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Healing + Human Potential
The Truth About Women’s Hormones: What Doctors Aren’t Telling You - Dr. Sarah Daccarett | EP 75
00:43:20
Are we missing key answers about our own health? In this episode, I sit down with Dr. Sarah Daccarett to talk about the hidden gaps in women’s health research and why so much of what we know about hormones is outdated. We explore how medical...
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- [00:00]
Dr. Sarah Docoret
It's actually embarrassing to say how far behind we are in women's health, especially hormonal health. We're a decade behind men's, and we're a decade even further behind transgender health. So we've made more progress with transgender population than we have with women over the age of 30. Doctors are not trained in medical school at all about hormonal health. And even doctors think that birth control is hormones. We need to be questioning that. Is this healthy? Like, our hormones are built to protect us. They tell every process how to function. So if you take that away, then you are potentially increasing health risks for a young patient, especially 13 year olds or 15 year olds. Long term, when women in their 30s are, like, doing all the supplements, all the things to try to stop this aging, because they can feel it, but if they knew that, hey, you can prevent this, then you can slow this down a lot just by using your own natural hormones, then that'd be great if you could prevent RA and hair loss and weight gain. We used to tell women like, you got to go through menopause, and we would even sometimes take away their hormones, which is unbelievably cruel. We don't believe in that philosophy anymore. All the data shows that you don't have to ever go through menopause if you don't want to. This is your entirely your choice. There's only one difference between perimenopause and menopause. They have exactly the same symptoms. The only difference is.
- [01:13]
Alyssa Nobriga
Welcome back to the Healing and Human Potential podcast, where today we're going to talk about how birth control might be affecting your bodies in ways that you're not even expecting. We're joined by Dr. Sarah Docoret to dive into all of these topics. And so if you're ready to understand your hormones, connect with your body and take actionable steps towards living a more vibrant, healthy life.
- [01:32]
Unknown
This episode is for you.
- [01:34]
Alyssa Nobriga
Amazing. I'm so happy that you're here, and I'm just gonna, like, dive right in because there's so many questions I want to ask you. I'm curious because I know hormone health can be, like, a mystery for a lot of women. And so I'm curious just to hear your opinion, why there's a lack of research and understanding about women's health and how that actually affects care that we get in the long term.
- [01:58]
Dr. Sarah Docoret
It's so. It's true. It's actually embarrassing to say how far behind we are in women's health, especially hormonal health. We're a decade behind Men's and we're a decade even further behind transgender health. So we've made more progress with transgender population than we have with women over the age of 30. For example, for hormone, even in innovation approach, reference intervals, everything. And there's always, you know, it's actually not that surprising, I guess. We, we have a huge gender data gap with everything. And then, you know, we've all. In medicine, all the studies have been geared towards men. Women have cycles and so our hormones fluctuate and potentially they complicated studies or drug studies, pharmaceuticals, the dosing is built for men. I mean even iPhones, like the size of an iPhone is built for a man's hand. I mean like car seats, everything. I mean, everything is. We are literally half of the population and completely ignored when it comes to even technological advancements. So it's, it's happened in hormonal health as well.
- [02:58]
Alyssa Nobriga
Yeah. And it's good for us to know that so that when we're hearing different research and studies, we can actually apply. Does that actually true for me is this, does this feel right for my body? Right. So that, you know, I heard somewhere, I don't know if this is accurate, that men's hormones are within a 24 hour window and women's are more through the month. Is that accurate?
- [03:16]
Dr. Sarah Docoret
It's probably accurate. I think some of them stay stable. When we look at these old cyclical graphs, they're based on very old lab assays, Outdated, in fact. We'll reject other research papers if they're done on these lab tests. But we still acknowledge this old data, so we can even question whether that's accurate or not, or whether that needs to be reinvestigated.
- [03:40]
Alyssa Nobriga
Yeah, it sounds like there's a huge.
- [03:41]
Dr. Sarah Docoret
Opportunity, misbelief or misunderstanding about even a period. Women think that they have a period because they've ovulated or dropped an egg. And this is not necessarily true. Women will have. Because we tell women that they can't take hormone replacement therapy. We've been telling them a long time, well, if you're still having a period, you're still making hormones. And this is totally wrong. Right. Women have this misunderstanding that they've made progesterone because they had a period. And we see women with zero levels of hormones and still having a period. So there's something else there, a different mechanism that's cyclical, that's causing a period that's not hormone related, that we don't understand that we have not even researched that basic thing about women.
- [04:21]
Alyssa Nobriga
That's crazy. It feels like that would be the foundation to get started on hormone research. Yeah. And I know that doctors oftentimes will prescribe birth control for various types of reasons without really talking about the long term implications of what that does to your hormones. I mean, I got put on birth control cuz I had cramps at like 13. And there's a lot that that does. I'm just curious to hear why you think this is so common. And then what are some of the HIDD risks for us doing that?
- [04:50]
Dr. Sarah Docoret
Yeah, this is something that we're not informing young patients. You know, this is like you said, birth control is prescribed for acne, bad periods. It's meant for, you know, a specific reason. And for that it, it's good, right? Birth control. But like it's not a treatment, it's not a treatment for endometriosis or pcos or acne or anything like that. And what I think the reason is, is doctors are not trained in medical school at all about hormonal health. And even doctors think that birth control is hormones. I hear it a lot. So women, you know, if, if they could understand anything from today, like if I wanted, you know, if they can understand that birth control is the opposite. It suppresses the production of your hormone, that's what makes you infertile. It stops the production of your own estrogen and progesterone. And we need to be questioning that. Like women need to like for their daughters and they need to be like, is this healthy? Like our hormones are built to protect us from a lot of different things. They tell every process how to function. So if you take that away, then you are potentially increasing health risks for a young patient, especially 13 year olds or 15 year olds long term. How do we know how that impacts your fertility? How do we know how that impacts your mental health? As soon as women, young women especially start birth control, we see an increase in suicidal ideation. Right. Like there could become depression, there's depression, anxiety, irritability, they can't sleep. Mental health is huge. Like why are, you know, and you're increasing the risk with birth control. There's certainly a better way to treat acne.
- [06:21]
Alyssa Nobriga
Yeah, yeah, yeah. And it makes sense. Like anything that's natural, there's an intelligence in nature. And so when we're just pushing it down so we can skip a period or to help our acne, like there's like you're saying there's other options for people. I know that there's so much infertility. Talk to us about infertility and why you Think there's so much going on right now, or what the current research.
- [06:42]
Dr. Sarah Docoret
Says about it, it's wild how much there is. And I think that when we look at men, we know that their testosterone levels, for example, are 50% lower. There are some statistics about how much lower they are now than they were even 100 years ago. The same thing is for women. I think women need to recognize that their estrogen progesterone levels are very, very low and it's making them infertile. What's causing that in a 25 year old? You know, I think in a 30 and above, our ancestors were probably not ever meant to live that long. So we weren't really meant to have babies maybe past 30. And so that's might be aging, that just might be biological, that our ovaries are failing us. But when you have a 22 year old or 23 or 24, what we're seeing really young women with low hormone levels. What's causing this? And it's likely environmental. I mean you can speculate all the plastics and toxins and there's phthalates. I mean women are inundated with beauty products that have fragrances in them, chemicals like they're putting them on their skin, they're all over their body, for example, and this and then the food. But I think largely it's just like the chemicals around us that they can't avoid no matter how much they try to eliminate these toxins that are everywhere. And they're. We're even breathing in plastics, apparently microplastics. Now it's in my tea now I've heard. So it's like everywhere. And I think that if women understood what actually maybe protected them against these plastics and I can get into this really quickly because yeah, I would love to hear because like people say that these plastics and phthalates bind to estrogen receptors, right? And they're causing like something like an estrogen dominance or they're making, they're giving women symptoms. But why are these receptors free in the first place? So if you think about it, estrogen, this is beautiful receptor that's completely empty because she has low estrogen and progesterone to begin with. And now you've allowed these plastics and phthalates and chemicals to bind to this open receptor and it's causing problems and it could potentially cause cancer. We think that it might cause breast cancer and other problems for her and you know, inflammation in the body. So if they were just to keep their estrogen and progesterone levels healthy, Then the receptors would be full. Right. You'd be protecting yourself because there would be nowhere for these plastics to bind or chemicals to bind because the receptors are full of our very own protective natural estrogen and progesterone, which they are built to protect us. If you think about pregnancy, this like, state that women are like, the most amazing creatures are able to do, literally, like on the planet is like have a baby, be able to carry, have a baby, birth it, and then heal from that, recover from it. Estrogen and progesterone. Do this for, you know, they are our nature's way of, of protecting the body and allowing it to heal. So when they're missing, we get disease, we get autoimmunity, we get a lot of unhealthy states.
- [09:22]
Alyssa Nobriga
How do we support our hormones?
- [09:25]
Dr. Sarah Docoret
So this is really hard. And with all these environmental toxins, like, see women who are really trying their best, they're eliminating all the toxins. Their diets are super clean. They have these pristine. The way they're doing it, they are doing everything and they're still struggling with their gut health. And when you start to see the gut health decline and they start to get autoimmunity, they start to get Hashimoto's. Their skin doesn't look as good in their hair. This is because they don't have their hormones there to regulate their immune system to help with their gut health, all, you know, weight maintenance, everything that it's supposed to be doing. But I guess the good news, there's good news is that what is wrong with simply replacing these hormones, we can actually supplement them like we would supplement anything else that we're missing, are no longer able to make. So I think if women knew that, hey, you could still, like, it's still good to eliminate all the toxins and have the clean diet. But if you're still struggling, you can protect yourself actually just by replacing the hormones. And there's some ways that are better to do that than others, but making sure that these levels, sometimes you cannot do it on your own. Like, you can't do it with like the will, you know, all this willpower.
- [10:29]
Alyssa Nobriga
Yeah, so it sounds like. Because I imagine there's lifestyle things that people can do. Maybe you can share some. I also imagine there's some herbs. But I also know for other people that might need more support, can you kind of list off a few practical things that people just so that they can see their options?
- [10:43]
Dr. Sarah Docoret
Yes, I think in a younger patient, like, you know, say, call a younger patient 20 to 30, I know that women in their 30s. I'm still young women in their 40s. But there's a certain point where the ovaries cannot function as well, even when the place of herb. So, for example, if you're a younger woman and you're struggling and you're able to remove all these toxins and you're able to reduce your stress. So, you know, I mean, if you're able to do this and practice exercise and all of the things like yoga, medit, anything you need to do to, like, be centered and reduce that stress will help. And then diet, especially eliminating, like, gluten and dairy and eating, you know, protein and, like, things that, you know, like, can work. And then herbs. Some herbs work. So here's the thing. Like, the herbs are not natural. Actually, you know, I think we think of an herb as a natural plant, but we don't naturally make ashwagandha. We don't make turmeric. We don't make black cohosh. That's not something my body makes. And when we take those herbs, they bind to those receptors, and they don't actually act like the natural hormone. Sometimes they raise serotonin and dopamine, or they just raise serotonin, and they make women sometimes feel better. Like, they kind of get a boost. But this is not, like, the most beneficial thing you can do. You need the hormone. We naturally make estrogen and progesterone. That's what we should be supplementing. Right. So then herb, like what we're trying to do with the herb and younger patient and I have done it, and it sort of works. Like, if you have a healthy patient, it can stimulate ovulation. Right. It can make sure that you're. You're normalizing LH and FSH in the brain, and that's how it'll work for her. And we can get a better result in men. So I would say that men actually have a little bit easier. A lot of the herbs work better to raise testosterone than they do for women. I know Vitex is a popular, like Chase Berry for progesterone, but I find that it's not as effective as you might want it to be. But it can, like, it can be helpful. And then beyond that, though, I find that if you try herbs in older women, you have less and less an effect because the ovaries, like, cannot function the way you want them to, even with the stimulant, if you're trying to stimulate it.
- [12:45]
Alyssa Nobriga
Yeah. And it's good just to see what our options are so that we can Think about and just test things. What actually works for me. Why not try to the different things and maybe start with some mindfulness or get having less stress and seeing how the body can find its own homeostasis.
- [13:01]
Dr. Sarah Docoret
I think that you still need all of that. Like there's no getting around all that either. Right. And so to be ultimately to be this like ultimate health that we want to be in and expand our lifespan, but not only our lifespan, but our health span, like women already live like longer than men. We really want to be healthy like as long as we can and vibrant and youthful and feel good and like chase our kids and all the things. And so I think hormone replacement, in my opinion, replacing, you know, estrogen and progesterone is just foundational. It's like brushing your teeth. It's like keep maintaining and keeping my health. And then on top of that, I still need to have the clean diet, I still need to eliminate the toxins, I still need to do the mindfulness, I still need to do the exercise, still need to do like everything.
- [13:42]
Alyssa Nobriga
And you get to, you get to do it because life is so much better when we are more centered and healthier and happier. And that's so much of what this podcast is about. And so we won't go too much into that. But that's like I'm such a, I'm such a fan of that as being the foundation because everything else is better when we are healthier and vibrant from the inside out.
- [14:02]
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- [15:21]
Alyssa Nobriga
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- [15:22]
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- [16:23]
Alyssa Nobriga
Let's talk about progesterone a little bit because I know this also plays a crucial role in our health and it's oftentimes overlooked. What is the connection between progesterone and various health concerns? And then how do we even know when our progesterone is low?
- [16:37]
Dr. Sarah Docoret
There's some confusion is what I think progesterone is completely ignoring. Like, we talk so much about estrogen and its role in breast cancer or whatever, and then like progesterone is our main hormone, actually it is the one that's highest. And when we talk about hormones in women, yeah, we can talk about the absolute level, but the ratio is really important. So women need to have progesterone levels that are much, much higher than the estrogen or testosterone or they have problems. So it's when the progesterone gets really low and they're still making a little bit of estrogen and testosterone that they start to get a lot of symptoms and they start to see things. So how can you tell if your progesterone is low? The main symptoms can be anxiety, depression, insomnia, really a lot of mood instability. So like women like progesterone is a calming hormone that keeps us calm and centered. It helps us tolerate men, small children, and when it is low, we literally cannot tolerate people around us. And, like, we can tell that. I just don't feel like. And I have no reason to be upset at my, you know, very amazing husband, but he's like, even breathing is driving me crazy. And this is something that, you know, you're in. And even with somebody who's practicing mindful practices and all the things, and they don't feel centered.
- [17:51]
Alyssa Nobriga
It's.
- [17:51]
Dr. Sarah Docoret
They still need their progesterone to help with that. And they. Can you imagine? That's the main thing that happens. But beyond that, you will see a lot of diseases like endometriosis, pcos, autoimmunity, Hashimoto's. So the immune system, like, if you think about. Again, I keep relating to pregnancy because women, everyone else can relate. Right. And we know about the state of pregnancy.
- [18:12]
Alyssa Nobriga
It's.
- [18:12]
Dr. Sarah Docoret
Our immune system is really complicated. More so than we are really actually different than men. We're actually practically different species. And our immune system is entirely different. And it has to be so that we can carry a baby and not kill the baby. Like, our immune system does not attack the baby, even though it's a foreign object that we're literally carrying for almost 10 months. So our immune system does not recognize that. And it's modulated and it's kept, like, in check. But it still has to be high because we still have to protect ourselves from infection while pregnant. So we have this really beautiful, complex immune system. If you think about how amazing that is, it's modulated by estrogen and progesterone. And when you're not pregnant and you don't have any hormones around, this immune system just becomes chaotic. So there's no. Nothing to boost it and keep it in check. And that's where you see women have, like, astronomically higher levels, more or more autoimmunity than men. Like, men don't have autoimmunity.
- [19:11]
Alyssa Nobriga
It's like 80% more are women. Yeah.
- [19:15]
Dr. Sarah Docoret
And so it's because we need progesterone in order to stop that and prevent that autoimmunity. And so if you have an autoimmunity, you know, like Hashimoto's, nobody tells you progesterone. Nobody tells you your progesterone is low. Right. And it's probably what happened first, your progesterone drops off and then you develop the autoimmunity later. Everybody kind of addresses the autoimmunity, right. With diet and like, all the things that you can do, but they're not addressing the underlying root cause. And then we see endometriosis, like in really young women. Like, so, for example, which is probably an autoimmunity. It's an inflammatory state of the body. They get pain everywhere. It's not just like, I'm cramping. You know, these lesions are formed from inflammation in the body. And this is because the immune systems like, wreaking havoc. We see, you know, so this, I think the immune system, really something that you wouldn't even tie to low progesterone, but it's so common.
- [20:13]
Alyssa Nobriga
So what I keep hearing you're sharing is like, get your hormones in balance and it will support. And I also know when you test your hormones, it takes a minute to get those back. Right. So what are some of the practical things that women can do to check how their hormones are doing and. Yeah, just get feedback.
- [20:31]
Dr. Sarah Docoret
The unfortunate thing about where we're at with women's health at the moment is that laboratory testing is contributing to the confusion that women are already facing and the lack of help that they already have. So they'll even if I tell everybody, go get your hormones checked, like they will, and then they'll get the results back and they'll be, quote, unquote, normal.
- [20:50]
Alyssa Nobriga
Oh, normal. Okay.
- [20:52]
Dr. Sarah Docoret
Labs do not flag. They don't not. Nobody has established optimal reference ranges for progesterone. There are five papers literally in the entire world. Five. There are like a thousand on testosterone just to give you comparison. Okay, so like everybody on the. Everybody on the call can be like, really upset that it's not. It's. It's just outreach, like the lab community. It's embarrassing. So even if the labs do not flag a low progesterone and dogs, doctors do not look at it, they're like, oh, this must just be normal. The only one that's flagged is a low testosterone, because testosterone is the only one that's been established the optimal reference range. It's not our main hormone. And so this is hard, but you can. You get your own labs and then be informed. So you can get labs. And if it's below, say six, which is 6,000 picograms per milliliter. So if it's number six or below, then it's low, you know, And I think that might help women because it's usually like 0.5 or 0.2 or 0 or non existent. Right. And so if they knew themselves to not listen to their doctor or the lab tests and they were fully informed, that might help. But other than that, like, their body, like, women generally know, they're like, I'm unhealthier now than I was like, five years ago. I don't feel like no matter what I do, I'm doing everything, and I still can't get the results that I should be getting. I'm working out like crazy. I'm eating all the right things, and I don't like the way I look in the mirror no matter what I do or even just my. The way I feel about myself. They know, like, everyone I've ever talked to has been like, something's off.
- [22:21]
Alyssa Nobriga
And I love that you are empowering clients to know their body and their truth. Because I've been to doctors, Western medicine, where it's like, your thyroid, you're fine. I'm like, I'm telling you, I'm not fine. They're like, no, you're fine. I'm like, no, no, I. You're not listening to me. So I found a new doctor. But it's good. It feels empowering to know that there's different measurements for men and women and to trust your body and to know that you have alternative options to test things, to find out what actually is true and how to hack yourself.
- [22:48]
Dr. Sarah Docoret
And it's also inappropriate for any doctor to put you into a reference range or, like, to try to stick your, like, thyroid. But it's your body into, like, a reference range or with all these other. Based on what, 50 other people you know, because the reference ranges are only. Like, estradiol is only based on 49 women and 100 men. Like, that means that you're being compared to 100 men and only 49 women, and they're telling you that you're normal. So it's like, well, how do you. How I know those 49 women are normal or even what I want to look like or be like? And so it's. We should. It's your. But, you know, it's like, we should be so individualized that I really encourage women. If anyone would do treatment, I would rather you tell me that you're feeling great. And I will never chase a lab test. I would, you know, because if it's normal, the lab test is normal. But you're sitting here telling me that you're not normal and we have a problem.
- [23:36]
Alyssa Nobriga
That's right. Thank you for listening to your patients and empowering people. Because. Yes, because sometimes people abdicate their authority and they give it to the expert, the doctor. It's like, no, this is Your body, you're more in touch than anyone else. Okay. I also want to talk about perimenopause and menopause because I consider myself an incredibly healthy person. I have no idea the symptoms or when I am going to be approaching perimenopause or when I'm in menopause. Like talk to us a little bit about this so we're on the same page and more informed.
- [24:04]
Dr. Sarah Docoret
Yes, we've over complicated this for women.
- [24:06]
Alyssa Nobriga
Okay.
- [24:07]
Dr. Sarah Docoret
Let's just say like we don't use words like andropause for men or different phases of life for men and women, I guess, have been tied to the start and the end of their period because it's such a visible thing. Right? Like, so yeah, we were excluded from the hut, you know, like when we were like our ancestors. So this is something that we could move away from potentially. But we, you know, we, since we're using the word perimenopause and menopause so much in the media, let's use it. But like there's only one difference between perimenopause and menopause. They have exactly the same symptoms. The only difference is menopause, the period has stopped for a full year.
- [24:42]
Alyssa Nobriga
Oh, okay.
- [24:43]
Dr. Sarah Docoret
So menopause by definition is your period has stopped. Perimenopause is like the whole 20 years before that period stops. And if women knew that the last thing to happen was the period stopping and they should not wait because it is like you have waited almost too long. And if they wait for a hot flash, a hot flash means your estrogen's below a hundred. I just like want women to understand how devastating that's. Like you've not experienced a hot flash because you're. But like they feel this sense of like impending doom. This is not just sweating at night. This is really like. And they have them multiple times. And the hypothalamus is what regulates our body temperature. It literally makes us different than like a snake or a reptile. We can regulate and makes us warm blooded animals. And so when it needs estrogen to function and when estrogen's gone, you can no longer regulate your own body temperature. It's not a way to live as soon as your quality of life goes way down. And that's in addition to like all the other things, like your vaginal and pelvic health, urinary incontinence, like all the things that come with it. So I don't want like, usually we associate hot flashes and the lack of period with menopause and then perimenopause any other symptom, and there are hundreds, like 100 symptoms. Well, and hormones are needed for everything. But I would say that the most common that I see first is like, a lack of centeredness. Like, they feel like they're losing it, and they can't. No matter what they do, they cannot feel calm. They have anxiety, depression that they didn't have before, irritability, and they can't sleep. And these are the things that start. Disrupt their life, you know, and then the brain fog, lack of energy. I'm not getting results at the gym, I'm gaining weight, I'm getting wrinkles, my hair is falling out. All the good things that we associate with aging, period. So we're seeing, like, hey, this is actually just me getting older. And I think women just associate it with something that they have to do or they have to buy another product to prevent aging. You don't have to, like, age so quickly. Like, so this drop off in hormones after the age of 30 is generally when it happens. Like, women after the age of 30 start going through perimenopause. And so we tell women it's like 50. So, like, when. But when women in their 30s are like, doing all the supplements, all the things to try to stop this aging, because they can feel it. But if they knew that, hey, this is actually, you can prevent this, then you can slow this down a lot just by using your own natural hormones, Wouldn't that be great if you could prevent wrinkles and hair loss and weight.
- [27:08]
Alyssa Nobriga
Gain and slow down that process? So what I hear you saying is that by using natural hormones can help transition that make that transition smoother.
- [27:17]
Dr. Sarah Docoret
I'm saying there can be no transition. You do not have to. That transition is optional. So like, we used to tell women, like, you got to go through menopause or whatever, and we would even sometimes take away their hormones, like, okay, now it's time to be, like, menopausal, which is unbelievably cruel. And we don't believe in that philosophy anymore. All the data shows that you don't have to ever go through menopause if you don't want to. This is your entirely your choice. And so you don't have to do this transition. You would can maintain your period. You know, if you want to maintain your period, we'll help you do that. And when I talk about aging, I'm talking about deterioration of the body, mitochondrial function, right? Estrogen and progesterone boost mitochondrial function. We're talking about bone health, heart health, muscular Health, like everything that we need in order to prevent like bone fractures as we get older. Like, it's like endless how we can prevent disease. And we just want to slow that down. Right. I just want to push that off as long as I possibly can and feel great. 40s, 50s, 60s, 70s, right. And 80s too. Right. So this is what we're talking about. No transition.
- [28:16]
Alyssa Nobriga
Okay. But you'll still, obviously still stop your period. You'll still get what?
- [28:23]
Dr. Sarah Docoret
So this is like, okay. Because women don't know and I wish like this again. It's like, this is great. We should talk about this. Like, women think the period is directly linked to this ovulation and so not. I, I'd be like a billionaire if I could make 50 year olds ovulate again. Right. With like hormone replacement therapy. It doesn't make you fertile, but it makes that you're still going to have some shedding of the lining forever, potentially. Because we're stimulating and keeping that uterine lining healthy. Just like we're causing a cellular turnover. So like, you know, I'm sure you've heard of Retin A and like the stuff we put on our skin, right. To cause this turnover of cells. So estrogen actually functions that way. That's where they got the idea of Retin A. Right. Because estrogen causes this turnover and keeps the skin like really bright, preventing age spots and all the things. So we want to keep this cellular turnover going. And it's doing estrogen, progesterone or doing that with uterus, you're always stimulating and turning it over and keeping that really healthy and intact. And so my clients that are, long story short, postmenopausal, they're in there like they've been on treatment for many years in their 60s and they'll still have some type of shedding of the lining of the uterus once or twice a year, even though they're not, it's not a period.
- [29:35]
Alyssa Nobriga
Right.
- [29:35]
Dr. Sarah Docoret
They're ovulating, have some bleeding. And I think some women choose to keep a 28 day cycle for as long as they can. And I encourage that because it's like you're keeping that period's like a sign of youth. So they want to keep that until well into their almost 60, potentially.
- [29:52]
Alyssa Nobriga
I did not think you were going there. I had no idea that that was even a possibility.
- [29:57]
Dr. Sarah Docoret
That's exciting though.
- [29:58]
Alyssa Nobriga
That's. That's exciting. Yes.
- [30:00]
Dr. Sarah Docoret
You should be like thrilled that this is not like, we do not have, it's totally optional. We don't have to have Symptoms. We can feel amazing and great and it, you know, we have like, we have self driving cars like on the street. Literally. Like women can feel dessert and they deserve it. They can feel great and look great for as long as they want. Right. So.
- [30:17]
Alyssa Nobriga
Wow. I, I just didn't, I just wasn't expecting that. I love that, that you went there. Okay, that's good. And, and yes, I want to feel vibrant and healthy as long as I am alive. And so why not look into different options and find, I guess, you know, testing what is the right dose for you and where are you low and high and probably continuously checking in on that to monitor it, I imagine.
- [30:38]
Dr. Sarah Docoret
Right. You can, I think it's again, it's like an internal check once you get your balanced. So the trick is like making it personalized is not necessarily a lab test. You know, like again, you're kind of like checking in, but it's more of like a self check. I guess I should say the, the difference between you and I, for example, or like another woman would be how you and I metabolize the hormones differently. Or like, let's say like I might make more testosterone than you or something like that. Or another woman might tend to. Because we convert progesterone into testosterone. Women do. And this can be problematic because sometimes testosterone has side effects like acne, hair loss, bloating, weight gain. Right. It can make us irrit, irritable and things that we don't really want necessarily.
- [31:20]
Alyssa Nobriga
I'm laughing because I took a testosterone at one point and I broke out like a teenager and I was so agitated and so turned on, I was like, my husband's like, thank you. What? I'm confused. I was like a little too much for me.
- [31:34]
Dr. Sarah Docoret
I hear that a lot. Like, I don't know if I want that teenage boy. Like. Yeah.
- [31:38]
Alyssa Nobriga
I felt so much compassion for teenage boys. I was like, wow, okay. It was a humbling experience.
- [31:45]
Dr. Sarah Docoret
Yeah. I think what, what we want, like so we get our natural receptivity and libido from estrogen. I think it's interesting that we know that estrogen binds to the same receptors as mdma, for example, and it allows that openness and receptivity that we need in order for libido to happen. And so it's not just like women are more complicated again, we don't just need a little like, I'm not a small man, I don't need a small dose of testosterone to get my libido. I'm a little bit more complicated. I'm going to, to need estrogen, progesterone, all the other things in place. But, like, when you're trying to personalize hrt, like hormone replacement therapy, I want to see. I will first see how you metabolize your hormones and to see what your body does. And then we can use things to, like, adjust. Like, if you're making too much testosterone, the ch. There's a lot of Chinese herbs and, like, green tea, for example, matcha tea. It's one of the most amazing things for women. It's like one of my most favorite things. Like, everybody could do matcha green tea. They would, you know, and that is how we can kind of keep testosterone in check a little bit, for example. So that's how you can make it more personal. Like, what am I doing? Am I. And sometimes the foods that we eat or the diet that we maintain or exercise level will alter these fluctuations in hormones, and we have control over that.
- [32:59]
Alyssa Nobriga
Yeah. And I think it's good that you just keep inviting people to listen to their body and test different things out. And I know that we were talking about sexuality and that obviously hormones can affect our libido and our sexual health and that, you know, sexual shame can also be a big part of our culture, especially for women. And so in terms of your work with women, what have you seen? Support their healing journey physically, emotionally, around sexuality.
- [33:27]
Dr. Sarah Docoret
Women sometimes come into my office, and that's what their concern is, that their relationship is in jeopardy because they. They don't want. You know, they don't want to be intimate with her husband anymore. It's like, sex can be painful, but even before then, they don't feel like it or they're irritated by their husbands. And, you know, we've norm. We've completely normalized erectile dysfunction for men over the last decade. We'll talk about it. Get Viagra, like, anywhere online. It's just like a normal thing over. Over a certain age. Like, even young men. And we didn't used to talk about it like we do now, and I think that we need to normalize vaginal dryness, for example, for women, just like we normalize erectile dysfunction for men. Like, hey, this is actually really common. And if you have, like, vaginal dryness or you have vaginal odor or, you know, like, we link erection. And I don't. I hope I'm not getting that. This is interesting. If women understand this, erections to libido in men, we need to associate vaginal, like a kind of a lubrication state for women. And libido. Right. That is our equivalence. And so we don't teach 13 year old girls this, we don't teach young women this. Like if we were to start talking to our daughters a little bit differently about this, like I have a young son and when they, they get just erections, you know, as they're growing and I'm like, this is normal body function, this is blood flow, this is keeping this area healthy for you. You don't have control, control over this. This is normal. If we talk to our daughters the same way, then they would think that that's a normal, like having vaginal, that state of vaginal health is normal. When I start women, older women on like hormone replacement therapy and they start to feel like a 13 year old girl again, which they tell me, I feel like a 13 year old girl again. And I'm like having to use a liner and there's a lot of, you know, it's a lot of changes in like discharge, they call it discharge. And I'm like, this is what it's supposed to be like. And it's okay, this is normal. But they, we don't associate it with like a good thing. Right. Like, does that make sense? Like men will be like, yeah, we need to start talking about this in a normal way. Like, hey, this is total normal body function. We need. And it will show that this prevents, this is really important for women. Like this prevents infections. Like if you have an appropriate vaginal health and a microbiome appropriate pH, you'll prevent urinary tract infections, yeast infections, urinary incontinence. Your pelvic health will thank you, you'll feel better, your, your intimate relationships will be better. Right? It'll be better for you. And so this is a huge part of pelvic health, is a huge part of women's health.
- [35:56]
Alyssa Nobriga
Yeah. And I love that you're just normalizing and bringing this up so there's less shame about it. I think shame happens when there's secrecy. And so just talking about it like this is healthy, this is normal, all of it is normal. And it may just be feedback that your body's giving you to look into something. And so I love that it's just brought out into the open. And I also know that women in society typically are taught to put others needs in front of their own. And it can be revolutionary to be, to move from shame to honoring their own pleasure. I'm just curious, what advice would you have to give women around learning to prioritize their own sexual satisfaction?
- [36:33]
Dr. Sarah Docoret
We should do it. We prioritize men's sexual health, and so does society and everything else. And so we need to start looking at, like, for example, this vaginal dryness or something as a health concern. We don't do that now. We think it might be a relationship concern. Or maybe I need to use more lube, or maybe I need to read a sexy novel or I need to, like, date my husband or get into it. No, we need. We deserve to have, like, this just as much as men. And I think the more that we just realize that we do deserve it and we need to prioritize it, and we're not doing that now. Like, I would say that, like, the vast majority of women I talk to, they almost want to do it so they can make their husbands happy because they want to save them. You know, that obviously they want a relationship and they love their spouse, but it's never about sex at first until they really start to feel better, and then it's like, great. And that it should be like that. Like, we should. They should be coming to my office asking for that first. Just like men come into my office for erectile dysfunction medication. Right. Women should be like, there's something wrong down there. This is, like, not right. And we need to fix this right away, even before they start to get other symptoms. And so I wish that women knew that they absolutely deserve it.
- [37:41]
Alyssa Nobriga
Yeah. And get to prioritize our pleasure. And as we're in pleasure, our partner, whatever gender, they're going to be turned on by our pleasure. And so us taking care of ourselves, it's just this ripple effect in the world.
- [37:52]
Dr. Sarah Docoret
I, you know, I talked to, like, husbands, and they're like, oh. So I describe what I do for a living or whatever, and they're like, oh, so you basically sell. It's a product for men. I was like, that's very. Such a man thing to say. But women, I. I think we're. I like that we're talking. I really like that we're talking about it more. And when women are kind of taking it into their realizing that this should be a priority for them.
- [38:21]
Alyssa Nobriga
And I'm just curious, in closing, if you. I know you have a son, but if you were to have a daughter who's going through puberty, based on current research, what would you share with her? What would you want her to know about her body and taking care of her health and hormones?
- [38:35]
Dr. Sarah Docoret
I. It would be priority, you know, since I am, like a total geek and I know about epigenetics, for example, I would make sure that she was tested so that I could know how fast she was metabolizing hormones. Because that could impact her mental health. Like, as she was a teenager, I would always ensure that like her hormone levels were optimal. I would never her on birth control, like, I would teach her other. We'd potentially talk about other ways. I think that more natural ways that you're not suppressing hormone production. Because knowing how protective hormones are and how devastating it can be on a mental health. I would say that over 90% of women experience mental health issues when they go on birth control. And so this. And I would probably test her, right. So I'd make sure that she was always. And I would think of that first. Like if she was having some type of crisis or low energy or not function, like, you know, I would just make sure that at least biologically that was okay. In addition to all the other things that you're trying to teach them, Right. All the tools, all the skill sets that you want to teach them, I would just at least make sure that she was healthy. And a lot of that's diet, exercise, like at that young age, making sure that you don't have those toxins around like a young individual, like around a young body.
- [39:42]
Unknown
Yeah.
- [39:43]
Alyssa Nobriga
Like reading the ingredients in products and food and obviously there's toxins that we can't control, but just to really take care as much as we can.
- [39:52]
Dr. Sarah Docoret
And then of course, I would talk to her about sexual health. Like completely normalizing this so at least she didn't have like, shame around it. Like, I think I don't. I never talked about it with my mother. I don't know, like a lot of my friends, not once did it come up.
- [40:06]
Alyssa Nobriga
Nobody told me to pee after sex. I mean, like, there was like some basic things some people could have told me. I didn't learn any of it. I learned a lot from hbo.
- [40:14]
Dr. Sarah Docoret
Exactly. And I think that I heard the saying that if you don't teach your kids about sex, somebody else will. And I think that, you know, teaching that even women how to pleasure. If you, if you teach your daughter, you know, you know, like talk to her about learning how to pleasure herself so that when she does find a partner, it's not like a mystery. And she's. And then she can ask for what she wants. And it establishes this like more of a, hey, I'm priority here in the relationship. And that can carry over into other parts of. Of her relationship. And I think that's powerful. And she. We don't teach girls that. It's. It's like, it's all just figure it out.
- [40:50]
Alyssa Nobriga
I agree. I my oldest, when she was 18 we read the the book Pussy by Regina Thomashauer, who's a dear friend of mine and it was so beautiful to share that experience with her and to talk about it and to help. And so I love, I love what you stand for. I love that you are such a voice for women's health and to really listen to our bodies and look at the research and I know that there are people that are going to want to stay conn and hear what you're up to. Can you share with us where they can do that?
- [41:18]
Dr. Sarah Docoret
So right now I'm online treating women for hormone replacement therapy with a natural bioidentical estrogen progesterone and we raised testosterone too a little bit with that. And I'm in 40 states so we make it really easy. Like I'll meet with you after you get started. You fill out intake forms online and you can just get started right away and make sure work with you over six months to make sure that you are balanced. Like I talk about. So easy. Like no barriers, no gatekeeping, no lab tests. Like if you want to try it, we don't just can try it and see if you like it.
- [41:52]
Alyssa Nobriga
Okay, great. Well we'll, we'll put your website in the show notes here below so people have that easily accessible to them. Thank you for coming on, for sharing your wisdom. Enjoy Hawaii. I love that you met us while you were there.
- [42:05]
Dr. Sarah Docoret
Yeah, of course. I wouldn't miss it. Thank you for having me on.
- [42:08]
Unknown
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