Her Discussions by Dr Faye - How To Hack Your Hormones | Female Brain Expert

Episode Date: March 2, 2026

Dr Sarah Hill is a leading voice on hormonal changes and the female brain.In this episode, we’ll explore how your menstrual cycle and birth control impact your brain, along with daily habits and supplements that can help you manage these symptoms 💗What you’ll learn:💊 How the pill actually affects you😔 Tips for when your period makes you moody⭐ 3 supplements every woman should take💔 The truth about hormonal birth control and mental health🧠 Female vs male brains☁️ How your period impacts your nutrition, sleep and recovery needsBut first, please don’t forget to subscribe and share, it really helps us to grow this podcast.Resources & links mentioned:@sarahehillphd🛑 Disclaimers:Opinions are my own. This content is for educational / entertainment purposes and not medical or financial advice.MIN 35: Reflections on IUD use, ovulation suppression and mental health include anecdotal reports.MIN 36: Statistics regarding increased depression risk in teens on contraception are based on observational associations and do not imply direct causation.Links to subscribe/follow:Apple Podcasts: https://podcasts.apple.com/gb/podcast/her-discussions-by-dr-faye/id1835829612Spotify: https://open.spotify.com/show/5viLYizHD4Zy6J42iqtPRoCan I ask you a BIG favour? 💙Please leave a review or rating. It helps us grow the podcast and bring you more amazing guests.Share with someone who needs this; it might help them live a happier, healthier life.Follow us on social media or join the broadcast channel to send us your questions for our guests. I'll leave the link here: https://www.instagram.com/channel/AbY4liwxlLnewx4H/?igsh=MWhuaXFweGtucTB3cA==https://www.instagram.com/channel/AbY4liwxlLnewx4H/?igsh=MWhuaXFweGtucTB3cA==

Women aren't made aware of the different trade-offs that they're making when they go hormonal birth control. Dr. Sarah is a leading voice in female hormones and the brain. And in today's episode, we're going to be talking about how your menstrual cycle and birth control impact your brain, along with daily habits and supplements that can help you manage these symptoms. There's some, like, decent evidence that there's some types of, like, teas. So if you have something, Chaseberry tea, for example, can help to promote a successful, ludial phase. What can we do support our brain and body during this time? I'm going to cheat. I'm going to give you two things. One,

an IUD. Where do I even start with this? There's lots of things you can do for your PMS. First is just start with the basics. If I was somebody with ADHD, I would say track your cycle and track your symptoms. A lot of women have a worst experience in the second half of the menstrual cycle. I'm just because they lack. But first, please don't forget to subscribe or leave a five-star review. It really helps us. keep bringing you podcast guests that help you live a happier, healthier life. Thank you. Hi, I'm Dr. Sarah Hill and you're listening to Her Discussions Podcast.

Dr. Sarah, our community sent in so many questions about female hormones and the brain. But first, I wanted to talk to you a little bit about what on earth made you so passionate about going into this. Yeah, so I've always been interested in motivation and just like why people do the things that they do. and so I ultimately got my PhD in psychology because I was really interested in trying to better understand the different motivations behind, especially attraction and mating related behaviors. That was my first area of research. And then what really got me into hormones was my experiences with the birth control pill. And, you know, I was on it for more than a decade in my life. And then I went off of it.

And I felt very different than I felt when I was on it. And so that led me into a sort of a deep dive into the effects of hormonal birth control on the way that women think, feel, and experience themselves and experience the world. And then ultimately, it's just kind of expanded into really trying to understand the hormonal foundations of women's behavior. That's an incredible answer. And I think something that so many of especially our community will completely resonate with. Obviously, you've got a second book out, which we will talk about a little bit later. on but I really loved about the first book.

So the pill changes everything. I really love, because I think the discussions around the pill now are super, super, super, interesting, but I love that you really address that the pill changes everything, not just our mood and our brain, but also the way that women are able to progress in their careers and the societal structures. What are your personal opinions of the pill in? like how do you navigate the almost like polarizing discourse around the pill at the moment? Right. Yeah. So, you know, I think that it's a, it's a complicated conversation. You know,

I think that it's a really nuanced, it's a nuanced thing. So on the one hand, I think that we can say the birth control pill has been revolutionary, you know, and it really has been. It's allowed women to be able to regulate their fertility in a way that allows them to be able to make plans, right, to, to, to, to, to, to, to, build careers to get, you know, advanced degrees and do all of these things that, you know, a lot of our great grandmothers and grandmothers weren't able to do because they didn't have the option to be able to say, I'm not going to have children until this is finished. So the birth control pill has been really positive for women. And then, you know, and so that's one side of the discussion. And then the other side of the discussion is that when you change a person's hormones, which you do with hormonal birth control, I mean, it's going to change women.

And it has a lot more effects than just simply, oh, you know, you're not going to ovulate and therefore you're not going to get pregnant. When you don't ovulate, you also don't produce sex hormones because that's the primary way by which women's bodies produce their own sex hormones. And so you're flatlining women's hormone production and you're giving them these synthetics that don't have the same effects on, you know, women's brains or the rest of their behavior. and this means that it changes women and it changes them in ways that extend far beyond, you know, whether or not they're just going to get pregnant or not. And so because of this,

you know, my whole position on hormonal birth control is this is this wonderful tool that we have, but women aren't made aware of the different tradeoffs that they're making when they go on it in terms of they're not being educated about the ways that being on hormonal birth control changes, you know, everything ranging from the way that their stress response functions to, you know, there's different inflammatory immunological profiles of women who are on the pill versus off the pill, to things like partner attraction, to things like mood. And women need to be aware of these things. So that way they can make informed choices about whether or not those tradeoffs make sense for them,

depending on what they're doing in their lives at that time. It's really just about making people aware of the tradeoffs that they're making. And I think that a lot of times women aren't told this, you know, told this information. And then a lot of women are meant to, you know, women are led to feel crazy for having these experiences that aren't on the warning label of the pill. And so, you know, a lot of the book was just giving women information about what the tradeoffs are that are being made when they go on hormonal birth control. And also, you know, for a lot of women, it ended up being very edifying where it was just giving language to these. experiences that they had had that nobody had been able to give them an explanation for. Yeah. That really resonates with me on a personal level with my experience with birth

control because as a doctor, I completely recognize the power of birth control pill precisely for women. And I'm very hesitant of talking negatively about it. I recognize those powers and especially for some individuals who it works really, really, really well for. But I came off hormonal birth control maybe like three, four years ago because, and I ended up breaking up with my boyfriend, which is like my boyfriend of three years, which, so it, anecdotally, obviously we know anecdotal evidence is very weak evidence, but that it does reflect my personal experience. And then I had some quite bad side effects with many different hormonal birth controls I tried. So I haven't been on hormonal birth control for the last

three, four years. And I always caveat that with saying I'm not anti-hormonal birth control, but for me, that was the right decision. However, when I look back at like, I was first put on birth control when I was 14. And I think about what decisions am I going to make when, if I'm a parent and I have a daughter? And I think, gosh, I do just want to wrap you in cotton wool. Make sure you get through your education and you do not get, you're not ended up on, you know, 16 and pregnant. And I'm in a long-term relationship. I'm more comfortable with that added risk, you know, not having that almost 100% sense.

that I'm not going to get pregnant. I'm comfortable with that. Would I be comfortable with maybe my 16 year old who might be sexually active? Not having that 100% effectiveness necessarily with, yeah. So what would you say? First thing I'd say is that this highlights one of the really big motivations behind writing the book was that one, I wanted to make women aware of what these tradeoffs are because some women, as you noted, have perfectly positive experiences. And And that's wonderful. But everybody needs to know what to be looking for and being able to make those tradeoffs. But the other motivation behind writing the book is that is making us all aware of this so that

way we can push for more options because we don't have a lot of options. I mean, I think that it's terrible that here we are in, you know, 2026 and women's options are if they're looking for something that's like pretty much like foolproof birth control is hormonal birth control. There's a copper IUD, which is non-wholesome. hormonal. And that, you know, I think is a pretty good option for a lot of women, but not all women, because it does cause, you know, it gives you have your periods at first. It can, it can cause really bad cramping at first. It's not pleasant to have it put in. It's a little barbaric.

But so there's that. And then what are the other full proof options? There's just not a lot of them. And, you know, you can do things like the fertility awareness method and tracking your cycle. I wouldn't recommend that to my teenager because the fail rate is too high. And so, you know, we don't have enough options. And so it is really tricky. And so, you know, this is why I say, you know, here's this information, you know, and then you can make the decision about whether or not making these tradeoffs to make sense. Like I have, I have a 19-year-old daughter and, you know, and these issues are very salient. And so we've had to make these decisions just based on, you know, what's best for her, given her circumstances. But, I mean, this is a question every, you know, woman and every mother has to consider.

It's like, all right, here are all these tradeoffs. Here are the available options. Like, what are we going to do? Because I think that we can all agree that a lot of the side effects that even the ones that I discuss in the book, I mean, are sure, a whole lot less bad than an unexpected pregnancy. 16 or 17. I mean, that's like a much worse outcome in many cases than some of the side effects I talk about in this is your brain and birth control or how the pill changes everything here in the U.S. Or here in the U.S. or here in the U.K. And so it's really about understanding what the risks and

tradeoffs are and then making those decisions based on what makes sense in your own life. And so, you know, to that, I say everybody has to answer that question on their own because I can't answer it for them. And also that we need to be pushing for more and better options. We've had so many community questions sent in. I think that just women wanting to learn more about their brain and understanding their cycles better is an issue that a lot of the community were interested in. So the first community question that we've had is how different is the female brain from the male brain in terms of motivation, focus and problem solving? Right. In those ways, our brains are very similar to one another. I mean, you know, when you

to understand sex differences and the differences between, you know, men and women, it's really taking a bird's eye view, men and women are similar to one another in domains in which the evolutionary challenges that we've had to confront are the same. And a lot of the sort of what we would call in the evolutionary world, we call these adaptive problems. But it's just like anything that an organism or a person has had to do in order to be able to successfully survive or reproduce we call that an adaptive challenge, right? And most of the adaptive challenges that men and women have been confronted with over evolutionary time have been the same, right?

We both had to avoid pathogens. We both had to avoid predators. You know, so there are a lot of ways in which our brains are the same. And when it comes to things like problem solving, our brains are very similar. Now, there are some, like, really small differences. Like, for example, we find that men, on average, are better at spatial rotation skills. And so that is like if you try to imagine like what a shape would look like if you rotate it, you know, 300 degrees this way or 150 degrees that way, men are better at being able to do that sort of thing. And this is just everything that we're talking about just on average.

And this is one of the reasons that we tend to see that men go into fields like engineering more is because this is a strength of theirs is being able to do these mental rotation tasks better than women. women are better at object location memory. So for example, after I leave this room, if you were to give me a pop quiz and ask me like, what did you see in that room? I'd be like, okay, well, you know, there was a Buddha statue over there on the right, and then there was these candles on the left. And I saw these little glasses in the back. When you ask most men about, you know, like what they remember seeing in space, they just don't encode it the way that we do. And they believe that these differences are the results. of adaptations that we have from hunting and gathering, and that for hunting, that, you know, throwing a spear and being able to track animals requires being able to understand where objects are going in space. And that with gathering, it's more about remembering where the poisonous berry bush is versus the berry bush that has lots of opportunities for feeding. And women's greater object location memory is also the reason that a lot of times men and children and we'll be like, Mom, where are my keys?

Or sweetie, where are my keys? Or where are my shoes or where is my coat? Because most women, we know where it all is. You know, it's like we know where everything is. We know what's in the refrigerator. We know when we're running out of ketchup. You know, it's like we know all of that. And it's because our brains just pick up on that and encode it to a greater degree than

male brains. So, I mean, there's small differences in sort of like problem solving skills and different types of strengths that we have. But they're really small. Like the big differences between men and men. women oftentimes are those that stem from our different reproductive biology. And because women have this really large minimum investment in reproduction, because women, if we have sex, there's a possibility of pregnancy, which means that then we have a nine-month investment in pregnancy and then subsequent

time spent lactating, et cetera, et cetera. And for men, the minimum investment in reproduction is just the act of sex itself, right? That creates different costs and benefits associated with. with short-term sexual behavior, with, you know, sort of choosiness about partners. And so you do get differences that way. But then you also get physiological differences because because women have to both, you know, have sex and attract mates and then also be pregnant and lactate in order to successfully reproduce, that also creates all sorts of different challenges that the female body has to solve, that the male body does not.

right? Because for men, reproduction just means attraction and having sex, right? And then they're done. And so that doesn't require any sort of special physiological gymnastics in order to reproduce. For a woman, like we have to be, we have to attract mates and have sex. But then we also, you know, have to, you know, have an embryo implant and successfully grow another human being. and that requires all kinds of physical gymnastics that the female body has to perform in order to reproduce. And what this has done, you know, is it's created these sort of two different developmental tracks. There's the male track and the female track. And the female track is characterized by having a physiology that shifts between states that are optimized for attraction and sex, which is what we see in the first half of the menstrual cycle when estrogen is high.

and rising. And then the second half of the cycle is optimized for implantation and pregnancy. And so the whole reason that women's cycle in the first place is because our bodies have to shift between these two states, one that's optimized for sex and attraction, and then one that's optimized for implantation and pregnancy. Male bodies don't have to do that, right? They're always optimized for sex and attraction. And because of that, it creates sex differentiation in our bodies and in our brains, both in terms of being sensitive to these cycling sex hormones. It's responsible for the fact that we have cycling sex hormones. And then it also leads to different adaptations that we have in the body from head to toe where our body, everything like our circulatory system, our immune system,

our respiratory system is sensitive to our cycling sex hormones because our body has to do different things when it's preparing for pregnancy compared to when it's not. And so sex differentiation, you know, for the most part, ultimately stems from differences in our reproductive biology, right? And it can create cascading differences. But like generally we see these in the area of things like mating behavior and mate choice and, you know, things in that domain. And then we also see these physical differences in the body that stem from the fact that men only have one one job that they have to do in order to reproduce and women's bodies have two. It's a classic example of averages, right?

You know how science is just based on the generalisations and averages. I am the one who has no idea where anything is. I'm always saying to my boyfriend, where's my phone, where's my keys. I also do have ADHD, so that probably does play into it. But also my boyfriend's an engineer. So then he fits into that stereotypes, you know, the man, probably the spatial, the better rotational visualization. Sometimes he explains, you know, he'll tell me something he's done in work and I, that's just not part of, I have no idea what, I don't even know where to start.

In some ways, it's great that we're learning more about the female brain. In other ways, what do you think of the drawbacks of applying these almost stereotyped views of women's brains in today's society where we're not hunter-gatherers, women choose not to reproduce? Right. I mean, I think that we just really need to understand that whenever we're talking about men, this and women that, that we are talking about averages. and that the male brain and the female brain are more similar to each other than they are different. But nonetheless, there are differences. And I think that understanding and recognizing that any time that we're talking about men, this and women this, that we're saying men on average this, women on average that.

And averages are really good at being able to characterize an entire population of human beings. But averages are really bad at being able to predict how any individual is going to respond to any given thing. And so just understanding that a scientific average isn't prescriptive and it's not telling you what things should be or even how things are likely to be for you. One of the things that I wrote in this is or how the pill changes everything is just this idea that you can look at all of these averages. And I think that it does help us and just better understanding the world on average. but really when it comes down to like how you should live your life and how to understand yourself, the only data point that matters is you, right? And so if you don't fall into that neat, tidy pattern that's predicted by the average of anything, know yourself, right? It's all about

understanding ourselves and learning the way that we respond to things. And I think that that's like the most powerful thing that we can do. So just understanding that. It's like just because on average X. That doesn't mean that you're going to X, right? We all need to understand sort of where we fall on any sort of a continuum. I think that's the one thing I'd want anyone listening. I wouldn't want them to set limiting beliefs on themselves in terms of maybe if you're a woman who find yourself attracted to like engineering and you have that sort of brain. It's don't set a limits in belief on yourself that you maybe couldn't do that because you're a woman. But using these tools and the information that you have to understand yourself better.

And I think I know personally understanding my cycle and how that impacts my energy levels, how that impacts the ways in which I want to work has been super, super, super, super impactful in being more successful in the things I want to be successful in, but also give it practice in forgiveness with myself. And I think the listeners will be very interested to hear about your book. But first, we've got a section called by or bye by basically. I'm going to ask you some questions. I'm going to show you some products and you're going to tell me whether you would buy these products

or say goodbye to them based on your understanding of female brain. First up, we have hormone balancing teas. Right. Okay, well, it depends on what it is. So just to give an example, there's some, like, decent evidence that there's some types of, like, teas. So if you have something like chasteberry tea, for example, like, that's one. There's a really good clinical evidence that shows that it actually can help to promote a success full ludial phase, for example.

And it's also, there's some good evidence showing that it can help minimize some of the symptoms of paramedopause. But I would just like look and see what is in your hormone balancing tea. And then anybody can go, you know, sometimes people don't know that they can do this. You can pull up, if you go on your computer or on your phone, you can like look at PubMed. And it's a free database of things that are published in the medical world. And look and see about the ingredients. And just like, so if it's like a hormone balancing tea and it includes, let's say,

I'm just throwing this ingredient out there. Dandelion extract. And you're like, dandelion extract, does that actually do something for hormones? Pull up PubMed and do a search for dandelion extract and then whatever your hormonal issue is and see what's been published on it and see whether or not there's some reputable evidence that suggests that it's good or not. I've started taking Chase Berry for my like PMS slash PMDD.

Yeah. Do you like it? I found it revolutionary. Yes. Really revolutionary and good evidence as well. Yeah, really good evidence. It's so amazing, right, that there are these herbs, because I think that sometimes herbs get this, like, you know, this reputation of being woo-woo and that it's not really going to work. And like there's really good clinical evidence. And so many women like you have had this experience. I did. I have had a really positive experience with it also with with I started getting when I was like 43, I was like getting hot flashes with coffee. Like if I drink a cup of coffee in the morning, if I drank it inside, I would just like, get a hot flash from drinking a hot drink in the morning. And then I started taking, I'm like, oh, this is the beginning of the end. And so I started taking Chaseberry and gone. Yeah. Amazing.

Worth saying with PubMed, you know, not all studies are created equal. However, some of the ingredients that you see in some of these hormone balancing teas, you will search those ingredients and they will not have any articles on PevMet. No, exactly. And I think that that's a red flag, you know. People don't realize that they have a lot, they have a lot more access to information. at their fingertips than they know. And going on to PubMed, and if you do see, if you go on PubMed and the thing that you're doing and it's saying that it's doing something health-wise for your body, and you go on there and there's no articles that have been published on it, it's probably not a good ingredient.

I would just say, no, thank you. Yeah, herbal things and medical things. So imagine driving is like a medication, but herb is like walking. So if you travel somewhere by driving, you will get there quicker, but you may have more of a risk of having an accident. If you travel by walking, it will take you a longer time, but it's likely a little bit safer, but you may not. I like to use that analogy with herbal stuff. Like sometimes it won't be as effective as taking a medication. Some people who maybe have more severe symptoms will require medications, you know. Right. Yes. But if you are someone who has more moderate,

mild symptoms, maybe you've got more time on your hands, you can walk to your destination and it can be safer. That's how I, because sometimes, yeah, you're right, herbs get, herbal remedies get such a bad reputation. Yes, it's all just being woo-woo and garbage. And it's like, no, there's actually some really good ones. Yeah, formulated for women supplements. I mean, I do think that there are some of these that can be good, just in that they tend to address some of the nutritional deficiencies that women tend to have specifically.

Because we menstruate and because we create an endometrium in this endometrial lining every month, our body does use different, you know, it depletes. certain nutrients at a greater rate than male bodies do. And so I do think that some of these can be good. Some of them, you know, they'll just like make a pink box and then charge you more for it. And so just I would like try to get a little bit more information about what actually is in your formulated for women supplement. But I do think that, you know, there are some things that are sort of female specific. And so, yeah, so the right one, yes. Female specific supplements you have in your stack. No, so I don't take a female specific supplement. I actually add additional things in with, so I just take a regular supplement, and then I add additional magnesium, because that's something that women need. I do additional iron because of menstrual bleeding and my ferretin levels get low, and that's like your iron stores. Those will get low after I've had a couple of heavy periods. And so I'll take, I take an iron supplement that I sort of cycle in and out of. And then I take an additional.

B vitamin that I take in addition to that. And so I add, you know, some additional things in there just based on my own things that I've had issues with, with nutritional deficiencies. But otherwise, no. Not the pink box. I don't take the pink box. Yeah. A lot of times that's what they do. They'll just like make a pink box and then make it more expensive, you know, and it's like, it's so silly. Morning after pills. Yeah. I mean, I think that if you have unprotected sex and there's a possibility of pregnancy. So like if you know that you're not in the ludial phase, yeah, I would totally take a morning after pill if I thought that there was a chance that I was going to be pregnant and I didn't want to be pregnant. I don't have any issue with those. Alcohol. Like, so this is one

of those things where I can answer it as a scientist and I can answer it as a human being. So as a scientist, yes, yes. Like when you look at alcohol, it doesn't have any positive health effects on the body. it can have positive social effects on people. And I think that sometimes there's a tendency within the area, especially of like medical science for people to focus only on the physical condition of the body, but then never think about mental health and the different things that helped to support that. And we really saw this with the COVID lockdown. You know, with the COVID lockdown, it was just like about trying to prevent spreading of an

illness. And nobody took into account the fact that sequestering people, people in their homes is going to be really bad for mental health. And I felt like there wasn't a balanced enough approach taken there because people were just making these decisions about the physical health of the body without considering the psychological health of the brain and the mind and of people. And so alcohol, like, do I think that the health benefits of no alcohol at all outweigh the psychological and like sort of relational benefits that you can get from, you know, one night going out for dinner and splitting a bottle of wine with your partner or like

meeting up with friends and having a drink with them, you know, and doing that occasionally. No, I think that I think that you can have a balanced approach to alcohol and have it end up creating a setup for a better life while also supporting your health. Do I think that alcohol is necessary to have a good life? No. I think that people can do no alcohol and do it really well. But for people who want to, you know, occasionally have a drink with a friend or, you know, with their partner when they're out for a good dinner, then yeah. So like for me, I do drink alcohol. I don't drink a lot of alcohol, but I do drink alcohol. And I do it knowing what the risks are and then weighing that with the benefits that I get from. having, you know, opportunities to connect with friends and connect with my partner. I'm the same. We had an incredible episode with a sober woman. A lot of the things she was saying are, you know, completely true. I am someone who still drinks, but I definitely have a more balanced approach, especially over the last few years. I think the conversation around alcohol has really

gotten bigger. But I read some really interesting research about drinking, the differences in drinking in your loose heel phase that actually, and I get really bad PMS, that actually did make me rethink. And like what you were saying, having that information and making an educated decision, maybe if I'm meeting up with friends in my Lucille phase, I'm probably thinking to myself, do you know what, maybe it's better to stay on the Lucky Saints, like the alcohol freebies tonight based on my cycle? Yeah, what should you think about that? No, I definitely, like women tend to do worse with alcohol in the second half of the menstrual cycle. And I think that you get worse hangovers.

And especially during this time when projection, is falling. So that's that last week of your cycle before you bleed. Your progesterone levels are falling. So you already have GABA receptors in your brain, which are the receptors that pick up calming neurotransmission. Those are already feeling depleted because your progesterone levels are falling. And when progesterone is metabolized, it releases a neurosteroide called alapregnanalone that stimulates these receptors. And so these receptors are getting less stimulation because progesterone is falling. And then when you add alcohol, which also stimulates these same receptors, and then when you get the withdrawal of alcohol, after the alcohol wears off, you have these

GABA receptors that are naked, right? They're not getting stimulated by allopregnolone. They're no longer being stimulated by alcohol, and it makes you feel terrible. And so women oftentimes do get a worse alcohol experience in the second half of the cycle than they do in the first. alcohol tends to cause more euphoria in the first half of the cycle because estrogen actually primes the area of the brain that produces the experience of reward. And so you get more rewardingness of alcohol in the first half of the cycle compared to the second half of the cycle. But it also tends to be more if you're somebody who's prone to binge drinking, you're going to be more in trouble with that in the first half of the cycle than the second half of the cycle. And so it also,

you know, it really depends on who you are and what your experiences are. So people who are having difficulty with alcohol and can't control themselves around alcohol, I would say do not be drinking in the first half of the menstrual cycle when estrogen is high. And especially, you know, when estrogen is rising and peaking near ovulation, that's going to be a time when your brain finds alcohol consumption incredibly rewarding. And if you're somebody who's likely to then start, you know, after you have one drink, like have another drink and then another drink, and then another drink, you're going to be much more prone to that in the first half than the second half. But then on the second half, you're more likely going to hang over.

So it's really all about understanding the way that your own body responds to alcohol. For many women, it does shift across the cycle. Women also get worse, you know, being able to metabolize alcohol and manage it well during a paramedopause and the menopausal transition. And so, you know, it's like with anything with women, I always advise people to track your cycle and track all you're responding to things over the cycle. And that'll help you better understand like your sleep needs and your nutritional needs and your alcohol needs.

Because, you know, as we talked about, you know, the average is one thing, right? But then it's like how you respond to something can be totally different. And so just understanding your own body's personal relationship with alcohol and how your body is handling it, I think can also lead to a better sort of managing of your relationship with alcohol if you drink alcohol at all. That's really interesting. you said about the differences in the follicular phase and that i'll be interested to talk to you a little bit more about it later on about how in social media there seems to be this dichotomy arising of like

the lucial phase is bad the follicular phase is good yeah and yet which is so so so interesting and that nuance just like a really good example of actually you know if you're drinking in your follicular phase that could lead to more binge drinking you know those nuance points i think we're really missing in social media so we'll definitely have to come on to that a little bit later on yeah yeah no You know, the whole reason I wrote the period brain was because everybody, like, falls all over themselves to talk about how amazing the follicular phase is and how great estrogen is. And the ludial phase doesn't need to feel terrible. And progesterone is actually a really beautiful hormone that does these amazing things to our brain

and to the rest of our body. And so I thought it was time that it got called out, you know, for all of its positive effects. Nice. Okay. Next one, magnesium. Love magnesium. I love it. I could sing songs about it.

I could write a play about magnesium. No, I love magnesium. I think it's wonderful. It's wonderful for women. It's wonderful for men. There's lots of different types of magnesium. And so what I would say is if you're supplementing with magnesium, try to find a broad spectrum magnesium. Because there's something like nine or 11 different types of magnesium that are out there. Our body uses all of them. And so to try to find a broad spectrum magnesium supplement. We have creatine. I love creatine. I take it. There's really good evidence that it's helpful for muscle retention and keeping and building muscle strength, but also good research showing that it can have improvements in preventing cognitive decline. And so yes to creatine. We spoke about this a little bit earlier at IUD. All right. So here's what I here's here's my hot take on the IUD. Okay. So first of all, it depends. Right. So there's two different types of IUD. There's a hormone IUD. And there's a non-hormone copper IUD.

non-hormone copper IUD if you're somebody who doesn't mind it I think it's great because you still ovulate you get all of your full spectrum of sex hormones that are being produced you feel like yourself and if you can get past the greater menstrual heaviness and cramping that women a lot of women experience with it I say yes I think it's great hormonal IUD is a little bit tricky so where do I even start with this So the way that most birth control pills work is, you know, you take this daily progestin, and it stimulates progesterone receptors in your brain, and that prevents ovulation, and then you don't get pregnant.

The hormonal IUD is tricky because when some women go on it, they never ovulate, and then when other women are on it, they continue to ovulate. And their experiences that they have when they're on the IUD is very much dependent on whether or not they ovulate or not. So for women who are not ovulating when they're on the hormonal IUD, it feels pretty bad. And the reason is that here you have this thing that's releasing these low levels of hormone and they're suppressing the HPGX. So they're telling your brain is telling your ovaries not to ovulate. So you're not producing any sex hormones of your own. I mean, really low levels of sex hormones of your own. And you're also not getting any hormones from the IUD,

like you're getting really low levels of them and so this creates this like sort of hormonal no man's land for women because women's bodies are used to being hormonal I mean we're hormonal and so and that's not a bad word yeah it's not a bad word it's a great word and and so to not be ovulating and then not having any like exogenous sex hormones that you're taking to replace that it makes women feel pretty bad like a lot of them don't feel great if you take if you put it in and you continue to ovulate, like, I think it's great. It's just one of those things where you have to know. And what research finds, if you look at women who are using the hormonal IUD,

for the first year, about 80% don't ovulate and only 20% do. After they've been on it for five years, about 80% are ovulating and about 20% or not. And so it's one of these things where the hormones in the hormonal IUD are low enough where some women will continue to ovulate, but some women don't. And so how it affects you is really going to depend on sort of how you respond to it. And so it's a really tricky one. And it's one that, you know, women have this wide range of experiences on. Like some women love them.

Some women hate them. And a lot of it has to do with whether or not they're ovulating. One last thing I'll say about this. And I know I'm talking about this probably too long. But with the hormonal, with the hormonal IUD, research finds that the rate of experiencing depression after having it put in is really high for teenagers. And so what I would say is that for the hormonal IUD, this is one where I'd say not for teens.

Because the rate of the increased risk of developing depression after getting a hormonal IUD is like 300% higher for a teenager. In adults, it's much lower. And I think that it's because with a teenager, you know, they're going through puberty, they're releasing all of these sex hormones that are helping to guide the puberty. digital transition. And so for somebody who's a teenager, being in a state of low hormones is even more unnatural than what it is for an adult woman. And I think that that creates a lot of chaos in the system. And I think that that's why you see teenagers having this really heightened risk of experiencing

depression in response to in response IUD. So like, you know, at the early on in our conversation, we talked about like, what would you say to your teenager if they're sexually active? If I was putting my teenager on hormonal birth control, I would put them on a combination hormonal birth control pill. Those are the ones that have the lowest risk, especially mental health-related side effects in teenagers. I think this is such an incredible, interesting book. But my last point on birth control is it makes me really, really sad that we haven't worked out a way to predict how women will experience these side effects. Because whenever I say that I'm adamant, I don't want to speak negatively about hormonal birth control. But women don't have three, six months of their life.

to just try something and see what happens. But that is what we expect women to do. We don't have much else to offer women than to say, take this knowledge and then try something. If it works, it works. If it doesn't, at least you know the signs. But I look at my own life and I think,

God, if I was depressed for three months, that would be a huge, that would have a huge impact on my career, like on my relationship, like so many different factors in my life. But that's, you know, that's what we expect women to do. No, it is what we expect.

It's so crazy. I mean, and when you think about it, and that's what it is. It is like three months of your life that you're going to be throwing away. And we do, we need to get to a place where we're better able to predict who's going to respond what way to what formulation of hormonal birth control. So that way we can give better, we can give women more informed choices. And that way, you know, we can minimize the risk of side effects. Yeah. Finally, let's talk about the new book.

So what inspired the new book and what is, if there's, There's one take home from the new book that you just want everyone to know, what would it be? Right. So the reason I wrote the book is, one, is, as we talked about, like, everybody's talking about estrogen, estrogen, estrogen, follicular phase, ovulation. And, you know, it does all these wonderful things and we feel so good and look at this. And then, oh, yeah, and then there's the luteal phase in progesterone, right? And then it seems like a bad guy and everybody thinks that it's awful. And it's not, you know, progesterone has these really beautiful. neuroprotective effects. So it's protective to the brain. And it's also anti-inflammatory. So it has

these really beautiful anti-inflammatory effects in the body. And these are all things that we want. You know, it's like we want our brain protected. We want our body to be shifted into an anti-inflammatory state. And so progesterons are really wonderful hormone. And, you know, so one of the things that I would want people to, well, I guess I'm just, I'm going to cheat. I'm going to give you two things that I think that people absolutely need to know. One is that progesterone is an amazing hormone and you want to be producing it. And it does have all of these really beautiful effects. I'm guessing, you know, right now there's some focus in the sort of menopause research,

looking at the protective effects of women's sex hormones on prevention of Alzheimer's disease. And they're just looking at estrogen. And that's a huge mistake because progesterone is neuroprotective and it has all these really beautiful effects. guess is that in 20 years that we're going to be really dialing in on progesterone and prevention of dementia because I'm guessing that it is incredibly protective and that we're going to find that one of the reasons that women are at a greater risk of experiencing dementia now is because we're not experiencing pregnancy as much and that's a high progesterone state

and that minimizing the number of exposures that we have to levels of high levels of progesterone is actually what's responsible for the number of autoimmune diseases that we're now seeing in women because, again, progesterone's anti-inflammatory and removing that break by preventing ovulation when we're on the pill or not, you know, having any pregnancies. So preventing being in a high progesterone state that way is the reason that we see so much autoimmunity in women. And I also think that's why we're seeing this, you know, this like huge number of Alzheimer's cases in women is because we're removing this really beautiful.

this really beautiful effect that progesterone can have on the brain. And so progesterone is a really lovely hormone, and so don't vilify it. So that's one thing, too, is that, you know, as our hormone shift, it does shift our brain and our body from a state that's optimized for attraction and sex, and that's estrogen, and then into a state that's optimized for implantation and pregnancy, and that's what progesterone does. And this means that we do become a different version of ourselves. a slightly different version of ourselves in the second half of the cycle compared to the first.

But it doesn't need to feel bad. I think that a lot of women are under the impression that progesterone is PMS and bad things and feeling cranky and overly emotionally sensitive. And so I wrote the period brain to help women better understand, like what is it that your brain is trying to actually do? What is your body trying to do during this time? Because it doesn't make sense that 50% of the population is going to be feeling terrible and in you know pathologically 50% of the time and so um i wrote this book after doing a deep

dive to better understand what is it that our brain and body is actually trying to do and what does it need in order for us to feel really good during the second half of the menstrual cycle and so just really trying to understand um and wrap our arms around the fact that there's two halves to our whole right we're not just one way as women we are a moving picture depending on our cycling hormones and so trying to understand what is it that progesterone is trying to create and then what can we do to support our brain and body during this time? What can we do support our brain and body during this time? Well, you know, progesterone, just to give you one example, you know, progesterone, because it is preparing your body for pregnancy, one thing that we know is that it raises our basal metabolic rate

by 7 to 11 percent. And so one thing that we need during this time is more food because we're burning an additional 140 to 200 calories a day during this time. And so a lot of women, you know, they're having these food cravings and they're feeling really hungry during this time and they think that there's something wrong with them. And it's that their body's actually burning more calories. You know, but we're not told that as women. We're given this like one size fits all set of nutritional guidelines where we're told you should eat this and you should sleep this number of hours and this is what you need for recovery. And that doesn't work for us. You know, it's like our nutritional needs change across the cycle, just meaning that we need more calories. You don't need to, like, you know, eat certain types of foods over here and then not eat certain types of foods over there. Instead, it's just about making sure that we're getting enough to eat. So we need to do that. We do need more rest and recovery time because our body is working harder. Our respiration rate is higher. Our pulse is higher. If you're somebody who wears wearable, like, tech, you'll see this. You'll see that your recovery tends to be lower in the second half of the menstrual cycle. And it's because your body

is working harder. It's building an endometrium. It's shifting all these gears in the body to prepare for the possibility of pregnancy. And that requires a lot of energy. And so just making sure that you're really being gentle with yourself during this time. Make sure that you're getting enough sleep. Make sure that you're allowing adequate recovery time if you're being really physically active. Make sure that you're eating enough. And then also recognizing that our body's threshold for what it considers to be something that's a danger lowers during this time. So we're also more socially sensitive where we're more likely to see something as a sign of a threat in the second half of the cycle compared to the first. And this is just an adaptation that our body has to

prepare for the possibility of pregnancy. Pregnancy is a time of incredible physical vulnerability for women. They can't get away from a saber-tooth tiger as quickly. And it's also a time where they become very dependent on their partners for access to things like provisioning and resources. You know, historically, women didn't have jobs in an office. We were hunter-gatherers for most of our time as a species. And women relied very heavily on their partners to get access to food and other types of resources, protection that they need when they're in this really vulnerable state of pregnancy. And one of the adaptations that we have is that our brain lowers the sensory threshold for what is considered threatening. We've become more

attuned to the possibility of threats. And I think that understanding that can really help us in our relationship with our partners because we're more likely to interpret things that they do as being signs of danger. Like, am I safe in my relationship? Like, is my partner going to leave? Like, like, there's a fact that they didn't empty the dishwasher when I asked them to. Like, does that mean that they don't value me and don't love me and aren't going to stick around? And obviously, most of this doesn't go unconsciously, but the unconscious brain is just like pinging anything that is a sign of potential threat and that, you know, being aware of this and understanding what our brain is doing during this time, I think it can be incredibly useful just in the own narrative

that we have with ourselves about what's going on. Like, why am I, like, you know, why am I so upset about this dishwasher situation? You know, it's like, okay, like my brain is more sensitive to signs of potential danger right now. I'm sensing that this might be a threat in my relationship. I should probably go talk to my partner and just feel reassured and get some extra reassurances about how we're doing in the relationship and then that's going to let me feel better and that's going to calm my ludial face brain. And so just really understanding what our bodies are doing so that way we can take care of ourselves and understand ourselves and change the way that we think about ourselves as well during this time. What I sometimes worry about the conversation about

lucile extra sensitivity in the lucile phase is it might lead to women dismissing their emotions more. And I think the example you gave about the dishwasher is a perfect example. It doesn't remove the validity of maybe being annoyed at your partner that they didn't empty the dishwasher. It just helps you understand maybe your reaction to it. And yeah, so I just worry that sometimes it may be feeds into this narrative that women's hormonal emotions are not as valid. No, it's valid. It's real. And I mean, and we're picking up on something that's the sign of a, that's the sign of a potential threat, right? And it's just like saying that, you know, so smoke detectors are created to be super sensitive to any sign of danger, right? So if you make microwave

popcorn and burn it in the oven, right, you're going to, there's your smoke detector is going to go off, right? And even though there's not a fire, your smoke detector was built intentionally to be really perceptive to any sign of danger. And that's wisdom, right, in the smoke. We don't want a smoke detector that doesn't notice when there's a fire, right? Because it's being too cautious about whether or not at alarms. And so, like, there's actually a lot of wisdom and it is valid. It's like we're picking up on a cue that potentially could be a sign of danger. And it's probably not, but it could be. And so I don't, I don't, there's nothing invalid about the way that women are experiencing the world when they're in this half of the cycle. And in fact, like I said, there's so much wisdom to

it. And I think that we need to move past the narrative that we've had for women for so long, which is that, oh, you know, it's hormonal and therefore, you know, it's, it's irrational or it's not real. And the fact is like, no, it is real. And the only reason that we believe that there's anything wrong with it is because we've all somehow bought in to this narrative that was created by a bunch of sexist jerks hundreds of years ago, you know, and like there's no reason that we can't flip the narrative and say, like, no, actually having, you know, two primary sex hormones instead of one is an advantage. And it allows us to look at things from multiple perspectives.

And how, you know, and like how, you know, men, on the other hand, are so simple. Like, how could we possibly trust them with important decisions when they only have one hormone and can only look at things from one perspective? Like, we're so much more advanced and that we're able to look at things from different ways. And, you know, so it'd be really easy to flip that narrative and totally turn it on its head. It's just nobody's thought to do it because all that we've ever heard is this, idea that there's something wrong with having cycling hormones. I absolutely love that you've said that because I sometimes feel that when I'm in my Lucille phase and I do get quite bad PMS, PMDD, like, and to a point,

it can be quite debilitating and impact my relationship. But then there's also points that I feel very, very, very, very grateful. But I get a Lucille phase and maybe I have, it almost feels like emotions that have been bubbling under for the rest of the month, suddenly get a chance to like surface. And I get almost more in tune to those things. I have like a moment to really appreciate them. Like emotions aren't always bad, you know? Right. No. And in fact, there, we wouldn't have them if they didn't provide us with an advantage. Right. So having emotions is is a wonderful thing. It helps guide our behavior in adaptive ways. And it really is a really wonderful thing that we go through this period where we get more access to what's going on beneath the surface psychologically. I'm going to come on to our

section called Real or Real. I'm going to show you a TikTok, and I would love to just hear your thoughts on it. Men and women have different brains. Wildly so. Wildly different. So this whole thing about you can't put your gender on your medical forms is just insanely stupid. Because gender matters.

Like estrogen and testosterone, they matter when it comes to brain function. I published a study on 46,000. and scans looking at the differences between male and female brains. And they're wild. Women have much better frontal lobes function, much better blood flowed to the front part of their brain. Which makes them good leaders. If you think of impulse control and collaboration and communication.

And the one statistic that just hammers this home is who goes to jail, men. 14 times more than women. But women get depressed twice as much as men because their limbic or emotional brain is much busier than the male brain. And that's why in every human society, women are primary caretakers for children. Women have a bigger nesting instinct.

So I told you we moved recently. And moving is much harder on women in general. than it is in men because they feel like they lose their nest and they have to redo their nest. And I was an Army psychiatrist for seven years. And I used to always tell the guys, I'm like, when you move, you stay home and help her put the house together because she's going to be way happier for you. There's a lot happening there. So some of it, some of it, yes, some of it, no. So to start with, male and female brains are vastly different from one another. No, like they're more similar than they are different. And yes, there's definitely sex differentiation. No question about it. As I noted, you know,

men and women have faced different evolutionary challenges just because of the differences in reproduction. Our brains are sensitive to sex hormones. Our sex hormone cycle. I mean, there's all kinds of things that make male and female brains different. There's also a lot of things that make male and female brains the same. Second thing is that he conflates gender with sex and they're different. And so putting gender on a medical form it doesn't need to be there. Biological sex does. And sex and gender are different. Biological sex refers to like, you know, from an evolutionary perspective, biologically, it's the size of your sex cells. So if you make large immobile gametes called eggs, you're a female. If you make

small immobile gametes, you're a male. And so that's biological sex. And that is the thing that is correlated to all of these different differences physiologically. And absolutely, that's something that should be accounted for it in medical records because male and female bodies don't respond the same to things. And this is the reason that there's such a push for adding women into medical research now is because women's, you know, they used to just study men and then apply all the insights that they get from this research onto women. And the women's bodies are not responding well. And it's because biologically we're different. And our bodies work differently. And so biological sex matters. Gender also matters and is not necessarily the same as biological

sex. And so I don't like it when people call sex gender because it conflates the two things and they're two separate things and they're not always the same. So that's the other thing. But yes, male and female brains do differ. And there are differences and some of those differences are important. Some of those differences like with the activity and the frontal lobes, yes, we do see that that's true. And yes, women also have our amygdala, which is our fear center, is more interconnected with the functionally interconnected with the rest of our brain than in a male brain. Our brains are also less lateralized. So we get more communication between our two hemispheres than men do. Men tend to have a denser, less communicative corpus callosum. And so there are

definite differences that create differences in behavior. Some of those, like the thing with moving, like that's never been, I've never seen that in research. So I think that that was just him talking about a story that he had, you know, an anecdote. So I don't, I don't know about that. But some of, some of the other things, you know, within, in terms of like the emotional differences, yes, and men are more likely to go into prison. But that's also a result of testosterone and not just the frontal lobes because testosterone puts the foot on the gas pedal of being willing to escalate to win. And so when you're willing to escalate and escalate and escalate to win, that means they're also more likely to get into a fist fight or break into somebody's

house or murder somebody because you're trying to get at some sort of a goal. So, um, so a little, there was a little bit of truth in there and then a little bit of, um, sort of confabulation of things that I don't think are like accurate. Interesting. And I, I think the really important point is there are more similarities than divisions because otherwise I think you, you fall down this trap of really feeding into very gendered stereotypes. I don't necessarily think of helpful in today's society where we're not we're not living hundreds of thousands of years ago even though like our evolutionary challenges might have been different that's not the world we live in one of the questions that we got was is there anything I can do for my PMS there's lots of things you can do for your PMS I mean

one is first is just start with the basics a lot of women have a worst experience in the second half of the menstrual cycle just because they lack what I call resilience to hormonal changes And that is that their cells aren't able to quickly adapt to the vast number of physiological changes that happen as we're shifting hormonal states. And ways that you can promote hormonal or resilience hormonal changes is just really taking care of the physical health of your body. Because the thing that promotes cellular plasticity is like low inflammation and being well nourished. So making sure that you're eating healthy foods, make sure that you're moving your body. make sure that you have healthy social connections because that's also really helpful in not only supporting resilience to hormonal changes, it also helps to promote fertility because your body

will shut ovulation down if you aren't feeling supported and you have too much chronic stress. And so anything that you can do to minimize chronic stress, but really just taking good physical care of the body. Other things, you know, if you have really bad, really bad PMS and like PMDD, things that I'm really excited about. One is cognitive behavioral therapy does seem to really be helpful to women with PMDD and PMS in terms of helping them reframe some of the ludial phase ruminations that can happen. And so I'm excited about that as a non-medication-based option. The other thing I'm really excited about is stimulating the vagus nerve.

And we're doing some research right now looking at vagus nerve stimulation using a device, that stimulates the nerve that's right by your tragus, which is this little flap, this little flap of cartilage that we have in front of our ears. And when you stimulate the vagus nerve, it activates the parasympathetic stress response, and it helps to regulate bodily systems from head to toe. And there's all sorts of really great work showing vagus nerve stimulation in decreasing heavy menstrual bleeding, decreasing endometriosis, decreasing treatment resistant depression. I mean, it has all these really wonderful effects on so many systems of the body. And we have really good reason to believe it's going to be therapeutic for especially PMDD.

And so we're starting a trial soon looking at vagus nerve simulation in relieving, especially the psychological symptoms of PMDD. And I'm super excited about that. I read some research about CBD in comparison to SSRIs in PMDD seems to have similar effectiveness, but the CBD continues, obviously when you stop SSRI, the symptoms of PMDD come back, whereas when you stop CBT, the symptoms continue, like you continue to have the relief, which is, yeah. Something like CBT is, you know, you're teaching your brain to think about things differently. And the thing we always say in neuroscience, right, is this idea that neurons that fire together,

wire together. And so when you keep practicing thinking that way, yeah, you take it with you. So even after you discontinue the therapy, you now have these new pathways that get activated when you get into sort of that dark PMDD spiral. You can get yourself out of that spiral without having to continue to go on to therapy. So it's really, yeah, really is great. Therapy often gets a bad reputation because of how maybe you don't see that instant. Right. Yes. And I would come back to my analogy of walking somewhere or using the car, like I think taking that walk, getting your steps in.

It might take you longer to get there, but it's better for you in the long run. Yes, no, absolutely. Another community question that we had, how do hormones affect ADHD throughout the menstrual cycle? What differences in behavior or symptoms might we see? Yeah, so, you know, ADHD, a lot of it is driven by changes in dopamine. Like that's one of the big sort of the big neurotransmitters that's involved in ADD. And that's something that also gets modulated by estrogen. And so what women tend to see is that they do get changes in their symptoms across the cycle.

it tends to differ woman to woman. And so if I was somebody with ADHD, I would say track your cycle and track your symptoms. And then learn about your own body's relationship between hormones and ADHD. And then I would just try to heavy load like the most intense workload and those types of things on your good days.

Right. Because some women get really like when estrogen starts to fall, like early, early ludial phase. They have a really difficult time with managing their symptoms. Other women have, like, the week before they're bleeding, they have really bad symptoms. Other women get really bad symptoms during their periods. And so just really understanding what your own body's relationship. But yes, there's definitely hormones will modulate your symptoms.

There's no question about it because they impact signaling of the same systems that impact symptoms of ADHD. But like I said, there doesn't seem to be a lot of research. consensus on who's going to feel what way when because so many there does seem to be a lot of heterogeneity and symptom worsening. And so just really keeping an eye tracking yourself and then learning that way. Brilliant. It's been an absolute pleasure to have you on the podcast. We've been asking all our guests this question. So Dr. Sarah, what do you wish every woman knew by the time she was 25? By the time a woman is 25, I hope that she understands her cycles. So

understand your menstrual cycle. Start tracking it early. Learn your relationship between your hormones, like how you feel your energy levels, emotional sensitivity, et cetera. And so I would just start really tracking and learning. Brilliant. Thank you so, so so much. Yeah, thank you for having me.