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128: What are some natural alternatives for vaginal lubricants, do brith control pills regulate your period, and is it possible to delay menopause? With Dr. Felice Gersh!

November 1, 2019

We are so excited to have Dr. Felice Gersh back on the podcast! She is definitely a fan favorite and always shares such insightful information wit us. Dr. Gersh is a board-certified obstetrician and gynecologist in California and has been recognized as the Orange County Medical Association’s “Physician of the Year” for 14 years in a row! If you haven't read her book "PCOS SOS: A Gynecologist's Lifeline To Naturally Restore Your Rhythms, Hormones, and Happiness" be sure to check it out. In this episode, we discuss sex, birth control, menopause, and more. Enjoy!

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Hey, guys, welcome to this week's episode, and I'm so excited to have Dr. Felice Gurche back on the podcast. She is one of my absolute favorite people. I adore her. And for those of you who don't know Phyllis, she is an obstetrician and a gynecologist in Los Angeles. She focuses on understanding the physical and emotional makeup for women's health. And so she uses conventional and holistic treatments. How is everything been going on with you since the last time we spoke?
Well, just wonderful. I've been busy as can be. We're now into the full conference season, so I'm revving up to travel all over the world, educating and meeting new people. So it's a very exciting time as well as I'm working in my practice every day and I'm speaking to you from my exam room. So in an hour or so, this will be turned into a patient care room.
Well, that's one of the things I love about you so much, is that you are really you have the best of both worlds. Some doctors are just and naturopath, but you have the conventional and holistic treatments, both combined, which really makes that powerful.
I consider it I call it my therapeutic toolbox, which has been greatly expanded by my education, by doing the fellowship in Integrative Medicine at the University of Arizona School of Medicine and taking courses in functional medicine and naturopathic medicine and mind body medicine. All of these things have really enabled me to help patients in this very complex world that we're now living in with so many new and really unexpected from a medical point of view, because this is not with medical schools or teaching people how to deal with the impact of chronic stress and electromagnetic radiation and the all the circadian rhythm dysfunction that we now are experiencing with the altered food that we eat. So much has changed just in the last few decades.
And the medical school environment has not changed enough to really keep pace with what we really need to implement to help everyone stay healthy in this world.
Now, if you had to narrow down your best health and wellness tips, what would your top three tips be if you said, look, if you are struggling with your hormones, you're struggling with different things? Here's the three things that are kind of your top three.
And when you hear them, they sound so basic. But that's what we have to start with, the foundational things that health is built from. So in No. One is real food. I love to talk about different types of diets and so on, but just eat real food. I'm not going to worry right now for a lot of people if they're eating one ratio or a different ratio of fats or carbs, just make it real food like what we call farm to table. And now I have to say organic farm to table, eat whatever you want, but make it real food. And the next thing would be recognize that we are earthlings, that we have this amazing circadian rhythm as every living creature on Earth has, that has enabled us to survive on this planet in accordance with the rotation of the planet with day and night. So please recognize that you are a creature. So please try to do all your activities during the day and try to sleep at night. So that means go to bed and get some sleep and eat breakfast. So those with that would be my next thing. And then so the last thing would be to move, stop sitting all the time, get up and move. Use this beautiful body so you don't get fibrosis of your fascher that you actually can exercise your muscles, your skeletal system, your muscles. Skeletal system was designed for us to move, so try to get fit.
So try to sleep, try to get fit and and try to eat real food. Those three things will keep you far healthier than most of your peers, I can tell you.
Well, I love the book that you wrote called PCOS S.O.S that focuses mainly on seven steps to beating PCOS naturally. So first, talk a little bit about what PCOS is for those who don't know and talk a little bit more about those seven steps.
Absolutely. Well, PCOS stands for polycystic ovary syndrome and it's the most common cause of endocrine dysfunction in reproductive age women, and it's the most common cause of infertility in the entire world for women. So it's a huge deal depending on whose estimate you get. It's anywhere from ten to twenty five percent of reproductive age. Women are afflicted with PCOS is a condition that really links reproductive function. With metabolic function, most people don't realize that the reproductive system is really intertwined with every other system of the body, so we call that metabolism is the creation and distribution of energy. So women with PCOS have tremendous problems with their metabolic functions. So consequently, they have four times the incidence of diabetes. They have high rates of depression, anxiety problems because it's really a total body problem that originally was focused on the ovaries, which, of course are a key to producing the sex hormones of women. So it's a total body dysfunction that then causes excessive amounts of androgen like testosterone predominantly, but also some adrenal androgens like DHEA sulfate. But usually this high testosterone levels, which can cause a manifest of problems like cystic acne, facial hair, thinning of the hair. So these are just horrendous for young women to have to deal with as well because of the hormonal problems they have. And ovulation, they don't have regular menstrual cycles. Sometimes they can go months and months without a menstrual cycle, very irregular. And if you look on ultrasound, most of them will have lots and lots of little cysts around the core, the outside core of the cortex of the ovary. And that's because every month constantly they're recruiting follicles that create eggs. But the signals are all messed up. So they don't have that special process that causes one special egg to be chosen every month for ovulation. So they just keep accumulating these little little little bits. And that's where the name polycystic ovary syndrome comes from. So it's a total metabolic dysfunction of the entire body. And, of course, it's manifested in reproductive and hormonal problems. And now we understand finally what's really going on. These are women who have a little genetic predisposition to not being able to convert testosterone to estrogen well in their ovaries. But in nature, it was a very minor dysfunction in genetically programed. So it turns out that of all estrogen in the ovary comes from testosterone. But if you can't convert, it will then you end up getting a buildup of testosterone and a deficiency of estrogen. And that's what they have, a little bit too little estrogen and a lot too much testosterone. And this is happening because of the world, like I mentioned, that they live in a different world because of exposure during critical development to endocrine disruptors. And the most recently discovered in research is BPA, bisphenol A. That's in all the plastics. And everyone is exposed to this. And during critical times, it can alter the way estrogen is produced or received on the receptor. And then on top of that, we eat these crazy diets, high fat, high sugar and not enough nutrients to support our gut microbiome. So we have an abnormal function of the gut. And this was now shown in studies, first out of China, that women with polycystic syndrome have abnormal microbial populations, what we call an abnormal gut microbiome, which creates more inflammation. So they have chronic inflammation, hormonal dysfunction, metabolic dysfunction.
So it sounds terrible, but that's why I had to help women, this huge number of women across the world to have a real solution to this problem so they can actually lead the life that they deserve and should have.
All right. Well, I'm going to start the podcast with a very crazy question. This one, sometimes we get some saucy questions and that's what we're going to start off with today. And this one's from Anonymous. I am in college and I'm starting to have sex with multiple people. I'm being a little wild and fun, but now something feels off. I was changing out my clothes and caught a whiff of something different down there. And I thought I knew myself pretty intimately and all of my bodily sense, my vagina naturally has a certain smell. It always does. I know that. But that smell is based on a specific part of my biological discharge, because I know this from a current chemistry class that I'm in. They talk about in my chemistry class, which is a scale of acidity. What is going on here and what should I do?
Oh, well, I am very concerned about Anonymous, I can tell you. So the number one thing that she has to do is go to the college or else a private gynecologist and get tested for sexually transmitted infections. I understand that she's having fun, but sex. With a lot of responsibility and unfortunately, sexually transmitted diseases are really at epidemic numbers right now, so she needs to be tested and not just for chlamydia and gonorrhea, which are the ones that most people know about. But now there's actually very high levels of mycoplasma and real plasma. And these tests require the newest kinds of testing and that's using DNA testing, not a culture. So that's called PCR polymerase chain reaction. So she has to go to a doctor who has this like we had in my office. It's very readily available for many, many lab companies. But not all doctors do it because you've got to test for everything because they've now studied male semen and it carries a lot of stuff in it, a lot of kinds of infectious agents. So when you sense this funny smell in the vagina, that's a sign of this by Yosses or abnormal microbial populations in the vagina, every single cavity and system of the body has its own special microbe population. And when the vagina has a different smell, it means it has different microbes.
It could be fungal bacteria. Viruses even are growing in there. This needs to be checked out. So she needs to have her vagina checked out. And I want her to make sure she uses condoms all the time from now on and is very, very thoughtful about who she has sexual relationships with.
What a great question. So let's stay there for just a second, because let's say that let's say that she does get married or get settled down and she's just having sex with one partner or someone does. So let's say that let's say that your partner is sick. Let's say they have a gut infection or something, something like that. You're saying that if if you're your husband, say, has some kind of infection that that could carry through through his sperm when he's having sex and it goes to the vagina, then you could get some kind of infection down there. And then maybe that smell could come through, talk about or let's just say with one person, let's say the person is with one person. Let's say he has some kind of let's say it's not a sexually transmitted disease. But is there anything else that he could pass from one to another through the sperm? That's a very good question. I haven't thought about that.
Oh, well, yes. So there's a couple of things that can happen that both can be transmitted, but can also be self sort of oral transmitted. So we know that the of course, the anus is very close to the vagina. So if a woman has her own abnormal gut microbiome, having sex can sometimes cause bacteria, suddenly the colon to come up and be pushed into the vagina. And we now have women who are on all kinds of contraceptives that or like birth control or injectables or implants and so on, that alter her own hormones. So what happens is the vaginal microbiome that is really are protective for both the bladder and the vagina and for the health of the cervix as well. And even the genital tract of the woman is altered. And we also sometimes use lubricants and other chemicals and spermicides. And all of these things can alter the normal microbial flora of the vagina so that they become more susceptible, at risk for catching things that they otherwise might not catch. So it's really important. We live in a different world once again. So bacteria from the anal area could get up. Males may carry some viruses or bacteria in their semen that maybe not even a sexually transmitted type of thing that then could get into the woman as well, which never would cause a problem. Viruses, for example, HPV virus. And of course, the most serious of all, which would be HIV, which we don't think about in this, but that is also transmitted through the semen, which, of course, carries the sperm. So there are many things that can disrupt and create infections. Another thing that doesn't get talked about very much is oral sex. So this has actually been shown that when men do oral sex on a female, the saliva, which is a very different composition of bacteria and P.H. that you mentioned, that it's very different than the vagina is. So women who undergo oral sex where a man uses his mouth, his saliva and his tongue and so on, on her genital parts, she has a significantly increased risk of having bacterial vaginosis and other infections that can occur in the vagina. So I know it's not always what everybody wants to hear, but using some sort of protectant, like a dental dam that you can. Open up or you can also use a condom that you sort of lay open and then put over the the external genital area, the female before having oral sex can actually prevent these infections. And so I see so many women in my practice that have gone to so many doctors with recurrent vaginal infections. And no one has brought up like what kind of lubricants they're using, if they're using different kinds of spermicides and with the kinds of sexual practices. And of course, it's not only just oral sex, but if someone has anal sex and then does vaginal sex afterwards, they can definitely, of course, cause all kinds of infection. So that is not a practice that should ever be ever be done.
So explain that to me one more time. With the oral sex you said, what would you do again? I didn't follow up on that part.
What would they do if this is the skin of the female genital area?
OK, so Jaina and the anus is here and the urethra that you take like a film of like latex and you actually it's a thin line that you put over it. And then there's the sexual action would occur so that this is a sandwich. She's here. Here's the latest film out here. And so it's actually a barrier. It's actually a barrier. And it's like a condom opened up, literally. You can open up a condom, you can cut it. So it opens up into a square, can actually do that and you can place it over the skin. And nowadays they make condoms that are so different than they made them like a couple of decades ago. They're very thin. In fact, many men who use condoms, they don't even feel them. So we did a survey of men and condoms and they found a very high percentage said I hate condoms. And then they said, when's the last time you used one? And it was never it was all in their head. They didn't even know what condoms were like. They just didn't like it philosophically, OK? They didn't like the concept. But really, condoms have come a long way. They're not your grandfather's condoms and they are so thin. They're like you almost like like a coating of skin. And they people can feel it. So don't don't think this is so terrible. The sound of it is like, why would I want to have latex on, you know, that type of thing. But they make it so thin that you actually have some people even feel they have enhanced sensation through it. So I don't know, don't wipe this office. I won't do it just because it sounds like I don't want that idea, because actually they make it so that you can have a very good sensation and then you have protection and you just nature did not actually mean for saliva to get into the vagina.
You know, that's also not a good lubricant, by the way, to use saliva. So it's just a very important thing that doesn't get talked about very much that can really help women to stay healthier. And those parts really matter.
Well, let's talk about lubricants for just a second. Let's just stay there, because what do you think about just good old fashioned, like coconut oil as a lubricant? Like if you are going to do like the most natural lubricant possible, what would you recommend?
So it depends on what the lubricant is for, if it's for intercourse. So it's going to go into vaginally. That can be a little bit different than if it's used externally, like for a clitoral stimulation. So we have actually not anywhere near enough data. As you probably know, studies on women are really in short supply, but coconut oil used in a small amount should probably be fine. Coconut oil and olive oil are actually pretty good lubricant. So people think like olive oil. That sounds, you know, maybe not as appealing because it's kind of messy. But actually, olive oil has been used as a medium to actually deliver hormones and medicine into the vagina by compounding pharmacies for women who have real sensitivity to some of the ingredients that are used for mixing hormones, because some people, even no matter what cream that you use vaginally, that you put the estrogen into it, it just irritates them. But olive oil seems to be one of the least irritating of all the oil. So consider olive oil. Also, consider organic aloe vera in the gel forum in the organic. And I like to say, don't put anything in the vagina that you wouldn't want to put in your mouth. Now, that doesn't mean that you should put it in your mouth, Crozet, but if everything that goes in the vagina gets absorbed into the body. So if it has chemicals in it, it's getting into your body as much as if you eat it. So things like natural oils, like cooking oils are used judiciously, can be a very good. Type of lubricant and ALAH, which, of course, you can drink out, you can go to the market and buy aloe vera juice and and so on, because that's a natural plant. So aloe vera. So those would probably be olive oil, coconut oil and aloe vera gel would probably be my prime choices. But I'd like to remind people that nature actually creates its own lubricants when women are sexually excited. The nature has all kinds of things. So then because if you think about the animal kingdom and remember, we are like up, but we're still a part of the animal kingdom. If you look at other mammals, they're not using, like artificial lubricants. They don't do that. And yes, things still work. So when you have the hormones of a normal female and you are sexually excited, you will have a process called transmutation, where Thero that is in the blood that actually flows to the vagina actually seeps right through the walls of the vagina into the interior lumen of the vagina that acts as a lubricant. And externally at the opening of the vagina, there are glands that secrete like a Mukasey kind of material, like the Brazilian glands and the vestibular glands. So nature actually puts all of this together to create a natural environment that is conducive to having intercourse. Now, a lot of women don't have that because they're on birth control pills. And it's really important to know that birth control pills alter the way all of these tissues respond because you don't have real hormones in your body. So these are things to really consider. So if you're a young reproductive age woman and you're on birth control pills and you find that you don't have really much sexual desire, maybe it's harder to have an orgasm. You don't really get natural lubrication. You're always having to use artificial kinds of methods. Then you may want to think twice about your birth control because it's not allowing your body. And this is making it obvious that you're not allowing your body to do the things it was really designed to do. So it's one of those things just like with PCOS, PCOS is the link between reproductive function and metabolic function, and we're all one body. So you can't sort of cut off reproductive functions and not have many other untoward side effects. And that can include sexual function.
And what I love that you said, I think that's really important. My my husband does a really good job of this. But, you know, like you said, your body will be your natural lubricant. So, guys, you guys need to step up your game. And if you need a lubricant, you might need to do some more foreplay to get her to have her own natural lubricant.
And for many women, having an orgasm. Women are multi orgasmic creatures. They're very much more able to do that than men usually cannot. They get one and then they need if they have what is called a refractory period before they can even get an erection again. But women can have orgasm or orgasm. So the best thing for natural lubrication for a woman is to have an orgasm before she has intercourse and then she can have more later. She can have as many as you want, like a normal woman. She just has to say, I'm done. I don't want anymore. Not that I can't have more. I just have had enough. So definitely this is what happens when a woman has an orgasm, is that you'll get much more blood flow to the area. You'll have all these secretions that are going to happen and you get the labia menora become engorged as well. And so everything kind of opens up and allows a male to enter. So it's really amazing when you let the body do what it's designed to do, how well it can perform.
That is so true. I agree with that. One hundred percent. All right. Well, this next one is actually a strange question. It's from Marcy in Lexington. It says, I've started out having regular periods. When I first got my period around 14, I always had horrible cramps every period to the point I feel physically sick. So I got on birth control. Ever since I've been on it, I've had irregular periods. I've switched from the pill to the depo shot and recently got next planning. My cramps aren't as bad as they used to be, but now I'm just so irregular. Is there a certain form of birth control that you would recommend that would help with both cramping and regularity? So that's for Macy in Lexington. What doesn't make sense to me is that I thought that one of the things of why people got birth control is to regulate it.
It doesn't it doesn't make sense that she got on a pill and is now having irregular periods. Is that I mean, that one?
Sure. So the number one foundational piece of information here is that when you go on any of the things that she mentioned, depo provera shots, birth control pills, the. Plan to implement an explanation. None of those contain hormones and none of them give you regular periods, whatever you have is called just believing. So a normal woman who is reproductive has a beautiful cycle and she ovulates and everything is hormonally regulated. When you go on birth control pills, it gives people the illusion that they're having a regular cycle and the people call it a period, but it's not a period. And we have to call a spade a spade. Birth control pills contain no hormones. If you go to the toxicology website for the US government, it lists every ingredient that's in a birth control pill. And that would include also the injectables, the shots, the implantable, the IUD that contain pretend hormones that they are all endocrine disruptors. Remember, their primary goal is preventing the normal functioning of a female. It just is what it is. They give you an illusion when you're on birth control pills of having a regular cycle. They even went through this. They said, let's create pills that give the illusion of having a regular period because you withdraw the pills and then you have what's called withdrawal bleeding. But it's not a period because it's not related to normal hormones. Well, it turns out that all of this stuff is artificial. And for some women, nothing works the way the pharmaceutical companies planned. That's why there are so many different brands and formulations of birth control pills. I lived through the whole heyday of birth control pills where like every few months, a new pill formulation came out. We went to try to try cyclones and they they had biphasic and they had sequential and they kept coming up with new birth control pill formulas to try to reduce exactly what Macie has, which is irregular or breakthrough bleeding. Some women do not follow the rule book and have this very regular withdrawal bleeding at the end of the cycle of pills. Some women just randomly bleed all the time. They created pills to try to not have a period at all for a year. Women have tremendous irregular bleeding all year long and then they have like little suggestions will stop it. And we started to I mean, all this stuff, because none of this is real. None of this is real wonderous cycle of a female. So it's really important for women to know that I'm against having unwanted babies. I mean, No. One, we are the only species that tries to plan our pregnancies. And I think we should I don't think girls should be having all their babies before they're twenty two. So I think that women have careers. We're different than the way the rest of the animal kingdom is. But we have to be circumspect. We have to recognize that by altering our fertility status with all these chemicals and they are chemicals that are not hormones, that we have many, many unwanted side effects. And one of them is that it increases mood disorders, musculoskeletal problems. You never build a bone. You never reach your peak bone density, which is very critical for metabolic health regulation of your glucose. Mental health is actually related to bone. People don't realize that bone makes hormones that actually affect your brain and you don't develop a joint function, that women have more more prone to injuries. So we have to come up. I mean, I don't have like a secret solution to preventing pregnancies in my pocket. But we have to really be honest that poisoning women's reproductive cycles and hormones to prevent pregnancy by giving these toxic medications, they're slow toxins. They don't kill you right away, but they alter women's normal hormones and rhythms to prevent pregnancy, that it's not ideal that we need to find better solutions. I don't have them yet. But if we don't actually be honest and may find the perfect example of how the body is not really having rhythm, it's not really bleeding appropriately. But the other thing that comes out of amazing story is that she had bad cramps to begin with and nothing has really helped that. So it's really important for women to know that the menstrual cycle is actually a vital sign of female health. And if you have an abnormal cycle, whether it's your regular, very heavy or very painful, that's a sign that something is wrong. That is not a sign that you should cover up the symptoms. Remember everything and integrative medicine and functional medicine is getting to the root cause. So if a woman has an abnormal menstrual cycle, we need to find out why. And we need to deal with the why and not just try to cover it up like wallpaper of a wall that's filled with mold because you don't want to deal with the mold. A woman should not have a terribly disabling, painful period, maybe a little bit of cramps on the first day, but not a lot because the uterus is actually contracting to get. That line, but it shouldn't be disabling, it should be very brief and it's a really big red flag that this woman has inflammation in her body. She may have nutrient deficiencies, circadian rhythm, dysfunction. We need to help her to be healthy and not just cover up the symptoms. And we need to look for better solutions for contraceptives than to actually alter women's beautiful natural hormones and rhythms.
All right, Brooke in Plano, Texas. I'm a forty six year old woman and my periods are very regular. But I just had my period two weeks ago and then I just started it again. Is this the start of menopause? What is the age range of menopause? And I have no other symptoms except sometimes I get hot and sometimes I get cold. But that's always been the case because my thyroid doesn't work and I have lots of problems with my thyroid. Can you give some suggestions on why my period is now all of a sudden starting irregular two weeks ago?
And how old did you say she was again? Six. OK, so perimenopause is really any time from the late 30s into the early 50s. Every woman is different. The average age for when the period starts in the US is fifty one, but it's not a moment in time. So it's really important to know that the word menopause is really not doing justice to this process, which is really ovarian aging or ovarian senescence. It's really the process of the ovary winding down and not being able to ovulate regularly, produce the same amount of hormones and produce new babies. That's why fertility goes down as women are aging long before that period starts. Fertility is declining and women know this. That's why women are freezing eggs, because they know that their fertility is going to go down. Once they're over thirty five and into the 40s, it really plummets. So things are really changing long before that last period. That's why I wish we could change the name of menopause to more like. Really over an aging process, because that's really what it's about, the period when it stops doesn't mean the ovaries are dead at that point either. They're still making estrogen. They're just making less and they're not ovulating. That's why you don't get the period. But it's still an ongoing process. And we never know when that last bit of ovary ovarian estrogen comes out. There's no bells and whistles that go off, so we never know when that last bit comes out. So certainly many women, because they're transitioning, they're not ovulating regularly, they're not producing the same amount of estrogen and progestin and the periods can get irregular. The most classic presentation is spacing out of the periods as opposed to getting like every two weeks. So a woman who has bleeding, that's too close. They really do need to go see a gynecologist because how do I know what she has going on is rare. But women can even have uterine cancer. They can have cervical cancer. So any abnormal bleeding really needs to be evaluated. You don't want to assume anything. And this particular person has terrible problems with her thyroid. Thyroid dysfunction can certainly cause irregularities. So we can't make assumptions. But certainly in someone who's forty six, it wouldn't be surprising that her periods might be getting irregular. And of course, there is nothing that we can do to really stop menopause. It's universal, but there are some things that we can do to help delay menopause. Eating higher amounts of vegetables with the antioxidants and polyphenols can reduce inflammation in the ovary. And we know that ovarian inflammation is real and that will give an earlier menopause. So having high antioxidants, polyphenols, vegetable, plant based diet can delay the onset of menopause maybe by a couple of years. But that's actually significant and it's better for the woman any bit that she can delay. It is in her best interest. So and the other thing is there are a couple of herbs like Chase Tree Berry can sometimes help to get the cycles more regular. That's sometimes known as the woman's herb chase tree berries, the Latin name by text. So that would be something to look into. But any woman with irregular bleeding, please get it checked out with your doctor.
Awesome. This next one is from Jeanna, a busy mom of four kids. She says, hi there. Great job simplifying intermittent fasting. Chapter twelve. You went there with gluttony is sin. Good stuff. She says I'm forty two or forty three. I can't remember, but I'm on twenty pounds in three years. I've never had much of a weight problem until forty, but I know it's because I changed how I ate in my forties. The hormones changed and my cravings for sugar went crazy and they are strong and bossy. I'm definitely going to try this and I'll get back to you in a month and I'll see how it goes. Thanks for putting this out there.
So she doesn't really have a question, but I'd like to address what she says about how in her forties the hormones changed and her cravings for sugar went crazy. So can you tell that of how your hormones can mess with you wanting sugar?
It is a fascinating new topic that really being better understood now than ever before. It turns out that we have this new it's not really new. It's newly discovered just about twenty years ago. It's called the endocannabinoid system. And it's a very interesting system. It was actually named after cannabis in reverse engineering. They discovered the plant. Oh, my gosh. Like eleven thousand years ago, the cannabis plant. And they found just in the last twenty years that it actually works on human receptors. And then we found out we have our own internal system called the endocannabinoid system, which is made of what we call lipid signaling agents or mediators. They're actually made from fatty acids, predominantly from omega six. So we don't we don't want to demonize omega six because that's how we make our endocannabinoids. Now, a lot of people know that marijuana gives people the munchies and gives people like food cravings. We have our own internal system that works similarly.
And there's a particular endocannabinoid called anatomy. But we have another one called, too. And these signaling agents made from fatty acids actually control our cravings and our appetite. And they're linked to estrogen. They're linked to our hormones. So when our hormones start becoming unbalanced, our endocannabinoid system gets unbalanced and we can have too much. We can actually we can have imbalances and you can have too much of these endocannabinoids that work in the appetite centers of the brain and can trigger just like like marijuana can trigger the munchies. It can trigger these uncontrolled munchies. And we can't always.
We can't consciously control it, so the things that we can do is actually time restricted eating by eating at the same time every day and not snacking and not eating at night. We can actually help control the production of these endocannabinoids. They've actually done studies, too, that if you even put a little bit of fat in your mouth, not even swallowing it, just a taste of the fat, it certainly increases the production of these endocannabinoids that further increase your cravings for fatty foods and snack foods. And that's an evolutionary thing because it probably came about because in ancient times, food was hard to find. So if you ate something like a fatty animal, nature would say you eat more, eat more and more because you needed to get that food in. But we haven't changed from ancient times. Only now we have food everywhere and becomes dysregulated. So if you are a woman going through this transition and you're already having this imbalance with your hormones and endocannabinoid system, and then you eat unhealthy foods, you eat a lot of high saturated fat foods or the manufactured foods like chips and things, you know, how they talk about like you can't eat. Just one lays potato chip. It will have. And that's actually triggered through the system in the brain, the endocannabinoid system. So we have to make conscious decisions to avoid those kinds of trigger foods and to try to eat. They found that when people are just regulated, they actually have increases of the endocannabinoids during the night when they should be really low. So they're triggering night eating. So we have recognizing that this is happening and that it's related to our hormones and this new system, the endocannabinoid system, by eating breakfast and lunch and dinner and not having snacks, not eating after 7:00 p.m. at night and exercising and avoiding all snack foods and processed foods, we can help control these what otherwise would be uncontrollable food urges. And it's terrible, wakame that comes along with it.
All right. This is Ruby in Denver. I recently started menopause. It's been such a struggle. And my husband basically gets whiplash from my mood swings. I'm trying the best I can to keep everything together, but obviously it isn't working too well. I really don't want to go on hormone replacement therapy. Please tell me there's something out there that can help regulate my mood swings. I'd really like to stick to something natural. Ruby in Denver.
Well, this is a very personal choice. I can tell you my own prejudice or which is based on science, is that I am in favor of hormone use in menopause, recognizing that, of course, it's not natural, but many of us don't care about natural. We care about healthy. Right. So I say everyone draws a line in the sand wherever they feel comfortable. If a woman uses makeup or puts on hair extensions or dyes, her hair will. None of that is natural. Right. And we do it because we feel better about ourselves. And when we lose our hormones, it remember, once you understand a foundational issue, that reproduction and metabolic health, which is all of health, are completely intertwined. When you lose your reproductive capabilities and that is your ovarian function stops, then you lose your metabolic overall health. And it doesn't like everyone is different when they go through menopause. Some women, it's like the engines go off and they go into a light and they can glide for many, many years. And they have like a soft landing and other women go, we hit menopause, go into a nosedive so everyone can go through it differently. So if a woman really decides, you know what, I just want to go with natural, even though losing my hormones is going to have many metabolic effects after menopause, women have significant increased rates of diabetes and depression and sleep apnea and gut problems, osteoarthritis, osteoporosis. These are all linked to loss of ovarian function now. But nevertheless, if she says but I really don't want to go on hormones, what else can I do? Well, you really have to do everything you can to try to maintain your circadian rhythm because estrogen maintains the normal function of the master clock in the brain that keeps us on beat. We now know that everything in the body is coordinated through time, through this amazing rhythm of our bodies, and we lose that. So ever when a woman goes through menopause, she enters a stage of life that's living a life of jetlag. And most people know what it means to be women or men who live jet lag because they're always crossing time zones or they have what's called social jet lag, where on the weekends they just stay until three o'clock in the morning and then they sleep late and they eat random times. That's called social jetlag. They have higher rates of metabolic syndrome, diabetes, hypertension, cancer, a. Lots of bad things happen when you don't live according to the proper rhythm and women in menopause go off the beat. So once again, very similar to what I had said before, is all similar. You have to trying to do a time restricting eating. You have to incorporate fasting. That's like a reboot to your circadian clock and your gut microbiome. You have to work very hard, you have to exercise more. And if you want to lose weight, you should exercise in the morning. And if you want to build muscle, you exercise in the afternoon. Everything is timed in our bodies. So that is really, really important. Now there are some herbs that can help. I actually created a product that is marketed by the nutraceutical company Pure Encapsulation. It's called jenaveve. And many of these is one of the first supplements for women going through menopause that actually understands that there's a gut microbiome issue and it includes ligaments and helps support the gut microbiome. But you can also do this with food. A lot of people maligned soy, but it turns out if you eat whole organic soy like tofu and Amami Tambini, so if you eat not processed soy, pretending to be Huddle's or something crazy stuff that they do with soy. So it's not a soy isolate, it's whole organic soy that actually can help nurture the gut microbiome. And it's actually very good for women in menopause as well. Flax seeds, which these are vital estrogen. So these are plants that actually combine two hormone receptors and do very good things. So eating flax seed and hemp seed and eating organic whole soy, taking a couple of targeted supplements like Minova. And you can also try Siberian rubab, which is another product that helps with hot flashes, that these can be very, very helpful. And if you're having anxiety, some of the nice to herbals that can help or Ashfall Gonda is very, very helpful. And Válková. So those are actually our you that a great Indian herbs that can be very helpful for some of the anxiety because we don't want this woman to have a divorce because her husband looses total patience with her. So those can be very helpful. And I am a big fan of mind body medicine. I love guided imagery. But of course, some people choose other forms. They can you can do all kinds of meditation. You can do spiritual meditation. You can do a walking meditation. But she needs to start really incorporating mind body medicine into her life. So it's really a very big project to get through menopause. Every woman faces it and we all need to work very hard so that what could be the second half of our lives is actually not filled with disability and pain and suffering. So we all want to have a wonderful second half of life. So we've got to work very hard when we hit menopause.
All right. This next question has a lot of questions in it. So it's from Cindy Lee in Corpus Christi. I found out my estrogen is really high and then I started taking progesterone cream. What is your thoughts on progesterone cream? One good thing is when I take it I'm not very hungry. The doctor prescribed it synthetic progesterone. And I want to take a more natural version. Do you have somewhere where I can buy some naturally. What is good estrogen levels for your lab levels to be accurate? Is it true that someone taking progesterone makes you eat less, or is this something I'm making up in my head? And what is the most natural places I can buy? What is the best natural places that I can buy natural versions of progesterone and what is the best way to put it on?
OK, so no one I don't know how old this woman is, but if she once again, if she's making too much estrogen, that usually happens during the transition years because it's a very imbalanced time when women are going through the menopausal transition because they make too little estrogen and then their brain says, hey, I want more estrogen. And they push out the the hormone to the or three follicle stimulating hormone, which can have a big rush of hormone. In fact, women going through the menopausal transition have a substantially higher rate of having twins if they actually get pregnant because they can have like overstimulation of their ovaries. So if she's going through the menopausal transition and she's having high estrogen, but it's unpredictable and actually going on progesterone can be helpful. If she's at a different time of life and she's not like in her forties, then we really need to figure out what is going on with her, that she should be producing too much estrogen. Something is really wrong. But if she's going through the menopausal transition, which I'll assume that's what's happening, then going on, some progesterone can be helpful. It can be. I usually use the oral version of progesterone because it actually helps with sleep. And women going through this time are often having a lot of agitation. When you have too much estrogen, it can be kind of activating as well. So everything is based on proportions. Too much can be. And actually make you feel more anxious, wears too little, can make you feel anxious, too. You just need that sweet spot and she's obviously not in it. So going on oral progesterone, this you have to get from the doctor. It's a prescription. But that's the only way I can really be sure of what dose you're taking is if it's with a prescription, either through a compounding pharmacy or a conventional pharmacy. Otherwise, I don't really know what you're doing when you're buying over-the-counter progesterone. I can't recommend that I'm a member of an M.D. I when I want to give progesterone, I prescribe it and I prescribe exactly the number of milligrams I want someone to get. And then I know they're getting it from a really certified source. So it would be very reasonable to take progesterone for two weeks out of the month, the two weeks prior to the period onset, assuming you have a regular cycle and that will help. But if it's really the transition years, you have to ride it out because this is just what women have to go through in life. Know, we were always challenged with different things. So it's a normal thing to have these ups and downs of estrogen if you're going through the transition, but it will level out and then you have to deal with menopause by going on. Progesterone is helpful if regarding progesterone and appetite, there may be some evidence that progesterone can reduce appetite, that may actually be true because progesterone lowers the production of some of those endocannabinoids that increase appetite that I mentioned before. So it very well may be that if a little that you may have less appetite during the time when you're on progesterone. But there's so many other factors that can go into appetite and so forth. I can say that that's why it's not used as a weight loss tool, go on progesterone. But it might in her case, if she notices it may have a little impact on reducing appetite.
Awesome. Well, where can our listeners go to follow you and your work?
Well, my office and people want to see me in person is in Irvine, California, and I'm very easy to find. It's called the Integrative Medical Group of Irvine. And you can also Google my name, please, Gurche, M.D., and you will easily find me. But my practice is integrative medical Ervine and my website is easy is integrative mgi dot com. And I have all of my information there. I have a new website that's going to be coming up in the next month or so. Then it will even be better because like everything, we have to evolve and I'll have a better website at that point. And I wanted to mention I have some very exciting news that I wanted to mention. So I bought my blue book here. It made on number one bestseller list this past week, and it's fun. So I really wanted to mention I'm not sure when this will play, but September is PCOS Awareness Month and we advocated on Capitol Hill a year or so ago and actually got Congress to vote for that. So it's an official US recognized month this month. And in honor of that, I have lowered the price of my book for the Kindle version to ninety nine cents for the entire month of September, and all the proceeds from the sales will be donated to the peace with foundations that exist in non-profits that are promoting and donating money for research and education on behalf of women with PCOS around the world. So I would like to raise a few thousand dollars to help with the cause of women with PCOS.
That is so exciting. Well, I am so happy for you. Your book is amazing and you are a joy. I just I just adore you. You know that. You're just one of my dearest friends, so I just love having you on the show. Thank you so much for being here. And if you have a question that you want answered, go to questions at Chantel Ray dot com. We'll see you next time. Bye bye.

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