because that's really what's going on there. If you are noticing that, yeah, I get like loose stools or I have diarrhea before my period. And you have period cramps. Your prostaglandins, they're too potent. They're made from omegas. You eat too many omega sixes, high standard American diet, you're going to have painful periods and maybe poop yourself. That's not fun. You counter that by more omega 3s in the diet, bring in omega 3 cells, supplement like 2,000milligrams of EPA and DHA. That can help, as can magnesium. Magnesium also helps with menstrual migraines. So another reason I love it. So for people who have headaches and period pain, I will often say five days before your period, we're doing 300 milligrams of magnesium twice a day. Like we're going to bump that up. In addition to the rest of the cycle, you were taking 300 milligrams and you were focusing on magnesium rich foods.
- [84:04]
B
Okay, let's talk purse essentials. You know the drill. Lip balm, hand sanitizer, maybe a snack. But there's one thing that's non negotiable in a girl's purse. Organic cotton period products from Garnu. We're not talking about the toxic chemical laden stuff that you've been leaving for years. We're talking about 100 organic cotton tampons, pads and menstrual cups. Beware those chemicals. The fragrances, the chlorine bleach. It's a big fat no. Garnu's got you covered with clean organic cotton products that are not only better for your body, but also for the planet. No forever chemicals, no lead or arsenic, and they even come in a sugar cane applicator. So honestly, if your period products aren't this clean, you're doing it wrong. And guess what? Garneu just launched light and super plus tampons for those heavier days in lighter days. So it's all taken care of. When you choose Garneu, you're helping support feminine health education and female entrepreneurship across the globe from Nepal to Brazil. You're helping girls who are at risk of sexual exploitation. Because Garnet is all about empowering women. Join the girls only Club and get 15% off your order, whether that's subscription or wine time, using code Alex Garnu.com that's G-R N U.com code Alex for 15 off. So this was actually just asked me by the sweetest girl that I go to church with who just had a baby. And she's super young, she's like 19 or 20. And I thought, oh my gosh, this is a great question she asked me last night and I said, you asked me this at the right moment because now I'm going to interview this woman who this is like her whole thing is this. And she was so excited for me to ask. So she wants to know what is the best way for a woman to support her hormones during the postpartum phase, especially when breastfeeding at night disrupts her circadian rhythm.
- [85:40]
A
Oh, yes, I love this question.
- [85:41]
B
Isn't this great? And she's like 19 years old, first time mom. She's precious.
- [85:44]
A
Yeah, love her. Such a brilliant woman. My first book that I actually wrote is all about postpartum health. It's called Healing your body naturally after child birth for all the things, hormones, but all, all the things that happen to your body body when you have a kid and no one tells you it's going to happen. And so here's what's really important for moms to understand is that baby's liver is immature. It cannot store sugar. That baby has to wake up. And it is the most important job for you to be waking up with them. Now, everyone says sleep when the baby sleeps. That's not always possible, but I really am like, we need postpartum doulas to come in and help us get more sleep. But a couple things that you can do is you can, can get red light bulbs in your lamp. So if you're going to wake up at night and turn on the light, you can do that. You can also put like a scarf over your, your light or you can get some blue light blocking glasses. So why we want to do that is because light, when it enters through our eye, it hits the pineal gland and it says, break down melatonin. Melatonin is great for sleep, but it's also an antioxidant protecting your brain and your ovaries. So we want that around when we see melatonin go down. Cortisol is coming up. So that's one thing that you can do, is help with the alteration of the light in the night when you're waking up. It is ideal if we can have a schedule where, like, if baby's sleeping in, you're sleeping in, trying to get as much sleep as possible. Because in our society, we hold space for the fact that like, if you ran a marathon, then you need recovery, of course, but you have a baby and people are like, yeah, yeah, get on it.
- [87:14]
B
When are you back to work?
- [87:15]
A
Like, go, go, go. And it's like your body actually needs a good year of healing.
- [87:19]
B
It's like we do that in America. Other cultures, the, those like 40 days after giving birth, you know, in a way better way to support mom.
- [87:27]
A
Both Mexican and Chinese culture, they have, like, you don't touch the floor with your feet for 40 days. Like, you're staying in bed, like you're resting, which I believe, and I've seen a lot of physical therapists say this as well, has a really big impact on uterine prolapse in our 60s by making sure when all that relaxin is around and your uterus is really heavy, that you are, are not letting gravity do all of this work on you. When your pelvic floor kind of feels like it's been obliterated. When a human Passes through it. It's a significant athletic event to have a human. I want people to understand even if you have a C section, it's still impacting your pelvic floor. Cuz sometimes women are like, I'll just have a C section and then my pelvic floor will be fine. And it's like, oh well, probably not. Cuz your pelvic floor isn't just what's in the pelvis. It's like all of these abdominal muscles come in and connect as well. So if we're cutting through those, that's going to have an as well. There's that, that piece of at night, how you're safeguarding the light when you wake up in the morning. Then we wanna, when you're up for the day, expose yourself to sunlight. Let's get that cortisol spiking. Melatonin degrading. So we are trying to set that circadian rhythm. This is for anybody who's had kids and they're now a toddler or older. They'll tell you this. A very short period, you feel like it's never gonna end and you're never gonna sleep again. But it does. And so you're not gonna like wreck your hormones beyond repair. Something you do need to be aware of that I mentioned before is postpartum thyroiditis. In a lot of cases it starts with the hyperthyroid phase. So you're the super mom, tons of energy, ready to go all the time, like can do everything. But you also might be really anxious and having trouble sleeping. Then it flips into about four to six months postpartum. More of that classic hypothyroidism picture. Now I'm gaining weight, my digestion is sluggish, I'm really tired. What else is happening at that time? Oh, I'm sad, I'm depressed and my hair is falling out. We expect that at that period of time postpartum so it can get missed. And so that's one of the hormones that I'm like really four to six months postpartum, we should be doing a thyroid panel and we should be screening for that.
- [89:36]
B
Oh, interesting.
- [89:38]
A
Yes. I do this in all of my patients. Let me explain what a thyroid panel is. So with a thyroid panel we have TSH. It's what the brain says to the thyroid. Free T4, that's how the thyroid responds. And free T3, that's the active hormone it's converted to. But we want to test TPO and thyroglobulin antibodies. If those are positive and the thyroid Functional. That I just explained. All of those hormones are fine. Cool. We've got early stage autoimmunity. We have no thyroid dysfunction. Let's head it off the path so we never destroy that thyroid gland to where we need medication. Like, that's the goal. If we start seeing that TSH is rapid rising, like, we need to look at. Okay. We don't just jump to a medication. Sure, it can be helpful, but we look at lifestyle, nutrition. What can we do to reduce stress on you? What can we do to support your gut health? What can we do to make sure that, like, you're getting the nutrients you need? Like, sometimes the question is like, do we have enough iron? Yep. Because if you don't have enough iron, you don't make the thyroid hormone. By the way, if you have a baby, take your prenatal. As long as you breastfeed or at least a year.
- [90:39]
B
What prenatal do you like?
- [90:41]
A
I actually made my own. Because. Because when I was pregnant with my son, I had such a hard time trusting so many. Some of your favorites, they get bought by big corporations. There was one I'm not going to name drop, but they knew they had unsafe levels of arsenic. They knew, yikes. And they just kept going. So that was actually the moment where I was like, I'm formulating my own. I'm putting everything in it. It is six capsules where people will say like, oh, my gosh, that's a lot. And I'm like, nine months is all you get to control your child's nutrition. They are forming in your body. And I don't hold back. It's like everything that I wanted in my prenatal, I put in there. And I say this to moms, not to shame them or guilt them, but for them to understand that once your child, even when they're six months and they start solids, they are autonomous person, they're gonna still reject things. So this is like such an important phase of the life. So mine's prenatal plus. And I. I formulated essentially because I was like, I. It needs to be third party tested. It needs to be screened for heavy metals, for any kind of contaminants. Like, I need to know that what I'm putting in my body is what the label says and nothing else. Yeah, yeah.
- [91:54]
B
What is your advice for women wanting to prepare their body to conceive?
- [91:58]
A
If you can start a year in advance, fantastic. But six months minimum and bring your partner along with you. They need to eat the same foods as you. Nutrient dense diet. Diet. Because sperm Health is just important as egg health. All of the focus gets put on women, but now we understand by way of DNA fragmentation. So sperm is not healthy. It can lead to miscarriages and heartbreak. And, you know, a lot of the issues we see with conception can be traced back to sperm.
- [92:25]
B
So how can you make it healthier?
- [92:26]
A
Male has to come with you. So things that help sperm. Selenium, vitamin E, vitamin C, zinc. Let's go back to your fish, right? Selenium and iodine is going to be in our fish. We can get the omega 3 fatty ac acids. Eating lots of plants. So your fresh fruits and vegetables are going to give you antioxidants. Antioxidants are so, so important for egg and sperm quality and track your cycle. If your cycle is irregular, you will have trouble trying to conceive. So you need to address that now and plan for it. Because if you think you want to have a baby at 38, you need to start planning for that at like 35. Because you may run into issues, especially like if you're on the pedestrian pill and you think, 38, I'll just come off of it, I'll be fine. Maybe, maybe not. And so even if you're someone who's like, well, what about 25? Still plan for it. We enter into pregnancy nutrient depleted, more so than our ancestors did. We have to build up our nutrient stores.
- [93:22]
B
And am I crazy thinking that that probably is heavily contributing to the rise in autism and different things that your kids are having?
- [93:29]
A
Yeah, well, let's talk about that. Because autism is genetic. The expression of autism is epigenetic. And this is, I think, important for people to understand is that somebody who is autistic. They are autistic. Where they fall on the spectrum can be influenced by different variables. Not just mom, but we know also dad and his sperm quality as well. It can happen. Preconception. It might be in utero things, things that you're exposed to, or it can be, you know, afterward, different exposures, illnesses that we get that can influence the epigenetics. So this is a whole spectrum of things. So not one size fits all. But there's been some research showing that in some autistic kids who are non verbal, they remove dairy because dairy is actually triggering almost like an autoimmune condition that's affecting the folate metabolism. It's their ability to use that B vitamin. And when they remove the dairy and they bring in something like folinic acid in, these children are improving in their verbal skills. Whoa. They're still autistic. But the symptom expression is different.
- [94:38]
B
Wow. Is it normal for a woman to really only be interested in sex one to two weeks a month?
- [94:43]
A
Yeah, it is. Okay, so that's that whole rise in estrogen that I was talking about. So here's the other thing, too, is that in your luteal phase, you can be at the mercy of stress. Right? We're like, our partner's breathing, and I'm. My nervous system is freaking out. For some people, stress will actually put them in the mood. It's a very small.
- [95:04]
B
Why can't that happen to me?
- [95:05]
A
I know, I know. So, but why? Why would it do that? Because people are like. Those people are freaks. No, when you have sex, you're connecting with somebody. You're very mindful, painful, you're deep breathing. You're doing all the things right that, like, the health gurus are like, if you're stressed, breathe deep, try to have connection. Like hug a person. You get oxytocin release, Oxytocin sees cortisol, and it's like, shut up. Get in the corner. You're done here. Like, I am chilling everything out. Endorphins are released. So understand that stress can play a major impact. Right? I said if the environment is stressful, it will stop you from procreating. And one way is to shut down your desire for any. Any type of sex there with your partner. The other thing is that when estrogen is up and unchallenged, it will. It will stimulate your tissue. So it's going to stimulate the brain, the main sexual organ. It'll also stimulate all your fun parts to be a lot more receptive to any stimuli or signal. But once we pass ovulation and we're into that progesterone phase, that's where your partner has to work a little harder. They will often feel like they're being rejected, they're being punished, or like, oh, well, because I didn't do X, Y and Z for you, you're withholding sex. That's not. Not it a woman. Especially when we talk about, like, having vaginal penetration, that's very vulnerable. We have to have our nervous system taken care of. You'll see men saying, like, we're your protectors. And it's like, well, not from predators, but from, like, the stress of life. Yes. If you can help, like, do the dishes, take care of the kids, like, alleviate these stressors. There's a model called the dual control model model. Bancroft and Jansen are the researchers. If anyone likes to look it up. The Brakes. They talk about the brake pedal and the gas and I talk all about this in. Is this normal? The brakes are what keep us from getting in the mood. And because our nervous system is so primed for the input of stress, we can have body image issues, we can have stress of our relationship, we can have stress of our kids, stress at work, whatever that stress looks like, it will hit us harder in that loose luteal phase. So that's where if partners come in and they take something off your plate, your nervous system will be more receptive to whatever, you know, foreplay or game they got. Your nervous system will be like, I'm picking it up, I'm picking it up.
- [97:23]
B
So there's a good chance if a guy's like, hey honey, I'm gonna start washing the dishes. Or you know what, why don't you take a, take a seat, I'm gonna go clean your car out or whatever, you might get in the mood.
- [97:31]
A
Foreplay is an all day game for women. For men, it's like the moment they think about sex and they start engaging. But for women, it's like it starts the moment you wake up. And by alleviating those little stressors, what it does is it makes your nervous system capable of receiving those signals. Sometimes when they come to you and they're like, ooh, I know she loves it when I nibble her ear. And then they're like, why don't you love it? It's cuz your nervous system's like static. Like I can't hear that right now because I'm dysregulated at the moment.
- [97:59]
B
Have you heard of a young couple getting married and they could be married for years? A couple one to three years. Years and still not have sex. Because she cannot relax to have sex. What could be going on? Trying pot, alcohol, sex therapy. Nothing is working.
- [98:17]
A
Okay, firstly, drugs and alcohol are not going to help your sex problems. And in fact, if we've got a nervous system dysregulation and we're not feeling safe, and then you put yourself under the influence, that can make things worse for some people. If you're not able to relax, we need to look at, at. Okay, could this be vaginismus? We also need to look at what is happening in your nervous system. Have you suffered a trauma of some type? People automatically go to sexual trauma. Yes. And you could have fallen off a horse, like you could have hit your pelvis in some way. And now the nervous system is caught in this loop and it's having like this feedback I had a neuropelveologist on my podcast, which is a nervous system expert of the pelvis. And she, she talked all about this and, and different ways that you can help the nervous system retrain and relearn. But the other thing is maybe you need to just start small. I'm a certified sex counselor and there's this model called the plit model. And you know, like 90% of problems can be solved with just the P part, which is permission. Permission that you don't have to have penetrated of sex. Like, you take that pressure off the table, you can do anything else but that. And some people, that's going to be enough for them, that they're like, oh, I'm easing into that. There's not this expectation of things. Permission to also know that it's okay to like nourish your nervous system and to focus on that. So finding different ways to connect and easing into that. There's a lot of pressure and expectation, right? You get married, you're supposed to have this honeymoon, and then you're like having fantastic sex and like all. And it's like, that's a lot of pressure. And for some people, that kind of pressure can actually cause their nervous system to be like, no, absolutely not. So there is an exercise that I think this is one that I would explore. If you've been trying sex counseling and trying everything is that close goes off. You can do whatever you want, but you cannot have penetrative sex. It is off the table. You can do kissing, you can bring in feathers, you can do whatever you want and explore each other's bodies, but you don't do that.
- [100:32]
B
Is that because it's almost like a reverse psychology thing. So then you're getting your body really, I want what I can't have.
- [100:37]
A
Sometimes it works that way for people, and other times it takes away that pressure and expectation that they can then start learning to be present in their body body to step into their sexual self and get comfortable in a way that doesn't come with expectations.
- [100:52]
B
If a woman suspects that her hormones are totally out of whack and imbalanced, what are the first steps she needs to be doing to get them figured out?
- [100:59]
A
First thing is track your cycle, track your symptoms, quantify that. Because if you're going to go to a doctor and you're going to say, I have period pain, they're going to be like, yeah, everyone has period pain. It's normal. It's never normal. They shouldn't say that. However, if you say to them, I, I can't go to work, I can't go to school. Like, it's, you know, a 10 out of 10. I'm on the floor, I'm vomiting, They're going to be like, ho, ho. Okay, that's not normal. It's not fair to a patient. But you, you have to quantify that. Then I would start looking at the buckets of what is your stress, what is your sleep, what is your diet like? And looking at that complete nutrition and lifestyle piece. There's more to it than that. Everybody, everyone. And saying, what is the smallest thing that I can do right now to implement change? One thing that I have people do is start eating broccoli sprouts if they are having, you know, cyclical problems. So estrogen progesterone, 2 tablespoons of broccoli sprouts rivals 2 pounds of broccoli in terms of its sulforaphane and its support of your estrogen reduces cancer too.
- [102:00]
B
Two tablespoons.
- [102:01]
A
Two tablespoons.
- [102:02]
B
Should I be doing that with my low progesterone and estrogen?
- [102:04]
A
It's not going to necessarily help your low progesterone. I'm not convinced you have low estrogen because people, people who are cycling regularly, okay, they don't have like low estrogen. There's not like zero. But it helps with estrogen metabolism through the liver. It's not going to push things through so fast that it drops your estrogen. Something that can be beneficial for everyone. Why I say look at the little things is because I could give you all of the things to do and there are many, but if I stress you out with all of that, then we just defeated the whole purpose. Also, I've never once had anybody be like, I'm just going to do everything all at once and that be sustainable and then be successful in my book. Is this normal? And beyond the pillow, I have two different, like, symptom questionnaires you can go through to figure out what is going on with your hormones and look at what can I do to intervene there so that you can troubleshoot things? Because like I said before, we got a lot of hormones, right? And we've got, you know, our sex hormones or reproductive hormones, we've got insulin, we've got cortisol, we've got thyroid and then a whole lot of others that we, like, never talk about. But the number one place that we all have to focus if we want hormone health for life is at the foundation of our hormone pyramid that I have in the book, which is insulin and cortisol. Looking at adrenal function and looking at blood sugar regulation because if those are not right, none of your hormones will be right.
- [103:27]
B
How do you find a doctor who will do all these different hormone tests for you?
- [103:31]
A
Yeah, so that can be really tricky if you are someone who is in perimenopause menopause, going through the menopause society. That's one resource with that I want women who are in per menopause to understand. We will not be testing your estrogen and progesterone because it is so changeable every single month. Your symptoms are what matter most. And if your doctor isn't willing to treat your symptoms and use you as the data, you need to get a different doctor. And, and by the way, they should be testing other hormones, just particularly progesterone and estrogen. When it comes to finding a practitioner, a naturopathic physician or a functional medicine provider, these are two schools of thought that are very invested in the why, the why and why ad nauseam. And so we can't ask why anymore of what exactly is going on rather than being like, just take the pill. If your provider ever says to you, well it's the pill and nothing else. If you, you know, won't take that, then there's nothing I'm going to do for you that's not the best doctor for you. That doesn't mean they're a bad doctor. It's just, you know, I would say.
- [104:35]
B
I would say yes, I like to.
- [104:36]
A
Say that like you don't go to the ice cream shop and ask for a sandwich. And so like you're at the ice cream shop right now, you need to go to the sandwich shop if you want to get what you want. I don't like it when doctors are like, well you need to take the pill. And then they say something scary or they threaten, they'll fire you. Cuz that's coercion and nobody should ever. It's unethical to make a medical decision when you're feeling coerced by your provider.
- [104:55]
B
If you could offer one remedy to heal a sick culture, physically, mentally or spiritually, what would it be?
- [105:01]
A
I would teach everybody that they are the authority on their body. And I would see exactly what we talked about. The implementation of every single individual being educated on how their biology works, how their physiology works, and how they can use the simplest of interventions in their day to day life to elicit positive change in their body.
- [105:22]
B
You brought up Sarah, Sarah Hill, I mean your books, her book, those are, I mean my absolute all time favorite Books on birth control, hormones, understanding all of these things that we talked about as women. And your books I love because there is pictures and graphs and little lists and dos and don'ts and like you have it broken down with all these headers and it's just so easy to like get the information, understand it, and then like flip through and find exactly the answer to the question that you have. So where can people get your books? And then what are the called again?
- [105:53]
A
Yes, so there's healing your body naturally after childbirth. That's the new mom's guide to navigating the fourth trimester. Then we've got the latest one which is is this normal? And then beyond the pill, which was your introduction to me. They're everywhere that books are sold. You can find them on my website, Dr. Brighton.com or, you know, good old Amazon I think is where everybody goes these days for books.
- [106:12]
B
Yes. And you interviewed me. So where can people listen to your podcast and follow you on social media?
- [106:17]
A
Yes. So it's Dr. Jolene Brighton and it's B R I G H T E N all over social media and the show is called the Dr. Brighton Show. And I cannot wait for our episode to come out because it was so good.
- [106:29]
B
Yeah, it was good. She, she asked me very hard questions, but really good questions. You're a great interviewer and stuff. I've never been asked in particulars about the Maha movement. You know, do I really trust that President Trump is going to do what he says? You know, what am I hearing behind the scenes about like, what's being tackled and a bunch of other stuff. So I think you will really enjoy that. So make sure you go subscribe to her podcast as well. Thank you, Dr. Brighton, for coming on Culture Apothecary.
- [106:54]
A
Yeah, thanks for having me.
- [106:58]
B
Don't forget to listen to Dr. Brighton's interview of me on the Dr. Brighton Show. Wherever you listen to podcasts, please leave a five star review and tell others why they should listen to Culture Apothecary. We are on a mission to heal a sick culture 20 twice a week, new guests bring a unique remedy. Mondays and Thursdays at 9pm Eastern, 6pm Pacific. Subscribe to Real Alex Clark on YouTube and follow me on Instagram at Real Alex Clark or the show at Culture Apothecary. We've got some brand new merch@tpusamerch.com use code Alex Clark to get 10 off. I'm Alex Clark and this is Culture Apothecary.