Way Better Sex Without the Pill – Dr Jolene Brighten

Bulletproof Radio, a state of high performance. You're listening to Bulletproof Radio with Dave Asprey. Today's cool fact of the day is that the birth control pill impairs women's emotion recognition. New research suggests that women who use oral hormonal contraceptives are less able to recognize facial expressions of complex emotions. Now, in the Better Baby book, my first book going back to 2011, I wrote about some very unfortunate side effects of oral contraceptives. Basically, your hormones are a delicate system that can be easily broken with all sorts of unintended side effects. In fact, some studies have suggested there's an association between taking the pill and having mood swings and increased risk of depression. And this new research says that impaired social judgment is another adverse psychological effect to the real benefits of birth control. Birth control is quite liberating and really useful. There are just different ways to do it that might not affect your psychology. According to this new study, women who take the pill are less likely to identify complex emotional expressions like pride or contempt accurately. And those differences in emotion recognition did not depend on women's menstrual cycle phase at all. And those findings now suggest that oral contraceptives should come with a warning label that say, hey, these could affect your ability to perceive and interpret emotions from others today. And this was just published in Medical News today. And this came out of a research group in Germany that was published in the Frontiers in Neuroscience. Now, today's guest is definitely going to talk about hormones, not necessarily just birth control, although I'm sure we're going to touch on it because I'm welcoming Dr. Jolene Brighton back to Bulletproof Radio today. She's a functional naturopathic medical doctor and a nutritional biochemist and she really digs deep on women's endocrine health. She was last on episode 415 about a couple hundred episodes ago about how hormones affect all parts of people's bodies and brains at different ages and stages of life. And, and today we're going to go in a little bit of a different direction because we're going to talk about something called Post Birth Control syndrome and the Long Term effects of Hormonal contraceptives. And that's in part because Jolene just came out with a new book called beyond the a 30 day plan to Support Women on Birth Control, Help them Transition off and Eliminate symptoms of Post Birth Control syndrome. Now, you may be listening going, I, I'm a dude. Not my deal. Here's the deal. You probably have women in your life and I am fully Convinced that the side effects of the way we're doing contraception today are much, much larger than is necessary. And that if we acknowledge these things, we can improve the quality of life, emotional life, physical health, and all sorts of things for about 51% of the global population. Jolene, welcome back to the show.

Hey, there. Thanks so much for having me. And I want to say, if you are a dude, you want to listen in, because birth control is impacting your mate selection. In fact, there's been research to show that strippers or exotic dancers, I'm not sure the PC term. I've been Googling this, haven't figured it out yet, but they actually, when I.

Do that, I prefer to call myself a professional dancer.

Yeah, probably professional dancer. No judgies, if this is what you do in your, you know, for your profession. But the interesting.

On weekends.

Yeah, just on weekends. Like, that's, you know, that's how bulletproof keeps going. Right. I can. I'm like, I could just see pasties that say bulletproof and you start spinning the tassels.

Like, I'd have to check with the licensing department.

Yeah, right. Is that on the up and up? Yeah. So, but here's the deal, is that these women make less money when they are on birth control or when they're not.

No way.

Yeah. Or when they're not ovulating. And so women who are ovulating, men, you know, pick up on that in their primal brain and they actually pay them more money. But women who are on birth control, they're actually. Men are selecting differently. So there. And there have been primate studies showing that the way that primates respond to a female on birth control is completely different than when she's off. Now, on the flip side.

Wait. Yeah, wait a minute here. Okay. How many guys know a woman around them is ovulating? It's not like we're baboons and we turn bright red and, you know, jump up and down.

Yeah, no, no. So it's really just picked up on by pheromones. There are hormonal changes that happen. So leading up to ovulation, our testosterone is rising, so we're going to be more energetic. We're probably going to be a little more flirtatious as well. But there's these subtle changes that we pick up on. And on the flip side, you know, women are actually selecting for mates based on their MHC complex, which is what tells us about immune health. And what we select for off of birth control is a man that is genetically different from us. So that we have the most viable offspring while we're on birth control, we actually select for a mate that's more genetically similar. Like, read. You know, when I say that, that's like dating your cousin kind of thing. And what we've seen is that women going on birth control or going off, it can have disruption in their mate selection, but also their relationships. And as you started this whole conversation with these studies, you know, the new study that came out saying we don't pick up on these subtle social cues, you know, at the end of that study, they were like, it's probably like, not that big of a deal, because we would have noticed by now except that we forget that we're animals. And it's all these subtle social cues that we run in the background of our brain put together that help us with, you know, mate selection is one thing, but also how we mother, how we form communities, like how we show up in the world. So, you know, this is a conversation for everyone to get involved in, especially given that. Where do you think that birth control goes when we excrete it out of our body? It's going into our water supply.

Wow, that is. That's so much information. I'm still stuck on this idea that men unconsciously pay exotic dancers more if they're ovulating.

Yeah, well, we're also plumper then, so estrogen is rising, so our lips are fuller, our breasts are fuller, our hips are fuller. And so that to a man is perceived perceiving, like, oh, viable mate. Like, this is somebody who could birth me a baby. And although you might not want a baby and people listening, I always get people who are like, well, I don't want a baby. Well, it really doesn't matter what you want. You are an animal.

You mitochondria want a baby. It's not up to you whether you want it, it's up to you whether you do it. That's different.

Yeah, totally. Totally. Yeah. We definitely have to talk about mitochondria and birth control today.

It's really intriguing to me because I didn't know that fact. And I can tell you that as a young adult, I had no clue that women were more attractive when they're ovulating. And as a married guy, married to a doctor and co author of a book on fertility, I definitely know when Lana's ovulating because she's just shockingly attractive. And I couldn't tell you why. I can look and say, oh, your hair looks good today. But it's just like, I'm going To do a double take that I might not have done the week before.

Yeah.

And over the course of a decade plus, you realize that. But then you wonder, okay, am I doing that unconsciously? And are all guys doing that unconsciously? Pretty much all the time. Are we?

Yeah, we definitely. Well, we. You guys are. You guys definitely are. And it's the same thing with women that like, as we're nearing ovulation with that testosterone rising, our libido kicks up. And that, you know, what is really going on from an evolutionary perspective is how long does sperm live? Well, it can live up to five days. So if we actually have intercourse, we capture sperm and then we release an egg and sperm's already there. We increase the odds of conception. And so all of this is again, your body program to make a baby. But it only happens when you are off of birth control in this natural cycle. So the mate selection. But also, you know, our brains fluctuate, our emotions fluctuate, our immune system fluctuates. There's a lot more going on to women's hormonal health that, you know, lends itself to this idea of like, how crazy are we to give a medication and to shut down a woman's reproductive system and act like that's not going to have any long term impacts or any impact on her body as a whole. This is really born out of who's been doing the research, who is like, who's looking at this? Men, they don't have this system. So, you know, a lot of this has been like, it's negotiable. You don't really need a reproductive system. Except we've never done long term studies to understand what happens to the female body. Like what happens when you start a 14 year old gal on birth control and she doesn't come off of it until like 44, 48. She's never ovulated her entire lifetime. We know that progesterone is necessary for brain health and for myelin sheath development and also neuroplasticity. But without ovulation, you don't get that progesterone.

Wow.

So this is like a huge experiment that we've been running. It's not controlled, nobody's documenting it. And in fact it's most experts, as I do, air quotes, are out there saying, oh, it's birth control, it's a woman's right. Don't question it.

All right? We just had a whole episode on adrenaline overload and progesterone and how important having adequate progesterone is for people who have this long list of autoimmune symptoms. And so, okay, now we're suppressing progesterone by using the pill. But I mean, here's the thing. The ability to choose when you want to have a child is really important.

Super important.

Before we get into the downsides of the pill and there are so many and what you could do when you decide to go off of it, I think a lot of people asking right now are saying, I don't want kids right now. What is the best thing to do if you're not going to use the pill?

Yeah. So chapter 13 of my book is dedicated all of that. Because step one, if you want to come off birth control, is to have a backup method of birth control. What we found out from a 2018 study is that even if you do want a baby, you shouldn't have a baby within the first six months of stopping birth control because the risk of developing childhood cancers is higher. That's right. Your baby is at higher risk of developing cancer. And we need a lot more research to understand this. Now, in terms of alternatives, we've got barrier methods. And I know people usually eye roll when I say condoms, but let me. You got you. If you are an eye rolling person, please go into chapter eight of book and read about HPV and HIV infections While on birth control. You are. You can potentially be more susceptible. So if you're not in a monogamous relationship, a barrier method like a condom is definitely a good idea.

Yeah. And that's, that's outside of just pregnancy control. That's more like disease control. And if you're saying, oh, that's gross, look at things like mycoplasma and all sorts of other bacterial things that are not talked about, even as sexually transmitted diseases. However, there's a lot of stuff that is designed to transfer that weight that goes beyond the stuff that we all recognize. Absolutely. So, yeah, okay. To live a long time, be healthy, bury a method. But okay, there's a lot of people here. All right, I'm monogamous. I'm monogamous, don't have babies, but I don't want to screw up my hormones or have my significant other. If you're the guy, you care about the woman in your life.

Totally.

And so what, you want me to keep going? Yeah, like what happens? And the cool thing is I say if you're a guy, because here's the deal. If you're a lesbian couple, you don't have to worry too much about this.

Yes. Yeah. That's like that's definitely a bonus right there of not having to. And this is something that, like women say as they enter menopause is like how nice it is to no longer be under the threat of pregnancy. And so these are words that my patients have used. So in other barrier methods, we have cervical cap and we have diaphragms. Now those have a higher failure rate. So when we look at birth control and contraceptives, we have to really weigh what risks are you okay with? And in my book, I go through hormonal birth control, whether it's IUDs, implants, NuvaRing, patch, the pill, all of these things. And then we go into these non hormonal birth control options. So there's also the copper iud. It works well for some women, not for all women. Of all contraceptive devices, this is the one that women sing the praise. The highest of it has a really high efficacy rate. It means that it's very low to failure. And in addition, women who do well with it, they do really well with it. Now, who doesn't? If you have a history of heavy periods, painful periods, endometriosis, copper AD is not going to be for you.

This is not, not coded with hormones. It's just a piece like a little copper wire.

Basically, yes, it's copper. And so that's something we have to consider as well. So I recommend that women get testing for inflammatory markers. There's zinc, there's copper levels tested, and also look at their thyroid because just because you're not having overt symptoms, like we want to test that before and then again six months later to make sure we're not ending up with any issues. There is research. You know, the research says over and over, the copper does not go systemic. However, the research studies will also caution if you have a copper storage disease, maybe we shouldn't use that. So that tells me that's very common. Yeah.

Just to be super clear, I write about copper as a necessary nutrient and as a potentially toxic nutrient. My new book, Superhuman, that comes out in October, it's already on Amazon for anti aging. So if you're a woman who has a copper problem and you want to live a long time and look good and you get a copper iud, it's going to do bad things. And if, on the other hand, if you're deficient in copper or you have normal copper metabolism, it could work really well, but without being tested, you wouldn't know what's the test you'd get in order to know whether you're copper. Sensitive or not.

So you can do genetic testing and then in addition to that, actually looking at like ceruloplasm or, and I like looking at zinc as well, because those two minerals really oppose each other. Um, they compete for absorption. And so that's why we don't, we don't supplement with zinc without copper and vice versa. And we have to be mindful of that. But you're absolutely right. This is something that is more common than we think. And in addition to that, if a research study uses that like, cautionary language, it tells us that there's something they were seeing that maybe they couldn't report on, wasn't in the scope of the study or wasn't statistically significant enough to enter into the study. There's something these researchers are seeing that says, you know, let's just pause with this one. Now. Another form of non hormonal birth control is fertility awareness method. And these days you can leverage femtech devices like Natural Cycles or Daisy. And so this isn't a guessing method. In fact, this is a very scientific method in which we really leverage mathematics to predict fertility. And you'll have a fertile window. No, you can't get pregnant any day out of the month. No, you won't get pregnant from French kissing. There are people who have, you know, been told a lot of things about fertility, and I'm sure you go into this in your first book is that really there's only one day that a woman's fertile sperm can live longer. And so that extends the fertile window to anywhere from five to seven days. But, you know, I love this method, even if it's not your primary method of contraceptive baby baby making prevention. It's also a great way to get in tune with your cycle and to literally biohack your cycle and your hormones, because you can start to make correlations between cervical mucus, cervical position, temperature, and also what are your other symptoms going on throughout your menstrual cycle. In fact, I've had patients that have caught their hypothyroidism. Well, they're doing fertility awareness tracking and they're like, why is my basal body temperature always so low? We do a test and there it is, their hypothyroid. So it's an incredible amount of data, and I think it's really important for women to understand, and men is that your symptoms will show up before your labs show gross enough changes, that is to fall outside the reference range of sick people for your doctor to catch on to it, which is why it's so important to be collecting your own data even on a daily basis and understanding where you're at. And if you're going to use them fertility awareness method, you can couple that with condoms with other sexual activity that does not include a penis entering the vagina so that there's no risk of sperm. And there are people who elect for the pull out method. And I was shocked when I got into the research because as a doctor, you're taught never ever, ever condone that it's not okay. But when done correctly, it's got about a 4% failure rate. That's with perfect use.

I was just gonna say, as someone who really looks at the way things work, I'm pretty sure if the sperm isn't where it needs to be, it's probably gonna work most of the time. But, you know, 4% failure rate, it's still, you know, if you have sex a couple hundred times a year, you have a 4% failure rate. Well, what if you had some awareness of when you were going to ovulate and you just didn't practice that method? Then you're now approaching really, really good odds. And frankly, that's what Lana and I do. It's like, look, you can tell even without all the cool femtech that's out there right now. You can tell within about three or four months. Oh, I'm about to ovulate. I'm ovulating now because there are very obvious changes once you're taught what they are. And your mom may not have told you. And then, okay, now I know this is my risk window. So this is gonna be crazy. I'm gonna change my behavior during my risk window. And I'm calling it risk. It could be if you wanna get pregnant, it's your opportunity period. But whatever you wanna call that your behavior during that time, you are probably going to have a lot more sex during that time. Because guess what? The guy in your life is gonna be all over you because you're ovulating. And because you're gonna feel really horny because you're ovulating. Cause that's what your mitochondria are doing to you. So that said, you're like, oh, this is the risk period. So I'm going to use the Barry method just for this one period of time. Or at least I'm going to do the pull out thing. And shockingly, this is what people did for thousands of years before we had latex. Right?

Yeah. Yeah. And you know, I've also had patients who are like. Because I'M practicing fam. I've actually started engaging in all these other sexual activities that I had no idea I was super into. So it's also an opportunity for exploration. Like, it doesn't always have to be intercourse. So what does it look like for you in terms of, like, there's. There's so many other things to do. I'm. I'm not the expert on that, but let me just say Google is. Google has lots of information for you, but, you know, that's something. A lot of patients have reported increased sexual satisfaction because now they were like, well, I don't want to risk it. I'm feeling nervous about this. Let's do X, Y and Z instead.

Got it. There was a rule in Game Changers, my last book about that. You know, find the stuff you really like in the bedroom. I'm forgetting the name of the exact rule. It's something like something about fantasy unicorns after 46 laws. But it was basically, the people who are happier with their lives are like, you know, I've always wanted to try X, and they go out and they do it. So this could be a good way to do that. I want to be really clear. We're talking about the pill as something that can mess with all this stuff. And we're saying, all right, here's some things you could do. But we're also talking about shots, patches, and pellets. Like, essentially anything that's giving you unnatural levels or types of estrogens.

Well, the synthetic estrogens and the progestin. So this is something really important for women to understand is that progesterone that you make following ovulation is not the same as progestin. And progestin is when we get into really big trouble in terms of, like, we. We've always vilified the synthetic estrogen because of the clot risk. And what we've come to understand is that synthetic progestin actually changes a woman's brain. It's associated with higher risk of depression. And we can certainly go into all of that. But. So when we talk about it, yes, the pill, she's the leading lady. She stepped on the scene first. We have the most research. She's the most widely used. However, that iud, that's progestin. That depo shot, that's progestin. So these other forms of birth control also have progestin. So when we talk about synthetic hormones, we were talking about all hormonal birth control. So don't. Don't be like, who. Okay. It's all good, because I only use the NuvaRing, I don't use the pill. And now, sorry, like all of these forms of hormonal birth control come with these risks. And with progestin, you know, as we were talking about at the top of this with the alterations in female behavior, you know, progestin has been shown on brain scans to decrease the cortical thickness of the brain, which is, explains a little bit about the behavior changes that we see when women are on birth control. Because the, this helps with regulating emotions. And this is where we see that women have an increased reward seeking behavior. And so there have been studies to show that women can on birth control can be more prone to becoming addicted to drugs, to alcohol. Like we, we don't have that stop break on our brains when we're on hormonal birth control. And you know, like you were saying at the top of this, we're not judging anybody for using birth control. I'm not anti birth control and I used the pill for 10 years to become a first generation college student. And but given now that we understand that over 66 of the percent of the population developing Alzheimer's are women and 98% of women have used hormonal birth control at some point in our life, we've got to start asking these questions. And if you are a woman who's used it, I'm right there with you being like, okay, what did I do to my brain? How did I sabotage my mitochondria by depleting CoQ10 taking this birth control?

Oh, wow, that's an interesting thing. I did not write about that in my fertility book. I didn't even know about that. So if you're listening to this, you've probably heard somewhere or another that statin drugs, one of the reasons that they're so harmful for you is that they deplete something called coenzyme Q10, which is necessary for cell membranes and for your mitochondria to turn food and air into energy. You actually have a study that says that the pill does the same thing.

Yeah. So the pill depletes Coq 10. And, and in addition to that, what's really important for women to understand because the conversation about will birth control impact my fertility? Always gets dismissed. People are like, that's a myth straight away. However, there are some mechanisms at play that we really have to question. And I talk about the CoQ10 depletions in my book and how the mitochondria are concentrated in a woman's ovaries. Now we will make CoQ10 ourselves and we will support ovarian health, egg quality. And however, as we age, CoQ10 declines in production and you're on a pharmaceutical that's actually depleting CoQ10. Also vitamin A and vitamin C and vitamin E, these things that are really important antioxidants. There's alterations in vitamin D metabolism. We deplete folate and B12 when we're on it. So these are all things that will make it so that you do not make the most viable egg possible. We cannot at this point say birth control causes infertility. We don't have causation, enough data for causation. However, by this mechanism, it may impact your fertility, especially if you are delaying fertility and saying, okay, I'm going to come off the pill at 38 and that's when I want to get pregnant. Well, your CoQ10 production is down if you've been taking antibiotics, if you're exposed to glyphosate, like, what have you been doing to your mitochondria? And there's this other question that I raise, which is that we know that birth control is actually toxic to our good gut bugs. And anything that is toxic to the microbiome can be toxic to these little organelles called mitochondria that actually evolved from there. So there's a lot of mechanisms at play that I just don't think researchers have been asking the right question. And so many people shut down and want to say, we've already solved this. Shut it down. Like, don't ask any questions. That's anti woman. Anti woman. And anti science is not asking the questions, not staying curious and not being humble.

I'm sorry. Here, I'll just say it. And I think I've probably said this before. The pill is anti woman. To be really straightforward, if you love the woman in your life and she's on the pill, she's at greater risk for huge numbers of diseases and things that suck the quality of life and alter her ability to perceive reality around her as in the cool fact of the day. So I would just say it's up to you as a friend of someone like this or a mate of someone on the pill, it's like, look, I care about you. I will do my part in us not having a baby so that you can have the full experience of your health. And so when someone says that if you're opposed to the pill for health reasons, that you're opposed to women, that's just industry marketing. There's no other word for that like the pill. In fact, we'll just say birth control. Not even the pill, but readily accessible birth control has raised the income of women by about 30% in developed countries. It's really a good thing to have control over reproduction. But the pill is not the same as control over reproduction. And when people conflate those, it's because they've been influenced by industry propaganda from birth control companies. And I'm not a conspiracy theorist there, but I understand marketing. I'm pretty good at it. And you can see what's going on here. So do not just. If you're listening to this and you're. You're stuck in that. That loop that was planted by someone trying to sell you hormones, you might. You might want to pay attention to that. All right, I'll get off my soapbox.

Well, and I talk about. No, but, like, it's great because I talk about this in my Reversing Metabolic Mayhem chapter, in which a drug was introduced so new. And just to be clear, everybody, these are drugs. These are medical interventions, even though they're passed out like candy. I would actually argue your doctor is more cautious with sugar these days than they are with birth control. So bad now. It's so true, though. So with this, though, there was a new progestin derived from androgens is what it's called, and it came out in Yaz. You also find it Yasmin Osella. And they knew it had a potassium sparing effect. And this was Bayer, and they marketed. They actually did TV commercials where they were like, this is all these benefits, and it's this wonderful thing. And the FDA got all up on them and was like, wait a minute. Like, there actually. Like, this is not a good thing. This puts women at a higher risk of stroke and heart attack. So if you're women with polycystic ovarian syndrome, like, you need to listen in because you're already at higher risk for those things. And in addition to that, you, like Bayer was saying, this will fix your pms. But they actually had no studies or data to back that up. And a lot of experts have said by the time the FDA stepped in, it was too late, because the indoctrination was done among healthcare practitioners and among women thinking, this pill will cure my PCOS or, excuse me, my pms.

Now, there are two recent clinical studies around the active ingredient in a bulletproof supplement called ketoprime. And in both of these studies, that ingredient treated the emotional symptoms of pms.

Oh, really?

Yeah. We're excited the way that Ketoprime works is it goes in and it provides a molecule that allows Krebs cycle. This is the ability of your mitochondria to make energy. It provides the compound that primes the pump so you can take a new molecule of energy into the top of the Krebs cycle, a molecule of food, I should say, and turn it into energy. So it's one of those things where, wow, upregulating mitochondrial function can help with that. Because at certain times, even if you're not on the pill, if your energy production is going somewhere other than into your brain, you're like, oh. And then you have less emotional regulation. But I want to know, aside from those claims about PMS and the pill and things like that, and certainly some pills seem to do that, you wrote on your Instagram that The pill depletes B2, B6, B12, folate, magnesium, zinc, selenium, CoQ10, vitamin C and vitamin E. Does that mean for people who are listening, who are on the pill and are choosing to stay on the pill, oftentimes, you know, they like, the risk reward for me isn't there. Should they be taking all these supplements with the pill, at least to minimize the harm?

Absolutely. So you're going to need at least a multivitamin or prenatal, and in addition, bringing in that CoQ10 as well.

How much? How much CoQ10?

So in CoQ10, it depends on, like, the quality of the product. Right. Because we don't. Like, there are some products out there that is like 400 milligrams is like the sweet spot, but, like, that is something. Yeah. And I always wonder about absorption, but at least 100 milligrams is, like, what I like to see coming in. If women are thinking about their future fertility and really wanting to protect their egg health. And, you know, it's something about your product. What I want to say is, is that if you are feeding the mitochondria to do their job, then when you ovulate, so you're going to ovulate a more viable egg, a better quality egg, the corpus luteum that's left behind will produce that progesterone. You'll see a reduction in those actual PMS symptoms. So that's a great mechanism and how that works. But, you know, there's so many doctors that have pushed back on me and say, you know, why are you telling women to take a prenatal or a multivitamin? Like, why would you do that with birth control? And I say, like, okay, with statins we know there's a CoQ10 issue. So what do you say? Oh, we're going to supplement with CoQ10. Okay, great. So metformin, a leading drug for diabetics, depletes B12. What do you tell your patients? Oh, take B12. Okay, so birth control is depleting B vitamins like folate and B12, which by the way, if you're taking the pill, there's a 9 out of 100 women will get pregnant. So it's 91% efficacy rate with typical use. So that's 9% failure with typical use. If you become pregnant by the time you, you know, you got a positive pregnancy test, you already needed that folate and that folate's been depleted. So that's the other concern that I have here. But when I list to doctors, when I list off all those nutrients, which, you know, some of these people push back and they're like, where are the studies to prove this? I'm like, look, this is their studies since the 1970s. This is not something anybody debates anymore. Like, when I was getting my nutrition degree, this was part of standard curriculum. Okay? So this is not something where people are like, oh, I need studies to prove that I need to take a multivitamin or prenatal while on birth control. Like, no, you need to take that. And you need to also recognize you have to have your diet dialed in. Because if something is hating on your mitochondria, like in and hating on your microbiome and impairing liver detoxification and causing all of these issues in your body, you don't have as much wiggle room as the average person to be binge eating sugar or eating inflammatory fats without feeling worse. And that's really the name of the game. It's not food shaming you. It's not, you know, trying to push you in one direction or the other, you know, just for the sake of doing it. It's really about how do you live an optimal life and be a high performing individual? And, and you know, as we were talking about, like, it is something that a lot of women I've had, women who are so, you know, I had a practice in the Bay Area, lot of executives at tech companies, women who are on birth control, who are like, I'm losing my edge. I have brain fog. Like, I am not the sharpest one in the room. Like, and, and having all these complaints, they come off of birth control. We work them through that and they're like, I just got a promotion. Like, I just Got a raise, like I am like killing it at work. And so that's when I really started to get interested in like what is this brain health connection between birth control, how it impacts our brain, but also how we can work with the menstrual cycle to be more productive. Wherever you're at in life, whether that's being a stay at home mom or being an executive in a corporation. Either way, like women world is always demanding that you multitask.

You know when, when a doctor says, you know, how dare you. There's no, there's no science behind this. Here's the deal. There's 29 million papers just on PubMed. And you go back to 1960 when a lot of these doctors apparently got their license, there was 100,000 new papers a year coming on. But back in 1960 you had a microfiche. If you're a millennial, you don't know what that is. But before we had the Internet, they would photocopy things until they were microscopic on transparent little pieces of plastic and you'd have to shape, shine a light and a magnifier through it so you could go to library and read these things. I'm not even making this stuff up.

Yeah, no, I know, I'm old like that.

Okay, so back then they couldn't keep up with it. That's 100,000 a year. Now there's about 900,000 new papers a year coming on and it's going up exponentially from there. We've had a 9x increase. So I'm pretty sure that these doctors haven't read all 29 million, nor should they, but they probably haven't searched. And when you do a search with a specific lens like you have, you're going to find some interesting stuff. So the answer for those people is basically because science.

Yeah, well, and it's just like, it's this crazy thing that you know doctors, they have the education they received in medical school, it's a lot of information. Then they have the education they receive in residency and then they have the continuing medical education. And so what does that all mean? They're not actively doing the research. Like you don't find a lot of doctors who are like, let me, like, I can't solve a problem with my patient, Let me go into PubMed and spend hours there. There's other databases, there's other ways, but it, there's a filter going on in terms of the education that they're receiving and that's an issue. And so your doctor's not A bad person. They've been taught that this is the pill for every female ill. You got a lady part problem pass or some birth control problem solved. And if you truly believe you were taught that is the best solution, why wouldn't you offer it? And it's just a, you know, it's a very narrow tool. Toolkit. I have a much broader toolkit. And, and it's something that it's also, you know, as you talk about unicorns, people are like, how do I find a doctor like you? I'm like, it's kind of hard to find a doctor who studied nutritional biochemistry concurrently with clinical nutrition, then became a doctor. Loves sitting on PubMed. Like, you know, there's not a lot of doctors. And especially when they've got caseloads of like 30 to 40 patients that they're seeing a day, they're tired, they're exhausted. There's a lot more going on to this story, which is why in my book, I set out to put the medicine in women's hands so that they could make an informed decision about their body, know how to talk to their doctor, know what labs to ask for, and know that like, their symptoms are not their body betraying them. In fact, it's an opportunity to heal on a deeper level. What is acne today may very well be hair loss in a few years and then may, you know, end up being an issue with your cardiovascular system or diabetes in 10 years. So this is the thing we have to recognize. Our hormones are not expendable and our hormonal symptoms are often rooted in a whole lot more dysfunction lying under the surface.

I want to talk about post birth control syndrome, but I also have a overarching question.

Yeah.

When you're done with post birth control syndrome, do you have better sex when you go off the pill?

Oh, women report this all the time to me. We get my customer service are women. And because, because a lot of like we did have a customer service gentleman and he was like, I don't really want to hear about women's vaginas and stuff. Like, I don't know, I don't feel appropriate. Um, women report increased lubrication, better orgasms, feeling like their libido upticks. That is if you do the work. Hormonal birth control actually alters your liver's genetic expression of sex hormone binding globulin. And the research, yeah, and the research has shown that it doesn't return to pre birth control state. Now I will say with the protocols in my book, which were developed one on one with patients, you can get that sex hormone binding globulin back in check because epigenetics is everything.

And, and just, just for people listening, don't know what that is. This is something that will stick to your sex hormones so your body can't use them. You don't want a lot of that. Otherwise, even if you have a little bit of that testosterone that makes you horny floating around. And I mean, I mean that for women as well as for men, just different levels, it won't do anything because it gets sucked up by that stuff.

Totally. Yeah. And that's not a bad thing, you guys, because it's a protective mechanism. If you're on birth control, your body's protecting you from too many hormones. However, it's a big problem when you come off. And with testosterone, it's not just about libido. It is our wake up, kick ass repeat. When your testosterone gets too low. You find yourself low energy all day, crying all the time, and your muscles can actually start to atrophy so you don't have muscle strength. Now take that to your pelvic floor where everybody's like doing their Kegels and whatnot. That's also involved in orgasm. So this is really important to understand. While we're on birth control, we're not bathing in our yummy hormones. There have been studies showing the younger you've been put on it, the higher odds you will have pain with sex. Dyspareunia is what that's called. And in addition, you can have vaginal atrophy. I've talked with a physical therapist who have seen 20 somethings whose vaginas look like 50, 60 something year old women because of this vaginal atrophy and tissue changes. But when you come off and you restore that hormonal health, women do report better sex. Because while you're on it, if you do actually get in the mood and then you get lubricant and then you finally do achieve an orgasm, sometimes those orgasms can be really painful. And as you know, I'm in your game changers book talking about the benefits of orgasm. So you guys, you need game changers and you need beyond the pill if you want to get your orgasm health dialed in and modulate your immune system. Live forever like all that business.

All right, I'm going to be like a crass guy. I'm putting on my man hats for a little while here. Not that I'm not normally wearing it, but okay, this is a bit of a leading question, but asking for all married men out there, if my spouse goes off the pill, am I likely to have more sex or less sex than I do now?

You're likely to have more sex in terms of my clinical experience and what so I mean, but think about it. Like, for women and I go through this, I have a whole libido chapter in my book, and for women, it's complicated. So one thing you have to know men is that everything do you do during the day adds up for either like, safety and security or this is a bad dude. And so this matters.

So you're saying do do the dishes.

That's actually foreplay or hiring someone to do the dishes if you can't do the dishes. But it's those things that, like, for women, you have to understand, like, having a penis enter your body, it puts you in a really vulnerable position. And so as an animal and through the evolutionary spectrum, you know, we have developed to be like, I want a man who takes care of me and that I've got this safety and security. And also, if she's not banana stressed out with her cortisol pumping, she can put that energy into reproductive health. Like, the fastest way to get your libido back is to find a way to signal to your body throughout the day that the environment is safe. And so, you know, while on birth control, it's this, you know, it's this thing where we think, like, oh, she's going to start birth control. We're going to have more sex because we don't have to worry about babies. And it's the sneaky way it really prevents pregnancy is that she is not in the mood anymore. She has vaginal dryness, pain with intercourse, inability to achieve orgasm, or pain with orgasm. Like, who wants to have sex when all of that is going on? And if it's painful, those neuronal pathways almost get like, I want to say solidified. But, like, we know there's plasticity here, so it's not forever, but if it's painful organisms that avoid pain, it's what they do. And so she's going to want to move away from that pain sensation. And so it's a very interesting thing that I've seen time and again with my patients. They come off of birth control and they're like, whoa, I thought women. Like, my doctor told me women don't have libido. And, like, a libido is a nice bonus. And, like, yet I'm really into my Nate. Yeah, because now you can smell them, you can perceive them. Your brain is Changing, you're fluctuating. Like your hormones are made to give you superpowers. It's like, it's the best kept secret of women's health, is that they actually help our brain in so many ways. They help our performance. When you work with your menstrual cycle, if you're an athlete and you're on birth control, like, there's studies to show that your, your muscle gains are lower, your performance is impacted. And when I say that, people might be like, why are we talking about sex and athletes? Sex is an athletic event. Okay? It's an athletic event. And if you do it right, you can get a little cardio in for the day. Bonus.

That is fantastic. I love that. All right, so there's our answer. What happens in the first 30 days when a woman goes off the pill? Maybe for the first time in decades?

So that's when we can see the post birth control syndrome symptoms arise. So what is post birth control syndrome? Like all syndromes, it's a collection of signs and symptoms that like to hang out together. Now, when you understand that hormonal birth control impacts every single system in your body, then you can understand how these issues can arise. Showing up with, like, new onset neurological symptoms. So maybe you start with migraines, brain fog, you're starting to have anxiety or depression coming off of birth control. Perhaps your digestion changes. You were having some digestive issues on birth control and now you come off of it and those things are getting worse. This is a phenomenon I've observed when women don't start ovulating right away when they come off of birth control, which is not uncommon, by the way, can take up to three months. If you had a normal, every, like clockwork, 28 day, let's say, cycle before birth control, it can take up to three months to start ovulating again. But if you're not ovulating, you don't have progesterone to oppose estrogen. Estrogen can cause issues not only for your liver, but for your gallbladder. And so we can start to see gallbladder issues. There's women who lose their gallbladder after coming off of birth control. And part of this is the mechanisms that's been put into play. It also, it impacts your thyroid, your adrenal glands. We actually see that there's massive HPA dysregulation with women on birth control control. So they lean one way or the other, where they're like anxious all the time or they're feeling depressed, like they've.

Got that burnout HPA is hypothalamus, pituitary, adrenal. So, in other words, your brain and stress system gets jacked.

Totally. Totally. And, you know, part of that is because hormonal birth control is inflammatory. So they've done studies where they measure a woman's blood, her C reactive protein, which is a marker of inflammation, they put her on birth control, and in some women, it's three times as high. What's the fastest way to develop a chronic disease? Jack up your inflammation. And so this is really important to understand, because when women come off of birth control in those first 30 days, it usually starts really subtle. And then what we see happens is that around four to six months, symptoms really start to peak. But for some women, actually, a lot of women do this head down, push through. You got to be everything to everybody. Ignore your symptoms, manage them the best you can until you can't handle it anymore. And. And that's when you end up at your doctor, and that might be a year later or two years later. So your doctor's not making the connection that coming off of birth control, you. You never reclaimed your natural menstrual cycle, your adrenals, your thyroid never got the support they needed. Your gut microbiome is still struggling. You know, in fact, we see women who have repeat yeast infections, so vaginal yeast infections on birth control, very well known side effect. But lesser known is all the dental research where yeast is overgrowing in their mouth. And that doesn't just go away once you stop. It's also overgrowing in your gut. So if you're somebody who's like, I can't clear Candida out of my gut. That's what yeast is. You got to start looking in your mouth. You got to start looking in other places, because hormonal birth control has skewed that microbiome enough and created intestinal hyperpermeability. Leaky gut, that's not going to heal itself just because you stop. And you know what's really shocking? There was a study that came out of Harvard showing if you have a family history of Crohn's disease, or inflammatory bowel disease, which also includes ulcerative colitis, you're at 300% increased risk of developing Crohn's disease after five years on the pill. And you know how that can start? That can start with little ulcers in your mouth that you're ignoring. And being on hormonal birth control can trigger autoimmunity. Coming off of it can be a triggering Event for autoimmunity. Any hormonal fluctuation that is, you know, somewhat extreme. Getting pregnant, having a miscarriage, giving birth, menopause, you know, starting your period for the first time can trigger autoimmunity. So that's why we see this whole collection, and people are like, it's so much stuff. It can't possibly be related to birth control. To that, I say, if your natural hormones can impact every single cell in your body and every single system, then why are these synthetic ones any different? When you're taking such a high dose that it shuts down brain ovarian communication? Because that's how it works. It shuts down your entire reproductive tract. Why would that not have an impact on the rest of your body? This is. To me, I'm like, that is some of the most craziest logic I've seen in women's medicine. You know, right up there next to hysteria. Like, your uterus is just wandering.

That's crazy. So there's so much evidence, but still, 60% of women are on the pill instead of the other methods.

Well, 60% of women are using birth control for symptom management. That's a big reason. And so, which is scary, right? Because you might be using birth control for acne and trading it off for a stroke or heart attack and not knowing it. It's your right to know that and to make that informed decision. Women with polycystic ovarian syndrome, these are women who have irregular periods. It's rooted in a metabolic disorder. There are issues with insulin regulation and inflammation. They're at higher risk of metabolic disease, and yet they're past birth control. Their doctor says, we fixed your period, by the way. That bleed is a withdrawal from a medication bleed and not a period. There was no ovulation, but with that, these women are already at highest risk for diabetes, for heart attack, for stroke. And we know with a new study that came out that taking hormonal birth control for six months or more in your lifetime is associated with a 35% increased risk of diabetes when you enter menopause. That, to me, is like, we've got to pause, because that is something a woman has the right to know so she can make that informed decision.

It's such important information that I'm super happy to be able just to share it on the show. And it's something that I've known about and believed in for, jeez, going on almost. Almost 20 years. And it's.

Well, you're a trendsetter, man. You're way Ahead of your time.

It was actually TS Wiley wrote a book called Sex Lies in Menopause sometime in the late 90s. And I read that book, I'm like, wow, it's one third scientific references. And she's actually been on the show not that long ago. And so I remember that weird conversation where you sit down. I sat down with the woman I was with at the time. I'm like, you know, I want you to go off the pitol. And it's like, not because I want to have babies, just because I care about you. And it was. And then we had a conversation about, here's all the. Here's all the science and all the data, and it's going to be good for you.

I mean, for sure. And if you just want her to be happy and not walking around irritable and cranky. Something that was really interesting is that when the depression studies started coming out, the big ones that we saw out of Denmark in 2016, showing this high correlation between birth control and new onset of mood symptoms, there were so many researchers and doctors who lined up to discuss, dismiss what, you know, essentially women have been saying since the introduction of the Pill. But then another study came out, and I was so grateful where they started looking at the mechanism of action. And we understand the pill is inflammatory. Well, inflammation in the brain is always a bad thing. But in addition to that, hormonal birth control actually alters your tryptophan pathway. So you make more quinolinic acid, you make more neurotoxins instead of nourishing compounds in the brain. And the progestin. So again, that synthetic progesterone may actually be upregulating free radicals. So oxidative stress in the brain. So we've got inflammation, neurotoxins, and oxidative stress. So when she's really cranky and irritable, it may not be you. Like, it may be what she's actually popping in that pill pack every day.

Wow. Okay. A new study just came out. I talked about it in one of the recent episodes about willpower. And some scientists using advanced algorithms for computational analysis figured out the mechanism of action of inflammation on reducing willpower. And they're just straight up interesting. Oh, we can show this. So when there is inflammation in the brain, it's predictable. And we understand the mechanistic behaviors that cause a reduction in willpower. So let's see. The pill causes inflammation. Inflammation reduces willpower. The pill liberates women. I kind of like willful women. Can I say that? I would like all human beings, men or women, to have their full willpower. Because guess what willpower does. It allows you to overcome your biological urges to act like an asshole all the time.

True, dad.

And I say this as a guy who used to have massive inflammation. Here's the deal. When you have enough energy, even if you get an urge to yell at someone, you will act like an adult and not yell at them. And if you don't have enough energy or you have too much inflammation, you'll get the urge and you won't have what it takes in that microsecond to make that decision. And you'll say something, and then later you'll be like, I'm really sorry I said that. And this applies to men and women equally. That's what willpower is for. It's your ability to overcome the biological urges. Because if you just listen to your biology, let's face it, all we would do is basically eat and have sex all the time, and that would probably be the end of the species. So it's probably a good thing that we have this dynamic. But I would like all of us to have that because we're meant to be nice to each other. And you've got to have enough energy to do that. Anything that sucks energy from men or women is bad news for all of us.

Yeah. Or alters mood. I mean, this is something. We are seeing that depression is rising. We are seeing that suicide risk is rising. You know, in fact, when these studies came out about the mood correlation and birth control, we found. So we thought, like, oh, estrogen's the bad guy. So women who took a combination pill most commonly prescribed of estrogen and Progestin, they were 23% more likely to be prescribed antidepressants. Now, if they were a teenager. So if they were actually a teenager, they were 80% more likely to develop depression and at higher risk of suicide. So teens actually had double the risk of suicide after one year on the pill. Now it peaks within the first two months or the first several months, and then. But it continues even a year later. And we thought, okay, well, you know, this is like a combination pill issue. If women are just taking progestin only, which is most commonly prescribed to new moms, they were 34% more likely to be prescribed an antidepressant. And teens who were taking the progestin only, they had a twofold increased risk of their depression. And this is when this research came out. I had to stand back and say, well, what's up with postpartum depression? Because I. My first book was on postpartum health, and I had a lot of theories around that and a lot of things that we've seen in the research. But now to understand, you actually can bring in this progestin only birth control pill or a progestin only IUD, and that increases it by over 30% in women that they're likely to be prescribed an antidepressant. That means new onset depression has happened, which led to the research. I mean, you know, it's really awesome. We're seeing more female PhD researchers stepping up to study brain health, and there's actually some in Canada, but we're going to see, like, women are really taking hold and control of this issue, and a lot of us are speaking up. I mean, when I was talking about this, like, eight years ago, I was not popular. I will say that. Now I talk about it and I get way more women. And I even have women in their 60s who've read my book, who write me and say, for the first time in my life, I finally understand what happened to me, that I wasn't crazy, it wasn't in my head, and I was never broken. Like my doctor told me. Like, it wasn't that way. I finally feel validated in my experience.

Well, that's a gift. Wow. I still think, though, you ought to file a patent. Imagine birth control pill plus antidepressant plus CoQ10 and maybe some zinc and some vitamin E. I mean, imagine the riches to be had. I'm kidding.

Yeah. Right? Yeah. Oh, yeah. And let me just say, for people with the alteration, the tryptophan pathway, I often get people who write me and say, well, then the answer is to take more tryptophan, right? No. Okay. It's like an I Love Lucy down the conveyor belt with chocolate again. I'm old like that. No, the answer is not to start up the machine and try to move it faster. Now, 5 HTP won't have the same effects. It can't go into that quinolinic acid pathway that we know of. But really, the answer is like, okay, well, really the answer is get off birth control. But if you can't go there, you have to be feeding the pathway with things like magnesium, which is depleted by birth control. B6 depleted by birth control. If you just look like. And this is the thing is like, no matter what theory of depression you subscribe to, whether it's the serotonin theory or the cytokine theory, there is evidence in both camps that birth control can in fact lead to Depression that so much of what goes on is in indirect. It's not that you took birth control and that caused depression. You took birthing control, it caused inflammation, it caused increase in free radicals, it caused nutrient depletions. And all of that led to your depression. And so that leads people to be like, well then it's not birth control causing, it must be fine, right? But I think that your, and that's why I'm excited to be here. Your audience is freaking smart. Like, they're way ahead of the curve with even a lot of like, clinicians that I engage with. I think, you know, biohackers actually understand a lot of these more complex lab tests than a lot of doctors do because it's just not what they've been trained in.

There's definitely an influx of people just saying, hey, I'm going to pay attention. And I think it's happening across food, it's happening across nutrition, it's even happening across aging. And that leads us up to the final question on the show today. So, Jolene, you're a functional doctor. You know a thing or two about hormones. You've got pretty much all the tools of anti aging at your disposal if you want them. How long are you going to live?

Oh, man, I saw your thing about living to 180 and I'm like, can I, can I reach for that goal if I'm living? If I am like healthy in my body, let's go 100, 120. Because I have this thing where I'm like, look, if I can't like jump on a bike and ride and like, do all the things that I love, like, is that really living? Like, are you really living?

I gotta say, if you ask 110 year olds, hey, are you really living? Like, do you want to die right now? Unless they're in an awful lot of pain, they generally say, you know, I think I'd like another year.

Right.

Even if they're not riding a bike. But there's nothing that says you couldn't be riding a bike at 100.

Totally. But I mean, we see these centenarians around the world that are totally kicking ass. That's why I take my supplements. I go do my hydrotherapy and I do all those things. Things because I want to live long. But I also, I want to live long and prosper. I want to be very healthy.

Wow, Star Trek jokes right at the end of an episode on post birth control.

Oh, dude, I'm such a nerd. I was definitely not the cool kid in school.

You got?