Can you Have Hormone Balance With Breast Cancer? with Esther Blum

Hi, it's Dr. Jen. Welcome back to another episode of Keeping Abreast. I could not be more excited for our guest today because this is a lady who is just really kicking ass across the board. She is amazing, she's interesting, she's fun, she gets it and she has a lot to say. And in my opinion, what she has to say is fantastic. So this is Esther Blum. She's an integrative dietitian, a menopause expert. In the past 27 years, she's helped thousands of women make menopause their bitch through nutrition, hormones and self advocacy. She's the best selling author of see you later ovulator Cave women don't get fat, Eat, drink and be gorgeous, Secrets of Gorgeous and the Eat, drink and be gorgeous project. She is known as Gwyneth Paltrow's menopause mentor and by Forbes magazine for helping women thrive through menopause. I want to say that I feel like I've seen you go through the evolution and when you go from book to book, from secrets of gorgeous to eat, drink and be gorgeous to Cave Women don't get Fat to see a later ovulator. Like, I feel like we've been with you on your walk through the decades.

Every book I write is the book I wish someone wrote for me.

Yeah, yeah. Like you're basically giving people a guide to how to win at that level. And you know, unfortunately we couldn't have fast forwarded you right to have the menopause guide. Like I needed your menopause guide then.

I know, I know, I know. You know, the timing was so divine after cave women don't get fat, I really thought I was done. I didn't think I had more books in me. And one of my colleagues was like, you're ready. You know, I just put my head to the ground and just really dove deep into research for years and obviously still have my clinical practice, which is his own little research study samples. Well and finally just one night, I sat down on the couch, one of my colleagues was like, you're ready? And in five minutes I still, I keep it on my bookshelf. Was the OG outline that I scribbled on just like a notepad. I was sitting on the couch with my husband and five minutes the whole outline was done. And I was like, my next book is here. And it, it was, each book takes about six to eight months. This one, I delivered the manuscript a month early. Like, I was just like, I wrote and wrote and wrote and then just said, I'm done. I'm out. I'm out of words now. Let's just get this printed. So, yes, I could have gone on. I may have another second book there regarding menopause, but I'm, I'm letting it marinate for a while. I'm in my postpartum stage. You know, I gotcha.

Well, you know, there's plenty of stuff there to go on. Right? And you know, there is a huge problem in this country in that people who are not feeling well are not feeling the way that they feel that they should feel. And they go to their doctor and unfortunately, their doctor doesn't know. Their doctor tells them that it's normal as you age to feel tired, to gain weight, to not have energy. I mean, they normalize all of this because they don't frankly know what to do about it. And then, you know, I get these women who tell me that they're tired and they're like, yeah, Well, I am 37. And I'm like, this is what we've come to. Like, we've convinced 37 year olds that they're getting old. Right. So I first want to know, how is it that you get it?

Because that's my whole practice, and that has been my whole practice for a long time. It's. I should just call my practice like, the Gaslight Free Zone. I mean, I, I literally on my website, I'm wearing like a custom top that says Gaslight Free Zone because I can't sleep at night. When I have women looking me in the eye and showing up, entrusting their health to me, I could never just say, well, that's just menopause. It's like the most frustrating thing a human can hear and the thing that steals hope and joy and a purpose for living. Is someone giving up on you or someone not even giving you an option for healing, or someone not giving hearing you and someone dismissing your concerns. And what kills me is these brilliant, educated women are saying, well, it must be in my head, and ignoring what our bodies intuitively tell us. So when I do work with clients and we do see that the tests track with their symptoms, I say, see now you know to never ignore your intuition, which is the greatest guide a woman has. We all know our bodies so beautifully. We know when the wind blows differently. We know when our hormones are off. We know when our gut is off. Every woman who says, I think my hormones are off, I think my testosterone's low. 99 out of 100 people are spot on. And.

Right. Yeah. So I think a large Part of the problem is that we as women, we go to our gynecologists in search of answers. In search of what? The term we throw around is hormone balance. I do want to specifically talk to you about that term, but we go to our gynecologist thinking that, well, they are the ones that will know. In fact, we forget that gynecologists are surgeons, just like I am a surgeon. And surgeons are not trained on helping women to achieve hormonal equilibrium. I'm curious as to. How did you get into this area of knowing that there are ways to investigate and achieve hormonal balance? Like, where. Where did that come from for you?

Yeah, it came from me not helping women and not getting the results that I wanted to, or getting results to a certain point, with diet and lifestyle and supplements to a point, but not getting all of the pieces. And I was like, I have to do better. It went back to me literally waking up in the middle of the night saying, I could have taken better care of this person. I let this person down. So it really the responsibility of really committing to healing someone and giving people results they need, that is what weighs heavily on me. Like, my father was a physician. My grandfather was a physician. My mother was a nurse. My grandmother was an anesthesiologist. Like, I have my dad's. I don't know if you can see behind me. There's like a teardrop shape award on my bookshelf. That's my father. See, that's my father's lifetime achievement award when he got. When he. That he got when he was 89 years old.

So what kind of doctor was your father?

He was a dermatologist.

How do you like that? Love it.

But, you know, that's what reminds me every day to stay humble, put my nose down and do the work. So the work entailed running tests because again, I was like, I'm hitting a wall. Let me look under the hood. So I do a lot of testing in my practice. And so that gives me the specificity to treat people and then just delving into the research. What kills me is that medical schools, I mean, everything I've learned, it's not been in school. I have a master's and a bachelor's in clinical dietetics. I worked in hospital for years. Nothing that I know is what I learned, except for the foundational biochemistry, of course. But on the day to day, what I do, the hormone and looking at gut tests, looking at hormone tests, making sure hormones are doing what they're supposed to do. And if not, how do we replenish those? That's what enables me to do what I do. And diving into the clinical research. So every practitioner, any human on the planet has access to all the research that's out there. So when. When they're.

But they're not accessing it, are they not?

They're not. And they're not looking for it. And most. There was a fabulous New York Times article that also made it to the weekend section because it blew up. It's called Women have been misled about Menopause. And the stats were that menopause care was only taught in believe it was. 50 to 60% of medical schools even had it in their curriculum. And of that, 50% of students graduating medical school said they were not confident in treating hormones. I believe this is due to all the fear mongering that has gone on with using synthetic hormones. It dates back to that Women's Health Initiative study which was very poorly designed and poorly interpreted and made women run screaming at doctors yanking women off hormones. So the messaging hasn't recovered. It's like it needs a better, newer, fresher PR campaign. HRT does. Because the other piece that's so incongruous to me is that the FDA has approved the use of bioidentical hormones and doctors still aren't prescribing.

No, they're not.

But they're prescribed birth control pill out the wazoo, which is five times the dosing.

Yeah. So bioidenticals, I think from that perspective. And I've had long conversations with Tabitha Barber about this. I don't know if you know.

Yes, I love her.

So, you know, basically they do what they know and they train what they know. Right. So the misinformation just gets handed down from generation to generation to generation because they keep teaching what they know and they only learn what is being taught. Right. And so we have to break the cycle for sure. And it's loud voices like yours and mine and Tabitha's and Avraham Blooming. And you know, there are lots of people out there trying to use their voice. But it's going to come in a grassroots movement. It's going to come from consumers because the physicians still don't realize. And if I'm being honest, I spent over 20 years as a surgeon, as a cancer surgeon, operating, no pun intended, with blinders on. I came out of training in 2003, the same year that the Women's Health Initiative was released. And my training and the person that taught me was considered the country if not the world's breast cancer expert. I was taught that women should use hormone replacement only when they absolutely needed it and couldn't function without it, and they should take it in the lowest dose for the shortest amount of time. That was my training, and I believed that for nearly 20 years. I know. I know and understand how it happens. And I just had a patient last week whose doctor told her she is suffering when I tell you she is suffering. And she has every single menopausal complaint that you should have, including, like, life stopping hot flashes and palpitations and horrible anxiety. And she can't sleep. She has no libido. She wants nothing to do with her husband. She wants nothing to do with sex. And so she is as miserable as she can be. And her physician said no to hormones for her. She does not have breast cancer. Did not have breast cancer. And her physician said no because the clot risk is too high. Not only is that person unaware of what hormone replacement is and does and how to deliver it, they are also unaware that there is no increased clot risk with transdermal estrogen, that it's only associated and with oral estrogen. So we have a huge education issue here. And so I do believe that the solution is going to come from women demanding it because they are starting to realize, I mean, there are some people who say to me, I don't care about the risk. I can't live this way. Right. And so they want hormones for that reason.

Yeah.

So while we're there, let's talk about this whole thing of hormone balance, because I feel like in your first books, you talked about hormone balance in the context of doing things with your diet and doing the right kind of movement, and you could achieve hormone balance that way. And now the tune is a little different. So can we talk about that? And how do you now see hormone balance? Yes.

So when you're, you know, bear in mind my books were certainly. My first book came out in 2007, so I was in my 30s then. And, yeah, I mean, you could. You can clean up your alcohol, smoking and sugar intake, and your hormones are going to recover way better. And although I do see women, I have had a woman in her late 20s, she was 29 when she went to menopause. So I really can't even say that anymore because there's no. There's a real ageism around menopause where the literature says, well, a woman can only go through, you know, menopause between the age of 45 and 52, which, please, we all know that's not true.

Yeah.

So regardless, your ovaries, there is going to come a time where no amount of yoga or green juices or adrenal support will help bring back your ovarian production of hormones. When the party's over, it's over. And the same goes for chaste tree, like using herbs like Vitex or chaste tree to really kind of eke out that last bit of hormone production. And at that point, hormones you do need.

Can you talk a little bit about what you're talking about there? Because I don't know that that is a commonly understood thing.

Okay. So your ovaries are the primary release site and production site of your estrogen, progesterone, testosterone, dhea. While you are regularly cycling, once you hit perimenopause and really late perimenopause into straight up menopause, your adrenals really take over. Your ovaries say, I don't need to ovulate. We're not reproducing anymore. That's why your progesterone production slows down dramatically and decreases. And that's why you can get those crime scene periods, heavy, heavy periods and clots. And your PMS window can extend for like a whole two weeks before your cycle. Because progesterone is a really calming neurotransmitter. It's like a kitten. It makes gaba very calming neurotransmitters. And it's not there to tame the tiger, which is estrogen. So estrogen's unleashed. We get menno rage, we get, get irritability and breast tenderness and bloating and tearful and mood swings and rage. Once your ovaries are on the decline, they are aging, if you will, or, you know, we call it ovarian.

So when you, when you run out of eggs.

When you run out of eggs, and.

As you're running out, you have this, you have this time period where as you refer to it, like, you're so estrogen dominant because you basically, your progesterone production has really, really decreased. And so we call this like an imbalance. Right. Except that there's no, there's no food or anything that can fix this. Though you do try in that window with, with Vitex and Cheese Tree. And at that point, it's kind of like your ovaries are shutting down.

Yes.

So you can only stimulate them so much.

That's right. And then, and certainly, yes, diet helps. You know, a good quality, protein rich, healthy fat diet can absolutely help. And in some cases, Your body is going to put on a little extra fat to try and eke out some more hormone production. But late perimenopause, early menopause, your production of hormones switches over to your adrenal glands, which are these small walnut sized glands, they sit on top of your kidneys and they are responsible for just a minimal amount of hormone production every day. So this is why women feel so much better when they reintroduce a small, gentle amount of bioidentical hormones, because it's giving their body support. And I also, if need be, do give some adrenal support as well. Of course. Diet and lifestyle, getting a lot of protein, timing your carbs appropriately, getting good sleep, managing your stress. Those are all really, really important pieces as well. Not over exercising if your cortisol levels are rock bottom, but after that. Hormones really help so much. They can restore a normal cortisol curve. They can help you feel energized again. They can help you have your mojo, your groove back, libido, mental clarity, energy, brain fog, plus all of it, while.

At the same time protecting your heart and your brains and your bones.

Exactly. Yes, exactly.

So there's still so much fear around hormone replacement causing breast cancer. And we started to talk about the Women's Health Initiative and the issues with that study. So do you believe that they increase breast cancer risk? I mean, I know you've spent a lot of time looking at the data.

I mean, according to the data. Well, let me just say, first of all, vaginal estrogen.

No.

The Framingham nurses study looked at women using vaginal estrogen for 18 years straight, and there was zero increased risk of breast cancer. There was no increase in serum concentrations of estrogen. So incredibly safe. Second of all, I have seen and treated women who have had breast cancer or ovarian cancer, hysterectomies, mastectomies, and their doctors put them back on hormones. Yeah, I'm one of them. So, yeah, yeah.

I absolutely do not believe that hormone replacement causes breast cancer. And you know, the typical backlash to me is that, well, I was on hormone replacement and got breast cancer. Well, that may be true. True and unrelated, because there are plenty of women who get breast cancer who are not on hormone replacement. And we know from the data that the people on hormone replacement that develop breast cancer do better than the people that get breast cancer that are not on hormone replacement.

Brilliant. Well, the other thing I was going to say was this is why I also do the testing I do, because I think a lot of women, the real skills, sticky Issue is that they're not methylating properly. They're not moving estrogens through the liver down the right pathway, so their ratios could be off. I look at 2 oh 4 oh and 16 oh estrogen. And if your 4 oh is high, we make sure we support it, make sure it's moving down the right pathway and that your body can excrete it. And also that you're not constipated because if you're not pooping every day, and certain enzymes, there's an enzyme called beta glucuronidase. If that's elevated, you're probably recycling your estrogens in your system too. So I really feel like it is probably a methylation issue or maybe our hormone receptors are just so damn clogged because of all the toxins in our environment. So, yeah. Is there a direct correlation with breast cancer and hormones? I, you know, I'm certainly not a breast cancer expert, but I will say from the research I have seen, it's quite, quite compelling to say that it looks very safe. And again, I'm not a doctor, but it does look very safe. And is it correlation but not causation? Because that's where I think the data really needs to be examined. Is it bioidentical versus synthetic? Synthetic is where people get into far more trouble. And also the synthetic estrogens in the studies, like Women's Health Initiative, we're not giving any opposing progesterone and testosterone and dhea. So I would say hormones are a symphony. They're not a solo act. You would never isolate isolating one hormone and giving only that, that is. I mean, Mother Nature is way wiser than that.

So the really interesting part about the Women's Health Initiative is the women who no longer had their uterus were given estrogen alone. And what happened in that group, that group, the group that was given estrogen alone, that group had a decreased incidence of breast cancer. And so in that group, it looked like estrogen alone was protective, which has always been my opinion, and my view is that estrogen alone is protective. Estrogen is a protective hormone. Yes. It does serve to stimulate. And if estrogen is the on button, progesterone is the off button. Right. That's how they work in concert with one another.

Yeah.

But I just cannot believe on any level that estrogen causes breast cancer. Like, there's no way that God would give us a hormone that is so vital and essential to life and it causes cancer. Now, that is not to say that synthetic estrogens don't contribute to cancer, that environmental estrogens don't contribute to cancer, because those are not natural compounds. Those are not compounds that our body is accustomed to having to detoxify. And I don't think we don't live on our grandmother's earth. We don't live on our mother's earth, this earth that we live in now. The amount of xenoestrogen, synthetic estrogens that we come into contact with since birth, since we put those plastic bottles in everyone's mouth, since we decided that we were too important and too busy to breastfeed. And I mean, I know that sounds super judgy, so I don't mean to say that, because there clearly are women who tried to breastfeed and couldn't, so forgive me for my brazenness here, but I think that there were generations of women who just thought that it was inconvenient. And so you start with the plastics from the very beginning, and then it just grows from there with the fragrance and the nonstick and all the protected surfaces and the non flammables, and it goes on and on and on. And this is way more of a toxic load than our bodies were accustomed to dealing with.

Yep.

And it's all going down that same pathway. And I think something that you touched on is really important to bring up in that. You know, I ask women all the time, are you regular? Yes. How many times a day do you move your bowels? Oh, well, I just go once a week, and they think this is normal. And so, you know, if we don't poop our toxins out, they're just staying in and getting recirculated, like you said. Yeah. So I think it's a really complex issue, and I think this is a great time to start to talk about. You're really focused on gut health. So can you. Can you start to tell us why is the gut important? How does that relate to the whole hormone thing? I mean, you're. You're like the hormone lady, the hormone. The menopause guru. Like, what do you. What are you so busy talking about the gut for?

Yeah. Well, what most people. Well, first of all, just if you want to optimize your health, you. You store it in the gut. I mean, there isn't a woman I see with horrible autoimmune challenges who doesn't have a tremendous amount of dysbiosis and a leaky gut. Just the correlation is there with every person I test. But the medicine and the research around gut health is. So we haven't even begun to hit the tip of the iceberg. It's so fascinating and so exciting. And what we do know is that the microbiome, which houses trillions of bacteria that make up the four pounds of bacteria circulating around our small intestinal tract. There is a subset of those bacteria called the estrobolone, which helps your body metabolize estrogens. Hormones also are a motility agent. So what happens when our motility decreases? We poop less, we become constipated. Then we keep reabsorbing our toxins and our hormones also. With the decrease in estrogen and progesterone that come with perimenopause and menopause, we lose the mucus lining that houses what are called our phyla bacteria, which promotes a really healthy intestinal tract. Without that mucosal layer is protective. It helps make sure we're digesting and absorbing our nutrients. When that mucus layer decreases, we're more vulnerable to infections, bacterial overgrowth, a leaky gut, where the gut membrane gets becomes semi permeable and undigested food is passing back and forth. So all of a sudden we have more bloating, we've got more brain fog, we're kind of constipated, we feel sluggish and tired all the time. And we're having all of the hormone symptoms as well. The irritability, the mood swings, hot flashes. Here's the really cool thing is when someone comes to me, right, I have to determine the pecking order of what are we going to treat first. I can't treat everything. I always say, just give me six months. Let's just do this. Peel off a layer or two at a time. When I treat gut health without even treating hormones, hot flashes can resolve just from that. Sleeplessness, depression, anxiety, gets far better. And how many times have you gone to the doctor, you, meaning the listener here, you gone to the doctor and said, wow, like since perimenopause, I notice I have so much more anxiety. My heart's jackhammering all the time. I feel depressed. I'm having all these mental health changes. Guess what? That's really. And you were prescribed an antidepressant, an anti anxiety med, when your doctor could have prescribed you progesterone and testosterone if you need it, and estrogen if you need it, which can absolutely lift your mood, help your brain fog clear out depression and anxiety. And you couple that with healing up gut inflammation, because we do make neurotransmitters in the, from in the small intestine as well. So. And you couple that with a high protein diet, which also raises serotonin and dopamine. So all of those three in conjunction work together. But the gut is where it starts. You have to digest and absorb your nutrients and clear out inflammation if you're going to optimize your hormones too.

Yeah. I think it's so important to get a handle on gut health. And it's so. I love that that's where you start. That's actually the first thing I do with every single breast cancer patient. I first put everyone on a parasite cleanse because I think they're so ubiquitous. And I check everyone's. I check everyone's microbiome and look at gut health because it is so essential to everything else. And it is impossible to be healthy without a healthy microbiome.

Yeah, exactly.

So you touched on some very commonly prescribed medicines. So antidepressants, bisphosphonates, lipid lowering agents like statins. And these are very, very commonly prescribed to the postmenopausal woman for the dysfunction that comes along with menopause. Right. But the solution, these prescriptive medications all come with a significant number of side effects and they actually don't nearly solve the problem as well as hormone replacement.

That's right. Because menopause is not an antidepressant deficiency.

Right, right. And that has often been the argument of prescribers that you don't need hormone replacement because we have antidepressants and we have bisphosphonates and we have statins, and they kind of perpetuate the fear around hormone replacement. I wonder what's keeping that going.

Like, I'll tell you, it's big pharma, it's the drug companies, because they're not making profits off of bioidentical hormones, but they're making a lot of profits off of antidepressants, anti anxiety meds, and also the pill and the iud. Right. Women are prescribed the pill and the iud, and both of which have synthetic progestins. Those won't touch your brain biochemistry or raise your calming neurotransmitters the way bioidentical progesterones will. So I will have women who come to me on the pill, on the iud, and they say, I'm using it for birth control or I don't want to upset the apple cart. I don't want to suddenly go off it. So what we do is I work with their doctors and say, can you just bring in some bioidentical hormones like progesterone while they're on the Pill in the IUD until they're through menopause and then transition over to. And a good doctor needs to be aware that the bioidentical hormones have a far lower concentration of hormones than the pill or the id. So they need to start women at the highest dose of hormone replacement if they're transitioning off the pill or IUD to minimize the potential for hot flashes or vaginal dryness or other symptoms. Yeah.

I think it's important to mention that the majority of the changes that come along with menopause, the brain deterioration, the acceleration of heart disease, the acceleration of bone loss, those are happening early. Right. So it's important to be aware and get started on hormone replacement early if you want the most benefit from it.

That's right. And women, I'm sure you get this too. Dr. Jen. Like all these women who are like, I'm 10 years out, can this still help me? It's like, can help your quality of life. It can't guarantee it can help your bone density, but it certainly won't hurt it. Or you can hopefully, you know, at least maintain steady state from where you are and not have further deterioration. Would you agree with that?

Absolutely, 100%.

Yeah.

So my take on women who are, like, in and around 10 years out is I do first do a calcium score just to see what their cardiac risk is. Because I think that that was really the only population in the Women's Health Initiative that we did have to worry about that those women that already had cardiac disease and you're starting them on hormone replacement, are you going to cause an acute cardiac event? So I do look at a calcium score. I do see, like, where they are in terms of heart disease. And if they're fine, then I do run a Dutch test, I think, just like you do, to see how they are metabolizing. I make sure that they are not constipated. Because we want to know if we're going to put people on hormone replacement, we want to know that they are able to metabolize properly. Then I do it because I think that the benefits to the bone, the brain, and to the heart. Because if we're talking about a woman who is 10 years out for menopause, she's 60, she has decades to live. And I don't want those decades to be defined by heart disease or pathologic fractures or, you know, I think we have a lot to live for, and we have a long time to live, and I want it to be enjoyable.

Yeah. Amen.

I think just the libido and the vaginal benefits alone, and also the brain benefits. I mean, I think that it has a lot to do with mood. Amen.

Amen. And the vaginal estrogen thing. Oh, my God. What kills me is that doctors won't even prescribe that for women who are having painful sex, just dryness and burning on the daily and who can't even insert a speculum at a gym visit without excruciating pain. It's like, why it is the most gentle, benign issue. Even the. My cancer patients who come to me, like their doctors still prescribe vaginal estrogen. It is the lowest, lowest dose. It's so safe, it stays so localized. So it's. And it can be life changing. Not only for preventing vaginal. The atrophy of the vaginal walls and naturally helping lubrication, but also preventing urethral and clitoral atrophy. So you think of how many women in their older years. But even I got some UTIs when I began, you know, when I really. When perimeters picked up. Very common. But the other thing is offsetting that.

Yeah. And it's. But it's not being connected. Right. So. So these women that are suffering with these recurrent UTIs, what are they given? They're given antibiotic after antibiotic after antibiotic. Right. Or they're. Or they're placed on another medication. And all they really needed. Well, I think a lot of them need gut work.

Yes, absolutely.

I think that there's a microbiome issue there. So I think a lot of them need gut work, they need probiotics, they need a diet that will facilitate a better microbiome.

Yes.

And that translates. I mean, we have a microbiome of our bladder, we have a microbiome of our vagina, we have a microbiome biome of our gut. And so. And we need to protect all of them. So I think that a lot of those women need gut help, but they also need estrogen.

Yes.

And how, how the urologists aren't recognizing this, how the gps aren't recognizing this. Like, I just, I don't get it. I don't. I don't. I don't understand.

Yeah. Or they're like outliers. They're charlatans. Like, God, God bless Kelly Casperson and Rachel Rubin, because I feel like they're so beautifully loud about the vaginal estrogen messaging. And really it's something you should use until you're dead. Like, how long until you're dead? Put it on. You put on moisturizer every day. Moisturize the vaginal walls. It's just that simple. It's twice a week. I do mine Wednesdays and Saturday nights. Those are my nights. And guess what? You can. If you're having vulvodynia, like in sclerosis, you can put it externally on the vulva, and you should put a little bit on the clitoris and the urethra at least a couple times a week to prevent atrophy and prevent the bacteria from getting stuck in there.

Yeah, you're absolutely right. I do hope that this becomes common knowledge and becomes commonly acceptable and we get rid of that fear that we're harming people, because what we're actually doing is harming them by depriving them of what they need. Right. Of this essential hormone that they need. I do want to shift a little bit and talk about alcohol because I feel like I am, like, womp, womp, like the bear of bad news all the time, because the American Cancer Society says that there is no safe amount of alcohol for women to consume.

Yeah.

And I feel like your stance on this has continued to shift through the years. So where were you then and where are you now?

Okay, well, I just have to show you the COVID of Eat, Drink, and Be Gorgeous, which is sitting in a martini glass holding our Cosmo holding.

I know. So I own that book.

I. I have a whole chapter in here on hangover recovery that I personally. I felt it was my duty to personally research and. And do my own little experiment. N of 1. But, yes, alcohol does really screw with your hormones, especially at this point in life and to the point where it's funny. I have an old friend who wanted to come and work with me in the practice, and my team was like, she won't give up alcohol. I was like, well, then she's not ready. If you, you know, you really want to be aware that your liver, Its job is to remove toxic substances and also hormones, Right? So it's going to prioritize the pecking order. If you are having a cocktail and you're taking your hrt, it's gonna say, yeah, we need to get that cocktail, that alcohol out stat. So it's gonna put your estrogen and hormone metabolism on hold for four to six hours after just one cocktail. So you're gonna be estrogen dominant in that state. You're not. You're not clearing it out. And then it will be able to continue detoxing your hormones. So, listen, I would be lying if I told you I never drank. Of course I drink, but I'm really judicious about when and if I really want it. And I've been meditating now. I'm so excited. I'm going to hit my two year milestone, probably by September. Daily meditation. Yeah, I do it five minutes in the morning. Yeah, five minutes in the morning.

That is something to celebrate.

I know, I know.

That is awesome.

I should have a party. I'm definitely having a party when I hit my full menopause one year, but I'm.

All right, well, I want an invitation. I'm coming.

I'm coming.

I'm going to.

Oh, my God. I'll be there too. But yeah, so alcohol, you know, I find that if you're really, really addictive, there's a lot addicted to it. There's a lot that can help. Believe it or not, microdosing can really. Psilocybin can really help break addiction and treat, you know, grief, trauma, a lot of depression.

I think you need to ask yourself, like, what are you drinking for?

What do you mean?

You just mentioned someone not being ready to work with you. I remember it was probably about a year ago or maybe a little more where I had. I was working with someone and I had met with her and kind of, we. We reviewed her history and she was a nutritionist. And over Covid, she started to drink a bottle of wine a day. A bottle of wine. And so when I was going over the things that may have contributed to her breast cancer diagnosis, I said, that's a lot of alcohol for your body to try to process every day, and no doubt that it contributed to your diagnosis. She promptly fired me because she didn't like that I blamed her for her breast cancer. And that's okay, because someone who's drinking a bottle of wine a day is not ready to work with me. Not ready to work with you, not ready to work with anyone. Because they're still suppressing. Right? Because if you're drinking a bottle of wine a day, you're really trying hard to not feel some pain.

Amen.

And so I think that everyone who is going to whatever is masking their pain, you need to start to ask yourself why? What. What are you trying to not feel? And oftentimes, you know, you brought up psilocybin. Like, psilocybin can help give you a different ending to that story that you're suffering from every single day that you've been replaying in your head for a year, five years, ten years, decades. Right. It can help give you a. The work at Hopkins in the metastatic population is amazing. And These people changing nothing else but giving a different ending through a psilocybin journey. Giving a different ending to whatever trauma they're carrying around with them, whatever is paining them, they live longer and live better. Metastatic cancer. And they haven't changed anything else other than they stopped suffering, stopped feeling that pain. Because that pain, it will kill you. And if you're masking that pain with substances that are toxic, it's going to kill you faster.

Yes. And I read also in those studies that it took away their fear of dying, which is also amazing. And yes, ideally too, yes. I mean, throwing in some therapy with psilocybin is also helpful. I think it's such a brilliant part of this conversation because, yes, I can say to you, yes, it's going to disrupt your sleep and it's. It's going to alter your cortisol and your blood sugar and you're going to eat worse the next day. I can say all these things, but you do need to connect to that bigger why and what really helped me. It's funny, I really stopped drinking in Covid. I was just so centered and dialed in. And I had also lost my father in Covid. Like there was a whole storm happening there. But I find that the more is going on in my life, the more grounded I need to be and the less I can have any alcohol interfering with what is connecting my heart to my mind. It just, It's a distraction. I don't physically feel well and my body doesn't crave it. And I used to crave it a lot. Like my body just wanted it. And I was like, there's other ways to access parts of yourself that you get when you're drinking. Breathing degree more like breath work. Yeah.

Yeah. I mean, you know, now I'd rather go take a stroll with my husband. Husband. Then have a cocktail.

Yeah.

You know, as you said, there are so many other ways to access that connection.

Yeah.

Than. Than alcohol. So I have a last question for you because I know that you have a time constraint, but I get asked this question all the time. Why no grains? Because I am. I do not think that grains should be a component of our diet. I know that you feel the same way, so I want to hear your why.

Yeah.

Grains.

Well, and I, I do incorporate rice, like white rice, because it is. It seems to be the least inflammatory and more easily to digest. That's kind of my exception, my loophole. But a. You know, you want the most nutrient dense foods. Those typically are not grains. A lot of grains can be Very disruptive to the gut wall. It's not in our DNA to eat grains. If you go back to paleolithic times, this is why I wrote cave women don't get fat. Because it really just delves into the research and the science that the gut is not really meant to be. Humans are not really meant to be eating grains. And legumes can even be tricky for a lot of people. What we tolerate well are plants, plant based starches, sweet potatoes, white potatoes, and some people will say the lectins are too high. To which I say fix your gut well and you won't have a lectin issue so much. But winter squash, butternut squash, summer squash, vegetables, fruits, honey, if you need, you know, a sweet or to fuel your workouts. But you know, those are really some of the oldest foods. Our DNA has not changed in millions or billions of years. And so throwing these new foods, you know, our body doesn't know what to do with a Twinkie. It doesn't know what to do with wheat that is so genetically modified. Doesn't know what to do with corn also, which is really genetically modified. And you know, it's just the processed food situation is incredibly troublesome. It's like I say this to my son all the time. He's 16. We always marvel at just the absolute rampant obesity everywhere. And we observe it and we talk about. And I'm like, if people just ate at the outer aisles of the grocery store, if do not go, do not go in those middle aisles. They are salt and corn syrup. Just skip it. It's all anything in a bright package with 5 million labels. Don't eat that. Just eat potatoes. Roast a potato with coconut oil. There's your homemade chip. It's freaking delicious. It tastes way better than a bag of, you know, crappy store potato chips.

Couldn't agree more. And actually my. So obviously my children have been listening to me and my cult talk for, for many years. And my 17 year old like figured it out this year and he said, you know, I'm sick of having acne. He's weight training and wants to be a bodybuilder. I wish he would work his mind as much as he worked his muscles. But in any event, we got to.

Get our kids together.

He figured out that the way to build a great physique and to have clear skin is to stop eating all the crap. And he just eats real food and it made all the difference in the world. I could talk to you forever. Can you give us a parting message for the menopausal what do you want the menopausal woman to know?

Know that you are going to be the change starts with us. So get ready because you need to be a menopause ambassador not only for yourself, but for other women. Don't be afraid to fire your doctor and find a new one. You can go to ifm.org instituteforfunctionalmedicine.org or just call a local compounding pharmacy and say what doctors are running labs through your what? What doctors are prescribing hormones? And know that everything you have, all the wisdom you need, is inside of you and your body is going to lead you on this journey. So definitely get my book. I almost said keep him. Do good fat. You can get that to See you later Ovulator. Come hang with me on Instagram at Gorgeous Esther and I have a free gift for you that you can download if you go to estherbloom.com cocktail. You will get my free happy hormone cocktail. That's the new cocktail.

I love it. I love it. And we'll make sure to put all of that in the show notes. Esther, it was so awesome to have you here today.

Thanks. Dr. Jen, you're here.

I look forward to many, many more conversations between us.

Me too. Awesome.

It's Dr. Jen. Bye for.