Liz Talks, Episode 46: Liz talks with Dr. Jolene Brighten about birth control and post birth control syndrome

Liz sits down with Dr. Jolene Brighten to talk about her experience as part of the documentary The Business of Birth Control, birth control as a hormone disruptor, the functional differences between “bioidentical” and synthetic hormones, alternatives to birth control for pregnancy prevention and hormone imbalance, Post Birth Control Syndrome, and other ways women can better own their reproductive experience.


So you wrote this book, you wrote Beyond the Pill, and this was, how many years ago was that? Oh gosh. That came out in 2019. Okay. January, 2019. Okay. And you were talking about this stuff long before that. I remember. So like you’ve been doing this forever and so you wrote this book, you sell 15,000 copies,

I can’t and say that without being like Holy, Holy Mo, and basically ignored by the New York Times list, which is an editorial list, which is like, you know, people sitting on high deciding who gets the crown and who doesn’t not based on sales, which basically sales, in my opinion, are kind of indicative of how many people you are actually helping and being useful to.

And they were just like, No, don’t see you. Yeah. Well, and the thing is is that, I mean at this point, gosh, beyond the pill, I’d have to go, I have to go and get them to like pull the numbers. But I know like as of. Last year, um, it was like in the 80 something thousand that, so as of like 2021, um, yeah, I had sold a lot of copies of this book and still like, um, the, uh, so like Good Morning America, like online had written a little bit about it, um, and interviewed me that, that nobody like really wanted to mention the book.

Um, but it’s interesting just in it coming out, just how many people. You know, wanted this information, needed this information, and yet how many of these major media sources, like didn’t wanna talk about it? And I think that, uh, you know, I don’t really know what went on, um, behind the scenes with like, cuz when you have a publisher, there’s like a PR agent.

Um, and so I don’t know like what conversations, but I will, I do say that like anyone who wants to be critical of it, the first thing they say is she’s anti birth control. So this is an anti birth control. Book and by, and in their mind, if it’s anti worth control, it’s anti women’s rice, so therefore it’s anti-women.

And what I don’t think people have really, you know, there’s a lot of people who have been harmed by birth control or they’ve had side effects, or they just wanna do something else. Like, they’re just like, I’m over going to the doctor and they’re always telling me birth control, or I do wanna be on birth control and I just wanna make sure I’m taking the best care of my body.

And that’s really what the book encompasses. But I think that there’s so many people who believe that birth control is the best thing that women ever got. And in some ways it really was. We did start graduating college at a higher rate. Um, we advanced in our careers. There’s a lot of advancements we’ve made.

And there are studies that actually go back and they’re like, is the introduction of the pill. However, there’s also this dark history of the pill, like the fact that women of Puerto Rico were coerced and manipulated into going into drug trials and when they died because they were basically already seen as less than their white female counterparts, um, it was brushed under the rug or this is even better.

The side effects they presented with and they complained about. They were, they were told they were not real and they were not really happening. So this is all to say, like, there’s a lot of nuance and the people who wanted to shut down the book or who were like afraid because they’re like, I have pharmaceutical companies pay for ads.

Like, I get that if you are a TV network and pharmaceutical companies are paying for ads, and this person might come in and say something that hurts that revenue, it’s like I get the business of it. And I, I respect that because that, like, you are not in medicine, you’re in business, like you’re here to make money and that’s what you’re doing is a TV corporation.

However, the problem is, is that, If we can’t have these nuanced conversations, one, women aren’t getting the care they deserve. But two, it’s not an all or nothing. Like I can talk about the issues of the pill and also, and, and tell you about the side effects I had on the pill. And also say that I’m a first generation college graduate.

Like I got to go to college. And part of that was because I can control my reproductive health and I have people who will say, No, no, no, no. Like you could have done other things and all this stuff. And I’m like, Hold up. I’m a Latina. I come from a huge Hispanic family. Like I was the first woman to not get pregnant before age 20.

In my family, like I’m on not my distant, immediate family, like my big giant family of people who have lots of kids. And I did. I was able to delay my fertility until, you know, and in terms of basically like putting my ovaries on hiatus and go on to have a baby in my thirties, I was able to do that because of the pill.

Are there other ways? Yes. Did anyone teach me those? No. Would I would’ve, if I had that information, would’ve done something differently? That’s a wonderful dream to act like my, like teenage or 20 something year old self would’ve made better decisions or done. Like, that’s the game, right, that we play. It doesn’t serve us like in any capacity.

It’s like it that is like this was part of my journey. This was part of my story. And because of that, like I wont ever be anti pill. I won’t ever be anti-access to contraception, but I will always be pro informed consent and knowing. I think that’s really important. The history of birth control and knowing that while the modern day person is like, this is the best thing that ever happened to us, there was a time where women fought against it because they saw that they, that this was the first drug in history that you didn’t need to be, to have a diagnosis to be prescribed.

That’s amazing. If, if, if you were bare, if you are these drug companies like Kch, that is like so much profit because we’re talking to roughly 50% of the population. All you have to have is a set of ovaries and done deal. And even then, did you, like, even if you’re at your ovaries removed, we’ll we’ll just come in with the pill, replace those hormones with that in some situations, uh, because that, you know, the drugs being used in a lot more ways than just controlling pregnancy.

And so I just think, um, you know, we talked about, we started this off of like, yeah, so like the book wasn’t getting out there in the major media sources, and yet because of this history, because of so much that we’ve been told, don’t talk about that. It’s basically the, you know, the. Don’t talk about your periods, that’s impolite.

You’ll make people uncomfortable. It’s also like hush. Don’t talk about the pill because, um, you’ll undermine women’s liberation and all of these things. And man, I think with the current political climate, like I definitely feel that, um, I definitely feel that, but I think that we, we should, should, we should be able to have her cake and eat it too.

We should have access to contraceptions and all of the information that comes along with. Well listen, and that’s how you prevent these like horrible side effects. That’s how you are able to, If something were to be happening to me and I didn’t realize it was symptoms of a thrombo embolism or whatever, like you have to be able to give people full informed consent and know what to look for, even if it’s just as simple as like, Hey, take this multivitamin, or watch your B-vitamin status, or whatever it might be while you’re on the pill.

It’s like having that conversation and being able to hold those two things that are true but seemingly oppositional to hold those at the same time can only benefit. Everybody. Yeah. I just, I, I don’t see how it’s, it has to be such a taboo conversation. And I wanna say something really quickly about the conversation before about, you know, where your work was kind of being, I don’t know, the, the trajectory of your work and how it didn’t really seem to matter that you weren’t necessarily getting the recognition that you deserved right out of the gate by these, you know, institutional gatekeepers.

Because it’s so funny, I have friends, you know, who kind of fall into multiple buckets, but many friends who have like very little idea what I do are not sort of in the same community as I am. And they just as much as anybody in my community, my professional, you know, health and wellness related community from all angles, these friends are like, You should interview Dr.

Brighton. She’s amazing. Gosh, seriously, You know, a friend of Yes. It’s like all across the board, they know you. That’s crazy. Isn’t that cool? Still not, never stop being crazy. It’s uh, it’s so funny cuz I just, I was speaking at a conference in, um, London and the people who were coming up to me and, and being like, Oh my gosh, like I’ve always wanted to meet you and all.

And my husband’s there with me and he is like, Isn’t that so cool? I’m like, It’ll never not be weird because like, to be like, like, and it’s, it is awesome. Let me just say that. It’s awesome. Um, if people could see my body, I’m like kind of like caving in right now. Cause I just feel like. I just feel like totally like normal person.

And then, you know, people will be like, Oh my god. Like, you know, from some part of the world. And I’m like, How did, how did you even hear? How did you even hear about me? Like, this is so crazy to me. But, um, I think it speaks more like I, I like to think that it’s less about me and it’s more about just giving, like validating women’s voices and really, you know, having the conversations that we’re told not to have.

And like, as you mentioned, thromboembolism, if anyone doesn’t know what that is, that’s a clot. Um, and a clot in your brain is a stroke, A clot in your lungs is going to be pulmonary embolism where you can’t breathe and, uh, can be very dangerous. And these risks are, they’re very, those are much more, you know, insignificant than some of the other things we see in terms of side effects with birth control.

And yet they are significant. And what I’ll hear sometimes is doctors say, Well, they’re so rare, we don’t really need to talk about it. You don’t get to decide that. And part of my work is, it’s not that I wanna scare you, I want you to know that you, and, and I think if you go to the doctor, a friend, anyone listening, if you’re like, Okay, well I need, I want contraceptions.

Like when I go to a doctor, how do I choose? Well, it should be individualized counseling and a big part of it. And that, that whole informed consent is what are the side effects? And how do you know as the lay person, as the average individual, you are not a medical writer. How do you know what are the signs of that?

And when to see your doctor? Because I think it’s something that, you know, when it comes to prescribing the pill, It is something that like, yes, we, we need to give all of that information. But I think some providers think like, Well, I don’t wanna scare women away because they want this, therefore I don’t wanna scare ’em away.

Again, that’s not, We don’t get to decide which, what information to give and not to give, to get them to make the decision we think is best for them. It’s about supporting them and making them the best decision for themselves. And what’s really problematic in all of that, especially as we talk about clots, is the women or the parents.

I mean, that’s the hardest thing for me is hearing from the parents who have lost their daughters because they went to the ER with a headache and nobody asked if they were on the pill. And they didn’t know that that could be a possibility that this massive headache they were having could be a stroke.

And they go, they’re sent home and told they’re just having a bad migraine and they die. Or they have like the, you know, pulmonary embolism. Like there are these real scary side effects out there that we don’t talk about, or they’re talked about in passing and just being like, Yeah, yeah, but no big deal.

They are a big deal if they happen to you or happen to someone, you know. Yeah, the risk is low, right? But we can look out for things like, you know, and if, you know, if you’re talking funny, like, you know, you’re slurring your words, like half your face is starting to droop or not move, right? You’re, you’re taking a selfie, it doesn’t quite look right.

You have the worst headache of your life. You’re, you know, you’re 22 and now you can’t go up the stairs cuz you’re short of breath. Like, these are the kinds of things that like, don’t ignore that. Go see your, go, see your provider, contact them immediately because maybe it’s something else, or maybe it has to do with the pill, but the only way you know, is to consult the expert in that arena.

The person who prescribed you birth control or, you know, people in ener uh, in emergency medicine. But I think that’s where, um, Too much falls on the patient to figure out. And then they do get afraid because then they go on the internet and they start to find things. And the internet’s a very scary place.

I mean, you have kids. Mm-hmm. . Um, when I wrote my first book about postpartum health, it was because I had my baby. I was looking up something. I think it was just like something about sleep because that kid just could not sleep. Um, they just did not sleep. And I was leaving something up and the things I would come across on the internet where I was like, if I didn’t know what I would, I know I would be terrified.

This is such a scary place I’m in right now of what it’s saying. , get out there. Yeah. When there’s stuff of like, if your child is not sleeping, like they might like have, you know, sleep apnea. Yeah. And there was a stop reading and there’s sleep and like all this stuff. And I, yeah, I was, it was, um, Yeah, it was a very scary time and I, you know, at the time I was practicing family medicine, that’s where I started before I, you know, well before my patients really excelled me into end endocrinology much deeper.

And then that’s when I pursued my board certification. So, uh, if people don’t know, I am board certified hormone doctor in naturopathic endocrinology, which means that I’m interested in both, you know, using pharmaceuticals when we need them and recognizing that. Diet and drugs both have a time and a place, right?

And like lifestyle and nutrition is everything to keep you off of drugs. If we, you know, like if, you know, I say that, but I’m like, Listen, if you got type one diabetes as a kid, like, that’s like not your fault. So I wanna be clear that I’m not, I, I just, I always feel like it’s such a slippery slope in the wellness arena where people are like, You should be able to do everything naturally.

I say that as someone with Hashimotos who takes a pharmaceutical and people are always like, I can’t believe you would do that. Like, don’t, you know drugs are bad? I’m like, No. Um, losing all your hair and not being able to get out of bed and being, having so much joint pain, you can’t hold your own children.

That’s bad. That’s bad. Like, And it has to be the, the, I don’t know. You know, we talked about before, before the actual podcast, podcast, podcast started about the patriarchy, and I can’t remember what phrase you used, but it corrected me up. Something about coming in, patriarchy, coming in full swing. But I imagine that this idea that we as women who are oriented towards holistic and integrative solutions to our problems or toward a healthy lifestyle, are supposed to completely shut the door to anything that can actually help us and just grit our teeth and get through it.

That to me sounds like Grin and Barrett like patriarchy. Women are supposed to be able to endure massive amounts of pain and service to other people type of garbage. And I cannot stand it. Yeah. Not cool. Well, it’s, um, it’s funny that you say this, So you, you guys, you missed so much of our conversation before we started recording

Um, because I talked about how I homeschool my son and I always say to my husband, like, I hate history. Like, I hate it. Uh, I just don’t, I just find it incredibly boring and I’m someone who actually took extra electives in college of history thinking I could make myself like it. It’s not good. Um, so like, it’s just not for me, right?

Except that yesterday I had the epiphany. Then I love medical history and my husband’s like, duh. So for our honeymoon, um, I like went to like, I love rare book rooms and I love, um, I just love really old books. Like I was just in Ireland at Trinity College, like the book of Cals and Ireland’s like just told my husband like, I know you have the kids cause let’s just like, leave me for a little bit because like, here are these books from like these old physicians and like Shakespeare, Plato and all.

And I’m like, just, um, can all these people go away? I’ll just be alone with these books. Like, it’s amazing. But I do really love, um, medical history, and I think that that is really the history that, that’s like, that should be a big section of history that we all learn. Because if you look at the history of medicine, it is very patriarchal.

And I know that some people are taught to roll your eyes and shut down if you hear patriarchy. Uh, because it’s anti-man, it is not, And patriarchy’s like anti everyone, like everybody loses, right? Yeah. Um, because way back in the day, the women who, well the people who attended births were women. Women were the medicine women, right?

And. Um, there was, you know, way back in the history part of getting medicine out of women’s hands and controlling it solely by men was calling us switches and persecuting us. So if you could attend a birth and you could help a small human come into this world unscathed and save the mother and everything was like easy peasy.

No, cuz the, like, you know, dogma is that childbirth should be painful and women should suffer because like, and that goes back to like E eight and Apple and all of that. And I’m not saying like everybody subscribes to that, but like, this is part of the history that was indoctrinated. And does it like play out today?

Of course it does because, you know, it wasn’t until, I mean, it, it really hasn’t been until our lifetime that we have seen a substantial number of women come back into medicine. But even then, I mean, if you look at. Uh, you know, obstetrics and gynecology, like being a woman in that field is very difficult.

And I will often hear like, it’s, it’s really sad to me how often I hear people say, and patients, it seems like women in that are ob guidance hate other women, like, don’t understand like why they’re in that field. And I have to explain like that it’s a, it’s rough to be in medical school as a woman. It’s also rough to be in basically a subset that’s, that’s been seen as inferior.

But like, you know, surgeons are like, You know, we’re like so much better. And I’m like, Yeah, these women operate on very delicate tissue. I don’t know, like if you, if you really like, think you’re that, and it’s again, it’s like, it’s not anyone’s better. Like everybody has their purpose. Um, but you know, in obstetrics and gynecology, like it is, it’s, it can feel very disempowering to go to your doctor sometimes.

But I think that we never talk about the humanity of the doctor and like how did, how did they arrive at that place? Like, nobody gets into medicine because they don’t really genuinely care about people. Um, but you know, Back to that history. I mean, we can just look at so many ways that, I mean, at one point, I mean the father of medicine was like, Women are hysterical.

Mm. Um, hysteria was still in the DSM in, and that’s for people who don’t know, let’s how you get a psych diagnosis. We consult the dsm, not me personally, because I’m not a psychiatrist or a psychologist. Um, but with that, that that was still like in the 1980s that was still in there. Like there are still doctors who are practicing today, who are teaching residents who were trained that that was a thing, that women’s pain was in their head.

And if you look at the research that we do have, you’re right, we are, we are dismissed at a higher range. There are male counterparts. Um, when men complain of pain, it must be real because for a man to go in and complain of pain, , uh, everybody who cohabitates with a man just leave us in the comments. How do they do when they get the flu or they get a cold?

How are they? Because we act like men are so tough and so masculine, and they would never, like, you know, they just, they can go through pain and all this stuff. Like, mind you, they could not push a human out of their vagina. Uh, trust my, I’m like, I love my husband. I don’t think he could do that. I don’t even like doing mad, but like, um, but it is something that like, I just laugh about.

Um, you know, it’s, it’s this, again, that’s patriarchy. Like I’m raising two boys who will be men and they’re entitled to their feelings. And if they are in pain or they have problems, like they do need to voice it. And, um, you know, it’s just, But you know, to your point, with women, we are all taught this narrative that.

Periods are inherently painful. PMs is, um, just part of being a woman. Women could never be president. Um, because like they, they would get their period and then they would drop a bomb on the world, right? Um, except them like, just tell me you don’t know a thing about hormones without telling me. Because actually when your period comes, you things usually break and your hormones are much better.

And you’re like, I actually feel better. Um, on my period. Mentally speaking. It was, um, you know, the week before I couldn’t put up with you and that was like not necessarily all about me. Sometimes it’s about you

Uh, I wanna like circle back around, well, I stay actually not circle back, but stay around this, um, idea of medical history because you talked a few minutes ago about those early birth control trials with Puerto Rican women and that is something that I remember having heard for the very first time when I watched the documentary, The business, the birth control, which you were involved with.

So can you give me like a little bit, I don’t know, talk about that experience, Talk about how maybe that documentary actually, you know, tackled what needed to be tackled there and, and particularly that aspect of history. Cuz I think for a lot of people, that was the first time we ever heard anything about medical experimentation, particularly as it pertains to the pill.

I’m like so mad at it right now and that I, I’m like, , I’m like trying to hold that in. Um, and I just wanna say like, what I’m mad about is that the, like, what a disrespect to the women who gave their lives, literally gave their lives so that we could have the pill. And yet it’s just been an ignored part of history because it’s too inconvenient to talk about.

Right. Or it would scare women away from using contraceptives or whatever bullshit reason people wanna say, because this is not, this is not news to the women of Puerto Rico, people on this island, like still do not trust some of these medical interventions because of those trials. I think that business of birth control, Did a good job of, you know, tackling some of that.

I love Ricky Lake. I love Abby Epstein. Mm-hmm. . I think they’re fantastic. Yeah. Abby came on my podcast and talked about the documentary. Yep. Yeah. And they, they did a really great job of, you know, pulling in, you know, lots of different women and speaking to this a bit, but really they’re not women of color.

Right. And so this is important, I think that, um, to say that women of color have been speaking about these issues for a very long time and have been talking about the Puerto Rican trials, the fact that Margaret Sanger, um, she like, I don’t wanna get this like ne end or anything. Um, cuz there’s certain words on the internet, you can’t say, uh, because they can be misinterpreted.

But, you know, the Triple K peeps mm-hmm. , uh, she met with them. This is the founder of Planned Parenthood. Yes. Those, This is the, the person who was like, Hey, I wanna get some birth control pills in the system because, um, you know, there’s some unfavorable people who have lots of children and they, we, we can control that.

We don’t need that to happen. Hey, there’s this like little island that the US has, has, you know, essentially colonized and made their own. They have brown people, and so let’s just give them the pill. Um, and we’ll just do the trials over there. And then, you know, these doctors and scientists were like, Yeah, that sounds like a great idea.

One of which, um, during the trial he, what he saw was so horrendous. He was like, I’m out. I would never recommend this to anyone and I’m out. I will not be a part of this. Um, And, you know, the pill was brought into black and indigenous communities to, uh, you know, Hispanic communities. And it really was a way to start to control reproductive health.

And, you know, during the same era, there were hysterectomies, there were sterilizations, there were things happening not only to women of color, but to disabled bodies as well. If anybody was, you know, deemed with certain psychiatric conditions, they might lose their ability to reproduce. Um, these, some of these psychiatric conditions were fabricated by their husbands who decided they wanted a new wife.

And so sent these women off like, these are really ugly things we don’t talk about. Or the fact. You know, when the pill came over, women didn’t really wanna take it. Um, and there were medical students where they were like, Hey, if you wanna go to medical school here, you have to be part of this trial. So if you want to actually have this career that you’ve worked your butt off for and you’re in medical school already, like you have to do this.

And so there are a lot of women that have really, um, they’ve been exploited, their bodies were exploited and that they don’t get their, the history is not talked about. They don’t get the really, the play in our ears and in our history that they really deserve. And so, you know, the business of birth control, um, that was, I think a great documentary.

It was so short compared to like how much that could really be talked about. Yeah, I mean, I filmed with them. For very long time. I, it is so long. Um, like under the lights, they had , so I’m, there’s some behind the scenes everyone. Um, I do not recommend putting gr Gorilla Glue on your skin. I don’t know what’s in it.

I don’t know enough. Um, and yet my mic needed to stay on and so they gorilla glue it to my chest. Mm-hmm. . So they did a grill glue, tape, tape guys, um, tape. So not actual Gorilla Glute, let me be clear. Please do not Gorilla Glue your body. Um, but they put the tape on and I was like, Oh my God. Way a minute.

Like after they put on, I was like, What is that? And I was like, Oh, snap. Is this gonna come off? We filmed for so long and I was under those lights for so long. I perspired it right off . So it perspired right off. God, it’s in my life. I’m like, thank goodness that like I take care of my liver and my monies and all the ways to clear stuff outta my body because that is a known insult I came into contact with.

There are lots of unknown insults I come into contact with, but they were not doing anything evil or bad to me. Everyone, please don’t run to the comments and say anything like that. Um, but so I talked a. A lot. And, um, Fe Ksh was in after me. I know she was there for a long time. Nicole Ardam was part of it.

Um, my friend Dr. Sarah Hill who wrote this, Your Brain on Birth control, I was like, Girl, you gotta get in on this. They pulled her. Uh, I just started contacting like, as many people as I knew were, had, like had a, a passion and expertise in the arena. And um, really I think the documentary is really fantastic and yet there is still so much more that can be said.

Yeah. And I do really, uh, appreciate, you know, I’m not Puerto Rican, but as a Latina I really do appreciate them talking about that and them having the conversations that make people uncomfortable like it needed to happen and, you know, their, um, My, my history with them. So their business of birth, uh, the business of Birth vi.

Did you ever watch that? Yeah. Business of being Born. Business of being Born. Yes, yes, yes. , I’m butchering it. I’m sorry, Mickey. Oh my God. Um, so like, I had a Homebirth, I I do a home birth. That’s what’s right for me. Um, no judges to how anyone wants to bring or needs to bring a human to this world. Um, and when I was having my first son, I was in the birth tub and I was like, Do you guys remember that movie, The Business of Being Born?

And my midwives were like, Yeah. And I was

like, Wasn’t, wasn’t gonna be like that. But I swear like birth is just like such a wild, crazy, right? Oh yeah. Anyhow, so like the first time I, I met Ricky at like a dinner party, I was like, I’ll have to tell you this story. . Um, I bet she’s had a couple of those. She had to have had a couple of those, I’m sure.

But I’m like the, that documentary was. Still so, so important. I mean, it was such a great documentary. I remember my mother-in-law like being like, Have you seen this? Because like, I’ve had two kids and nobody told me this stuff. And, um, it just, I think that the work they do is so impactful. So if anyone hasn’t seen their documentaries, definitely, definitely make some time to see those.

Yeah, the thing I loved about the business of being born, I mean this was years before I was even in like the wellness holistic, you know, I started out in Paleo, CrossFit, all of that stuff that felt so alternative and so against the grain, I watched that documentary years before I ever felt like I was going against the grain on anything.

And it was like mind blowing because never had I ever questioned anything that I was being told. And it’s that, it’s what you were talking about earlier, right? Where we have to have the information, it has to be given to us. Otherwise we are literally getting half of the story and people get hurt. So that’s part of the reason I thought it was so, so brilliant, just going into my reproductive experiences with a little bit more information than I would’ve had otherwise asking more questions than maybe I would have otherwise, and hopefully becoming a more empowered patient.

And I went, I had a C-section with my first, and I had a home birth with my second. Both experiences were wild and intense and crazy, but I at least felt like while I felt a little bit disempowered with my C-section, there were actually moments where I felt disempowered with my home birth too. Mm-hmm. . But I can never say that I didn’t have almost all of the information that I needed.

So yeah. At least there’s that, You know, you hit the nail on the head though. What that documentary did is it actually made women start questioning your providers, which is why they got so much hate and why to this day. Um, there is a subset of the medical community that hates Ricky Lake and Abby Epstein because how dare you undermine the authority of doctors.

We wear a white coat, we are in charge. Who are you to question us? Um, I’m the person living in my body. Thank you very much, . So, yes, like, and that’s the thing is like they disrupted the system and I think that is just so important. I mean, everybody who is listening to this podcast is definitely part of disrupting the system.

Like even the fact that they seek knowledge and that is really so, so important because the, you know, as a doctor, I love my lab test. I love my data. I, you know, love my physical exam. And I also love the patient story because they live in their body. Almost no one presents like a textbook. When it happens.

We get really excited cuz we’re like, Oh my God, this is exactly what like, was in the textbook. Yay. Um, but the thing is, is that we don’t all respond to natural therapies, to pharmaceutical therapies, to whatever the intervention is. We don’t all respond the same. There is this general population within a bell curve that like, they’re gonna be, they’re gonna, they’re gonna ish, they’re gonna be close-ish.

Okay? But then there’s gonna be the outliers and the outliers usually get dismissed. The outliers are usually ones who end up in my office because they’re like, no one believes me. And I’m like, it’s a really strange thing because I put up this on social media every time. I’ll put up this. We’re we’re due for this quote card to go up again.

Um, is that, I say a doctor shouldn’t need a study to believe your story. Oh my God. The number of doctors who are like, Look at, look at this quack. She’s so crazy. She says, We don’t need a study to believe a patient’s story. Yo, how do you think we get studies? Right? We know what questions to ask because enough people are coming to us.

The pandemic. We have vaccines. The women are like, Hey, something’s up with my period. I’m seeing it. I’m like, this is like, Okay, tell me more. Tell me more about this, because I, This is new, right? And we saw so much medical, gas, lighting because that’s just like the, the default, right? Um, doctors and scientists being like, you are just trying to scare people out of taking the vaccine, right?

It’s always like you’re trying to scare ’em outta the medical intervention rather than you could be possibly concerned about yourself, right? Like, it can be selfish, right? Like, I just care about myself right now. Something’s wrong. Um, And it was, once there were enough women that were saying this, that then science, then they were like, Oh yeah, we’d never actually like, studied periods that might piss some people off.

Yeah. It kind of pisses me off of like how often drug makers are like, Yeah, we didn’t really think about women, which is like made this thing like whatever. Um, and yet we were in a pandemic, It was like panic button mode. Right. And they were trying to get something out, anything out to try to protect, like especially the most vulnerable people.

And with that, they came out and said, Yeah, we didn’t actually study this. We need to study this now, now that we’ve studied it, Yes, this happens, it can happen. And it’s um, you know, temporary and it goes away, which is what I and many clinicians were seeing as well. But the crazy thing is, is the first default was, Nope, these patients are making stuff up.

Nope. These people cannot be telling the truth. No, these people are anti-science and they’re just trying to scare people and they’re making up more conspiracies. And any provider who talked about it was being accused of spreading misinformation. Right? And then social media’s like, We’re gonna shut you down.

And like, all of this backlash happens. And, um, I had to wait until like, it had enough of a, like there was, they were like, the drug makers were like, Okay, yeah. Like we, we messed up. We didn’t study that. Um, we’re gonna get on that until I could go on social media and start talking about it freely. Because if I said anything, I got Instagram at the, you know, the powers the be are like, Yeah, we don’t know if you should have account an account anymore because right, you’re, you’re spreading misinformation, but then misinformation becomes fact and you’re like, Well, , maybe we should like, make sure that like, you know, , I just laugh.

I’m like, maybe we shouldn’t make seven to 15 second videos and, uh, encourage people to read captions. I don’t know. Um, , I feel like what we get pushed into is like how we’re expected to educate now, and I get people who are like, You, you know, you’re not talking about all the nuances of every single aspect of this.

And I’m like, It’s not possible in your, in your 15 second video. How dare you. Exactly. And then I, yeah, I read a caption and people are like, , I was these comments like where they’re like, you know what, not everybody might watch your entire video and not everybody might read your captions and not everybody might read the article that you’ve linked to.

Like, you mean all of this free information I’ve put out? Someone might not choose to do that. Yes. And because of that you are dangerous. Because if they, if they only read one sentence that says like, you can’t get pregnant on your period, then like they could get pregnant. And it’s like, If somebody chooses not to educate themselves, I can’t do anything about that.

And uh, actually this one lately was because I said like, How can you get pregnant on your period? Then people were big mad because they’re like, No, you can’t get pregnant on your period. And I’m like, Well, explain that. Explain it in the video. And they’re like, Oh, you, what if people don’t read? What am I supposed to do if people don’t read like that?

So I just crack up because I’m like, I now everybody likes me. Some people have already turned this off because they’re guy like, God, she’s annoying. Yeah. I to some people, and I definitely am annoying. Like, um, there, there’s probably moments in my life that my husband would tell. He would actually never tell you.

He would be like, No, I’d love to talk to her. Like, listen to her for hours on end. . . I don’t think that’s true. Um, , so, but like, that’s okay, right? That’s why we’ve got like lots of people saying things, but. There’s just this line of like, we need people to take personal responsibility, but as providers we, we also need to step up and be there for them and support them and understand that.

Back to the original point, patients don’t really lie. Like there’s, you know, that TV show house, if you’re old like me and he’s like, patients lie, Patients like patients do lie when you are a judgemental asshole doctor, they, Amen. And it’s something that, you know, I’ll have colleagues who are like, you know, do you, do you feel like your patients like lie to you?

Like do you ever, And I’m like, it is a very rare instance that I end up with a patient who, you know, that I know about that ends up lying to me. But a lot of the times the conversations I have, people are like, I’ve never told anyone this before. Is not because like I’m some special magical per no. It’s because I’m like not gonna judge you.

Like that’s really what it is. And. I mean it’s, I mean, I’m sure there’s like more, a lot more to it, but it’s just to say that like it’s not a special person. I’m not a special person. It’s that I have been on the receiving end of gas lighting. I have been on the receiving end of a. Doctors. I mean, I talk about it and be on the pill, doctor being like, you know, you’re having pain with sex.

Let’s just cut your PE nerve and then you can just lay there and have sex. And I’m just like, what in the madness is this? Um, that was a female OB guy. It was, that was filling in for my male OB guy who actually came in and was like, when I told him about it, he was like, horrified. He’s like, At what? She said, What this experimental surgery?

Um, and I just think that’s like an important part of the story because people often are like, Well, that’s why I would never see a male gynecologist. It doesn’t matter what the gender is like. People either cultivate the skills, um, and the humility to be present with their patients without judgment and they do their own work.

Uh, everybody listening, I’m a big fan of therapy. I, I, I do it weekly when possible because my patients don’t need my baggage getting in the way of their care. So, okay. Coming back around to opinions and, we’ll, we’ll call it feedback, feedback when, and obviously like we’ve been talking for an hour and we have a whole nother episode to record after this, but I wanna stay on birth control for like 10 or 15 more minutes if that’s okay.

I stop with the tangents, Dr. Brown . I want all the tangents. I just wish this was like a three hour podcast. I just need to like develop the, the clout to be able to do that. Cause I could talk all the time. You on, You used to do that to me on Balanced Bites, . She would like, she’s so clever. I love that woman.

She, she’d be like, Oh, um, do you have a hard stop? I checked in with your assistant and she said you didn’t have anything. Like, you know, And I would be like, Yeah, no, I don’t have anything. She’s like, Great, let’s go for three hours. And I’m like, Wow. Okay. Like I walked into that. So there is that like reverse gas lighting that’s like for the benefit of mankind.

It’s like . Hey, guess what? I already know your schedule. So , I mean, I just, you just have so much wisdom and knowledge around birth control and like, I don’t wanna miss out on a couple of these things, but this has to do with what we were talking about at, at some point in your practice, listening to people, hearing people’s feedback.

And like we were saying, like feedback becomes data. Like you don’t know what’s gonna become data until you start aggregating feedback and experiences and anecdotal, you know, whatever. So at what point. In your career, did you start to realize that like it’s not just thrombo embolism or any of these like really severe side effects that happen to a tiny percent of the population?

Like what I feel like you were saying earlier in part was at the very least that it doesn’t matter if a really horrible side effect happens to 0.01% of the population, it matters 0% when that 0.01% is you. So like it still matters, but what about all these, like, I guess you could say subclinical stuff, When did you start to kind of suspect that birth control was problematic for so many women on that level?

Nutrient deficiencies, gut issues, thyroids, libido, all of. Yeah, well, it was still, so while I was still in medical school, I just noticed that like, and it was like, and I say like, I just noticed because really, like, I don’t feel like it was like this, like, oh, some, there’s something here. Um, and it was like in a lot of big ways, just the way the story evolved was being more and more validating for me personally, who had so many issues while being on the pill.

And then when I came off in medical school, I, you know, lost my period. I ended up with acne that turned into cystic acne for the first time in my life. I was having so many issues and my doctor that I went and saw, so my OB guy was like, It’s probably just, uh, P C O S. And I was like, No, wait a minute. Hold up.

Like I had regular periods, like, which is when you start your period in the beginning they’re not usually like, well, they. They don’t have to be regular. Like when, when you are very first get your period. They might not be regular first. Mine were, I counted them down like, you know, my doctor was like, You’re misremembering.

I’m like, No. When you bleed more than seven days and it’s extremely painful and like you, you, your sheets look like a crime scene. Like, you know, you know, you count this down, you, you start planning, you get savvy. Did that, so my period had always been regular, which is P Cs. One of the hallmarks of it is an ovulatory cycles.

Nobody in my family has infertility, has struggled with their periods in terms of, uh, or their menstrual cycle, like ovulation. No one’s ad problems getting pregnant again. Big family and um, You know, there was a lot that I went through and all that. And then I started seeing women while I was in medical school who were like, you know, talking about how they stopped birth control and they, um, you know, started having all of these symptoms.

Um, when I was in, you know, I was getting my nutrition degree, we were taught that about birth control, nutrient depletions. We were. That if somebody is on the pill, like there was the, you know, all this whole section on, uh, pharmaceuticals and the nutrient deficiencies they lead to and what you need to look out for, and we were taught if somebody was on the pill, it was a good idea to have them on a multiplied, even though the rhetoric was like, multivitamins don’t really do anything.

I’m like, Yeah, the, the one a day junk, they don’t, but if you get a good one, they do. Um, so we were taught that and how their diet really needed to be dialed in. Like you really needed to make sure if somebody was on oral contraceptive, that you were counseling them about their diet and about these important nutrients they needed to get.

So, um, went through the same thing in medical school, like in pharmacology, learning about, you know, you’re learning about metformin. Statins and you’re learning about birth control. Cause this is all really well documented. Even though like when I started talking about it, doctors were like, but this is not true.

Like, we’ve known this since the seventies. It’s not new, it’s just new to you because you don’t get taught about nutrition. And so with that, um, so I just wanna say like that piece I definitely knew, it’s just, I just started seeing so many of these issues in my practice where, you know, women with autoimmune disease, like could, they could get so much better, but we just could not get those antibodies in remission.

We could not. Um, I was on the Self Helpless podcast and one of the hosts there was talking about how I went on the Self Helpless podcast. We talked about birth control. She wanted to come off, she came off, ah, shemos antibodies went into remission. Can we say that’s gonna happen with everyone with birth control?

No. We, we can’t say that’s gonna happen with everyone cuz autoimmune is so complex and there’s so many things going on, but it’s something that I observed with a lot of patients is that like, they would be doing everything right, but they’d be on the pill and it would be like the, like, okay. Like that’s one of the last things.

I never was like, Oh, you should get off the pill. Um, excuse me, I don’t know everything about everyone’s life, so I can’t just be like, Oh, just get off the pill. Unless there’s like something major going on, like, Hey, you’ve got factor five lidin mutation, or like, we are, we are starting to see some, uh, you know, your CRP is really high.

Like we’ve gotta look at like what’s going on with this birth control pill. But otherwise, it was usually them coming to the point where we see this a lot where people are like, I eat bad. I exercise, I get my sleep, but do all the things. I’ve cleaned up my house, I’ve cleaned up my skincare, like, and they, I’m taking this thing every day and I’ve never actually questioned what does it do to my body?

Or who am I without this to my body? And then they come off and I would see these amazing things start to happen where, and I’m like, That’s not me. Like that’s not me. Like this is you, like you are, you’re doing this thing. Um, and it was back in, gosh, I think it was like. 2012 or 2013 that I actually heard Chris Kruer use the term post birth control syndrome.

And I was like, that’s, that’s like the best thing I’ve ever heard to describe what I’m seeing. When people come off of birth control, if they just jump off cold Turkey, like, and they’ve got this fallout that happens as basically their body kind of goes through puberty again in some, you know, some instances.

Um, and that is, I mean, really the first time that I was. Uh, you know, I heard that and it was like, Yes, there is this group of all like this, this is what I’ve been seeing all these things and I just haven’t had like a way to talk about it, um, to say this thing. And I think that’s where, you know, it’s, I, I talk about this like, you know, it’s called post birth control syndrome Now.

I hope it evolves into, like, gets a name, gets proper research is something else, but it’s like where we start, uh, it’s like polycystic ovarian syndrome. For a long time it was like you’re just, you’re just too overweight cuz you’re eating too much and you’re causing your problems. Oh, get so mad about that.

Um, and that is something that, I think, you know, we now have seen where it got recognized and now it’s evolved and we recognize that like there’s, like P C O S is likely several different conditions and they’re gonna, maybe they’re gonna get pieced out in the future and we’re gonna study those separately and we’re starting to understand the different things going on.

But we’ve had to fight so hard just to get people to listen to P C O S. So like maybe that’s not gonna happen. And so, you know, with post birth control syndrome, it can be the return of symptoms that you had before, but like with myself and other patients, new things can start to come up. So, you know, me getting cystic acne, um, and I wanna say that like I was able to heal a lot of this stuff, losing my period.

Um, I was really scared because I was actually, it was the first time in my life that I was like, Well, maybe I wanna have a baby. And then when you’re faced with like, maybe you can’t have a baby, That’s a really bad feeling. Like that’s a really bad feeling, um, to be. And, um, and so I do wanna say, uh, there’s a lot of people who believe that birth control causes their infertility.

What often happens is that we’re put on birth control for our symptoms. So things like P C O S end endometriosis, um, you know, PTs could show up as acne. First you put on the pill, nobody questions it. Your acne went away fine. Um, endometriosis, you’re having painful, heavy. We put you on the pill, they went away fine.

But then 20 years later you come off and you find that you’re not having a period anymore. And because your doctor was calling those things, periods all along, you’re like, Well now I’ve lost my period. And you know, I just said the same thing. So I should definitely own that. It was never a period, what I was experiencing on the pill was a medication withdrawal bleed.

I was giving myself synthetic hormones and then I was withdrawing them. A period follows a very complex symphony of hormones and is the result of an egg that was ovulated with the potential to be fertilized, either not being fertilized or being fertilized and not implanting. So the absence of HCG has happened and you could argue, well, there’s no HCG in the pill.

So like Same, Same. No, because you’re not getting progesterone, you’re getting proin. Like there’s all these other things going on and it gets really, and I, this is where I think the language is important. Because a withdrawal bleed, we understand like that’s a pill period. Okay. That’s like different, it’s a withdrawal.

Bleed a medication so that when you come off and you don’t have an actual period, you don’t say, Well, I, I lost my period. I had my period last night and now I lost it. No. You didn’t, you had your period like a decade ago, two decades ago. Um, we don’t actually know what it looks like because all of this time you’ve been on birth control.

So now we’re kind of like, we’re gonna, we’re gonna start over. We’re gonna track. But we first, and this is what’s really, really important because so many women are like, I come off the pill and I’m gonna use contraceptive, a different contraceptive and whatever. But they don’t. They think I didn’t get a period, therefore I can’t be fertile.

Ovulation comes before menstruation. We always think teach the period first because everybody knows when they bleed. Like it’s very obvious. So we teach it in that way. However, it’s not actually how the menstrual cycle works. When the menstrual cycle actually works, is that you ovulate and the consequence of not having a fertilized egg is the uterine lining must go.

So unless so, I mean, I could talk about the whole nuances around that, but just for people to understand that your body is building up for a baby. And if that doesn’t happen, then you have a period. So if you come off birth control and you don’t have a period, that doesn’t mean you’re not going to ovulate in the next two weeks, four weeks, six weeks, 12 weeks.

So if you don’t wanna have it, have a baby, it’s very important that you understand. You definitely need a backup method, um, whether you wanna jump to an I U D or you want to use condom. If you want to use something like barrier methods, it’s gotta be a hundred percent. It’s gotta be a hundred percent because there’s no way for you to know exactly when you’re going to ovulate without recording consistent ovulatory cycles for several months.

So, can we talk about synthetic hormones for a second? I wanna know what. Are all birth controls made of synthetic hormones and what makes them different? Why do they affect the body so differently? Mm-hmm. . Well, so a birth control that’s going to, So like the pill, this is like the most common one that’s prescribed, that’s gonna shut down ovulation.

That’s how it works. It has to be a high enough dose to tell your, a, your ovaries not to release an egg. And why, how is it doing it? It’s affecting you in the brain level. So it is actually suppressing brain hormones. So whenever you like, have mood symptoms and your doctor’s, like, it can’t be like, it can’t woo there’s receptors in your brain for these hormones.

Um, yes it can be, and that is where it’s a listening, its impact is through this feedback loop. And so, With that. Um, there was other forms of birth control. So like progeta only, like, uh, the IUDs for example, like Marina. Marina, um, the i u d doesn’t always shut down ovulation, although sometimes it can. Um, and the progess in there, they’re helping thicken up your cervical mucus.

And really these, these hormones, if they don’t shut down ovulation, they’re about blocking sperm and making the endometrial lining thin enough so that implantation doesn’t occur with like, um, uh, so with the, there’s a synthetic estrogen and then there’s a synthetic progesterone called proin. It is not the same as your progesterone.

Fun, uh, medical history is that this progeta was actually developed in Mexico. Uh, so you can thank Mexico for this intervention, uh, invention. Uh, although the US gets credited with it a lot, but Progeta came, uh, from a lab in Mexico and it does a pretty good job as a contraceptive. It doesn’t do a great job mimicking progesterone, especially as we see in the brain.

So progesterone, your natural progesterone only comes after ovulation. So after you ovulate, what’s left behind is the corpus luum. The corpus luum is a temporary endocrine structure.

12 days. That’s your LAL phase. And then if there’s no hcg, it goes byebye. If there’s an implantation and you have hcg, then HCG is like, Hey, we’re gonna make a placenta. But in the meantime, if you can make some progesterone, that would be really awesome. And the ovary like as we hope it says, I got you.

That’s how we wanted to go with pregnancy. So Proin. You know, it’s gonna, it’s gonna help with, uh, the whole, you know, birth control piece. However, progesterone we understand influences bone health and influences brain health as part of like why we developed the model sheath in our brain. Which, um, if anybody, um, I hope you’ve maybe questioned at some point in your life.

Why don’t I get electrocuted when I plug something into an outlet? Because you’ve got a mylon sheath, basically. You’ve gotta, you’ve got this plastic cover and it allows electricity to go through like where it’s supposed to and not do be dispersed. And that’s what’s happening with the Mylon sheath. It’s very important in the brain.

Um, and this is an area where we just haven’t studied a whole lot. We know progesterone is really important for the. It also helps with our GABA receptor. GABA is the neurotransmitter that comes in and is like chill. It’s all good. Um, that’s why when your progesterones right before your period, you’re like, I love people, I love my life.

Everything’s good. I’ve gotta, I, you know, Stress can still get to me, but like, not like it would if I didn’t have progesterone. And without progesterone we can feel really irritable, anxious, have difficulty sleeping. And some people experience that when they have progeta in place and they’ve stopped ovulating.

So we’ll see the anxiety coming up. We will see, um, you know, sometimes people are having some difficulty sleeping. Is that because birth control caused that? We can’t say that. We may never have a study that shows its causation cuz causation is really hard to, to show in research. And because we are complex biological system who’s very in tune with our environment.

And so while you can say I took birth control and then I had this issue like I had, I was depressed and I came off birth control and I’m not depressed. That might be true for you as a doctor and scientist as well, who are like, we can, we can say there’s a correlation, but we can’t say there’s causation.

Um, with this I talk about, I have a chapter in Beyond the Pill about the mood symptoms. If you wanna hear it from a research psychologist, I definitely recommend reading. This is your brain on birth control. Um, they like, I think, um, Sarah and I wrote our books separately and then read each other’s books.

Um, and we were like, Wow, we had some of this like, and it was actually like really good to be like, I had this same, I read the same study and had the same conclusions as like this person who is just researching women’s brains. And, um, I think it’s a really important book that, um, I wish that we could give, I could give both of those books to like everyone when they’re starting birth control, just to be like, Here’s what you should know.

Here’s what you should look out for and here’s how to like, just take care of your body on birth control. Like I get. Um, criticism sometimes when people are like, Oh, she’s just like, you’re on birth control and women already have to do so much and she’s just asking you to do so much more. And I’m like, , these are doctors being like, she’s just asking you to do too much.

And I’m like, I’m just asking that you eat right, like you, for your body. Like, did you get the nutrients you need? Does that mean like you can never eat like a donut? Like ? I’ve got donuts on my mind right now. . Um, like I have to be gluten free. Uh, who doesn’t have donuts on their mind at all times, right?

Yeah. I was watching, uh, an episode of, um, the Boys on Amazon and there was a, a hamburger with like a donut bun. Like the kid was like, and I. The guy was like, I don’t know, I think he said like, they have like no morals or No solars. I don’t even remember. He was like criticizing it and I was like, I’m just curious.

I’m just curious right now, like, what would that be like, Like would it, could it even hold together? Okay. I digress. Um, but, you know, India on the pill, everything that I’m giving is what? I wish I had when I started birth control and what I wish that I could have known, um, you know, as I was starting it and going through my twenties and what I’m, what I’m asking you to do is ask the question, what’s true for me?

Let’s test food. Let’s, let’s, let’s eat this, not that. Let’s bring it back in and let’s see what happens. Like, let’s, you know, track our menstrual cycle, see what interventions will help with that. Like how does sleep affect things? How does stress affect me? I want to help people build their own user manual so they know their body so well.

They can’t be gas lit by their provider. They know their body so well, they can ask the questions about it, they can pinpoint things, they can help their provider, help them better. And really my hope is that you don’t need your provider. Except for like screening exams. That’s really what I’m after. Maybe that’s why doctors get big mad cuz I’m like, I want you to not need doctors.

that’s called empowerment. Yeah. I’m like, I want you to need us when we like when we’re there. Okay. But like, I want you to need us when it’s like, it’s time for your screening exams. Let’s check some blood work. And I want us to be there when, when things start for you. And that’s what’s so important about tracking and knowing your body so well, is that when you start to see your energy, like, so I’ll just take thyroid as an example, how often a patient arrives in my office and when I ask them, When’s the last time you felt like yourself?

They stop, they pause and it becomes like sometimes they’re like 10 years ago. Wow. I’m like, go. You get one life, you get one shot. 10 years is too long to not be a hundred percent yourself. Like, and interventions can take time. Figuring it out can take time. Like, and that’s just like, you know, as a mom of two, I’m just like, I don’t, we don’t got that kind of time.

Like these humans are growing up way too fast. Like we, we gotta get you feeling better real fast. Um, and you don’t even have to be a mom for me to empathize for you. I just like, go to my, that’s where I go in my place of like, I don’t wanna miss out on a minute of this. Yeah. Um, so that is something I just want everybody to understand that you don’t.

Have to be perfect. But if you can be tuned in and you can identify for yourself when things are getting off, and you can seek help sooner than later, and be able to identify that you are more likely going to get the help you need. And like what I, you know, with, with thyroid, I’m always like, if we can catch it when, when your thyroid starts to falter rather than when it’s like your TSH is at 27, you don’t have T4 and T3 going on, you are a wreck.

I’m, your cholesterol is through the roof. Like, you know, And when I say you are a wreck, they’re telling me I feel like wreck. Okay. I’m not telling them like, you’re a wreck, you’re a mess. No, no, no, no. They’re saying like, My life is falling apart. I’m so fatigued. There’s all this stuff going on. Um, and that’s something where it’s like, we’re going to have to use a medication.

Yes, we’re gonna use diet and lifestyle therapy, but it’s gonna be my recommendation that we also use a medication. And I just wanna be very clear in that language because I do have people deny me, and that is their choice. Do I have to par you them of like you are facing serious cardiovascular risks?

Should you choose to go that adventure? Um, yes. And yet I can’t force anybody and I’m not going to coerce anybody. And yes, sometimes I’m gonna scare people because it is scary to face your own mortality and I have to be honest about that. Yeah. So what’s the low hanging fruit then? If you have somebody come in and they’re like, not quite a wreck yet, but they’re like, something’s off.

Is it a really good multivitamin? Is it rest? Is it stress? Is it, I mean, you said you can’t really tell people to get off the pill, but you know whether they’re on it or it’s post birth control syndrome. What’s the low hanging fruit that you, this easiest adoption for people? Yeah. Well that’s like the whole lot of stuff you just listed off at

Uh, yeah. Um, and like I, you know, I just wanna be clear to people, uh, cuz sometimes, a lot of times I think we come from places from our own understanding. I worked in a homeless youth clinic for two years. Um, there are women that cannot, they couldn’t control being sexually assaulted. Like they, it was, they didn’t have a door to close at night.

Yeah, yeah. There are women who are in abusive relationships. Like, there’s people who are very, very vulnerable and the pill is the best thing they can do, You know, or a depo shot or an i u d and who am I to act like I know how to live their life better than them? Um, you know, there’s, and so, uh, this is where, you know, working in a homeless youth clinic, um, You know, I have people who are smokers, people who are Ivy drug users, all of these things.

And it was never for me to judge them and tell them to stop these things. Everybody knows that like smoking’s bad for them. Like they know, people know they don’t need a doctor being like, This is bad for you, you’re gonna die, blah, blah, blah. Like, nobody, like, you know? Um, and also these are youth. I wouldn’t have listened to that if you were telling me that.

And so it’s all about, you know, risk mitigation and how can we come in and look at the small changes that we can make that can have a really big impact. And so I use that extreme so that people wanna understand, don’t, don’t be judging other people on, you know, how they’re choosing to live their life. Um, and secondly, to understand that like even you can do the smallest thing to, you know, to improve your life.

And so, um, I love that you’re like, Oh, is it take a bowl? Ivi? I wish it was. Was that great? Like, I just wish, uh, it’s not that way. So I mean, the reality is it’s, it’s the totality of all the steps you take. So, um, I do have a new book coming out and I actually talk about like, you know, thinking about there scales, right?

And I think in wellness it’s always like, this is the good and this is the bad. And it’s like, here’s the like optimal choice and here’s the less optimal choice. But if you fill your life with nothing but optimal choices, what happens to that scale? Oh, we’re outta balance. , right? Because we’re writing for this perfection all the time.

Mm-hmm. . Um, which is like, I mean, people, people judge me so hard. It just, it cracks me off sometimes because they’re just like, um, you know, I was like eating a benet and people are like, I couldn eating a benet like sugar and all this stuff. And I was like, and fat. And it’s so good. Like, you know what? I get one life, I’m a foodie and, um, I just like, I’m not gonna, I’m not gonna let this meal pest.

I’m not gonna let this pass me by. I’m like in a in Paris. Like, no, I have to, Oh, gimme a break. You have to eat everything in Paris. Give me a break people. Yeah. And so it’s just something, it’s funny because um, I think sometimes people think that anything that talks about like nutrition at all, uh, like that’s must be diet culture or something like that.

And I’m like, Nah, I like, here’s like, and so the way I would approach it, so like, let me just give you an answer. Like, let me stop this. Like, let, just give an answer. people are listening and they’re just like, You do whatever you want. Dr. Brighton, I, I’m loving it. I need to, I need to, I need to give you what you asked for.

So, um, here’s the thing. So I was talking about like my new book and I talk about how like you, every day you get to take steps. You, you just get to take steps and you get to make choices like towards your health. And really it’s never gonna be one thing. It’s not one thing that made you sick. Um, it might be one thing that tipped you over the edge, but it’s not one thing.

It’s not like you did one thing and then you ruined your life and you made yourself sick. It’s like you did the one thing and all this other stuff was going on. And so we have to really be looking across the board, and this is where I think people, they need to take inventory of their own life, right?

Cause I might come in and say, You know, the thing that you need to do, um, is build a nutrient dense diet. So with my children, the way I talk to them, like we have a, um, cookie jar, thank you, Siete, because they had, um, Mexican cookies, Costco, and I was like, Oh, hello, hello. I don’t wanna deal with the powdered sugar in my life.

Um, and these are like a much better alternative, um, you know, for people who are gluten free. Uh, my whole house is gluten free so people know except when we’re in Paris or somewhere else, and that’s a whole different conversation. But, so we have a, like a cookie jar now for the first time ever, um, who don’t know, my son has panda.

And as it’s like in remission, but it’s like always waiting in the wings, like all auto immunity. So we’ve worked a lot on impulse control and the way that I approach him and why am I talking to you about children? Cause like every, like a lot of this stuff that like we do, it comes to like inner child.

Like Yeah. Be like, be the parent. You always need it. Um, and so what we talk about is like, he wants to have a cookie, and I’m like, have you nourished your body? Like, have you nourished your body first and given your body what it really needs? Because right now your brain and your taste splits want that.

And you can totally have that. Well, we just wanna check in, have you nourished our body? And he’ll say like, Yeah, actually, you know, I had a cucumber. I had, you know, And he’ll, he’ll list off like some of the things he had and he’s like, I think that’s pretty good. I won’t tell him No, that’s not good. Like, or any, I’m like, Okay.

All right. Like if you, Yeah, if you wanna have a cookie. Thanks for asking. Um, and we are slowly getting to a place where he’s not even having to ask me. So that’s something that when we wake up in the morning and we just wanna slam coffee, by the way, I love coffee. Hmm. Um, but we just wanna slam coffee and maybe wanna just like have a bagel.

Then we just ask ourselves like, have I really nourished my body? Have I given myself the nutrients that I need? But maybe that’s not a conversation for the person who’s listing this. Maybe that’s not the thing that they need to focus on. Maybe the thing they need to focus on is sleep. That’s all of us.

And so I’d say like, One of the two areas I think are best when it comes to women’s hormones to really focus on if you can do nothing else, is what can you do to tend to your sleep and tend to your stress. And so I think new, I mean, I have a degree in nutrition, like look who I’m talking to. Like, yes, I think nutrition is really, really important, but I also think that is much harder to make, to have that higher level.

And yes, it takes higher cognition, like to have that conversation with yourself about food, about nutrients, um, if you’re not well rested and if you are banana stressed out and those two things. So please everybody, Liz, Infertility, diabetes. Do I have your attention? Do not skip this. Uh, because people skip it.

Whenever I start talking about sleep and they’re like, Whatever, y’all sleep’s important. I’m like, No, no, no, no. See, we study these people called night shift workers who are super, super important, super important, so grateful. Them er nurses that are up all night, I stand, You are amazing. And yet we study them and we see their health outcomes are not good.

So what we see from disrupted sleep, disrupted circadian rhythm, and specifically in women because we are so in tune with our light dark cycle, is that when that gets off, what we see happen is we see inflammation goes up. More reactive oxygen species are being made. Oxidative stress. That means cellular damage is happening.

We see disruption of the menstrual cycle. We can see anovulatory cycles, we can see insulin resistance starting all of this. Leading to diabetes, leading to other chronic diseases. We see cancer can come up and we can see infertility. That is how important our, our light dark cycle is. And so why I say light dark cycle is because it’s not just sleep, okay?

It’s also getting that deep restorative sleep and the way that you’re going to get there. So if you could just do these things at night, it would be super great one, can you avoid screens? 30 minutes to two hours before bed. Oh, you can’t, can you at least wear, Oh, you like we’re not on camera, but I have my glasses right here.

like, yeah, wear your glasses, wear your light blocking glasses, your blue light blocking glasses. Cause like, you know, again, perfection’s not the name of the game. That’s just more stress. Can you not exercise within two hours of bed? Can you sleep in a cool room? Is there any way you can turn on an ac, get it down to like 68 degrees maybe.

There’s cooling mattresses, there’s cooling blankets. There’s like all this tech these days that can make a huge difference. It’s gotta be dark all the way dark. I travel with blackout curtains and I throw wash cloths and pills. If I’m in a hotel room there, there will be no lights. There will be no light.

I cover up everything that I can, um, because even a little bit of light, the way you are evolved is that your eyes let light is gonna pass through and it is gonna break down your melatonin. Melatonin is not just about sleep. It is a very potent antioxidant when we are doing like, uh, advanced fertility protocols and we are like, we, we’ve got oxidative issue, We’ve, you know, we’ve gotta get those antioxidants up.

Melatonin is one of ’em that we’re using and there’s, you know, people that are like, if you’re using like more than 0.5 milligrams, then you’re disrupting your sleep. What? Not using it for sleep. , we are using it for fertility, we are using it to protect our eggs, but that sleep component is so important when you wake for the morning, expose yourself to natural light.

Now I will say two things. One is, um, even if you think there’s not light there, there’s some light that’s coming through. However, you might be somebody like I was, I was in Europe and someone’s like, I live in Finland and there’s no light and I’m. It’s kind of true . And I’m like, well maybe like, look, if we are so concerned that our screens are gonna break down our melatonin, like that blue light, maybe we hack it and we use our screen in the morning.

I’m like the, the next thing I would say if you can’t get sunlight is to get an alarm clock that has the natural light. And if you can’t do that, or you’re waiting for that order to come, cuz I don’t know which chippings, like in Finland, um, maybe doing what we tell you not to do at night might actually work.

Do I have a study to say that I actually do not? Um, I could go look, but if it breaks it down at night, that’s what we’re trying to do in the morning. We’re trying to break down melatonin and spike cortisol at night. That, that adhering to the circadian rhythm and getting that good sleep can make such a difference on your hormone.

And then as I talk about the stress piece, there is so much that’s out of our control. We just went through a pandemic , We went through the most like good luck. Right. Good luck. Yeah. Controlling any of the stress. Um, like, ah, like there’s just like, when you think back, I, you know, I don’t know about you, but I like still feel the stress in my body.

Like I can still feel like, ooh, I get tense just thinking about going in the lockdown. Yeah. And mask and what’s happening and like, ah, like there’s just all this stuff. Um, and so just to recognize that there’s a lot that’s outta your control. . How do you actually manage your own stress though? So like block people on social media?

Yes. Do that. Block people in real life, like love that. Like if they gotta go, they gotta go. Like there’s like, you know, lots of things that you can do, but what can you be tending to every day that that starts you in the parasympathetic? So we’ve got the immune or the nervous system, which is like go fight flight, you know, or freeze.

That happens. Mm-hmm. . Uh, and that’s sympathetic. And that’s where we end up like running. And that’s where. Social media is trying to keep you because they’ll keep you addicted. They’ll keep you on the screen. Like, that’s why more conflict or things that make you feel depressed are gonna come up, um, in the algorithm because that’s the stuff that makes you stuck.

Okay? So like you’re like, you are in a real life game and it’s a real life game. Start yourself in the parasympathetic and like, if you’re gonna get on social media, just like, don’t do it in the first 30 minutes. And also, um, just like make sure you’re curating your stuff well. Um, so I will, like on TikTok, people are like, How do I do that?

TikTok has a really good algorithm. Um, they know what keeps you on. So, uh, if you go and you find like hashtags and you’re like puppy, puppy, TikTok or whatever you go through and you like all of that, just go crazy. Go nuts, like all the puppy tos, , leave it playing while you’re brushing your teeth. Don’t even look at it.

Just like, leave the video playing and the algorithm will be like, This person loves puppy. Tick TikTok. Somebody comes into your F Y P and they start saying like, you know, stuff that makes you like, you’re like, Man, they’re really, they’re trying to make me like scared or depressed. Leave the apple together.

Close it. And TikTok will say, Oh, they hate that. They hate it so much. They bailed on us. So you can actually do that with social media. So people are like, Oh, I don’t have power on social media. You, you have that power, so you have that power on social media. So that’s something you can do to actually mitigate stress.

And people might be like, I mean, I feel like if you’re like elder millennial as they call it now, or Gen X might be like, This is crazy. And. Um, it is very weighing on younger millennials and Gen Z and like Gen Alpha will be coming up as well. And we know this, there’s studies showing us Yeah. That like, it’s not good for our mental health, but what things can you do to start your day in parasympathetic?

Can you do deep breathing? Can you go for a walk? Um, can you meditate how everybody says meditation? Yeah. Cuz it works. Mm-hmm. , it works. We do, we say it all the time. It works. Uh, um, and looking at things like do you wanna dance? Do you wanna sing? Singing in this shower actually stimulates the vag nerve.

Like, yeah, that’s even better. Like, what can you be doing that brings you joy and puts you at ease? And that might sound really simple, but when something, when you hear stuff and you’re like, I’ve heard that before. I always challenge people. And how well are you doing it? Because my patients often will say to me, Oh yeah, I already know that.

And how often are you doing it? Oh, I’m not. Okay. That’s what we need to explore. So you’ve heard it again, and now that’s your prompt to really explore, how do I integrate this? How do I actually follow through on this? So the reality is, is that there is no lack of information out there these days. If you want information, you can get it.

What there really is is a lack of, you know, one follow through on the individual, but two, the container of society to hold space for you to actually care for yourself. Yeah. And so it’s not all in you of why this can be so challenging. I view it in some ways as an imperative, simply because for the most part, the folks that we’re talking to with this podcast today are actually very capable of doing those things.

For the most part, I am. Reaching people in circumstances who are completely out of control of their circumstances. So for the most part, if you are listening to this podcast and you’re overwhelmed and you’re stressed and you’re seeing all of these, you know, negative symptoms around your body and your mental health or whatever it might be, there are probably at least one or two things out of what you’ve just said that are completely workable, completely doable.

Many of us are privileged enough to incorporate those with absolutely no danger to our persons, and that is a very, a fortunate thing. So we can do it. And you said meditation and I was like, Dang it. I spent the money on the meditation class, but I don’t actually meditate. And why doesn’t spending the money just count?

Why can’t that I know, right? Just check my box, Just take a pill and spend money. Like why can’t I? Yeah, I have ause meditation, uh, device, um, which I used, I used consistently, like for. Oh gosh, probably four or five years. Like, I’m very impressed by myself. Um, and it was fun. Um, it gamifies meditation, but I will say like when my, my son went through his health crisis and it became like, I kept trying to put on the mute and I was less consistent with it.

And it became one of those things where I just realized that like I, I just need to just at any point, like I can’t go get my zfu be in my space, like put on my, my mute, set up my, set up my phone, deal with clicking through opening the, I can’t, I can’t do it. Yeah. Like, it’s just too much. And so for people to understand, um, if you just park your car and you’re waiting and you’re like, you know, waiting, like you, you’ve got an appointment, but you’ve made it there early or you’re waiting at school pickup or, um, you, you find that you’re in line at like, you know, a coffee shop or something, you can actually just.

Tune into your breath. How am I breathing right now in this moment? How do my shoulders feel? It seems like everybody puts their shoulders up to their ears, like, , am I standing on both of my feet evenly? And you can do it from the top down or the bottom up, but just doing a body scan, getting really aware and focusing on that breath.

I think we always think meditation needs to look a certain way, and it needs to be this like, Oh, I am, my mind is completely clear. Mm-hmm. , it’s not really what it’s about. Um, You know, in some there, like, in some instances, but you know, when we see the benefits of meditation, slowing down, calming down, and seeing that, like thoughts fly in.

But those thoughts don’t control you. Right? You recognize them, you let them go. Sometimes I have to stop and put in a dodo list. I’m like, I just gotta write that down. I still gonna keep coming. Like, I just gotta write it down. Okay, we’re done now. Like, and you know, the, so we’re talking about meditation, but there’s also just the act of mindfulness.

Like when you’re drinking that ice coffee, how cold is it? How do, like, is is it cold the moment and it touches your lips? Or is it cold when you fill it on your molars? Like that’s like some, like how many people drink through ice coffee and think of that. Not most, right? We’re usually drinking the ice coffee while we’re walking and maybe looking at our phone or having a conversation or like, instead, can you just slow down and take a minute?

I mean, even 30 seconds just to be like, Ooh, I feel the coolness going down my throat. Like, Oh, that taste, what does that taste like? Um, you know, is it overly sweet? There’s it bitter? Like that kind of stuff we take for granted, but it actually gets us really in tune with our body and little practices like that.

Yes, it’s good for stress, but it also gets you really in tuned with like your overall body. So when things start to change and shift, you are more inclined to start to notice those things. And you, again, being the person who lives in your body, you know, it’s normal and you know it’s not, and you know when it’s time, like when, when it’s time to like get help intuitively, you know, when it’s time.

We have unfortunately been in a culture. That one tells us, like, you, you can’t, your body can’t be trusted. You can’t be trusted. Um, and like that, ultimately, a doctor will tell you when you need help, but really you need to, you need to trust yourself. And building that awareness is very important in doing that.

I think that that is an amazing place to close out this episode. You’re amazing. Well, thank you. Seriously, I could do the tangents all day long. I loved every single minute of that. Thank you so, so much, Dr. Brighton. Yeah. Thank you so much for having me.

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