Keeping Abreast Episode 77: Understanding Reproductive Health Signs with Jessica Preston

Foreign. Today we are going to talk about something that I think we do not shine enough light on, that we do not talk about enough, and we don't talk about what the implications mean. So today we're going to talk about fertility. And I know it seems strange to talk about fertility on my podcast, but as I always say, breast health is health and at the same time, fertility is health. And we do not recognize in our system the implications, the meanings of not being fertile. And what typically happens is that we make no preparations for fertility and we get to that point in our lives where we want to procreate. And then so many people and an increasing number of people struggle with fertility and then what do we do? Rather than dealing with the problem, rather than looking for the root cause of infertility, we force a pregnancy on people and then that can just get kicked down the road until they wind up in. So I brought Jessica Preston here today to talk about because she is the master of fertility and has spent her professional career in this area probably because of her own personal journey. So, Jessica, welcome. I'm so happy to have you here today to talk about this ever increasing problem.

Thank you so much for having me.

Dr. Chen, why don't you start by telling us why fertility is so helping people with fertility is so important to.

You, of course, to give you a little bit of background for me. So I did have my own fertility journey. Prior to my fertility journey, my first degree was in biochemistry, then in medicine. So I'm a physician assistant, spent 20 years in OB GYN helping people with a focus on fertility, mostly because of their needs, the ever growing need. We know now the risk of infertility is 1 in 1 in 4. So it's 1 in 5. 19% on the rise at this point. And I found that I was struggling with infertility, found ended up pregnant on with medication through the conventional medicine method and then started helping people in a more alternative way. The reason being I had a pregnancy that was complicated, preterm labor, ended up with two babies. I had twins, they were born early, 3 pounds each. My son assessed for autism at 18 months. My daughter with impulse control issues. So I'm fortunately trained in functional medicine, healed my children through functional medicine and really felt I needed to heal all the babies and then thought prevent it in the first place. So I was really going to help egg and sperm development and health more so than the infertility aspect. And when I did that, I found that we were reversing infertility and that was where it all Went it all started. But the truth is exactly what you said. When we're looking at infertility, it is our first sign that something isn't going right in our body at a younger age. And we're seeing it. It used to be a concern in our 30s, now it's in our 20s. So we're seeing the same stats, the same 19%. So one in five people struggling to conceive when they're even in their 20s. No one knows what to do about it. So it is about not just forcing a pregnancy on our bodies. It really is looking at the root cause, the why, why are we here and when we can help with that fertility and healing our body in the fertility space, it has that beautiful ripple effect of improving our health overall.

Absolutely. So I'm curious, how does someone, I mean, in this country, unfortunately, as you very well know, no one worries about something until they failed. Right. Like no one is prophylactically saying, is my health the best that it can be? They don't deal with their health until they have a major health crisis. Even minor health issues don't get dealt. It has to be somehow affecting your life or it has to be a crisis. So I would love for you to kind of lay out to start. How would people know in advance if they would have fertility issues or not? Like, what are the signs of reproductive health? Right.

Thank you for that. So when we look at our menstrual cycle, we're supposed to have one period every month. So one every 28 days. That's when you have a period on the first day that you bleed is day one of your period, if you count it out, every day until the next day one, that would be your length of your cycle. So that is normally, normally 28 days. So if we normally have a 28 day cycle, we have light to moderate flow, not too light, not too heavy. And I know that's really so subjective. So that's a, that's a challenging part to describe to people. Having some cramping is normal, but debilitating, Debilitating cramping is not. So if you have periods, cycles, menstrual cycles, that are shorter than 28 days, longer than 32, and I'm being very particular with my window here, because we ovulate two weeks, 14 days prior to that first day of our period. So we really want that ovulation right around day 14. But it's okay, we can have some variety in that when we're over 32 days. Some people say 35. I'm a little tighter with that. With 32, if you're under 27, I would want to know because that ovulatory cycle can be an indicator that we are struggling with fertility. Really heavy cramping can be an issue with fertility. Very, very heavy, heavy flow with lots of clots, or very, very light, scant flow. People think they're lucky, but sometimes that's an indicator that they're actually not ovulating.

If you do not have a regular cycle in that, if sometimes it's 28 days and sometimes it's 32 days, and sometimes it's 29, does that mean that you're having ovulatory dysfunction?

So it could be ovulatory dysfunction, like primary ovulatory dysfunction, or it could be something that is implicating that ovulatory dysfunction. Your thyroid might be implicated in some fashion. Your. Any kind of autoimmune can cause an issue. Your blood sugar and your insulin, that can cause an issue as well. So there are a lot of reasons why you could have that irregular cycle, which then ultimately does mean that there's likely an ovulatory issue. Ovulatory issues are our major problem. You've heard of polycystic ovarian syndrome, pcos. That is something that we can see as well, which is an ovulatory issue. But it has so many factors. So it's not. We don't want to just pinpoint ovulation in itself, as with anything with functional medicine, as a holism lens. So there are so many aspects to look at it. The issue that we're really seeing a lot of now is people are getting normal. Normal lab tests and they're not able to get pregnant, and they are not ovulating or not ovulating appropriately, or they believe they're ovulating with those LH surge kits that they're getting online. But they're not accurate and you're not actually ovulating.

So what is it. What is it about, like, what should people be looking for that would set off an alarm bell in that? What's happening now is you just said all your labs are normal. Is the problem that we're not measuring the right labs or how. How is that normal tag getting assigned and what should people be looking for? I guess my question is, what is ideal? What labs should be measured and what is ideal?

Yeah, no, that's a wonderful question. So we are looking at all of your sex hormone labs. When we're looking in conventional medicine space, we are looking at your estrogen Your progesterone, where it depends on who you're seeing. For me, I always get your testosterone for a woman, because your range, they can call you normal, but that's for men's ranges, not for women's ranges. So we want to look at testosterone. A lot of fsh, lh, a lot of people are looking at amh, anti mullerian hormone at this point in time. I'd love to talk about that for. At some point when, when we can. It just, it's a, it's a test that when we look at it, it can be scary because it can be low. And historically it was thought to be an implicator of your egg reserve. And it can be an indicator, but it implies that you can't change it. But you can. With our functional medicine intervention, you can actually change that and bring that up.

Have you seen that happen? Have you seen that number go up?

Always, always, all the time. And it's actually, it's a beautiful thing to watch because when we do, when I see somebody's records and their AMH is low and we take a look at it, it's give me 90 days and we're going to see an improvement. And people are, they feel relief. And the relief is so important that they feel so that they can know. But they can know that they do have this egg reserve if they don't take our word for it. But we do have a really high success rate. So usually they do take our word for it on the journey as they start getting into the whole making change, they can feel it, you can feel the difference. So a lot of the labs for conventional medicine, I was in conventional medicine for almost 20 years, and there are normal ranges and there are ratios that we can look at. I don't want to get too in depth for audience. There are ratios we can look at that say this is abnormal. So there's an FSH LH ratio that can look abnormal for pcos. And that is one of those indicators where we say this is something that means you may have pcos along with your history and your ultrasound results. So we can put all of that information together. But if those, if that ratio isn't off, you still may not be ovulating appropriately. We aren't looking at the right ranges and we're not looking at necessarily the right testing either. So we don't look at estrogen metabolites in conventional medicine, but we do in functional medicine, and that's important. And the other part, when we look at functional medicine, for your viewers, if they Want to read about something that the best thing I would look at for reading is estrogen dominance. So that's not something discussed in a conventional medicine lens, but in functional medicine it is. And so that basically is more of a ratio issue and also an estrogen metabolite. And I know you know all about this.

Yeah, that's, that's a ratio of estrogen to progesterone.

Yes.

So, and is that not being measured in conventional medicine? How else are they diagnosing something like pcos? Because isn't that a function of estrogen dominance?

Right, it is, but estrogen dominance is not a term that is used in the conventional medicine space. So what they're looking at is, are your ranges normal when it comes to estrogen, progesterone, fsh, lh? They're looking at normal range when they're talking about a PCOS diagnosis. And what we do a lot more in functional medicine is also symptom based. But so PCOS is a great example because it's so common, it's so prevalent. At the same time, polycystic ovarian syndrome is a syndrome. So when we're talking syndromes, we're talking about collections of symptoms. And so in conventional medicine, we do collect those symptoms for you, so we can call you pcos. And it seems to be more of a loosey goosey diagnosis that can actually get people scared, going online, reading PCOS and seeing you're not going to be able to have a baby, which then in turn causes more stress, which causes more of an influx and uptake in cortisol, and then in turn a decrease in progesterone from our own physiologic function. So we need to get a handle on this, get better education out there and then talk to people about what do syndromes mean, and understand that there really are lifestyle factors that we can make a change with so we can move you out of those ranges. That being said, we are seeing people with PCOS symptomatically with normal ranges. And there's something now called skinny pcos. Historically we thought it was for people that were just overweight, bad acne, hersages, facial hair. That's not necessarily it anymore. You can have someone 105 pounds, very complected and perfect skin like yours, and, you know, the perfect picture and not knowing what it is, but it's a skinny PCOS picture.

So.

So we're moving out of the range of being able to look at these labs where we can say pcos proper estrogen dominance is more of a broader Spectrum view. I'm trying to think of in the functional medicine lens, which catches more in that than that narrow lane of pcos, which is trying to now have outcrops of skinny pcos. And how many, how many symptoms, which we have in medicine, as you know, there's a requirement of how many symptoms you have to have or how many lab studies, studies that are abnormal, you have to have to have a diagnosis. In functional medicine, we're a little bit more catch. Catching that because we've seen it so much and because we can see exactly the estrogen dominant picture. Yeah.

So we talked about measuring estrogen and their metabolites, Progesterone, testosterone, fsh, lh, amh. What else, what else are you looking for that is different than the workup that people are generally getting inside of their conventional medicine offices?

Yep. For me, I want to look at your fasting insulin, A, hemoglobin A1C. I want to check your thyroid, a TSH, a free T3, free T4, a reverse T3. Those I always want to know because when we have, we know our adrenals, which is our cortisol, tend to have an issue before our thyroid does. And when we look at a picture of a woman who is in a high stress state where we're in that estrogen dominance or even we're just in that high stress state where we're presuming that's our picture. I want to know what's going on prior to, you know, what's going on earlier on in that cycle. Do we have something that we need to look at there? I want to look at your prolactin level. I want to look at, I don't always care for a cortisol level. I'll be very honest. The cortisol measurements, you know, first thing in the morning, those aren't accurate. I don't love those. I will do some of the saliva tests that look at our, you know, our circadian rhythm of our hormones. And in addition, how is our, how is our cortisol pattern? Because that can give us some information that I'm happy to look at as well.

Yeah, that's far more reliable I have found in my practice is knowing what is your cortisol when you wake up, what is it 30 minutes later, what is it 60 minutes later? Where's your mid afternoon, where's your evening cortisol that I, that I think is a really important indicator. And then if you're not sleeping, what's your cortisol in the middle of the night?

Absolutely.

Because all of these things that, that cortisol pattern really matters.

Yeah.

Right. Like if you're low in the morning and high at night, your body thinks that you're crossing an ocean or you are constantly being chased by a saber toothed tiger, it's not letting you rest at night because you're on high alert.

Right, right. So and when we're doing our in between testing, I think for your audience who might be saying maybe that's for me, the things to look at for yourself is are you waking up in the middle of the night between 2 and 4am, are you having that, that middle of the night awakening, I want to know sleep pattern? So for a lot of what we're doing as well, for what you're doing is taking the history that's really in depth to see what is your life like on a day. And so do you wake up refreshed in the morning? Are you struggling to get out of bed? The other question is, has that been your entire life? Do you sleep well through the night? Do you fall asleep quickly? Too quickly is also an issue. Right, so do we fall asleep? How long does it take? I don't remember my head hitting the pillow. If that's the case, we need to know about that too. And then are you waking up between 2 and 4 in the morning and then unable to get to sleep? What's happening during that time? Do you wake up because you have to go to the bathroom? Do you wake up and then your mind starts going and you can't stop it? So so much of our history and what we're doing on a daily basis is, is so important to think of. And that's something I really want people to think about. Not just for fertility, for with your work or any space with hormonal balance. That is a very important thing to think about.

Yeah, absolutely. So you're measuring a full thyroid panel like you said. Maybe you're getting that five, five point cortisol test.

Yeah.

You're looking at insulin and glucose in a fasting way and the hemoglobin A1C, which is a measure of your glucose over a three month period of time. What about CRP? What about vitamin D? Where do they figure into what you're thinking about?

Okay, yes. I didn't know how far in depth we're going here. So yes, we can do a deep dive.

My audience is real astute.

Okay, wonderful. Okay. I'm, I, I never know. I always want to make it so people can understand. So everything comes from inflammation in, in our Mind. And also I want to think about our polyvagal lens. Lens also. So polyvagal theory, which is where our. Let's make that simpler. Although your audience probably is aware of polyvagal theory too. But it's a. It's an autonomic nervous system balance thought. So basically it's. Are we triggered into a stress space? And what does. What happens with that? And mast cell activation syndrome, Your people probably know about that as well. I don't know.

That one may be pretty in depth. So you can talk about it.

Right. Okay. So we are seeing so much more of an increase in illness across the board. And as we said, fertility is what hits you first or earliest. It's a warning flag. It's a red flag. Infertility. Yes, infertility. And so when that happens and that red flag is waved, we need to start thinking about everything in our entire holism, our entire system. So when we have a stress mast cell activation syndrome, when we have a stressor that occurs, we have a. In our mind, the first thing happens is stress occurs. And our most primitive innate immune cell is a mast cell that degranulates, causes an inflammatory response and that. Actually think about it like people get stressed out and they get flushed, they get red on the back of the neck or whatever it may be. This is a normal response and it's gotten out of hand. Okay, so that is affecting the majority of us. Is it actually affecting us to a point where we can't, we can't control it? The stats are about 30% of people have mast cell activation, which is an inflammatory cascade through your body, which is out of control in a way that our nervous system is not able to calm it down. So it's really important. So if that's 30% of people, we need to be looking at all of that. So we need to look at your crp, we need to look at all of your inflammatory markers. We look at an entire panel. So. And I'm going to, I'm just going to give you a little disclaimer. I have a medical practice, Michigan only, where I'm doing this. Our coaching model is nationwide. We don't do testing in our coach, in our coaching model, but we do work and collaborate with functional medicine and conventional medicine providers nationwide. So this is really my mission.

And I'm sure you, you probably do what I do in the scope of coaching, which is these are the labs that I measure and these are what I ideally want to see in terms of results. And if you're falling outside of these Ideal ranges. Because we can't go with what the lab values say. Like, I'll take thyroid, for instance. Right. So with tsh.

Yeah.

If you look at a national lab, tsh, thyroid stimulating hormone. That is the hormone that is made in your pituitary gland that travels down and to your thyroid and tells your thyroid gland we need more thyroid hormone.

Right.

So the range for normal TSH if you're at a LabCorp or a Quest or something like that is like 0.5 to 4 or something, or 4.5 or something like that. And we have to understand that that means that 95% of the population falls within that range. That is in no way shape or form ideal.

Right.

We have to remember that as a society. And I only really know the statistics in the US, I don't know the international statistics, but in the US less than 10% of our population has ideal metabolic health. Less than 10%. So how can we say our labs are normal when the scope of what we're assigning to normal is already abnormal?

Right. I know. And then the.

I don't want to be amongst this group. This group is actually failing.

Right. That's it. Well, and you can get an idea. Especially tsh. And it's just, I, you know, it's wonderful. So for us, tsh, as close to one as possible. It's a simple way. As close to one as possible.

Yep.

If I see you above two, I'm. I'm on it. I, I'm not.

I'm really on to. You're looking for reasons.

Yep, absolutely.

And while we're talking about inflammation, what we have to remember is that if your body is inflamed, if you are under the influence of cortisol more than 5% of your day. Right. If you have an exaggerated stress response. We are very primitive beings. Our body knows two states, safety and danger. If your body thinks that it's in danger, this is not the time to bring a child into the world.

That's right.

How will you protect said child in this dangerous time? Which is so true.

There's a perfect transition back to polyvagal theory. So basically, polyvagal theory is this switch, you know, when are we going to be in safety and when are we not going to be in safety? And it's not quite the way that we used to think that it was, which is, you know, fight or flight, rest, digestion, procreate. So it's, instead of being like a, a lateral line, it's, it's, you know, it, it's more of A, we have devolved from a safe space in ventral vagal, you know, to a dorsal vagal state of being first fight or flight. And then below, fight or flight is freeze. And you can see that you basically can descend into this space. And we've gotten more into a frozen space from. We don't, we won't get into it. But you know, societal conditioning and the way things are going in that space and what we actually have to do is we have to have, we have to ascend through fight or flight in order to get to safety. So it's a real challenging space to go to and we have to actually help people get through. And that's where coaching is so important because people can't necessarily do that on their own. It's very hard for, for somebody to pull themselves out of that fight or flight state to the point where that we've developed too. And in that primitive brain space, as you say, like we are just triggered back into our primitive way of being. And that is a reactivity, it's a reactive response. And getting us more into that hypercortisolemia, our cortisol is getting higher. So what do we need to do? And that stat of 5%, I'll be honest, I didn't know 5% of the time. Only that's our limit. What a hard thing to hear. Let me just say it's hard for me to hear. And I live a good, like, like I, I nurture my nervous system like, like nothing else. And to hear 5% makes me feel almost defeated. Right. But it's not, it's not, it's.

Okay, well don't feel defeated.

Right.

We have to understand where that comes from. We are modern beings living on a very old gene code.

Yeah.

What were our threats? Our threats were saber toothed tigers.

Right.

So what happened if you and came out of the cave in the morning and encountered said tiger, you were running like hell away from the tiger. And in a matter of seconds, right. Not minutes, not hours, not days, not weeks, not months, seconds, you either got away from the tiger or you were dead. Right.

That's it.

That is all the time we are meant to spend. That's in sympathetic drive.

That's it.

Get away from the tiger.

Yeah.

Or die.

No, that's it. I just didn't realize it was so small. 5%. And when you, when you think of it like that primitive time, that makes sense. 5% this time. Because now our sympathetic activation is changed. No, there's been no, our genes haven't changed.

That's the Thing it is. The world has changed, but our genes haven't.

Yeah.

And this is why it is so important. And I will give a plug to like Asha Gupta with the Gupta program to Joe Dispenza, to Emily Fletcher, to Tamara Levitt. You have to find a way to manage that response. You do have to find a way to manage that stress response. We need modern tools to deal with this modern world because otherwise you. It takes over.

Yeah.

Everything in your life is a saber tooth tiger.

That's it. So I find that what we have to do at this point, because it's hard. We people are so stuck in their cortisol cycle in their sympathetic nervous system, they can't pull themselves out. We need that way. So I love the names that you. That you listed. Want to add Michael Singer on there? I think Untethered Soul is just so empowering. Something that can give you some empowered space. I love the masculine, feminine dynamic work. So I'm a big fan of John Wineland. That might be a little bit further in. And we do a lot of relationship work. So I think community and relationship. Making sure that you have those close people to you that can help. That you feel safe and help me, can you help me? Those are so important because we do need to find a way out and it is a struggle. So that is where I think that also finding people that work in the. Not just the conscious space, because that's only 5% of our thinking is our conscious space, but our subconscious unconscious space. So working with biofeedback, working with hypnotherapy, getting in past that brain that can't stop the monkey mind, the part that can't stop going because we're so chronically in sympathetic. The other part I think people really need to realize is we're. We are. We're addicted to it. And let me tell you what I mean by that. When we're addicted to our sympathetic state. When we're in our sympathetic state. So if it seems. If our body feels like it's relaxing at all, your brain is going to find a way to ramp it up again. So you actually have to break an addiction cycle because we're addicted to that sympathetic. We like homeostasis. Our bodies like to be completely normal. And that normal isn't normal these days. That normal is totally abnormal. With sympathetic dysregulation, our limbic system is completely haywire. Our autonomic nervous system is out of control. And so what we absolutely need at that point in time is to find a way to change it. Now, let me tell you what happens a lot of the time when we do that with people and we have a change made, especially when it comes to hypnotherapy or biofeedback. Let's take biofeedback, for example. Heart math. We use a lot of heart math. So breath work, having decent breath work. Just when we breathe a certain way, it actually automatically puts us into our parasympathetic. So we need to retrain ourselves to breathe. What happens so much of the time when we're training ourselves to breathe, retraining ourselves to breathe, is we feel like we're hyperventilating. We feel like we need to stop, we need to just trash it, we need to throw it away. I need to do something else. I need to get back on my hamster wheel of sympathetic activation. So when we're going in that direction, we need a way to retrain. What we need to do when we're taking on something like our sympathetic nervous system is be aware that we're going to be uncomfortable. We're uncomfortable already. We're in our sympathetics, so we're already going to be uncomfortable. It's going to take a while to change. So we do have, for our people 15 minutes twice a day of biofeedback, and in 90 days, you're going to be okay. What happens is it's kind of subtle at the beginning. You just have to get yourself in that space where you're going to be regulating or reregulating where you are. And you have to break the cycle of your addiction to your sympathetics, because that's your normal. That feels good to you, and it's harming yourself. It's harming yourself. How many times do people think, I just wish I didn't have to think about this. I just wish my life was different. I wish I didn't have this negative. You know, you. You know, people, they do something negative, they get out of it, and then they dive right back into something else that is negative because they're addicted to their symptoms.

It doesn't even have to be something negative necessarily.

It doesn't.

I. I will give you the perfect example. When I wrote my book last year, I. It took me around eight months of really, really focusing. It was probably a year and a half from when I started to. When I finished, but it took eight months of really, really focusing down, working every single night until midnight. Sorry. I know I shouldn't be doing that. I. I fully am aware. But what drove me is I gotta get this done. I Gotta get this done. I gotta get this done. I gotta put this out there, I gotta get it behind me. And whether I was addicted to that sympathetic drive or whether it was the sympathetic drive that just allowed me to do that. And all I could think of the whole process was I just have to get this done so I can put it behind me and breathe, right? I can't breathe until this is done and out there. And what did I do the day after I finished that book and published it? Picked up another project, started my second book.

That's exactly what we do.

What wrong with me? That's it. What is wrong with you?

So, and you know what this is, and here's the thing that's like you're providing a service, you know that you are, you're doing such good work for the world and it's, and when you're writing your first book and it has that ideas, those ideas behind it, you're like, ooh, I have more thoughts about what I want to put in paper. But it doesn't go with this theme. I want this theme so it makes sense and we just need to pay attention. It is good work. I think what we need to tell ourselves is there's never going to be an end of projects. So if we know that. Never, never. And so I just started, you know, I started this business and we just got involved with a big collaboration and I know that's going to take a bit of time and take us a different direction and I don't know how I'm going to add those 20 or 30 hours to my week, but I'm going to do it. But I also know when that's done because it's a 10 week intensive. When that's done there will be another. So I'm not going to kill myself over it. We can't kill ourselves over it. We have to be reasonable, delegate where we can understand that, that deadline, it's, it's never going to be done and behind us we're just moving to the next. So as long as we're aware, it's a continuous, like it's a continuous set of what we're going to be doing and we just need to be very aware. And there are, now there are some things that we don't love.

We need to build a skill set. We need to skill set because if we're not, if we're not taking care of our response, right, that's the thing. The stressors don't go anywhere. They're not going to change, they're Certainly not going to change for me. I don't know. You know, maybe someone else can go from where they are professionally now to like a virtual island. I'm, I'm living in this, in this place for the next 10 years because I have something huge that I'm building. Right, right. Yeah. So I know that there's no end in sight for me anytime soon. I may have periods of time where I don't have as much on my plate, but my plate is ever, ever, ever overflowing.

Are you able to give yourself a time? Like, I've just started taking some time off on the weekends. Like, can you give yourself noon to 4 on Sunday where you don't let yourself do something?

Not now. No, not now.

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Back to our show.

So I think that now more than ever, and I don't, I'm not so special. I think there are a lot of people in my position. It's the, you know, single mother that has to work two jobs to make ends meet. It's the, it's the, you know, person who's building a business and building a business, you know, it is totally. Entrepreneurship is totally different than working a job. When you work a job. I don't care what job it is. When I was a surgeon, but I was an employee. So, yeah, I worked a lot of long hours, but when I was done, I was done. Right, Right. When you're an entrepreneur, it's never done. Right. It's never done. When the business is yours, it's never done. When you're building a business, it's never done. Like, I love all these people who, like, I want to come work for you. I want to build this with you. I was like, no, you want a job.

That's it. I am the same. I am the same.

You would, you would build something, right?

Yeah.

You want a job or if you.

Really knew what building this was, you probably wouldn't necessarily want to because the level of mission person, mission purpose, passion, you have to have to build something like this. Yeah, it's, it's all encompassing. It's all consuming. You have to have people around you.

Who love you, but you can sacrifice your own health in the process because otherwise no one's going to do it.

Right. Like, you don't take care of you.

You can't. You can't do it. So that's why when you talk about breath work, and I just want to call out, like, James Nestor and his book Breath, which is amazing, and people like Satchin Patel who lead amazing breath work practices, you have to find your thing. You have to find the way that you are controlling the environment's impact on you.

Right.

The same way that you don't drink out of plastic bottles. You can't suck in toxicity from the environment and let it have its effect on you. Like, you have to be in charge. It's the reason why we don't get up and on our cell phones first thing in the morning. Right. Because if you do that, you're on someone else's agenda and not yours. We all need to be on our own agenda and control what. We have to be in control of what we let the environment in due to us.

Yeah. Your audience is probably well aware, you know, those are dopamine hits and they're a false dopamine hit. They, they are a rise and a fall and they, they form also their own addiction pattern. And I don't, I know I've said the word addiction a lot more loosely in, in our conversation than a true, like, addiction. Addiction. But it really is a biochemical change that happens in our body and we need to honor those. But breath, just to go back to breath for a quick second. It is a way to for. For all humans to be able to get into that Paris parasympathetic. Even if it's momentary, even if it's just for short lived feel it. And those people that if they feel anxious from it, just be aware you need more of it, not less. Yeah, you need more of it. That less.

That's an amazing point. If it makes you anxious, you need more, not less.

Yes, that's it. Not a quit. I can't do that. That one doesn't work for me. Let me find something else. No, it's actually let's find a way to get you in.

So I feel like I totally derailed you. So I want to come back to. For the teenager with cycle irregularity because I feel like this is where it starts.

Right. Yeah, it really is.

Teenager with cycle irregularity that goes to her ob GYN and that person gets put on birth control pills at, you know, 13, 14, 15, 16 years old. Like what do you think of that and what's.

No, thank you for that. That was. That was my life for so much. That was so much my career. So here's the. I just want to be very clear. I want to take all of those teenagers and make them fertile. The problem is I'm now making teenagers fertile, but I can't. Not so there's a lot of consent involved. I will get a standard. I don't go as in depth when it comes to labs usually with teenagers, as I do for fertility, depending on their presentation. If I do feel like I need to go with the inflammatory markers. I always also want your lights, LFTs, liver function, kidney function, your basic general labs if they haven't had them done. Because a lot of teenagers have not had all of those labs done. I do want the more comprehensive thyroid because we get more information from that depending on their history, I might add in some other things. I don't always get CRP on teens, but I can. I will also. Do you know SED rates. I'll get ANAs depending because we're seeing so much more in the way of autoimmune condition in. In children while children teenagers. So I do want to catch that early if so so that we can get on it. My daughter had an elevated ANA and she was, I think around 12. She doesn't know and thank goodness I ran it. Who would have run that? Nobody would have run.

I'm glad you said that because that is something that is reversible.

Yeah.

If you, if you address it.

That's absolutely true.

And now continue to do the same Thing.

That's it.

Right.

Like, right.

It's the definition of insanity. Continuing to do the same thing and expecting a different outcome. But if you figure out why that ANA is positive, then you can reverse that.

Yeah. And for her, it was. It was gut. It was anxiety. And those were our main components where gut anxiety.

And sometimes they are one and the same.

They are actually.

If you have an inflamed gut, it is going to cause anxiety because that is just the way through the vagus nerve.

Absolutely.

What we traditionally thought about in terms of vagus nerve messaging, because it's the. It's a cranial nerve. It's cranial nerve 10. So we typically thought that it was a message from the brain to the gut, but in fact, it is probably way more of a message from the gut to the brain.

Yeah. And it's bidirectional. And so also our microbiome has a big component in that. And she was on antibiotics when she was little. My babies were born three pounds each. And there were. She had some issues at that point in time. And at that point in time, even being in functional medicine and everything, I'm a scared mom who is basically deferring to my pediatrician saying, okay, what needs to be done? Just get it done. Just get it done. Because you want to keep that baby safe. So no matter what, we. We too, may make mistakes in that space, but also was necessary. So there's just been so much cleanup after that, and we're still, you know, we. She still lives in this environment, and so there's still cleanup. That's going to be. It's a constant, constant cleanup. Let's get back to that teenage picture.

Yeah.

So, yeah, so Ana can be reversible. I don't get them on everyone, but if it looks like somebody. And these kids, usually there are two pictures, usually for these teenagers that come to see me. One is my periods are horrible, heavy, debilitating. There's nothing I can do about it. I can't get on top of it. Let's talk about them for a minute. Then we'll talk about the ones that have infrequent periods. Okay. So the ones that have the debilitating periods, they're very heavy flow. We don't know what to do. We're going to. We're going to get our labs. We're going to get a good history. I may get an ultrasound. It's possible. I may not. So for them, the question is, do they go on birth control? Let's say they even do go on birth Control a large number of them. The birth control is not controlling their bleeding. The, the birth control pills. The IUD said I'm not a huge IUD fan. I'm not a huge. Any of it fan. The next one, just a little rod in your arm. All of these things can potentially help control your bleeding, but may not. It's still giving us a signal that there's something abnorma going on. If labs are normal, no matter. I can't say a broad overall, I usually try to. I want a good idea where you are for your stress life. I want to know how you do in school. Now, this sounds a little off, but another area that I work in is. Is genetics. Like the cheek SWAB genetics, the PGX genetics.

Okay.

And so there are some SNPs, single nucleotide polymorphism that are really also focused with estrogen metabolism. The COMTI C O M T, for example. There's another one that is. There are a couple that are not related to hormonal regulation at all, but they are very much related to cortisol. So there's one called SLC6A4. It's one of my favorite genes. That gene in particular tells us about stress resilience. So if you have one of these SNPs, we presume that you have a decreased stress resilience. And in study it has been demonstrated that you have that you are more prone to hypercortisolemia. Decreased stress resilience. Okay, so hypercortisia, hypercortisolemia, decreased stress resilience, increased risk of ptsd. So when that's the case, so essentially.

It means that stress affects you more than most.

Yes, exactly. So what I love these teenagers are there. They. They're there with a parent usually, which is great. They usually come with mom, which is wonderful. It gives me an opportunity to say, did you ever find to the child in front of mom, did you ever find when you were younger that you would like all the. All your siblings are around, but you'd lose it more than somebody else? You're the sensitive kid. You know, you can't say anything around them. Yes, that's the way it is. You know, you didn't get an ice cream. You were the last person to get your ice cream cone. So you lost your mind because you were the last one to get your ice cream. So what's really great is they say, yes, mom now says, wow, this isn't a kid that is just working the system. This is a kid that actually has a SNP that says that they have decreased stress resilience. Stress impacts them in a harder way. Good to know. What do we now do about it? Because what we can do is I can put you on some supplements for that. I could do that or. And you can be on a supplement forever. I can put you on an adaptogen where we can help your cortisol regulate. I can put you on ashwagandha. The other thing I can do is I can teach you some regulation skills. So definitely breathing. Neurofeedback is helpful. Biofeedback is helpful. Start teaching these kids and their moms how to have conversation about how much is too much. So I had one. One example, I had a young woman, she was actually about 20, and we would have a conversation about how much is too much with your college friends. So she wanted to go away to a concert for a weekend, camping, concerts, one of the. Anyway, so she said, I don't know if I can do it. So we figured out who she was going to be in a tent with. It was somebody that was supportive to her. How much time can you spend with people? How much time do you then need to go be by yourself? And this sounds like it's a lot, but she wanted to go and didn't want to miss out, really wanted to be there, really loves her friends, gave her a system. She came back, had a beautiful time. So sometimes it's really about how much can you handle and understand it's not your fault, it's not your fault, this is who you are and it's okay. Also when you know that and you have inputs that can cause more stress to you, saying, okay, is this a normal stress response? Am I, am I, is this impacting me more than it should? And even if it does, give yourself the grace because it's who you are. So it's okay if it impacts you that much. We just need to say, then, okay, what are you going to do? Give you the tools to deal with it. So I think when we see some of these genes, there are about four different genes. I look at that. If I could make a lab test, which I might someday, basically I want to have a vaginal microbiome test. I want about four genes on it. I want blood tests, saliva, So I want all of the things in one, in one report just condensed. I would love to have these genes because it can tell me, are you going to have a decreased stress resilience? If I know that as a teenager and I give you some of those skills when you're a teenager to be able to Help modify how you're reacting. Realize when we help your cortisol normalize, your sex hormones, your healthy sex hormones will, will flourish. In this instance, we're not talking about with detox and any other, you know, foods or gut imbalance, anything else that we might need to do, but this is number one, and I'll tell you why. I can fix your gut, I can fix so many things. And now if your brain, your nervous system now says I'm out of control, it's going to disrupt everything we've done. So I can take out the bad, I can put in the good, I can balance your microbiome, I can have you eating the right foods, I can have make sure you're digesting appropriately, chewing right. But now all of a sudden, if I have you with a preponderance of sympathetic nervous system activation, what happens? Our blood flow goes away from our gut, our digestion shuts down. We're going to our stomach acid changes. We're not gonna have enough stomach acid, appropriate stomach acid concentration to be able to trigger the pancreas to release digestive enzymes to digest our food, to absorb our nutrients. We need the nutrients as building blocks to make our hormones. If we don't make sure that your nervous system, number one, every day is intact, it must be intact or all of the other work we're doing is for not.

Yeah, and it's important to mention that this isn't just for the teenagers or the 20 year olds or the 30 year olds. It's for the 40 year olds and the 50 year olds and the 60 year olds. Because these are the same things that are important every step along the way. Absolutely. Whether you're still menstruating or not, whether you've had breast cancer or not, this is all important because in the same way that fertility is health, breast health is health, right?

Absolutely.

All of these things, it's true for everyone.

And you're seeing that in yours, younger and younger women are with breast in their 20s.

Now, without question, without question. Which, you know, we could get into that. But I, I first want to say, I want to talk about what the problems are with birth control pills. And I just want you to weigh in on what you think is the best birth control method for people. What is the healthiest birth control method for people?

Okay, so back to our teenagers. We have our teenagers that are heavy bleeders. They don't do as well on birth control. We have our teenagers that don't bleed regularly. Either way, it's pretty much the same workup and we can see, you know, is there. Usually the ones that bleed less regularly are more of our PCOS picture with abnormalities. And labs, our heavy bleeders usually have normal labs. I'm a generalization, but we'll call it 85%. So our people that aren't bleeding as much. Our concern as. As providers is we want to make sure that you are releasing the lining from the uterus to maintain health, because otherwise we can cause problems, including, not usually young, but including cancer or precancerous issues inside of the uterus. Yeah, those are more of our people.

Need to hear that.

Yes.

So we are meant to shed that lining every month. It is one of the ways that we detoxify.

Yes.

So if you are on a birth control method that prevents you from bleeding, I would really, really, really think about that. Because you are retaining those toxins. And we are not meant to. We are meant to get rid of them. It is. Even though people don't think of their menstrual cycle as a blessing, it is a blessing. It's an. It's a way for you to rid your body of toxins. And one of the reasons, not certainly not the only reason, but one of the reasons why we see a rise in breast cancer after menopause is because we lose that avenue of toxin, of detoxification.

Right, right.

We're not getting rid of toxins in that way. And you replace it.

Yes. And the beautiful thing about a period is it is a signal on whether your body is healthy or not. So postmenopausally, if you go a year and a day without a period, you're now menopausal. If you have a period after that, it's abnormal. Isn't it beautiful that it's a beacon telling us that there's something abnormal going on so then we can go figure out what is going on. It actually is a great signal for us. So when we look at postmenopausal, and then we'll come back to our teenager. But when we're looking at that, there really is a reason. So when people then remove their uterus, we're removing the beacon that's going to tell us that so much about our bodies. Because the hormonal imbalance is one aspect, and we didn't start with the hormonal imbalance. That is not where things start. That's where things end up. So we need that. That kind of information and so we can go with it. So back to our teenager. I'm so. And you know, I have a teenage daughter and so this is so much in my head. She's 18 and, and this is just. And I'm not practice. I don't prescribe birth control pills or birth control at this point. I don't, I don't prescribe that personally. We have to think about the teenage pregnancy. We need to think about compliance and all of this as well. If I could count on compliance, I would say condoms for birth control is exactly where, where I would want you to go. Basically, that's it. I know we are having a lot of latex sensitivities these days, but I would say condoms for birth control. My next least worst would probably be, well, all progesterone only without any estrogen and nexplanon, the one in your arm, more than the uterus. Because the IUD issue I have is the never pregnant uterus is the size of a walnut. And an iud, even the Skyla, they're big enough that they can cause cramping and pain and they cause inflammation. When we're looking at inflammation, we're thinking of allostatic load. So how much inflammation piles on top of inflammation before something goes askew, before something breaks. And so I'd rather do the least of an issue. So really if I have to, that's the one that I would prefer. Now when it comes to, if we didn't worry about sex, if we are just worrying about regulation of cycle, there are certain supplements that I, that I recommend and lifestyle modification. And usually we can take someone who hasn't had a cycle in 120 days and get you regular in about two months. So it's not, it's, it's. We're actually like about six weeks. At about six weeks we have you regular. And what's interesting, because you know, we're, we're a fertility program. So what's interesting is frequently we hear I just had a 28 day cycle, why am I on day 45 now? Why didn't it work? And we say take a pregnancy test and it's positive, you know, so it can go pretty fast. We would rather disclaimer have you wait three months before getting pregnant because we don't optimize egg health too. But we can regulate you. It is not a, it's not very hard as long as people are willing to do the work. So I am talking about an ideal world. If you're willing to make some changes, if you're willing to. And it really is like giving yourself a bedtime. Nobody wants to do that. But if you are doing this for your Health and longevity. There are ways, once we get all of those aspects in place, where we can give you an 80, 20 rule and give you a little wiggle room, and it's not going to disrupt the apple cart. So that's really. I'm not a big fan.

What does the work look like? I'm curious. Yeah, because this same work, like, if you don't do this work now, you have fertility issues and you don't do this work now, this is. You're going to be forced to do the work later when you wind up in my office.

Absolutely. And so I would like to also say we've just expanded beyond fertility because we reverse diabetes, hypertension and insomnia, depression, anxiety. So we have a menopause, menopause program that's rolling out, a weightness and wellness and weight loss program. Anxiety, depression, and metabolic syndrome. So those are rolling out right now, too, because it's happening and we just need to change the terminology and the specifics of the little. The little tweaks in between. So we start just. I'll walk you through how this works for us. We start with nervous system regulation. I know that surprises you with this conversation. So we start with. We give everybody in advance, this is the nutrition plan you're going to be doing. And we have them take out in the very beginning their caffeine, their sugar, alcohol. So we have them remove things that are challenging to remove before we have you change what you're putting in. We have you stop a few of those things while you're learning. So we give you the information so you can read about it and start preparing yourself. And then we spend a good week or two simply on nervous system regulation. We get you into biofeedback so that you can start feeling calmer about it and give you the tools to be able to make change. So understand that. Think about when you're going to go to your college reunion or high school reunion and you're like, okay, I want to lose weight. I can either change how I eat or go to the gym. I can't do both. I don't have enough time. Well, we're asking you to change all of these things. We want you to exercise a certain way. We want you to have a low stress life, eat a certain way, sleep a certain way, and have good relationships. The so with all of that, you can't do it all at once without a good support. So we start with your nervous system, get you understanding it's okay. Everything takes time. It didn't take you two weeks. To get into this situation. It's not going to take you only two weeks to get out of this situation. So we start with nervous system mindfulness biofeedback, and we educate on how this is making change in your body so that you can actually see it and notice by how you're feeling. And we have people look at their own. We do questionnaires. We have them do their own questionnaires and follow themselves as well. So now you know, how do you feel in the morning when you wake up? Also no phone in the morning. We do the same things, I'm sure that you're doing. So we get you more in that space. Then we bring you into our nutrition. Because now you're like, okay, I can do it. And if I fall off the wagon, it's okay, we're going to get you back on. You know, it's just we all fall off. I still fall off the wagon. It was New Year's, it was Christmas, it was Hanukkah. I fell up and I celebrated all of them. So I was eating all the foods, you know, so within reason. So we'll get you back on the wagon and then it's okay to fall off. It is, right?

It's not okay to stay off.

That's exactly it.

One bad day. Don't let that be one bad week, one bad month, one bad year.

That's.

You can't let. One bad day has to be one bad day.

Right. Well, and then what we need to do is not kick ourselves over it because that'll. That'll trigger our nervous system into sympathetic. And the. Yeah, we just can't. We can't do that. And we also have to realize that when we make a little change in every area, it snowball effects in a positive way. So we can also end up what.

We do most that matters. It's what we do most. Right. And it's not the totality. And no one needs to be perfect. You cannot be perfect. It's impossible to be perfect. And if you strive for perfection, you're only going to meet failure.

That's. Well, that's it. And the thought of perfection I had. We have people who say, I went to a restaurant and I didn't know what kind of oil was in the dressing. I did the. I did the balsamic dressing. I had a salad. I didn't know what kind of oil because they're worried about seed oils and we're worried about seed oils. But we can't worry to the point where we're not going to enjoy going out with our family. And to the point where we think that one salad dressing that isn't perfectly clean is going to completely disrupt the thought of having a family someday. That's correct. To maintain that balance of look, we've got to be okay with ourselves. People, we. And we get there pretty quickly. So it does, it does work out. We do. And people see gains. They see their mood change, they see their weight change, they see their periods change, their. All of it. So much. So much. Yeah.

Okay, so you're talking to them about nervous system regulation, biofeedback, mindfulness. They're following their questionnaires and, and doing self evaluation. And they're seeing their wins when they're doing that.

Yeah.

You're talking to them about exercise, about sleep, about having good relationships and conversely, taking the trash out. Like, this is the time where you have to get rid of the relationships that are not working for you. And this is very important.

It's really impressive how well they do with that once you learn. So we teach imago dialogue, nonviolent communication. Marshall Rosenberg work. So we teach how to have communication. And since we're a couples program, you're there changing the way you eat with your partner. You're. You're there giving each other a bedtime. And if you have a different bedtime, one partner will tuck the other partner in so their relationship is strong. And we're teaching them how, how to have these communication. We give scripts, we actually give you scripts to say, this is how I'm feeling, using I statements and how you can have those loving communications that we are a team. Especially with infertility, there is a lot of, whose fault is this that I can't have my baby? And whether that's a conscious thought or a subconscious thought, a lot of especially we take care of a lot of very professional, high achieving women. Go figure. That's us, right? That's the whole, what do we do with our cortisol and our hormones? Right? Yeah. And so that's frequently what we see. And so we struggle sometimes with very vulnerable conversation with our husbands. And so we want to make sure that we can help women find that vulnerability and help men receive the vulnerability when they're not used to it because we've been together for so long. So we have a team of eight coaches, three men, five women. That's part of our team as well as we have three men all trained in Mankind project work. So they work with the men on sovereignty, you know, masculinity, because infertility can be Very emasculating. Especially if there's a male factor, which is 40% of infertility cases as a male factor. Not ruling out female factor, but male factor alone. So we work with the men and then we work with the women in the feminine space. And we have a somatics coach who works in masculine and feminine dynamic. And we have a good balance of connection. We teach intro to tantra and eye gazing and helping people with connectivity. Because those relationships start with the two of you. Then you start having conversation about. You start becoming sensitive to those people that just don't feel right to you. Where before you just kind of tolerated them or you put up with it or you thought you needed to. Now you're owning your own sovereignty. Like, I don't need to be surrounded by that. Where else do I need to be? And it's much easier to take out the trash than you think once you're given these tools. It's really. I've watched that. You think that is the hardest piece. It's not. It seems to be such an easy disposal at that point in time.

Yeah. So we've talked about so much today. We started off with giving the statistic that one in four to one in five people are dealing with infertility, 40% of which has a male factor that has to do with sperm counts. But so much more. I would love to just talk a little bit about the. So much more. What are the things that are driving these infertility rates?

Oh, so we have three categories for infertilities. We have structural issues, which is like a blockage in the tubes or a varicocele in the testicles. So that's. We have that population and then we have other diagnoses. It's just a category of you have infertility because you have another chronic disease state. So that's basically diabetes. Diabetes, yes, exactly. And then. Right, right. So if you have a diagnosis and you're not getting pregnant, you're in that bucket. And then there's structural. Structural is the one where we do. I mean, we work in turn in hand in hand with IVF clinics. Structural is a requirement that we would need to do that because egg and sperm structurally can't get together in the same space. So we definitely let our people know we will be working with someone. If you don't have someone, we'll find them for you. Then there's the largest bucket, which is about 55%, which is all other catch, all of unknown. And basically those are the hormonal imbalances Those are the factors that are subclinical. Those are the low testosterone leading to low sperm count. And, and there's. So the, these lifestyle factors really are, are factors that are the underlying why of why we are having infertility issues. And so when it comes to. Let's just, I want to, let's touch briefly on male factor. Yes, it's usually low testosterone. We're seeing erectile dysfunction now for men in their 20s. Major thing that we need to look for when you have erectile dysfunction is do you have a cardiac issue? You just need to rule that part out. But so much of it is hormonal and low testosterone, low T related and you can get that in lab testing. Yes, but history taking depression, anxiety, what else is going on that needs to be taken care of. So a lot of mood disturbance underlying this allow a lot of malnourishment. We don't have the appropriate nutrients in our food that we can actually make appropriate amounts of energy, ATP or amounts of hormones. Amounts of pregnenolone for example, which is our precursor to hormones made on the inner mitochondrial membrane that is on the decline. It already declines when we're starting in our late 30s, early 40s, but we're seeing that number being very, very low also. So I do check that one earlier and earlier. Earlier, earlier it is, yeah. And that is a direct relationship to, to stress as well. So the food, we're not getting the right food if we're not getting sleep. So men need to have eight hours of sleep per night to make. We have. They're making their testosterone while they're sleeping. So they need to have the appropriate sleep at night and quality sleep in order to make their testosterone. So that's. And same with women for progesterone. So we need to have our good quality sleep for that. Environmentally we're looking at the toxins. You had mentioned the plastic water bottles, you know, all of our, all of our xenoestrogens, all of our, our PFAs, our Teflon pans, our, the containers, anything.

With fragrance or perfume, anything.

Our cleaning products at home are the stuff we're putting on our body, our makeup. Like I look at my daughter and I just, you know, it's only so much. You control control. You have over an 18 year old daughter. Oh, I know, but it's looking at the makeup on her face and saying what, what are you, what are you using exactly. And hairspray and hair products and the fragrances are out. I don't really allow them here and I have, you know, 18 year old twins now. So I have a boy with cologne and a girl with perfume. So we're just trying to balance what, what is. What is acceptable here. And you can blame it on mom all day, you know, but it's really important.

I think antibiotics are also a fact.

They're a huge factor. And so, and everybody's. There's a lot of, you know, we think that when you go, when we go to the doctor and I know your, your community is not necessarily this community. You need to get something for God, you know, you go when you're sick, so you have to get something. I should get an antibiotic because I came in here and I'm sick and I have paid my co. Pay where our body is meant to naturally heal itself already. So if we can give something, but it's a natural thing instead or some kind of a natural support or. Yes, I'll take you off work because you do need the rest to recover because we don't need to burn the candle of both ends. That I will happily do. So, yeah, antibiotics are, as I saw with my own daughter, it's, let me.

Just say, like allicin, which is garlic extract, saffron threads. These things go a long way towards helping your body to restore health.

Yeah, there's a big kick and it has been for years. And I see it's re. It's resurfacing on oregano oil. I just want to warn people and caution people. You can't take your oregano oil near your probiotics because it'll destroy the efficacy of your probiotics. So at least two hours.

Also, you have to be very careful with oregano oil because you burn. You do.

You have to be. It's so hard because we know all of this and you go on. People go online to find it and they can cause so much more damage than even with, when it comes to it can fertility. Yeah, Supplements. People go on supplements that inhibit their own ovulation and they don't realize it because they read somewhere it would help with their endometriosis. Yes, but it's going to inhibit ovulation. So there. You need to be with a functional medicine provider or somebody who's knowledgeable in this space. So, so, yes. So toxins. Don't forget our toxic thoughts. That disrupts our gut pattern as well. Definitely our, our probiotics. We want to be, we want to be definitely on a probiotic or have. And then have prebiotics in your foods. What did we miss? I mean, I think we pretty much covered all of that.

I mean, that's a pretty comprehensive list where we talked about, at least from the male factor, low T, cardiac issues, mood disturbance, malnourishment, which is a huge factor for everyone.

Everyone.

Our food is just. It's not what it was. And most people who think they're eating healthy are not actually getting what they need. And so many people confuse thin with healthy.

Yeah.

Not the same thing.

It is not. And so thin. I was just having this conversation yesterday. We were watching a football game, and we were talking about how some of these football players are really overweight, and I'm so surprised how well they can still function. But we were talking about they still have muscle and they're still, you know, they're still muscular in that now. I'm not letting go.

Weight have a lot of dysfunction as soon as they stop playing.

That's absolutely. Because I. I work with the next NFL crowd, too, so I completely understand. But our next part of our conversation was the skinny. The fat skinny out there, the people that are slender, but it's because they eat one meal a day, and it's French fries, and that's it. And they don't move, and they just lie on the couch all day and scroll on their phone.

This.

This is not health. This is not health. It's.

I love the people that tell me.

I can eat whatever I want and I don't gain weight. I'm like, yeah, that's not a good thing.

Right?

It's not a good thing at all. Yeah. You are not helping yourself. And this is going to catch up with you. You may not become obese, but you're for sure going to have dysfunction.

Yeah, that's exactly right. And it is harder to get those people that don't see it physically to make change because they don't see it where people see it. If people say, I have a little extra around my. Around my belly, it's easier to get them to make change. And they see change so fast, especially with the work we do. Because we're women, we don't want it around the middle. That's basically. We just don't want it around the middle. And that's the first place it goes from. With the way that we change our food and the way we change our mindset.

Yeah, absolutely. So the people that should be thinking about this is if you don't have a cycle that runs 28 to 32 days, if you have light, scant flow, it's just as bad as if you're having that heavy clotting and a little cramping is okay, but you really shouldn't be suffering through your periods. If you can't go to school, if you can't go to work, if you're, if you're completely dysfunctional with your period, that is not normal. We ran through the list of labs. The only thing that I would have added to that is I just check a vitamin D on everyone.

Yeah.

It is so, so, so important to know what your vitamin D level is. You did mention thyroid. Let's just stretch stress again that having euthyroid, a normal thyroid function is absolutely essential to fertility, but more importantly to a healthy pregnancy.

Yeah.

And we are absolutely, positively seeing the connection between thyroid dysfunction and the later development of breast cancer. So you want to make sure that that is in line. We talked a little bit about birth control. Obviously the ideal thing for birth control is to use condoms. To use a barrier method, that is the ideal thing. And in a uterus that has never sustained a pregnancy, an IUD is not a great idea because that uterus is so small.

Right.

And that those, those IUDs, they are foreign bodies. Right. So they are going to cause some foreign body reaction. And we don't want to do things that are going to complicate or compromise pregnancy at a later date. We talked about the major environmental factors that affect pregnancy.

And.

And then we did talk a little bit about SNPs and those genetic factors that you, that you look at. But at the end of the day, it's about nervous system regulation, biofeedback, mindfulness, exercise, sleep, having good positive relationships and dialing in your nutrition so that your body is nourished, so that it can create the energy that it needs to create and that it can potentially nourish a child.

Right.

Because that, that actually is what fertility is all about.

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So you have a big campaign coming up. Can you tell us about that? Yes.

Thank you so much for asking. So it's brand new 2025. So this year is 2025, the year of your healthy baby. We have found that people are struggling when it comes to infertility. But as you and I have talked today, as you know, people aren't even aware of the issues that they're going to experience. More often than not, I would have women coming to me in clinical practice and say, I'm getting married in six months, I want to have a baby. What can I do to be able to prepare? We have developed a program to help people prepare for pregnancy regardless of their fertility status so they can be ready when you're wondering, you're seeing these infertility rates. You're your best friend, your sister, they can't get pregnant. You wonder what you can do. We have developed a rollout automated six week program that goes over basically the meat and potatoes of what we usually offer. So you're going to get our entire nutrition program, stress management tips and tools, some somatics, what you can do with your body. We're going to talk about how you need to sleep and move your body in order to conceive. And it's you get an app with it and you can roll it rolls out weekly with a module so you're not overwhelmed by it. You have access to it for three months. And so we have put that together for anybody who would like to try to get pregnant for the year of 2025. Our goal is to have 10,000 babies in 2025 through our year of the healthy baby program.

Wow, that is amazing. That is aspirational. But I love it, I love it. So. And people can just head to your website to learn about more about that.

Yeah. So it's year of the healthy baby, year of your healthy baby and it's our baby basics program.

Amazing. Amazing. So thank you so much for being here today. I loved this conversation. I think it is so important. I think it's so important for us to know about fertility in our youth so that it can translate into health throughout your life, because fertility is health.

And breast health is health.

So I loved this conversation. Thank you so much. If you loved this conversation, then make sure that you like this episode. Share this episode Send us a comment, but make sure that you're sharing it with your friends and your daughter and your mother and your neighbor, because this is really important information.

And know that I will be back.

Next week, same time, same place. It's Dr. Jen Awesome.