Episode 47: Get Pregnant Naturally, with Sarah Clark

Hey beautiful, it's Dr. Tabatha. I want to share something with you that I believe God is doing right now in women's health. We're in the middle of a massive movement and most people don't even know it. Every single day, 6,000 women in the U.S. enter menopause. That's over 2 million women a year, and by 2030, that's more than 1.2 billion women worldwide. So here's the thing, most of these women feel exhausted, bloated, anxious, disconnected from themselves, and the medical system is Doctors are handing out prescriptions and quick fixes, and no one is helping women heal from the root cause of their issues. That's where Fast to Faith coaches come in. As a certified coach, you'll be equipped to help midlife women balance their hormones, heal their gut, regain their energy, and reconnect their faith, the foundation that so many of us have been missing. And from a business standpoint, woo, this is one of the most lucrative untapped opportunities in the entire health coaching world. The global health coaching industry is expected to reach over $33 billion by 2023, and midlife women are the fastest-growing, highest-spending demographic in that space. Most importantly, these women stay with their coaches. They invest deeply because they are desperate for lasting transformation— body, mind, and spirit. So if you've been feeling that pull and that whisper that you're meant to do more, This is it. Now is the time to rise, to serve, and build a purpose-driven business that not only changes other women's lives but transforms your own in the process. Because when you help one woman heal, you help her family, her marriage, her faith, and her future. That's the ripple effect that we're creating with Fast to Faith. So join me, click the link to come watch this webinar. It might be the one thing that really moves the needle for you in this next— Season. I can't wait to see you in there. Hi, I'm Dr. Tabatha, the Functional Gynecologist. I'm a board-certified OB-GYN and functional medicine physician. I've embraced the world of functional medicine and wellness through my own personal health journey, and I'm super excited to share my wisdom and unique perspective as it pertains to women's health. So if you're struggling with hormone imbalance, weight gain, period issues, anxiety, insomnia, you name it, Then you've come to the right place. I want to be your functional gynecologist. So welcome.

Hi ladies.

This week I'm mixing it up a little bit. I was a guest. On Get Pregnant Naturally with Sarah Clark. She is a fertility coach that helps women get pregnant naturally. So she had me on her podcast and we talked about some awesome stuff. So I think it's super important for you ladies to get this information because we talk about like conventional testing for fertility. And what the pros and cons are. We talk about, you know, what are conventional doctors missing when they're looking at infertility issues and the way that it needs to be handled. So I think it's really eye-opening when you are taking a functional approach to infertility because it's just so different, and it can be a beautiful thing when you don't have to to go through in vitro fertilization, right? Or do all these other things. You can switch up your diet and your lifestyle and get healthy. Sometimes it's your gut. Sometimes, you know, it's the stress in your life. But I hope that you are interested in this episode. I found it to be really awesome, and that's why I'm sharing it with you. So please follow me on Facebook and Instagram at Dr. Tabatha, Tabatha, no I's, or check my website out, www.drtabatha.com, where you can book a consultation with me and see what I'm doing. I'm also doing a Renew You Sisterhood coming up here on October 25th. It starts— it's a 10-week comprehensive sisterhood program that helps you reclaim your health, gets rid of that stubborn weight That brain fog, that tiredness. It's going to give you freedom from food. It's amazing. We do some intermittent fasting, but we are working on lifestyle changes that are maintainable and that you're going to keep for the long term. So it's not just some quick fix that you're going to regret 2 months later. And the amazing part is it's a sisterhood. So you're all connected, supporting one another. It's so beautiful. And I really hope that you'll be a part of it because it's life-changing, life-reclaiming. Okay, let's get on with the episode of me on Get Pregnant Naturally.

Hey, Dr. Tabatha, excited to have you on the podcast.

Thank you so much for having me. I'm excited for this conversation.

Yeah, absolutely. Yeah. So can you share your journey of really how you came to do this work? I was just sharing with you beforehand when I read your bio. It was just so, so inspiring. It like brought a tear to my eye. And I'm like, yeah, I'd love for you to, to share your journey as to how you came here.

Oh, well, thank you. I— it was a long, crazy journey. You know, I was kind of a rebel child. I didn't listen to authority. I did what I wanted. I didn't really have any interest in school. I just wanted to socialize and have fun. And I got into the wrong crowds and I made the wrong choices, and I ended up getting pregnant in high school, yeah, in 11th grade. And I had to drop out after that to stay home and take care of her, so I didn't go my senior year. And I'd really never thought about my future because I was always living in the present moment. I was just a very spontaneous fun person. And that was a big reality check. And what was a bigger reality check was how I was treated as a pregnant woman, or I guess I was still a child myself, but I was on Medicaid and food stamps, and I was definitely treated differently. I was talked down to. I wasn't, you know, nothing was explained to me. I wasn't given options. I had no voice, no choice in the matter. Things just happened to me. And I had a really traumatic labor and delivery experience that scarred me. And I came out of that with open eyes, like, oh my gosh, there's probably more girls in the world who are treated the way I have been treated, and it's not cool. It's not okay. Somebody needs to stand up for us. And that's when I started thinking about how could I be a voice for women like myself and help them through those times. And I realized I need to be a doctor. I need to take care of women and talk to them and do, you know, have conversations with them and give them a choice in their healthcare and help them understand things and respect them. And so That led me down this long, painful journey to finding my purpose of taking care of women, and I've just committed my life to it. So I went back, I got my GED, I went to a community college, and I kicked butt for 2 years and got a 4.0. And then I got scholarships and I transferred to Michigan State University, and that led to the long, arduous path of becoming a physician. It was Definitely one of the most grueling and painful things I've ever done. I don't regret it for a minute, but it was not healthy for my own self mentally or physically. It destroyed me. And I lasted about 10 years after residency being an obstetrician and gynecologist, but I got to the point where it broke me down and I could no longer function. I actually had a back injury. And I had to do the unthinkable and take 4 months off of practice, have back surgery, which didn't help. And I had to figure out how to heal myself. So I found the world of functional medicine and I healed myself after conventional medicine failed me. And that was another eye-opening moment, like, wow, there's so many tools in the world that I could use to help heal my patients and I didn't know anything about them. And so now I've been on another journey to just gain as much knowledge that I can and just really embrace the world of wellness as opposed to the sick care that I was doing before. And so now I take care of women with conventional medicine and functional medicine.

Yeah, I love that. And it is interesting where we sometimes have to have our own, our own dark night of the soul kind of thing where we all, you know, and then we're like, wait a minute, we discover this functional side of things. And then you You can never look back and sounds like that's kind of similar to you and yours. Yeah, definitely as you're saying through going through medical school, very grueling and brutal and then years later discovering the functional side of things which I think is to me very empowering, the functional side of things.

Yeah, exactly.

And so today I just want to take some general questions kind of around You know, the, the functional approach to gynecology. So, uh, that's what you do. So, but first of all, I wanted to start off with, um, some of the conventional testing for fertility. And if you could talk about some of the basics, if someone comes to you and they've been, um, you know, trying for a year and they're under 35 or over 35 and, uh, less than 6 months.

Sure. So yeah, I was trained, you know, as a conventional OB-GYN that There's a differentiator between women who are less than 35 and those who are over 35 because your ovarian reserve starts to go down. So the definition of infertility was you've been trying to get pregnant for a year if you're less than 35 and you've been unsuccessful, or less or six months if you're over 35. So that would give us the green light to go ahead and start investigating. And it was traditionally like you're going to think of. Possible factors of the uterus, the ovaries, the hormones, and the pelvis. So that— it was very much geared toward, you know, your gynecological issues. There wasn't a lot of thought or concern regarding any other systems or lifestyle or anything like that. So it's, you know, standard to do day cycle day 3 labs and then check of progesterone on cycle day 21. So on day 3, we wanted to see what your FSH, or your follicle stimulating hormone, looked like. That's kind of the hormone coming out of your brain talking to your ovaries and saying, hey, it's time to ovulate. And so you want that level to be low. That level is what gets high in menopause. And then you want your estrogen to be a good amount but not too high, because that indicates that maybe your follicles are maturing too quickly and not releasing an egg. So we do those, and then day 21, you want your progesterone up there. You know, 3 to 5 is a decent number, and you— that would indicate that you ovulated and the leftover cyst is making progesterone to support a possible pregnancy. So we do those labs, and then we usually start with a pelvic ultrasound where we look at the ovaries and the uterus to see Is there anything obvious like cysts on the ovaries or fibroids in the uterus? And the big one is you also wanna make sure that you're doing a semen analysis on their partner because there's not a lot of reason to go on and get— do more advanced stuff with the woman if it's a male factor issue, which it very often is. So I will tell you that men are hesitant to do this quite often. So I've had a lot of patients who go through the rigmarole of getting an HSG done, which is a hysterosalpingogram, which is a very uncomfortable x-ray test where they put a catheter in the uterus and shoot dye inside there and then take pictures to see what it looks like. As far as, are your fallopian tubes open? Are there anything growing inside of the cavity? Or doing surgery, a laparoscopy, and women will go through all these things before their partner finally does the semen analysis, and we find out that they're the major issue. But diagnostic laparoscopy is pretty standard as well. That's where we take you to the operating room, put you to sleep, put a couple little incisions in your belly, and then we look inside and we see like is there endometriosis growing on the outside? Side of your uterus or ovaries, on your bowels, on your bladder, things like that. You can also inject dye into the fallopian tubes during that procedure called chromotubation, and that can see if your tubes are open. And oftentimes, I'll tell you, having done that procedure, women will have blocked fallopian tubes and that will open them. So oftentimes just doing that procedure is enough to help them get pregnant. But that's pretty much the basic, um, workup.

Yeah, and I think it's interesting what you say about the semen analysis because, yeah, women go through all these tests and then wait a minute, the male partner— I speak to many that haven't even had— like, she's been through all this workup and he hasn't even done a sperm count or an analysis. Or maybe it's just a very basic sperm count but not like the DNA fragmentation, you know, Motility in any more detail. As you say, well, it used to be 60/40%, 60% female factor infertility, 40% male. Now it's more 50/50. So really key to get those really, those basic tests, you know, first.

Exactly. And it's such an easy test. Like, literally, I give them a cup to take home to their partner. They masturbate and ejaculate into the cup. They bring it back into the lab within an hour, keeping it warm. And it doesn't have to be embarrassing. They can do it at home. It's not a big deal. You know, it's so much less than going through surgery or these invasive procedures.

Absolutely. And so what are you seeing, or what are some tests or questions do you wish that were asked during an appointment with your gynecologist for fertility?

So I will say, this is what I learned in functional medicine. It's all connected. So you need to ask about the patient's diet and lifestyle? How are their stress levels? You know, how are they functioning through the day? Are they sleeping? You know, these things impact your fertility. And if you are seeing a physician who's not addressing these issues, then you probably aren't— you're probably not going to get the success that you are looking for, or Less likely to, that's for sure. That's what I've seen. I've been so much more successful getting my patients pregnant now that we tackle their diet and decrease their inflammation, and we manage their stress and get their cortisol levels down, and we get their vitamin and nutrient status up to par, and we get them sleeping. We manage their subclinical hypothyroidism or their autoimmune issues like All of that stuff will make you so much more successful.

Absolutely. That, that mind-body-spirit approach too. So looking at the physical stressors on the body and then the chronic stress, even dealing with an infertility diagnosis by itself is stressful. And then the spiritual piece where I see a lot of people, you know, you dig into the functional side of things with the lab testing and making all these changes with diet, but then maybe you just have an underlying belief that it'll never work.

Right.

Spiritual side of things too, digging into those You know, your intuitive hits and spiritual nudges and things with the, you know, the universe, God, higher power, whatever it is for you, that's equally as important. I think, you know, some of the functional side of things.

Yeah, I would say that it's super common, unfortunately, in conventional gynecology, for miscarriages to be downplayed, because they're so common that You know, a typical scenario would be a patient calls the office and says, I missed my period, I think I'm pregnant. The physician orders, you know, HCG levels, progesterone levels, we watch them go up or down, they— and then she ends up having a miscarriage at 5 or 6 weeks. And she's either given medication to help pass it, let it go spontaneously, or scheduled for a D&C. That all takes place, and then we don't see them again. Until the next time they call pregnant, and in the meantime, they have all these you know conversations going on in their head, believing that they did something wrong or they're never going to be able to get pregnant again, or why did this happen to me? And I really don't think that we sit down and talk to women enough about why this did happen and how she can intervene and take. Control of her health so that it hopefully doesn't happen again. And I think because those conversations are hard, and we're not really trained to do that as physicians. And so we just don't have them.

Especially with the miscarriage where they're waiting to have 3. What's your take on that?

Yep. So we're trained to not deal with it until it's after the 3rd one. And then we do this huge workup and, you know, check for all kinds of zebras, all kinds of rare things instead of common things. And so my approach is let's talk about it after the first one. Maybe it was just a fluke, for lack of a better term. I mean, a million and a half things need to go right for your pregnancy to occur and continue on. Like, it is really a miracle, but there are certain things that you can do to optimize that and To not discuss that after the first miscarriage is doing that patient a huge disservice. So often I realize that these women are just you know very busy, super stressed out. Then they're stressed out about trying to get pregnant. They're eating fast food. They're living on Mountain Dew and coffee and things like that. They're a little bit overweight. They have you know. Polycystic ovarian syndrome, or, you know, their blood pressure is starting to go up. You know, things are trending in the wrong direction, and nobody's dealing with it because they don't have an outright diagnosis that needs a medication yet. And so those discussions just don't happen. So I love to step in and say, you know what, you're trending in the wrong direction. We need to optimize Your health, that's your house that you're gonna, you know, grow a baby in. Let's make that the best environment possible for that baby to, to, to want, number one, even exist, and number two, thrive, right?

Yeah, absolutely. With the trending piece, we're looking at— we're doing blood chemistry reviews, so looking at them through the functional reference ranges, so it flags it before it goes to disease. And we're not diagnosing, we're educating. But yeah, that, that trending piece where, oh wait, you know, instead of waiting until you have It's prediabetes or diabetes. Well, wait a minute, there's things, you know, if the blood sugar is going off, there's things that, you know, things we can do right now. And if the weight, or, or if you're eating a, you know, fast food processed diet, there's things we can do to optimize your success. And a lot of times in the miscarriage side of things, waiting, waiting for the third miscarriage, like, that is absolutely heartbreaking. And like, to go through when you could have said, okay, after the first one, here's some things that you can do. And typically in conventional, it's like, it'll be making just very basic things such as, you know, eliminate your— eliminate alcohol, don't, don't do drugs, um, you know, reduce caffeine, and maybe look at you're getting your BMI in the, the right range. Whereas the functional side of things, there's a, there's a very targeted approach and that, you know, that, that you can take. So there's a lot of missed healing opportunities.

Yeah, I mean, I think conventional medicine is trying, or they're starting to see a glimmer of things, you know, when Reproductive Endocrinology and Infertility Society came out and said, "Hey, maybe if we optimize thyroid function, you know, women tend to get pregnant more often." And so then they started looking at that more closely. And I, you know, of course, it's because they have a medication that they can give to treat it. So it's an easy fix. But it did give me hope that. You know, they are starting to realize that all of our systems are interconnected, and if your thyroid's not functioning well, your fertility's not going to function well, right?

Absolutely. We see that all the time. Either it's undiagnosed Hashimoto's or Graves' or hypothyroidism or hyperthyroidism. We're seeing more hypothyroidism, or then the subclinical where it's not even the thyroid. We see typically Most clients we're working with, a thyroid that's not optimized. Are you seeing a similar thing?

Oh yeah, all the time.

Yeah, yeah, yeah. And so what do you— so this kind of goes into the next question there. So what do you think, um, is regularly missed with someone who's struggling with infertility from a conventional standpoint?

Well, I kind of alluded to it. So I think stress is the biggest key because we are all way over You know, stressed. We are go, go, go nonstop from morning until night. Too much on our plate. We're not stopping to process everything. So we are making cortisol and adrenaline like all day long in ways that we're not supposed to. And every time we do that, we steal progesterone from our hormones. And so we get super imbalanced, and that usually You know, leads to infertility. So, or it leads to miscarriage as well. So it, I think stress is the number one factor and the most ignored factor. In addition to that, I would say the nutrition and the sleep, because it all relates to inflammation in your body. Inflammation is the main reason you get endometriosis and fibroids, and you're not ovulating, like so many issues with that.

Yeah, this distress thing, obviously, like the physical stressors, but then the mental-emotional stressors too, with that infertility diagnosis and impacting all aspects of your life. We see people with their cortisol, especially if they've been through— like, most people are coming to me, they've come through, um, either a failed IVF or IUI or multiple failed IUIs and IVFs, like sometimes 5 or 6. Which is crazy. But but then seeing cortisol completely burnt out, people are just there's nothing left. Right. So yeah. Right. They they come to me and they're like, it was supposed to all be perfect. I don't know why it didn't work because you're not addressing these other systems and they're all connected. They're all interacting together. Yeah. As you say, the the getting the the right nutrition and sleep is key. I talk to so many people. They're like, I've got insomnia, or I wake up during the night, or I wake up, I'm exhausted. Like, your sleep is a huge red flag to wait a minute, let's, let's dig deeper as to why it's off. And sometimes it's been off for years and years and years.

Yeah. And it, it could be your gut health. You could have major gut dysbiosis. You could be having too much bacteria in your gut producing toxins that are causing inflammation. We know that's directly related to endometriosis. And infertility.

And so what's your take on the business of IVF?

Well, I think that it's probably overutilized because we're not addressing these other root cause issues. I don't think it would be as needed if more gynecologists were addressing The diet and lifestyle aspects. You know, there's a place for it. I, I agree with it. I get concerned because there are studies that show it increases your risk for ovarian cancer. And then all the ethical questions, right? Like, are you altering the embryos genetically? Things like that. But I think that we probably don't need to do it as quickly and as often as we do, unfortunately.

Yeah, because it was developed for people that have issues with blocked tubes, and now it's being used for, you know, every diagnosis, you know, that, that unexplained infertility, which to me with the functional side of things, unexplained, and there's always an explanation. But like the industry in itself is— it's got a little stat here where it's, it's in the US, it's a $25 billion industry, and it's predicted to grow to $41 billion by 2026. In 1985, there was 40 fertility clinics in the US. In 2015, there's 440. So it is big business.

Yeah.

And I had both my kids with donor eggs. I got diagnosed with premature ovarian failure, and I went right to the fertility clinic, didn't get a second opinion, went on a list for donor eggs, actually thought that other people that had to go through years of You know, treatments were worse off than I was. Um, and then, you know, years later I had my own health crisis where, you know, I became allergic to all these antibiotics and food sensitivities and gut infections and chronic stress. So it eventually kind of catches up with you. But, um, yeah, it is big business and people being pushed through those multiple rounds of IVF and keep doing it and keep doing it. Like, what's your take on if someone's doing it over and over again without laying that— laying a proper foundation for it to even work.

I just think it's heartbreaking. I, I wish people would investigate and just take a step back. But, you know, we are told to trust the medical system, right? And they, they're supposed to have all the answers for us. And unfortunately, It's an answer, but it's not the root cause answer. It's just kind of a Band-Aid. And so, so many people get stuck in the system and don't realize there's another way. I will tell you, I didn't realize there was another way because being a physician in the system, I was so busy and so entrenched and exhausted that I wasn't researching and looking outside of what I had already learned and trained to do. Why would I? What I would—why would I even consider that there would be something else if it hadn't already been that I hadn't been exposed to it, right? So the idea for patients to not trust their physicians and go out and look for other explanations—you know—I don't blame them. I don't. But I want them to do that. That's you know why I started my podcast, The Functional Gynecologist, because I. want women to realize there is a whole nother world. And it's getting to the root cause of your issues. And there's another way. And it is okay to question your doctor. And it is okay to do the research on your own and keep investigating and don't give up and don't just settle. But I think it's scary for people.

Absolutely, especially when you have a trained person, you know, smart person saying, oh, this is the only way you can do it, or, you know, it'll never work for you. doing it this way, or you have a very low percent chance of it working. And that, you know, well-meaning advice, or maybe not well-meaning, you know, this is what they're trained in. They're not— they don't— if a physician is not trained in a functional approach, they don't know how powerful, you know, diet and lifestyle changes are. But that gets embedded in someone's, you know, consciousness, and they can't even shake it because it's like, wait a minute, this, this, this person over here told me it's not gonna work.

Exactly. I mean, I have Cancer patients whose oncologists tell them it does not matter what you eat, it does not matter what your vitamin D level is, and it just makes me sad. You know, and so I'm like, okay, well, we got to keep educating people. We have to get people's eyes open because once your eyes are opened, then you keep looking, right? But you have to get to that point, and so it's going to be a long time. You know, but it takes people like you and I to just keep. Spreading the message and giving people hope.

Yeah, because once you discover this stuff, you're like, why does everybody not know about this? It's like, before I was on my soapbox, and now I guess my soapbox is the podcast, but I literally want— I just want people to know about it and be like, oh wait, there's another way, because I had no clue. I consider myself an educated, smart person, and I didn't even look. to see what was going on in my own body. I completely was so disconnected from my body. It was just— it took me years to even— because most people I'm coaching are like the Type A busy professional and like the spiritual side of things, like they're into the tests and the diet and we nail into that. But the spiritual side of things, that takes a while for people to even know that there's something to look in there to really trust yourself, to not beat out your intuition, that you know your body best.

Right, right. I think that you represent most women. I mean, that's how most of us are, unfortunately.

And so at what point, uh, knowing what you know now, would you refer someone to the fertility clinic? How long should we really focus on our preconception health?

Um, that's kind of my last resort at this point. I rarely send people to the REI office or the endocrinologist, at least around here, because What I have found is they are quick to do the procedure or give the pill, and I want to spend time with them revamping their diet, changing their lifestyle, really looking at what— how are they dealing with their emotions and their baggage and all their relationship stuff? You know, what is holding them back from getting healthy? And you work on that, you will get pregnant.

It's hard because sometimes I feel like I'm fighting people off from going to the clinic, and they're like this panic that they're— they've got to go over here for it to work. You know, I'll just give a little bit of time to work on some of this stuff. And but really feeling like that guarantee is the clinic. But yeah, and that's their right.

If they— if that's what they want to do, then You know, I'll be here if it doesn't work. That's what I say.

And so, okay, let's go into a few questions here about, okay, what's your take on the birth control pill and how it impacts hormones and fertility?

So yeah, that's a controversial one as well, because it's used for everything in conventional gynecology. It's supposed to You know, regulate your cycles, fix your cycles, fix your hormones, make you feel better. And really, it's not doing that. It's shutting down your hormone system. It's overriding it with synthetic hormones. And so it may look like you're having a regular cycle, but you're really just having a withdrawal period from these synthetic hormones that you're taking. And we— are now understanding that that is not the healthiest situation, especially for our young girls trying that haven't had children before, because it disrupts our gut microbiome, it disrupts our gut lining, you know, it can shut off our ovary, our HPO axis, or hypothalamic-pituitary-ovarian axis, for good. You know, some women will Do the pill for 10 years, they'll come off, and they won't have periods because that communication has been shut down for so long. Your body's like, what? What's the problem? You didn't want us to talk, we don't talk, right? And so that can be really hard to restart that axis, you know, from communicating. So I think that medicine thought it was the end-all be-all greatest thing. It was more than just birth control. It was, you know, giving women their freedom. Then you didn't— then they all started the, oh, you don't have to have a period more than 3 or 4 times a year. And they tried to, you know, give you these prolonged pills, and that caused more breakthrough bleeding and more depression and weight gain and issues. But the idea was You're just not on the right one. You just need to keep trying. We just need to monkey with it some more. And so there's like over 100 different types of birth control pills out there, you know, all these different formulations of this estrogen and progestin that there's supposed to be one that works for you is the idea. And really, it's a bunch of garbage. I mean, honestly, we need to use it for what it is. It's to prevent pregnancy. And I, as a professional woman, am very grateful for that because if I would have had a second child after my first baby in high school, I probably would not have been able to succeed and do everything I've done. But I should have been aware of the risks of taking the pill, right? And the possible long-term consequences, but I wasn't. So I think it comes back down to education and Just awareness again.

Yeah, when one of the side effects is stroke or death, like, why is that an option to help someone who's got acne?

Right, right. But it's completely acceptable. And then you're— when I recommend you stop eating dairy to get rid of your acne, I'm looked at like I'm crazy. You know, like, okay. Yeah, no, it's— and I had Dr.

We had Jolene Brighten on, so we have a good episode about that talking about—

Yeah.

Her book Beyond the Pill, so post-birth control pill syndrome. I see a lot of people, like myself, so I was put on the pill in my early 20s when my cycles were very irregular. Then when I came off, for me it was POF. Then I was also then put on it for 10 more years after that after I had my kids. That's the food sensitivities, the gut infections, all of that predisposes you To that. And we see a lot of people that have been on the pill— not to say everyone that goes on the pill is then going to be experiencing infertility, but the people that I'm speaking to typically didn't go on it for prevention. They went on it for, like you're saying, like the irregular periods, the heavy periods. Something was going on with their cycle, and it's just a band-aid approach. And then now on the other end, now they're dealing with— they can't get pregnant.

Exactly. I mean, I just had a nurse practitioner ask me yesterday about a patient who's 36 years old. She's kind of an uncommon situation. She's 36. She's not sexually active. She doesn't plan to be or have any children, but she's been having heavy periods for 6 months. And so the approach was, should I just start her on birth control pills or should I get an ultrasound first? And I'm like, she's not sexually active. Like, birth control pills are not the answer, you know? I mean, you can offer that to her, but you need to have an honest discussion. Like, This is not really what they're for. We use it for this because it's a good band-aid and it will lighten up your periods, but it's not going to get to the root cause of why you have estrogen excess, which is most likely your obesity and your stressed-out lifestyle and your poor diet, right? So that's where I still struggle is because, you know, trying to work with my conventional colleagues on things. And them not understanding this, it's just like okay, time to educate some more, right?

Yeah, the conventional side where it's a pill for for an ill.

Yeah, in this case, yeah, because it's a quick, easy fix, but then you're just adding ten new problems, and it guarantees that you're always going to have a patient coming to your office, right? True. I don't think that's the intent. I think most people become physicians because they care and they do want to help people, but. I think there's something deeper within the medical system that keeps people sick and really drives that, you know, Big Pharma issue. I was gonna say Big Pharma. Yeah.

And what's your take on someone who hasn't had a period in a year? Is that, is that full menopause of the year? Or like, obviously, obviously, there's amenorrhea, but like, what's your take on with low AMH, high FSH, no period for a year?

Well, it depends on their age. If they're over 45, I'm less likely to, you know, think about anything other than just menopause. But if it came out of the blue, that's a little weird. If they're younger than that, you need to start investigating as to what's going on because it's often reversible. You know, if you listen to Dr. Anna Cabeca, she reversed her premature ovarian failure and went on to have a baby. Like, it's come—

Yeah.

It's totally doable. And so I think that we have this mentality, at least in the United States, that having a period is a big inconvenience and I don't really want it. So I get a lot of patients who are like, I can't wait to be done with this and be in menopause. I'm like, you are asking for the wrong thing. I promise you, you know, that will aid you in so many ways. And You should want to have a healthy period. That is an indicator. It's a vital sign of your good health and functioning body. And so we just need to change the dynamic around how we think about periods and how we train our daughters to think about it. I get so many moms bringing in their teenage daughters for birth control pills because they want to stop the period. They're in sports and they don't want to have the period. I'm like, how about We optimize the period so that you know when it's coming, and it's not heavy and crazy and painful, and you can manage it because in the long term it's going to be so much healthier for you. But that takes a lot of educating. It takes a lot of time to talk about, you know, eating processed foods and sugar and all of those things. So teenagers. Traditionally have just wanted to hop on the pill. And I get it. It's an option. But it's not my first go-to like it was 10 years ago.

Yeah, that's my daughter who's almost 19. And yeah, anyways, it's interesting, kind of, I'm like, I'm over here talking all this natural side of things and functional things. And then, you know, she has to make her own decisions and goes on the pill. And I'm— and it was interesting because I'm like, gee, I can't control what she's gonna do. But I'm just like sending her articles. I'm like, here you go, here you go. She's like, okay, I'm going off. She had acne, but she's done a lot of diet and lifestyle changes too for that. There's just so much pressure.

Yeah.

Even though she knows all this stuff, she's known the diet piece for years and years, but so much pressure. She goes off to university and everyone's like, you better go on the pill. She had a doctor literally yelling at her, why are you going off the pill? Yeah, you don't let anybody talk to you that way.

Exactly. I think that's really common, unfortunately.

Yeah, it's like a young woman and you've got someone in a position of authority, like, you know, you know, trying to make you feel less than. It was just like horrible. Um, just about— just back to the period side of things. So if it's been— so you believe, um, so the period hasn't been for 2 or 3 years and they're under 45, there's still things we can do to, to reverse?

Yeah, yeah, I've seen it happen. Yeah. Okay, and you did yourself, right? You said that happened for you? No, I didn't. No. Okay.

No, I wasn't able— I didn't figure this out till I was 40. So like, I went into POF at 28, and wow, I was on HRT and, and the pill for, for years, and then I never— the period never came back. Wow. So like, I missed the window because I was Sleeping for freaking 12 years, right? You know, all my health took a nosedive and then— Oh my goodness. Helping other people reverse it. But it's just, yeah, it's— because I know, yeah, I'm going to be interviewing Dr. Anna Cabeca about her experience there with POI and we've helped other people get pregnant naturally or even, you know, at the fertility clinic getting pregnant with POF. So, but yeah, I wasn't able to bring mine back so it's been Freaking years.

Well, that's really awesome that you are on a mission to help other women. You know, you didn't like let that get you down and just turn bitter. You turned your pain into purpose and you're doing amazing work. That's awesome.

Yeah. So thank you. Um, and so what's your take on blood sugar and hormone balance?

Oh my goodness. So important, you know, especially if you have a diagnosis of polycystic ovarian syndrome, because really that's a metabolic syndrome, a metabolic issue of insulin resistance, and you're on your way to getting diabetes. But even if you don't have that diagnosis, cortisol and insulin and blood sugar play such a major role in those downstream sex hormones. So I like to say that sex hormones are just innocent bystanders. They're like just hanging out doing their thing. And the big dogs— cortisol, insulin, thyroid— When they get messed up, they affect the sex hormones. You know, they're just trying to survive. And so, if your blood sugar is constantly elevated and you're constantly having to push out more insulin to bring up that blood sugar, take it into the cells, you're causing all kinds of inflammation and free radical stress on your system. You are damaging. Things at the cellular level. I mean, we need to think about the fact that our body, all of these functions are microscopic cellular level functions. They're not like— just because your uterus and ovaries are big organs that you see, your fertility is microscopic that you don't see. And you need to make sure that the cells are not inflamed and that they're functioning well, right? So It really does make a difference if you have this chronic inflammation going on. So I like to tell women cortisol, your stress hormone. Every time you get stressed and you pump out cortisol, your body thinks you're either going to get in a fight or run away, and so it has to make sugar from your liver, pump it out into your bloodstream, and then you have to make insulin to go take care of it, and you just get on this vicious. Cycle of, you know, your blood sugar going in and out and your pancreas working overtime, and it's just a recipe for disaster.

Yeah, those, those hangry, the irritability, the sweating, like all that stuff with the blood sugar popping all over the place. Yeah, yeah.

And so, and then you can't convert your thyroid hormone into active thyroid hormone. You're converting it way too much into reverse T3, which is kind of like a bully. It's inactive and it'll sit on those receptors receptors on all your millions of cells and block active T3 from giving the signal. It's like, hey, boost your metabolism. Hey, do this. You know, it's like a big bully. And as long as you keep having insulin resistance and blood sugar issues and chronic cortisol production, your thyroid's not going to function well either.

Absolutely. And what about vitamin D? We talked about this one. I've done a whole podcast on this, but, but yeah, we see this all the time with vitamin D in the single digits or double digits. And then, okay, it's good to supplement, but then, well, why is it off to begin with?

Right. And I think, you know, you're up in Canada, I'm up in Michigan, it's super common for us to be in the low double digits, you know, 10, 19. I mean, that's just really low. And honestly, vitamin D is a prohormone. It's not really a vitamin. And so it's needed for hormone conversion, right? So if our levels are super low, our hormones aren't going to be able to do what they need to do. And nowadays we slather on sunscreen for the 2 months that we actually do see the sun. You know, it's been 90s, in the 90s up here in Michigan. Oh, I understand. But everybody's covered in sunscreen, so they're not even making their own vitamin D. You know, I honestly have most patients on at least 5,000 IU of D3 with K2 a day because That's what it takes to get them up to about 50. You know, that's where I see you being able to function in an optimal range, 50 to 70. Some people say higher, but, you know, conventional medicine says 30 is good enough.

Yeah.

Some literature even says 20, and I just think that You know, we're not trying to prevent active disease. We're trying to create optimal function. You know, I'm not trying to prevent you from getting rickets. I'm trying to help you get pregnant. There's a huge difference. You know, the recommended daily allowance of vitamins and minerals is the bare minimum that's going to prevent you from getting an active disease. Do you want to live at that level, or do you want to like function optimally, right?

Absolutely. I know. I think, well, I think the functional range is 60 to 80. But yeah, it's interesting how many people we see at so low.

Yeah. And it totally changes your insulin resistance. And it's associated with fibroids and endometriosis. There's, there's studies out there showing that IVF has a 35% success improvement rate when your vitamin D level is optimized. Like, How can you ignore that?

Yeah, crazy. And so what about— what's your take on sometimes with the conventional side of things? Again, that's that band-aid approach, and just instead of looking at the whole body, it's attacking the hormones. So looking at bioidentical hormones, typically with low AMH or POF or POI or DOR, it's— the recommendation will be supplementing with DHEA, and also for other ones, supplementing with progesterone. So what's your take on that?

Well, I think that sometimes it's necessary. Sometimes you need to support those downstream systems when you're working on the upstream systems, right? So that women can feel better and get an easy win while they're doing the hard work. I think where people go wrong is they think the bioidentical hormone is the answer to everything, and then they still don't feel well, or they feel well for like 6 months, and then they go back to how they were because it was just a Band-Aid. And so I think it's super important to do the diet and lifestyle. Like, I sound like a broken record, but it's so true. Like, you can take the supplement, but your body's still gonna steal it if you're, you know, trying to make too much cortisol. Or you can take the thyroid hormone, and if you're Cells and receptors can't even bind to it and hear the signal, it's not really going to matter. Like, it's the same thing with sex hormones, with your progesterone and estrogen. So if you have like premature ovarian failure and you've literally healed your gut, you've done the emotional work, you're like got your priorities straight, you're eating a low inflammatory diet, and Your ovaries still aren't back online. Yeah, I would say I personally would take bioidentical hormones because you're going to age prematurely. You know, if you're in your 30s, you don't want your bones to start thinning all of a sudden. You don't want your heart health to go down, your brain, you know, start having brain fog and thin skin and vaginal health. Don't even get me started on that. That's a whole nother podcast.

Okay.

So I think there is definitely a time and a place, and it also matters what type you're using. So you want to make sure you're using a natural progesterone that isn't going to, you know, increase your risk of blood clot and stroke. And I would much rather use the transdermal approach for estradiol so that you're not converting so much of it to estrone, which is a more concerning estrogen metabolite. So You know, there's details inside of that that require discussion for each individual.

Absolutely. We've got a couple quick— well, not quick, but I'll try to make them quick— audience questions here. So one is about early ovulation. So ovulating before cycle day 10, what's your take on that one?

Yeah, so maybe your estrogen's too high and your antral follicles are maturing too quickly. I would go back to the basics of trying to optimize your diet and lifestyle and see if you can get your stress dialed in. And, you know, I don't see that very often, I'll be honest with you.

Yeah, because it could be, as I say, the stress, or there could be hypothyroid issues. But yeah, the stress, the diet. And yes, there may be estrogen dominance potentially there too. Yeah. Yeah. And then another question on increasing chances of pregnancy with diminished ovarian reserve in the early 40s. We kind of talked about some of that. What's your specific take on that?

What's the question again?

Oh, increasing chances of pregnancy with diminished ovarian reserve. And so she's in her early 40s.

Yeah, so we know that Your chances go down significantly. And I would love to see like what your levels look like, your anti-Müllerian hormone, FSH, estradiol levels on day 3, that type of thing, so that we can see, do we just need to maximize what you got going on? Or are we at a point where we're looking at premature ovarian failure? I say if you're still having cycles every month, that you should really try and work on that because I think there's hope for you. But if your anti-Müllerian hormone is, you know, like 0.3, I haven't seen that improve necessarily. I think unfortunately once your ovary reserve is that low, it's hard to get that back.

Yeah, we've helped people with 0.08. But yeah, nice. Nice. Yeah. And what about— so what's a success story you'd like to share with us? Anything coming to mind?

Oh my gosh, I just had a woman last month. She came to me earlier in the year. She was typical PCOS, overweight, having a couple periods a year. And she had done Clomid, I think, 4 times, like 4 months in a row with no success. And she's like, okay, what do I need to do? We need to figure this out. And honestly, I made her do the elimination diet with my nutritionist.

Okay.

So we really decreased her inflammation significantly. She had subclinical Hypothyroidism with Hashimoto's picture. Her TPO antibodies, I think, were 300 or something like that. And so I said, you know, you need to stay away from gluten and dairy long term. And she ended up doing a food sensitivity test and realized that she was eating some healthy food that were also contributing to her inflammation. So I said, let's remove those for a good 6 months. Let your immune system calm down. Maybe you can add it back in once your immune system's calmed down and your gut's healed and everything. But then I added some Vitex or chaste tree to her, and like literally 2 months later she was pregnant, and she had lost 30 pounds within that time period. She had so much energy. I mean, I did some vitamins and other things as well, but just Decreasing that systemic inflammation, I think, was key for her to like be able— because when you think about fallopian tubes, it has millions of little villi inside of them, like little finger-like projections that have to grab the egg and sweep it down through the tube, and then the sperm has to meet it. And once that embryo's developed, those villi have to function and get it down into the uterus. And so many things will damage those villi, just like the villi in our intestinal lining that helps sweep food and nutrients and things like that. And so we know that smoking destroys those villi in the fallopian tubes and chronic inflammation. And so getting that to function better, I imagine, makes the sperm able to get up there, meet the egg, and then have that egg actually get to the uterus and implant. So it's back to that microscopic stuff. But I mean, she healed herself just by revamping her diet.

Yeah, I love it. We see it all the time. I love it. Yes. And so you have a free download for our listeners. So it's a Functional Gynecologist's Guide to Balancing Hormones. And I'll have the link in the show notes. But what can they expect in that guide?

So we talk about your gut health and your liver function. The liver is a major detox, you know, center for our system, for our hormones, our estrogen metabolites especially. So I talk about how to optimize function of that and how to balance your stress to decrease your cortisol production and all good tidbits like that. So lots of usable daily tips that you can incorporate to really change how your body's functioning.

Definitely go to the show notes and grab your free download of the Functional Gynecologist's Guide to Balancing Your Hormones. Yeah, and thanks so much, Dr. Tabatha, for coming on. This is like— I just love this conversation, and thanks for all the work that you're doing, uh, and, you know, to, to further the message around this and really to empower women.

Thank you so much for having me, and keep up your good work. You're doing awesome. Wasn't that an awesome episode? So if you want to connect with Sarah Clark, I will put her links in my show notes. You know, and I have some amazing connections, some beautiful women who are taking the functional approach to infertility. Dr. Amatma Simmons is one of them. I will have her. Her links in the show notes as well, because she is doing amazing work. And if you are struggling and you don't want to go the conventional route, I urge you to check her out. Also share this episode, hit the subscribe button. That lets iTunes know that you want to keep hearing this because I need your support to keep doing this. So use your voice to have a choice. Hit the subscribe, give me a rating. 5 stars would be amazing. Let me know your questions. Let me know your topics. I am here for you. I want to be your functional gynecologist. Okay, so go out and have an amazing kick-ass day. Bye!