Well with Arielle Lorre - 198: Periods, PCOS, Birth Control, and Total Hormonal Health with Lara Briden

Episode Date: September 21, 2022

In this episode, I'm talking about natural treatments for women's health issues with Lara Briden, a naturopathic doctor and best-selling author. We go in-depth about periods and birth control: whether women need periods, which, (if any), birth control is the best decision for your body, and natural alternatives to the pill. We also talk about related women's health issues like PCOS, endometriosis, heavy periods, hormonal acne, and even the correlation between gut & hormonal health.   Find more information at: larabriden.com.   Right now, Sakara is offering our listeners 20% off their first order when they go to Sakara.com/BLONDEFILES20 or enter code BLONDEFILES20 at checkout.   Visit Houseofmacadamias.com and use code BLONDE20 to receive 20% off your first purchase of their nuts or bars.   Become the best version of yourself and get 15% off Ned products with code BLONDE. Go to helloned.com/BLONDE or enter code BLONDE at checkout.   Visit athleticgreens.com/blondefiles for a FREE 1 year supply of immune-supporting Vitamin D and 5 FREE travel packs with your first purchase.   Download the Alto app and use code BLONDE in the Promotions section for $20 off your first 2 rides.   Produced by Dear Media.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

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Hey, welcome to the Blondefeited podcast. I'm your host Ariel Lori and I'm here to talk all things wellness. From how to achieve optimal health and well-being to the best beauty tips and everything in between, no topic is off limits and I'm bringing it to you real and unfiltered. I know there is so much information out there so I'm here to help you navigate it all. Thanks for listening. Let's get into it. Hi, everybody. Welcome to the show. Do I have a story for you? I'm definitely teasing it right now because I'm not telling it on this episode. But you guys know, I'm traveling. I was traveling alone for a little bit. Now I'm with my dad. And the last three days

has been such a shit show, such an ordeal. I'm like still recovering. I'm on no sleep. I'll tell you is all about it on Monday when I record a or when I release a solo episode. So make sure you check back in on Monday for that. But today I have a great episode with Dr. Laura Brighton. I'm sure a lot of you are familiar with her through her books, her bestselling books, period repair manual and hormone repair manual. That's how I found her. She is a naturopathic doctor with a focus on women's health and a little background on her. She worked as a researcher and evolutionary biologist at the University of Calgary. And then she went to school for naturopathic medicine. And she talks about this in the episode. But her love of science and the natural world has

really informed the way she works with patients and she views the body as a logical, responsive system that knows what to do when it's given the right support. And she's worked with patients for 25 years. She focuses a lot on diet and lifestyle, and those are her main mechanisms to work with women's reproductive hormones and period problems. So she treats a lot of PCOS, endometriosis, perimenopause, and many other period problems. And we are talking about all of that today. So we go in depth about periods and birth control, whether women need periods, which birth control is the best decision for your body. We talk natural alternatives to the pill. We also talk about health issues like PCOS, endometriosis, heavy periods, hormonal acne,

and the correlation between gut and hormonal health. So I think you guys are going to love this episode. Please enjoy Dr. Laura Bryden. Welcome, Dr. Brighton. I am very excited to have you here. Thanks for having me. You could just call me, Laura. Thank you, Laura. Very excited to have you here, especially halfway across the world where you are. That's the beauty of Zoom, I guess. I really didn't utilize Zoom until the pandemic. And now it's like almost at least 75% of the people that I podcast with are elsewhere. I don't know if you've had that experience. I have, but it's such a treat when you occasionally get to do an in-person interview. Yes, it's totally different. Yeah. Well, to start out, can you just introduce yourself to the listeners and tell them about who you are and what you do and how you came to do it? Because I know that you had a little bit of a windy road getting to where you are. Yeah. So I'm a naturopathic doctor.

I trained in Canada, hence the Canadian accent. So my accent will be a mix of Canadian with a couple decades in Australia plus now New Zealand. and I've been working as a clinician for about 25 years in women's health, so I mostly treat period problems, hormone problems, so PCOS, endometriosis, perimenopause, and helping women find alternatives to hormonal birth control. And I've got a couple books, period or paramanual for women of any age, and hormone or paramanual for women over 40. And my background before that, before I became a natupeptic doctor, I was an evolutionary biologist and I actually published a peer-reviewed paper and evolutionary biology. So I do tend to see things through that lens of

evolution, which in which, you know, in the natural world, obviously female physiology is normal is actually probably, I would argue, the standard physiology, and which is quite a different perspective than in some ways than our current medical approach, which tends to view female of the physiology and periods as sort of a pathology to be fixed rather than a strength. Do you feel like that changed with the introduction of the birth control pill? I mean, this was a huge thing, obviously, and it had so many incredible benefits, but also it can be detrimental in some cases to women's health. So do you think that around that time, that's when the view around periods in women's

health changed and became more pathological, or has it just been kind of like deeply ingrained? That's a great question. And of course, if we start talking about hormonal birth control, which I think we're going to, that opens a bit of a Pandora's box because there's lots to talk about in that story. But one thing to keep in mind is when the pill was, the pill was invented in the 50s and 60s, which was actually before there was really any scientific understanding of the menstrual cycle. So almost from the get-go, we've had the suppression of the menstrual cycle with contraceptive drugs as this big elephant in the room, this thing that we're doing that we're constantly trying to sort of normalize, but it's obviously it's not an ideal situation.

One of my key messages is that women, we benefit from regular ovulation and natural menstrual cycling and shutting it all down, well, suppressing ovulation, which is what most, not all types of hormonal birth control do. We're told this story, these sort of narratives about how it helps to regulate hormones or it regulates the menstrual cycle. Of course, it can't do any of that. It suppresses female hormones and puts women into a temporary chemical menopause. I mean, I emphasize the temporary part of it and then replaces our own hormones. with these contraceptive drugs that are actually only kind of similar to our own hormones. This has been happening now for three or four generations, and this all started before we had

really any idea of some of the effects of the estradile and progesterone that we make with our own cycles. So in answer to your question, you know, has, I guess I would say the pill has arguably held back or stalled research into the menstrual cycle because it's almost from the get-go been kind of confused between, you know, what are these contraceptive drugs doing versus what are our own hormones doing? I know that I personally had a very different understanding of what the birth control pill could do. I mean, I thought for such a long time that it would balance your hormones, quote, unquote. And I was, I don't know how it is in New Zealand or how it was in Australia or Canada,

these different places that you've lived. But I was put on it, I think, when I was around like 15 for no reason. I mean, I wasn't sexually active at that time. My skin was clear and I had a normal period, but it was just like hand it out. Like, here you go. This will make your skin even more clear. And I took it. And I mean, I have like just, I've had PCOS.

I don't know if there's any link there. since my early 20s and a whole slew of issues with my hormones and then the different issues that that causes. So it's been like a trickle down thing. But is it similar in other places? Or do you think that's like just in the United States where it's just such a common thing to give it out? It's similar in Australia and Canada and New Zealand. Yeah, for sure. The part that really kind of gets most women are like young women like you're kind of thinking, wait, what? What was I doing? It's actually when we've been told the pill will regulate the cycle and then women figure out it actually can't do that. It's the opposite.

It just kind of shuts down the menstrual cycle and then creates this withdrawal bleed that just to be clear is arbitrary. It's really just to mimic the menstrual cycle. There's no reason, there's no medical reason to bleed monthly on the combined pill. I mean, for decades, women have been told to bleed monthly, but it doesn't mean anything. And certainly for women who have had irregular cycles for various reasons, and that wasn't your situation, but let's say because of PCOS or something like that, and then they get these regular pill withdrawal bleeds, it hasn't done anything to correct the underlying problem. So as soon as they stop creating those drug withdrawal blades, they will go back to whatever situation it was. And it's, the problem is even,

a little deeper than that because we know now, and here's something we didn't know when the pill was invented, for example, it takes girls or young women about, possibly about 12 years to fully mature their menstrual cycles. So you guys probably know that I am in Paris right now. And let me tell you, I am eating all the things and enjoying every minute of it. But I have to admit, I'm waking up every day, feeling a little bit groggy, a little bit of a food hangover because I'm eating so many things that I don't normally eat. And let me tell you, my AG1 athletic greens is such a savior in these moments because I drink it as soon as I wake up before I have my matcha or coffee or anything. And it really gets rid of that kind of food hungover, groggy feeling that I have. So with one scoop of,

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We really are all connected and I can't wait to explore these conversations with you. Every week we will be putting on our comfiest BJs, circling up with a cocktail and chatting with fans and friends alike. We might even get a little too comfortable. Check out Earth to Ariana anywhere you listen to podcasts. We release new episodes every week. So from, you know, 12 or 13, when you get your period, the first couple of years the periods are what are called an ovulatory. So there's probably no ovulation.

It's just this sort of, it's like practice bleeding. You know, your body's just kind of testing the waters. There's a bit of estrogen around and getting some bleeds. But then if that process is able to progress in a healthy way, ovulation will start and start to become more regular. and ovulation is how we make the hormone progesterone. And it actually, well, the research suggests, and I have a citation for this, it can take up to 12 years to fully mature that process. So it's not until, say, women's 25, if she's been allowed to cycle naturally, that she'll have kind of peak fertility, like really good levels of progesterone, like a really what we call like a robust or strong ovulation, which is not just for making a baby, because progesterone has lots of other benefits or health.

And I might just take a moment to describe a couple of the differences between our own progesterone and all the various progestants, which are the drugs like the progesterone analogs that are used in hormonal birth control. Because mistakenly, the word progesterone is used to describe those drugs and it shouldn't be. Because although estrogen is a generic term and the word estrogen can be used to describe the estrogen and the pill versus our own estradiol versus different estrogens, that's not the case for progesterone. Progesterone is actually should. only be, that word should only be used to describe the hormone we either make or we can take in the form of body identical or natural progesterone. But the progestions should be called progestions and they all, they have, there's many different ones actually and depending on which one you take, they all have their own set of side effects potentially. And they're quite different from progesterone in a few key ways. So one of the ways is that our own progesterone without being too technical, but it metabolizes in the body to what's called a neurosteroid or kind of like a neurotransmitter. The brain loves it called Allopregnantalone.

And your listeners don't have to remember that name, but it's actually quite good for the brain. And it helps to regulate what's called the HPA or the adrenal sort of access or stress response system, allopregnolone is involved in that alopregnolone is actually involved in sort of helping to mature the menstrual cycle and arguably, I wouldn't they prevent PCOS, but sort of reduce the risk of PCOS. Because actually, interestingly, all young women actually go, it's normal to go through kind of a temporary PCOS stage in our development. And then as we become, you know, into our late teens and into our early 20s, if we're ovulating and making Ella pregnant alone, we sort of mature into a more mature menstrual cycle. So potentially, that's one big difference with between progesterone and progestions,

which is why normally our own progesterone is quite normally quite good for. mood, although some women have sort of a paradoxical reaction to it. And then, of course, our premenstrual symptoms can be from that withdrawal from progesterone at the end of the cycle. But just another little difference, for example, is real progesterone is really good for hair, like head hair, like for promoting healthy hair. It has kind of an antigen effect, whereas some progestions cause hair loss. And that's something that a lot of women don't realize. Like they may have been on a pill for 10 years. and starting to get this thinning of their hair and then be told, then kind of finally figure out,

oh, it's from that pill that you're taking. That's more kind of heartbreaking. That kind of chronic hair loss can be very upsetting for women. And there's a few other differences like that. Like when you really start to dig down and think about the difference between our own hormones and contraceptive drugs, that's when you really start to think, wait, what are we doing here? Yeah, just on that progesterone piece, and I don't want to like, if any, is taking these or might be. I don't want to necessarily make anybody like scared. This is just my experience. But I mean, like I mentioned, I have PCOS. I've been offered every different thing, combination birth controls as a solution. Progestin only birth control. What else? I was given a progestin

only. I mean, they call it progesterone only, but it's progestin. Only IUDD last year. And it was interesting when you said that it can have kind of a testosterone effect because I was told I would have no side effects. It wouldn't, I wouldn't feel anything. I, I lasted seven days because I felt like I was in such a heightened state of panic and like a, like arousal, not like sexual or not like, you know, fight or flight and panic. And it was crazy. I, I have never experienced anything like it. And my doctor told me that it was not a result of the IUD. Conversely, I've taken bioidentical progesterone, and I friggin' love it because I feel great, I sleep great, I feel calm. I'm like just, I mean, it's like I absolutely love it.

So the difference is very stark in my experience. I'm sure that we all use ride sharing at some point in our lives, but I know for myself as a woman, I'm not always comfortable. I definitely double and triple check license plates and make sure the driver knows my name and everything before I get into a car, but it can still be kind of uncomfortable. But that is all changing with Alto. So Alto is an amazing service. They own their fleet of five-star safety rated luxury vehicles that are easy to find. They are all marked and they're cleaned between every passenger ride. Also, their drivers are W-2 employees, not contractors.

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Alto is currently on the road in Dallas, Los Angeles, Houston, Miami, D.C., and San Francisco. I absolutely love Alto. I've talked to other female friends who also feel super safe, using Alto and I know men that love them as well. So whoever you are, you are guaranteed to have a great experience. So you can download the Alto app and use the code blonde in the promotion section for $20 off your first two rides. Again, that is the Alto app, Al-T-O, and the code is Blonde, B-L-O-N-D-E, in the promotion section for $20 off your first two rides. I'm sure most of you listened to my episode with glucose goddess. In it, we talked about so many tips and tricks to avoid major glucose spikes throughout the day. And something that we talked about was how even if you are being cognizant

about what you're eating throughout the day, your morning coffee or matcha can set you out on the wrong foot if you are having it with oat milk or adding some kind of sweetener, which I do. I like to add maple syrup to my match. And that can actually kind of set you up on this roller-cocter. coaster. So a hack that I was actually already doing, I was very proud of this, but that glucose goddess actually validated was I have a handful of macadamia nuts with my morning macha. And this is actually really helpful because the fat and the fiber in macadamia nuts helped to reduce the spike in your blood sugar or your glucose. So my absolute favorite are House of Macadamias. The reason I love House of Macadamias over any other kind are because they work directly with South African farmers, which is the

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And their nutritional composition is unsurpassed. So they are rich in omega-7s. Omega-7s are a fatty acid that boost fat loss and increase your body's natural collagen production. So you guys can get 20% off your first purchase if you go to house of macadamias.com and use the code blonde 20. Again, that's house of macadamias.com and the code is blonde 20 for 20% off your first purchase. Yeah, with IED is interesting actually with any type of IUD, there can be a nervous system reaction. It might be from the levanogestrel, which is the drug in the IUD, or sometimes it's just an anatomical thing. The cervix, of which obviously the IUD went through, it is kind of bumping against potentially. It has a lot of nerves, including the vagus nerves. So some of them get this like really anxiety reaction

from IUDs. And there's not a lot of research on that, but I predict or I suspect that's partly a nervous system reaction. But yeah, IUDs. So it delivers a little bit of the drug, leaving agestral into the uterus. It fins the uterine lining. It can be great for, to be fair, like really great for improving heavy bleeding and can help with endometriosis. And so some of my patients use the hormonal IUD. I'm not anti it in general. Like there's always a cost benefit analysis, right? And I'm then just trying it and see how it feels but like for a long time the story was oh no it's all local like there's no systemic effect at all and then but of course there is and so we know that now from a bit of research that we can detect

breast changes in women like sort of by imaging breasts in women who have hormonal iudes we know actually the the big 2016 study about mood and hormonal contraception the progestin-only methods including the hormonal IUD were actually a little worse than the combined methods, partly because estrogen is it has a very mood enhancing effect, even the synthetic estrogen. So, and progestions generally are not great for mood, although normal, natural progester normally is quite good for mood. One thing about the hormonal iod, it can, not in all women, but it can permit natural ovulation and natural cycle, like natural cycling, which is a little, quite different. from most other methods.

In fact, it's sort of the opposite of the pill in some ways, which is this is something I own in my messages, is that with the combined pill, like the normal kind of oral estrogen birth control pill, you women will, can bleed regularly if you're dosing in that way, but not cycle, like not ovulate, not make their own hormones. So with the pill, you bleed but don't cycle. With the hormonal iod, weirdly, it's actually possible.

to cycle, get an actual natural hormonal cycle happening, but not bleed. So, which is, for some women, it's kind of the best of all worlds. They get to make their own hormones, but not have crazy, you know, period problems. And I got the IUD, and we won't turn this episode into my, my gynecological history. But when I got it, you know, I mentioned PCOS. I've had uterine fibroids, polyps, you know, large cysts, this, that, and the other, PMD, terrible bleeding, terrible pain. So I think my doctor has had success with it and that it has reduced a lot of those symptoms, especially the pain and the bleeding, really heavy bleeding,

really prolonged bleeding and helps shed the lining, right, which is an issue for me as well. So I was all in. I was like, yes. Ready for some relief. Yeah, it just really didn't work for me. But I have tons of friends who absolutely love it too. So I think it really is just like a personal thing. Let's kind of rewind a little bit. So are we all more or less, this is definitely an overgeneralization, but born with naturally balanced hormones. I mean, when we begin our periods, our hormones more or less functioning and then whatever factors start to influence them, whether that's medication, lifestyle issues. And that is what causes things to start to fluctuate and go into disarray. Short answer, there are factors that kind of come into play before that. So kind of a sad reality, but some women are just born kind of with a higher risk for problems. And yeah, so that's important for women to hear. It's not necessarily, you know, they've something they've done wrong. A lot of those, some of those risk factors actually, sadly, are coming from exposure to environment.

toxins potentially in utero, so when you were a little female fetus, or even by a concept called epigenetics. So toxins, your mother or grandmother were exposed to way before you were born. And that's creating changes in hormone receptors, hormone production. In the case of endometriosis, for example, which is a common condition that causes pain, often sometimes gets misdiagnosed as other things. But yeah, there does seem to be some evidence that it has a genetic component. Some women can just from the gate really like be having problems. In some cases, it might be that they were doing pretty well, but then a combination of maybe being put on the pill too young or under-eating can have a, that's actually obviously reversible. That hasn't done any

long-term harm or anything like that. That just needs to be addressed so that women can be fully nourished and get their periods back. But there's lots of ways to lose a period. Like there's lots of ways, lots of reasons for period problems, which is why certainly in natural medicine there's no one-size-fits-all. I mean, medicine has wanted to have this panacea, which is the pill is one-size-fits-all. But unfortunately, it only works because it's just suppressing.

It's shutting the whole system down. But that's not the same as trying to regain a regular natural cycle. or obviously deal with the pain in the case of endometriosis, there's a whole immune side to what's going on, which is not hormonal at all. I had people send in questions for this episode. And I got a few categories of main ones. Endometriosis was one. PCOS is another hormonal acne with another. So we'll try to hit best we can. I know that we could probably do a week worth of podcasts on each topic or more. But yes, definitely it's a big issue. Yeah. Well, it's a sensitive topic. just to be clear, my position is that women should 100% have access to hormonal birth control of all types. Probably my preference would be for the hormonal IUD when it can be tolerated because it does

sort of at least allow women to make their own hormones, which is kind of my main goals for women. But even some of the other types, if they're giving relief from severe symptoms, certainly if they're for that woman, if that's what they gauge is the best method of avoiding pregnancy. then that should be available to them. There are other ways of avoiding pregnancy. There are a few non-hormonal methods, unfortunately not as many as there should be. And I think that's another way that the era or what I call like the epoch of hormonal birth control the last 50 or 60 years has not served women is that I think it's potentially held back, because the pills there and these drugs are there, it's sort of potentially held back research into other methods. And

So there are big gaps. Like it feels like there are other methods of avoiding pregnancy that should exist. There are potentially a number of male methods that should have come to market that have not yet. I wonder if something like that ever did come to market, though, how long it would take to shift the burden off the woman. You know, I feel like it's been, the burden has been on the woman since birth control. And again, that's not like to say birth control isn't incredible. I mean, the pill. But they, yeah, men are interested.

Oh, good. They are. I mean, that's what the surveys, that's what the, you know, they're getting participants in these studies. And so men are stepping out. I feel, I mean, that's an objective finding. And so I think we have reason to be optimistic about that. It'll be great for women to have, yeah, the burden shift a little bit. So in the potentially there's other methods for women, too, that have not, I mean, really, if you think about it,

So what I say in my first book, period of Paramanual, like, think of all the technology we have. And yet the way we're still, you know, choosing to try to avoid pregnancy is by shutting the entire female hormonal system down. Like, it's very primitive, really. Like, it's kind of barbaric, if you think about it. You guys know by now that I am traveling. I'm in France. I'm sure you're listening to this going, we know, we got a girl, we've heard you say it a thousand times. But this is relevant because I have to tell you guys how much my Ned products have been getting me through this trip and not just one product, all of them. So we'll start with flying. I used to really hate flying. I went through a phase for a couple years during the pandemic where I was terrified of it. I'm not that bad anymore. But I still have a little bit of trouble getting comfortable on like a really long haul flight. So Ned's de-stress blend is my go-to. It helps me so.

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saccarra.com and put your zip code in and you can check out for yourself what is on the menu in your area. The food is always amazing. And they also have the Sakara shop, which is stocked with functional plant-rich products and wellness essentials to help you create a body. You feel strong and vibrant in, like their best-selling metabolism super powder, plant protein bars, teas, and their super seed and nut blends. And true story, my mom was supposed to come on this trip to France, but my dad came instead. That's a different story in and of itself, but she had ordered a box of the Sakara protein bars, and she sent him here with them for the bike portion of the trip.

So I get to have a Sakara protein bar every day on my bike trip. They're so good. Definitely try those. And right now, Sakara is offering my listeners 20% off your first order if you go to sacara.com slash blonde files 20 or enter the code blonde files 20 at checkout. That's sacara.com, s a k-a-r-a-r-com slash blondefiles 20 to get 20% off your first order. Sakara.com slash blonde files 20. I'm kind of curious, like, if somebody wanted to find out when they were fertile,

but they have PCOS or they have just irregular periods for whatever reason. And can they still figure that out through temperature and cervical fluid and all of that, even if it's not regular every month? Yes. Short answer, yes. I mean, some of the algorithms do put are not, you know, not valid for very irregular cycles. So you sort of have to look at the finer print of the computer algorithms. But in terms of, you could still figure out ovulation.

certainly if you're using temperatures or cervical fluid, even with a longer cycle, it's still possible to use that meth that you should have to know what to look for. Yeah. So with PCI, it can be tricky because you can see fertile fluid or mucus. It looks like when it said it's peak day, it looks like raw egg white. It's this very slippery, quite a different sort of discharge than you get just on a normal kind of what they call dry day. Like it's liquid, it's fluid, it's gel-like. it's and in a normally that would come just before ovulation but with PCOS with paramedopause anytime

when there's sort of a problem with ovulation you can see that a few times before you actually ovulate so having seen that and then that going by doesn't mean that ovulation is behind you you have to actually in that case you have to know what you're doing and like track temperatures to confirm did ovulation actually happen or was that just a body attempting to ovulate so in answer to your question. Yeah, you can still use those methods. In the case of Daisy, for example, which is a method that a lot of my patients use, so it gives, that's one I'm most familiar with. Like, obviously it gives a red, yellow or green days. So red means you're definitely fertile. Yellow means it doesn't know. And green means it's 99. Whatever it is, 3% confident that you're not fertile if you see a green. And in the case of irregular cycles, it won't

give a, it'll just get lots of yellow days, basically. Lots of days when it's just not just not just, sure. It won't give a green day until it's like, oh, yeah, detected the temperature change for ovulation. So that's the difference. You just potentially have a lot. It's kind of frustrating because you have a lot more days when you're not sure, whereas with the very regular cycle, you're going to have a lot more safe days. Okay. So PCOS, there are so many, so many angles that we could approach this from. But I guess let's just talk about potential causes, how to diagnose it and how to manage it or navigate. Let's talk about how to diagnose it first. The ACUS is both overdiagnosed, which we'll talk about, and underdiagnosed.

And a big part of the problem is this using ultrasound, using the finding of polycystic ovaries to try to diagnose when it actually can't do that. Arguably, through my perspective, this is kind of a bold statement, but I explained it in the paper, I think the finding of polycystic ovaries should just be thrown out. Like it's not a valid method of diagnosing this condition. because a lot of women, any woman at any time can show polycystic ovaries, essentially. She can have polysistic ovaries if everything's fine. Like there's just nothing, no problem at all.

She can have polysistic ovaries if she's under-eating and has lost her period that way. And that's actually very different from PCOS. She can have polysistic ovaries if she has endometriosis, which is a totally separate condition. So, and at the same time, conversely, especially in older women, like by their late 30s and into the early 40s can have the hormonal condition PCOS but not have polycystic ovaries, which is sort of the underdiagnosis component, because it's really just about the number of follicles. They're not cysts.

I mean, there are, there is such thing as ovarian cysts, and there's different types of ovarian cysts and cysts can cause pain and problem. That's a separate, totally separate issue, actually. The so-called polycystic are just multiple small eggs or follicles. And if you think about it, younger women have more eggs in their ovaries. That's just a fact. And so this is where a lot of young women get mistakenly told. They have polycystic ovaries and they really just have a lot of eggs because they're young. And it's sort of issues around the magnification of the modern ultrasounds are picking up a lot more follicles. And so there's a lot, there's a whole set of papers around this and trying to rename the condition potentially and take the emphasis off the polycystic. appearance. So at the end of the day, what PCOS is, by definition, essentially it is the situation of having high androgens or too many male hormones, including testosterone, when all other causes of that have been ruled out. So there are other reasons, like,

so there's something called adrenal hyperplasia, which is not common, but not totally uncommon, which affects about it. I think it's about one in a hundred women. They, sometimes, that's a different condition, right? Like they often get misdiagnosed as PCOS, but they actually need different treatment because they have high testosterone for another reason. High prolactin can cause high testosterone. So there's lots of different causes. And it's sort of a diagnostic process of identifying the high antigens, whether that's with blood tests or just symptoms. Symptoms would be facial hair and quite strong jawline acne and thinning part type of hair loss. All those symptoms don't have to be there, but those are all potentially androgen symptoms. And weight gain around the middle is an

androgen symptom because in the female body, too much testosterone or androgens can cause or drive insulin resistance or weight gain around the middle. As women, we need a small amount of testosterone, so it's not like we want zero. But there is a sweet spot and having high levels is not good in the long term. So that's the diagnostic process, is acknowledging you have high And then the next stage is how you lower those antrogens. The pill can 100% lower antigens, which is why it's given, especially depending on some of the progestins or, well, you know, the estrogen and the pill that synthetic estrogen lowers antigens. Some progestin specifically are anti-androgens. So they can, the pills, different pills can definitely relieve androgen symptoms,

such as skin breakouts and facial hair. But the symptoms will come back when you stop it. Like it's only a band-aid, right? And it hasn't done anything to. recalibrate or help to regulate the system. So talk to kind of methods that I have different medicines that I talk about in period of per manual and in my paper. But the big ones on my radar right now, one is called enocetal or myoenocetal. It's really good. I always feel like I'm doing an infomercial for the supplement when I talk about it.

Like it's very inexpensive. Like it's so cheap, which is great. And it doesn't taste good. You usually want to take it as a powder because you need quite a lot and you need to take it for quite a long time. And any brand is fine, essentially. And it's done so well in clinical trials that it's, it is truly evidence-based medicine for PCOS. It made it into the 2018 international guidelines for PCOS, which was amazing to me. It's safe when you're trying for pregnancy. It's really great. So it can help with, you know, weight loss. It can help with, you know, gradually. And it's not as immediately ant-androgen as the pill. say, but it does help. And then the other one of the other treatments is called cyclic progesterone therapy. So this is using the real progesterone, like you mentioned earlier that you, you know, tried it. It's 14 to 28. Yeah, exactly. So that in the states, it's called, you can either get it as prometrium. It's by prescription. Other as prometrium or a compounded formula. It usually works better as a capsule, although it is also possible to take progesterone as a cream. But most of the clinical trials

are using capsules, the endocrinology professor, who's quite a close colleague of mine, Jeryl from Kanadash. Her lab in Vancouver is currently doing a clinical trial of cyclic progesterone therapy, natural progesterone for PCOS. So yes, little plug, if any of your listeners are in Vancouver and want to be part of that trial, they're still recruiting. They need people in person because they do a little bit of testing. And it's not you do. difficult for the participants, but you do need to be able to sort of go to her lab in person. No, that's helpful. And I'm sure I do have listeners there that would want to participate. Science. Yeah. Are there, I mean, I feel like you hear a lot that PCOS is a lifestyle issue and you

lifestyle your way into it and you can lifestyle your way out. How valid is that? Yeah. I think that's not entirely fair. That's really not because we know from the research. This is where that's in utero. I mentioned earlier, like, you know, when we're little baby female fetuses in utero being exposed to different environmental toxins, different things can kind of set us up or increase our risk for different hormonal conditions. PCOS is definitely like that. So in utero exposure to androgens, either from maybe your mother had PCOS or environmental toxins

or, you know, different, whatever the factors are, that increases the risk of PCOS by five times. So women are born with. the risk. Some of them are just never going to get PCOS no matter how much, you know, how bad their diet is. It is true that, for example, like a diet that promotes insulin resistance, so, you know, maybe high sugar, hyper-processed food, that kind of will worsen the condition and potentially, potentially, and anyone can sort of push you into a state of higher angstens. So there's a definitely, what the great thing is, that means diet can also help to reverse it. So eating a more whole-food diet, avoiding concentrated sugars.

I'm not saying everyone eats a low-carb diet or you have to avoid fruit or anything like that. I'm just talking about like soft drinks and desserts and that type of food can potentially worse than PCS, especially women who are genetically susceptible to it. Yeah. To that point about diet, I mean, there's so many different things that we could talk about, but a big one that I wanted to ask you about and that a lot of the listeners asked about too was the connection between things like gut health and hormonal health. And again, like, my experience has been that when I was dealing with a really bad issue that started in my gut

years ago, my period stopped. It was, it just stopped. And I'm curious, like, scientifically what that connection is and how much they influence each other, if at all. Not at that often, I mean. Oh, no, there's a lot of cross talk. There's a, as you can imagine, there's a lot of potential effects from the gut for sure. I'll answer your question about your period stopping, but just circling back to endometriosis, there's a huge connection with the gut. It's actually more to do with an immune type of inflammation coming from the gut and sort of a whole picture emerging in the research around that. But in terms of irregular periods, there's lots of ways gut problems could cause that.

I mean, certainly if you're not absorbing the nutrients, you need. to the body the brain needs to be absolutely 100% convinced that there's enough nutrition coming in to agree to ovulate like if there's any gap then the brain's like oh no no don't think that's not a good idea I don't want to do that because obviously the brain needs to be ready to make a baby and the thing is if you want to if you want to ovulate you have to convince your brain it's okay to safe and okay to make a baby even if you don't want a baby because this is just how female physiology works. But another thing that happens that I see with my patients is especially when there's a lot of gut problems

and then women have to, they're trying to find a way to not bloat, you know, not have the pain. So they start, you know, avoiding reducing phodmaps and carbs, which is understandable, like just trying to find a way to feel better. That can inadvertently lead to, like unintentional under-eating. That's just that you're just not getting enough. that's the situation potentially of sort of a, you know, an unintillamic aminorrhea or under eating. And again, under eating or losing your period to under eating can be misdiagnosed as PCOS. In fact, often is because polycyc ovaries could 100% be there. And they don't really mean anything in that case. Lots of ways that gut problems. Yeah. How about stress? Is it a similar

mechanism? Yeah. Any kind of stress, certainly like illness or. or, you know, traveling or, because as I say in period of perimenual, our monthly regular ovulation is our monthly report card in a good way. So it does, it's, it's, it's not necessarily a bad thing if you've, you know, missed a period or two or missed an ovulation because you were stressed or it's just your, it's just your, it's just your body, right? It's just your body's like, oh, like telling you that's where you're, you know, that's how sensitive your body is to those stresses. And it's actually quite handy because then you're like, oh, that was, I need to, you know, observing our period and some of the symptoms are on our period

as a nice feedback to say, am I eating enough? Am I getting enough sleep? Is this working for me, what I'm doing right now? And when I'm practicing, because I occasionally treat men as well, and then I'm always just left sitting there going, wait, but where's their period? I need to ask about the period gives such a great window into health, and I don't, you know, have that for them. Right. Well, I have an F-minus. No. Well. But I'm working on it. Yeah. I get again, I say report card is kind of just an easy way to think about it. But again, acknowledging there are lots of factors outside of our control too that are causing symptoms that it's not your fault necessarily. Yeah. Okay. I want to go through some of the questions and see if we can just do like maybe some rapid fire. I know that none of these are really warrant a rapid response. They're so nuanced and they're. so much that goes into all of the topic. Yeah. Okay. A big, big one was hormonal acne. And we kind of touched on that. Is that all just the androgen effect? Okay. So I have a couple, I have a blog post,

and I have my own little podcast, which is just me talking for 15 minutes. I have one on post pill antigens. So just what, one thing women need to know is particular pills, especially Yasmin or anything that the pills that have the progestinidididid, which is an anti-androgen drug, essentially, that there is going potentially going to be a rebound acne when you stop those. So those kinds of pills work really well for suppressing androgens and improving the skin. But it comes with a cost, unfortunately, which is that when you stop them, there can be a temporary surge in androgens that you can sometimes pick up on a blood test actually, but certainly you can see in the symptoms.

And because there's a bit of a lag time. So it's usually the skin problems really fire up about three months off the pill, three to six months off the pills when they just kind of start going crazy. And because we're women, we're like, oh, I'm broken. Oh, I get, you know, I'll talk to my patients. They're like, oh, gosh, there must be something really wrong with me from my skin to do this. And one of my messages is in that situation, it's not necessarily something wrong with you. It's the drug you were given and now you're trying to withdraw from. So what's important about that is the withdrawal process won't last forever. Obviously, there are treatments that I, you know, suggest in the various strategies you can try to minimize

that, but very often, just knowing it's not going to last forever, it's not how you are. It's not inherently something wrong with the hormonal system. It's just the hormonal system trying to adjust to coming off that anti-androgen drug. It's sort of mentally, it kind of shifts, help them and shift to. Yeah. I think that is helpful. Does that happen with spyrinolactone as well? Yes. Well, actually, Drosprinone and Spirtelectone are almost the same drug. Well, I think We've talked a lot about the different things that can happen as a result of our periods being imbalanced and being on the pill and going off the pill and all that. But what are some ways that women can best support their bodies and best support their hormones, whether they're on the pill

or off the pill or going off the pill? And I would imagine that varies depending on the circumstances. But what are if there are some universal things like whether it's sleep or, you know, focusing on nutrition or anything that we can supplementation, whatever it is. Sure. Okay. Great question. I'm going to have to answer this kind of bit of more philosophical way, which is that it's really important to understand.

Our periods and hormones are not separate from the rest of our health. So whatever is going on with your general health, whether it be gut or, you know, is going to potentially manifest itself in period problems. So there's no like one set of things that just work for periods. It's always about coming back to what does my body actually need? like what is the obstacle to me being healthy, which will often be the same obstacle to having healthy periods. It is important to eat enough. There is different, obviously many different ways to lose a period, but under-eating is a common one and it's an uncommonly missed one. So I just want

to say for what it's worth that as women, we actually need a lot more food than we might have been led to believe. And the same diet that works for a 40-something man, he's like, you know, fasting and low-carb and like he's just thriving on that. a 20-year-old woman is going to crash on that. And there's an age thing, too, because women in menopause are a whole different, have a whole different set of requirements. And so I'm just, I know for a fact that some of your listeners have lost their period to under eating.

And especially just if you've been, if you potentially are in that situation, but I've been mistakenly told you have PCOS that are now trying to go lower carb than you were before, you're going in the wrong direction from what your body needs. some low carb is fine for some people. I'm not saying nobody should do it, but I'm just saying, be very careful if you're getting your advice, dietary advice from a 40-year-old man and you happen to be a 20-year-old woman because that's a very different situation physiologically. I've been in a few Twitter debates about this. And also just coming off the pill, philosophically just understand like you're potentially, you're just, you've only masked whatever was going on before you went on the pill. So when you come off, just to be clear,

like pill bleeds are not periods. So if you've gone from how, having regular pill bleeds and then you stop the pill, you go back to whatever was underneath that. It's not like your period stopped when you came off the pill. Your last real period was whenever 15 years ago when you first started the pill, if that makes sense. So you really have to sort of think about it in the right way to be able to figure out what the body needs. And then you come off and you're back with PCS that you had in your 20s and it probably hasn't gone away, although it is possible to outgrow PCS in some places. So I know that's a little coy, and I'm not trying to be coy at all.

Like I think it's the only way to success is to try to figure out actually what is going on for real. And that will potentially need help from your doctor. So this is why in both my books, actually I have sections called How to Speak with Your Doctor about like questions to ask. It's like, you know, well, am I ovulating or, you know, what is it possible that I have PCR? Or is it possible I don't have PCOS? Or could this be endometriosis and just try to get some answers so that you then know what is the logical next step? Yeah. And I did get a lot of questions about what to specifically ask for as far as labs go.

And you talk about all of that. So I give you one little example. One of my favorite ones is when you're, for anyone sitting there thinking, wait, is it PCOS or is it under eating? Like which one is it? Because they can look very similar. and they're actually entirely different in terms of treatment. So a test I often use it, it's just a normal, boring test that you can get for many doctors. A blood test for two hormones called LH and FSH, their pituitary hormones.

You'd get them in a blood test. And if you, very generally, if you're looking at that on a preferably like early in the cycle, if there is any kind of cycle, day two or three from the counting from day two means you're like on day two of your bleed. then in general with PCS, you'll usually see kind of an elevated LH compared to FSAH, not always, but usually. And then with under-eating, you'll often see a very suppressed or low LH compared to FSAH. So that can just be, that's like a little troubleshooting thing that you can even, you know, ask your doctor or kind of go back and look at your lab reports that you already have and try to get a clue that way. That's an example of lab tests. I do mostly kind of normal like blood tests. I test insulin. I test for insulin resistance. I test for thyroid. I test for hormone called prolactin. I don't do with my own patients a lot of functional testing or expensive fancy testing. It's a lot of testing your iron. Like women are often low in iron. It's very boring, but it should not be overlooked because low iron can make you feel quite terrible and cause hair loss. For example. Yeah.

Amazing. Well, I have a million more questions. So maybe we'll have to do a part two someday. Do you work with people virtually or how does that work? No, I see. So I live in Christchurch, New Zealand. I see patients here face to face. I'm kind of old school that way. I really do like sitting down with people in a consulting room. Yeah.

But I have a forum. I have obviously my blog at Lara Bryden.com. I have my podcast and forum. And people can ask me questions in some of those places. Yeah. On my social media. And your book is so helpful, period repair manual. and I have not gotten hormone repair manual, but I'm sure it's equally as helpful.

Can you tell everybody where they can find all of that, where they can find your podcast and follow you and all that good stuff? Sure. Yeah, I'm easy to find. Everything is Lara Braden.com. So everything links from there. All my social media is at Lara Bridin. My two books, Period of Paran Manual and Repair Manual are on Amazon, you know, just all the normal online bookshops. And yeah, it's been a delight to talk to you, Ariel.

Thank you so much for coming on. Yeah, it's going to be very helpful for a lot of people. So thank you. I hope you enjoyed that episode. If you liked it, and if you like the show in general, please take a second to rate, review, and subscribe. It goes a long way, and it's actually the best way to support the show. Also, if you want to see more about each episode, you can head over to The Blonde Files podcast on Instagram. I'm always posting about each episode there or over on my personal page at Area Lurie. Please note that this episode may contain paid endorsements and advertisements for products and services. Individuals on the show may have a direct or indirect financial interest in products or services referred to in this episode.