Episode 58: Why Testosterone is Important for Women and Men, with Dr. Deb Matthew

Hi, I'm Dr. Tabitha, 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. Hello. Hello. So today I have a fun conversation. I'm going to be talking to Dr. Deb Matthew. She is the happy hormones doctor. So she is doing amazing work and she usually works with women to get their hormones into balance a lot like I do, you know, so we connected on that topic. But she now has a new book coming out which I'm super excited about and let me read what it's called because I messed it up a whole bunch during the interview. I think I was having a Freudian slip moment because it's called why can't I keep up anymore? And I kept saying, why can't I get it up anymore? Or something like that. I don't know. So it was a Freudian slip on my part. But it is for men over 40 who are having issues because what she found was taking care of her women patients and getting them back into balance and having them feel amazing again. They were like, wait a second, my husband needs help now he's having issues and he can't keep up with me and I'm feeling amazing and he needs help. So she dove in and did the research and figured out what is going on with men and why are they having issues. And she's gonna talk about all that today because it's super important and they have hormonal issues just like we do. The problem is it's not addressed. You know, if we get them to go to the doctor, which is rare, the doctor doesn't usually talk about this stuff. So this is a really important episode. If you know any men, you have any men in your life who are struggling with their health, they're feeling tired, you know, they're struggling to get through their days, or they're feeling anxious or irritable, angry or depressed, you know, they could be having all these issues just like us women. So I love that she's shining light on this topic. And so this is just a really good episode. So I hope that you'll stay tuned and listen or watch all the Way through. And don't forget, like the best thing about this is you can pause it and come back later if you have to. So that is why I love the podcast and the videos so much because you don't have to sit through the whole thing. You don't have to miss it. If you walk away, you can always come back and press play. Play again. So if you are finding value in this podcast, I would love for you to hit the subscribe button, let itunes know or the subscribe button on YouTube and let them know that you appreciate this content and you want to keep getting more of it. So. And I would love your feedback. I would love like a five star review, obviously, but only if you're so inclined because I really do want to serve you and I want to know what you want. So. So send me your questions, give me your comments. I want to serve you. Let me know what you need. Okay, so Let me sing Dr. Deb's praises real quick. She's the happy hormones doctor. She's the best selling author, international speaker, educator, wife and mother of four. And after suffering for years of fatigue and irritability herself, she had this quest to resolve her personal health and that led her to change everything about her practice of medicine. Does that sound familiar? I think I had the same issue.

Right.

Like so many functional medicine practitioners, we go on this journey of healing ourselves and then we can help our patients. So Dr. Deb has been featured on national podcasts, radio broadcast shows including NBC, abc, CBS and Fox. She's all over the place. She's awesome. She's just like super down to earth awesome lady. So I'm really excited to talk to her because her new book, why Can't I Keep Up Anymore for men over 40 is out. You can get it on Amazon, so check it out. Get it. It would be great, you know, Christmas present. So here we go. Let's talk to Dr. Deb. Well, welcome, Dr. Deb, to the Functional Gynecologist podcast.

Oh, it's so fun to be here.

I'm excited to talk to you today because you are. You've just launched your new book. How exciting.

Yes.

I'm so glad.

It took a long time to come out, but I'm really proud of it, so I'm happy.

Yeah, exactly. Why can't I get up anymore? So it's for the men in all of our women's lives, right?

That's right. I have a book that I wrote for women, but I needed one for the men, so now we've got it.

Yeah. Exactly. I love your book. For women, you know, is this normal? Can you talk to me about how women, you know, present to you normally? Is it. Are they saying, I don't feel hormonally balanced, or is it your typical symptoms, like, I'm gaining weight, I can't think anymore, I got the brain fog, I'm super anxious. What are they usually complaining of?

Well, a lot of times women choose, you know, to come to see me as compared to a different doctor because they wonder whether it could be their hormones that are causing. But they usually come in because they've got a list. They're not sleeping well, they're tired, they're irritable or anxious, they can't lose the weight, they're feeling bloated, they've lost interest in sex. You know, some combination of all those things. And the bottom line is they just don't feel like themselves. Like, they know that this is not normal, this is not the real them. But they're just at a loss for what to do about it. And a lot of times they've already been to their regular doctor. But when they walk in and they say, I'm not sleeping, I don't feel like myself, they end up walking out the door with prescriptions, Right, for sleeping pills and antidepressants. And sometimes those things can help a little bit, but they're not really fixing the underlying problem, which often is a hormone imbalance.

Yeah. I'm so glad that you're helping me get that message out there because it's so important. And I'll be the first to admit I was trained in conventional medicine. You give an antidepressant, you give the sleeping pill.

Right.

The ambient. And then I remember I came out of training and antidepressants were now be given for vasomotor symptoms. Now you're having signs of menopause. Let's throw it at that, too. And it's just like, oh, my gosh, we're just throwing drugs at everything. So I love that you're focused on the root cause and you're getting to that. How common is it that it is a hormone imbalance? Is that usually the case?

You know, a lot of times we do find hormonal problems. So sometimes it can be like an estrogen progesterone problem as women are going through menopause can be low testosterone, but often it's a cortisol problem. Right. It's from chronic stress, and cortisol throws the other hormones out of whack. Or a thyroid problem. And it's not always the thyroid gland. That's the problem because a lot of women have already been to their doctor, had their. The standard screening test done, and it's okay, but yet the thyroid hormone isn't working properly in their body. So they got all the symptoms of low thyroid, even though that darn lab test looked normal. So a lot of times we do find hormonal issues, and then we still want to dig to help understand why do they have these hormonal issues? Because, you know, some women, they just slide right on through menopause. They never even have a hot flash. They don't know what the whole fuss is about. So, you know, why you. Why. Why is this happening to you? We always want to try to get to the root cause whenever we can.

Yeah. I would say that in my practice, I often see insulin and sugar as a huge hormone imbalance. You know, do you find that a lot down in North?

Sure do, yes.

Yeah. And a lot of times we're not looking for that necessarily because people think they're eating healthy or making pretty decent choices. But so many other things can create elevated blood sugar, Right? Like in our patient population, stress alone can push you down that path of insulin resistance, right?

That's right, yes. Stress affects cortisol, cortisol affects insulin. They're all tied together. Even as women go through menopause, their estrogen levels change, their progesterone levels change. That even causes more problems with insulin resistance and vice versa. So that's why, if we can kind of look at the big picture and understand how the different hormones are balancing against each other, that can really make a big difference, as opposed to even just the standard of prescribing hormone replacement therapy. Even if it's a natural kind of.

Hormone replacement therapy, Right, Exactly. I love that you look at all aspects of the woman. I think it's so important. You know, I was just thinking today about birth control pills and how so many women start on them as a teenager, and then they're literally on them until they hit 50, and then they get transitioned over or get pulled off altogether. And I just think it's going to be interesting to see what all that synthetic hormone is doing down the road. Because really, we're just kind of a big experiment. Right. The past 30 years doing all of this medicine, we're assuming it's all safe and fine. But birth control pills affect so many aspects of our health. You know, do you see that a lot of women are just on the pill and then they're ready for their hormone Replacement therapy at that point, I do.

And I even see women who. They don't feel good. They come in there, maybe, let's say they're like, in their 40s, and they're on the birth control pills. And I actually try to talk them into maybe thinking about alternatives instead of the plan that their gynecologist suggested, which is stay on it till 50. Because we know that when you swallow your estrogen, that increase your risk for blood clots. So if you're 19 and you need birth control, your risk for a blood clot is so low, we don't worry that much about it. But, you know, when you're in your 40s or in your 50s, like, that's a real concern. And there are other ways that we can do it. It's. Birth control pill is not the only option. It's just really the only option that we were taught in medical school.

Right, exactly. I think that's a super important point. There's so many other options. Oh, my good. So you love talking about women's health, getting women in balance, but now you're coming on with this book about men. How did that happen?

Well, so I have in my practice lots of women who, you know, they walked in the door not feeling that great, but now they've lost weight, their skin looks brighter, they've got their energy back, they've got their interest in sex back. Like, they're feeling good and they go home to their husbands. But, you know, their husbands are sometimes tired or they've kind of got low libido, and they're just not feeling that great. And the wives want to support their husbands. They want their husbands to be healthy. Then, you know, the husbands want to be able to keep up with their wives. Right. They see the opportunity to have a good life. And so the women would come back in and say to me, like, do you see men? Could you help my husband? Because a lot of these guys just weren't keeping up anymore.

Yeah. And I don't think there's a lot of doctors out there that are checking testosterone levels and doing that. And it's not typical for men to go search out that doctor. Right. And ask for help. So I find the same thing. Women are always like, what about my husband? What about my husband? I get their eating cleaned up. I get them moving again. I get them balanced hormonally. And they're like, yeah, come on, husband, let's catch up. Like you're saying, you know, they're about to enjoy the second half of their life. And why not make it beautiful? So tell me about your book.

Yeah, well, I wrote the book because what I see is so many men don't feel that great, but they chalk it up to their age. I hear that all the time, you know, yeah, I'm tired. I'm more achy. I feel older. I don't feel like myself anymore. But, you know, I'm not 21 anymore, or I'm not 30 anymore, or I'm getting older. And so they sort of write it off to age. And for women, we have all these hormone changes, right? Every month in our cycle, we get hormone changes, and then we go through perimenopause and menopause, and we kind of have some concept that hormones are doing something for us. But for men, it's a slow, gradual decline over time, and it's much more subtle. So often they really aren't aware, hard to really notice over the short term. And so they don't even realize that there's a problem that could be fixed. And so they just kind of live with it. They just sort of put up with it. And so I really wanted to help men understand that you don't have to put up with feeling this way. You know, maybe you don't need to feel 18 again, but I don't know. How about let's feel 35 or 40? Like, you can feel good. You can get your energy back. You can have sexual function even into your older years. Like, let's make the rest fun.

Yeah, exactly. I think so often they just feel like I don't have the energy. And, you know, if they do end up going to the doctor, they could be diagnosed with depression or some other incorrect diagnosis, you know, because we aren't evaluating their hormones. So I love that you're bringing up this topic. I think it's super important. Do you find that stress affects men the same as it does women?

Oh, my goodness. And this has been quite a year for stress, hasn't it? Yes, yes. So men and women, when we are stressed, it affects our adrenal glands, which make our stress hormones like adrenaline and cortisol. Right. And so when we are stressed and our cortisol is going haywire, that shuts down a lot of our other hormones. And so stress can be a cause for low testosterone in men. It can be a cause for all kinds of hormone problems in women, too. And it's a really, really common cause of hormone problems. But for men especially, I find that. And it's true for women, too. But as a culture, what we celebrate is Working hard, being busy, getting everything done, trying to be everything to everybody. And we don't really value smelling the roses and taking the time to breathe and meditate and I don't know, sometimes some people think maybe those things aren't so manly, right? Yoga and. But those things are so important and they really go a long way to helping us balance our hormones. And you know, if you and I could figure out a way to package that in a pill like that would be one of the best selling pills of all time. We could retire and go move to the beach in Fiji because everybody would need that pill. But that exact pill doesn't really exist. There is, though, so much that men can do in order to help get their health back, to take control over their health, get their hormones back in balance. And I think that's a really important message that I want to get across.

That's awesome. Do you talk about diet at all or nutrition?

Yes. Now, one of the things that can cause low testosterone is an unhealthy diet. So eating too much sugar, eating a lot of processed foods, a lot of starchy carbohydrates which cause the insulin blood sugar problems. And when you have a problem with insulin, when you have a blood sugar problem, whether it's prediabetes or diabetes, that is one of the things that, that causes low testosterone. And so if you can improve your diet, if you can eat more of the fruits and vegetables, less of the sugary things and the processed foods, that can go a long way in optimizing hormones. Another thing that's really important for hormones is healthy fats. So a lot of men are actually kind of relieved to hear that we're not recommending a low fat diet, which sometimes is kind of bland. But healthy fats are actually good for hormone production because testosterone is made out of cholesterol. So you need some cholesterol in order to be able to make testosterone. So men who are put on really high doses of cholesterol lowering medications, that can be one of the causes of low testosterone. So if we can get your diet improved, get your cholesterol better so that you don't need the cholesterol medicine, that can be really helpful. And one more is when you carry a lot of belly fat, as a guy, if you got a lot of belly fat, that belly fat is very metabolically active. It's creating a lot of inflammation which makes insulin not work so well and pushes you to the pre diabetes and the diabetes. And those belly fat cells are little factories that take your testosterone flip it over into estrogen. So you can have low testosterone and high estrogen and as a guy that doesn't feel good, you don't feel right, it causes problems with erections. And so if we can help you to improve your lifestyle, hab and lose weight, then that can actually balance out and testosterone naturally can drift back up again. So what you eat is important and what you drink is important. So alcohol is toxic to your liver, it's toxic to testosterone production. So too much alcohol is another cause of low testosterone. So not that you can't have any alcohol under any circumstances, but needs to be in moderation.

Oh yeah. I mean that beer belly just flips up to man boobs, right?

That's right.

It doesn't take long. So yeah, I would love for men to realize that that beer belly is fat internally around their organs and in their organs like their liver. And that is so dangerous. So how much should men be drinking alcohol on average?

Yeah, so for women we recommend no more than four drinks a week. For men we recommend no more than one to two drinks drinks a day. And you know, less is better. I know that there's some degree of alcohol that can be good for your heart, but I don't recommend that people start drinking for their health. So, you know, if you could try to limit it to no more than one or two drinks a day, that would be better for a man.

Yeah, I agree. Because our liver is so busy detoxifying everything from our environment that our grandparents never had to deal with and our great grandparents. So our liver's already over functioning. Right. So to add the alcohol and the fat on top of it, not so good.

You know, one more thing to mention that is not good for testosterone production is pain medication. So when, you know, a lot of times when we have poor lifestyle habits and we gain weight, we get more achy, we have back problems and knee problems and things like that, we end up on chronic pain medication, especially opiate medication that is such a powerful testosterone suppressant. And so we know this, we know that if you have to be on morphine or some of those stronger medications, testosterone levels will go down. And we also know that you hurt more when your testosterone is low. So it's this self fulfilling prophecy that you hurt more, you're going to exercise less, you're more likely to eat to make yourself feel better or drink to kind of self medicate. Testosterone goes lower, you hurt more, you need more medication. It's just this terrible cycle that people can get caught in. But no matter where you are, even if you're in this cycle, there is so much that can be done to help you get back in control and to take charge of your health and to turn things back around.

I love that. That's so awesome. I'm so happy that you're spreading this word because it's so important. I think we saw so many people become addicted to opiates over the last decade, and whether they like it or not, now they have to get off of it. And so they're realizing, I got to figure out how to get pain under control. And so often it is a testosterone insufficiency issue. Right.

And just like you said before about the depression, testosterone is so important for so many different things. It's important for maintaining muscle mass and strength. It's important for heart health, it's important for blood sugar, but it is so important for brain health. It's important for energy, it's important for sleep, it's important for memory, it's important for focus, and it's so important for mood. And so when testosterone is low, anxiety, depression, irritability, they are so common because testosterone is what gives us confidence, motivation, self esteem, competitive drive. So when those go down, you know, you just don't feel right. And the anxiety, the depression, if you try to put it in words, when men go to the doctor. So first of all, a lot of times it's got to be pretty bad before men go, right, because they try to suck it up and not complain. But. But when they do go, if they complain of anxiety and depression, what do we do? We write a prescription. But I feel like it really should be malpractice not to check hormone levels in men that are coming in complaining of these symptoms, because otherwise we're not treating the right thing. And so it's so common. 2020 is such a year that people have been through mental health issues, have gone up so dramatically. And. And we know that stress is a cause of low testosterone. So we really need to make sure that we're addressing the right problem.

Yeah. Oh, my gosh. It's so important. So if your man is going to the doctor, they need to get their testosterone level checked. Right. So important. Oh, my gosh.

And I was just going to say, too, that we know that testosterone levels gradually decline with age. And so for older men, it's not uncommon to have low testosterone, but we are seeing more and more younger men developing low testosterone. So I have patients in my practice in their 20s who have low testosterone. And really commonly in men, by the time they're in their 40s. So this is not a problem just of older men. And there's lots of reasons. Right. We've talked about diet, we've talked about stress and alcohol medications, but also toxins in the environment. We're all exposed. We already talked about. Right. All these chemicals out there, and many of them are hormone disruptors and they're causing fertility problems in men and women. And a lot of them are causing low testosterone. So we don't always know exactly what the cause is, but we definitely are seeing it more and more in younger men.

Yeah. And that's really unfortunate. And not only does it affect your sexual health, but it affects your overall health. Right. Like you're saying it increases your risk of diabetes and heart disease, right?

Yes. In fact, there was a study that was done on older men, and they looked at the guys that had the higher levels of testosterone versus the lower levels and the men within the normal range, but the men who were at the lower end of the normal range, they just didn't live as long as the other guys from all different causes. So testosterone is really important for overall health, and low testosterone is just not a healthy place to be. And it's tricky, too, because the place to start is to go to your primary care doctor if you're a guy or if you've got a guy and seems like maybe testosterone could be a problem. Actually, I find that most of the time, guys kind of know. So if they come in and they say, no, I don't think my testosterone is off, they're usually right. And if they come in, they say, you know, I think my testosterone might not be right. They're usually right. So if they go into their primary care doctor and ask for a testosterone level to be done, many times they are told that they're normal. But, you know, if the normal range is this big and they're sitting, like right at the bottom end, you know, that's not a good place to be. But also the bottom end is controversial. So some labs say you have to be above 250 to be normal. Some labs say 300, some labs say 350. So depending on what lab you go to, one lab might say you're normal and one lab might say that you're not. So even if you're sitting right in the bottom end of the normal range, I would argue if you're having symptoms and not. That probably needs to be addressed.

Right. You're not in your optimal range, obviously. So we want to be in our optimal functioning range.

That's right.

I love that you make that point so important. So you hit on all kinds of amazing things that testosterone helps with. You know, the muscle mass, the brain, clarity, the energy, the focus. That's true for women, too, right?

It is absolutely true for women. And a lot of times women are really surprised because we think about testosterone for men, but we have testosterone too. It's just that we don't have nearly as much as the guys do. But all those same things are true for women. Our confidence, motivation, self esteem, get up and go get stuff done. And so what I see a lot of women complain about when their testosterone is low is that they just feel flat. They're just putting one foot in front of the other, trying to make their way through the day. If it has to happen today, they'll get it done. But if it's not really a priority at this exact moment, they'll often just kind of leave it by the wayside because they're just not really feeling it. They're sort of a little bit in survival mode. And this is so common in women, even in women in their 40s, you know, it doesn't have to wait until menopause. And if that's the case, normalizing testosterone levels can make a huge difference in how women feel.

Yeah, for sure. I mean, I tried to go back on a birth control pill after my last baby, and I realized that I was just flat unmotivated, no energy. And I was like, what is going on? And my testosterone was, you know, bottomed out because it was all suppressed. You know, women go on it for better, you know, acne results, things like that. But what you end up getting is low testosterone and no libido. And, you know, I've had patients, we take them off the pill, and all of a sudden they want to have some sex again. So it's kind of amazing how all of that works. Right? But that's. Right, so important for women to realize that testosterone plays such an important role in both men and women. So what is the number one thing that men can start doing to feel better?

I think the number one thing that they need to do is to first of all realize that their doctor does not have a pill to fix them. So if they're not feeling good, they need to decide that they are going to take charge of their own health. They are going to do what they need to do to look after themselves, because living well is the best medicine. But then improving lifestyle habits. So working on nutrition, getting some exercise, and for testosterone, weights is the better kind of exercise as opposed to like long distance running, if we want to boost testosterone. So nutrition, exercise, and stress management, those are really great places to start. They will go a long way. And then get your testosterone level checked. And that way, if your testosterone level is up at the top of the range, you'll know you're doing pretty good. If it's down in the toilet, then you know that something needs to be done. And if you start with your primary care doctor and you're just told that everything is normal and you can kind of see that it's kind of not that great, you may want to look for a doctor who specializes in natural hormone balance, because there is a whole lot more to the evaluation than just a testosterone level. There's a free testosterone level, which is the portion that you actually feel. So if your total testosterone production is okay, but the free fraction that really matters is low, then you won't feel good. And another common one is some men flip that testosterone over into estrogen. So the testosterone is low, but the estrogen is high. We talked about that. But then if we just go give more testosterone, they just make more estrogen. And so then you're not feeling better. So it needs to be a more comprehensive evaluation. We want to know about cortisol, we want to know about insulin, we want to know about all the other hormones that interplay. So a more comprehensive evaluation can of course, give better answers. And the whole idea is we want to bring everything into balance.

So much good information. I love it. And your book is out. You can get it on Amazon, right? Oh, my gosh, that's right. I got it here.

I'm so excited. I just unboxed it. Yeah. Why can't I keep up anymore? It's got lots of great information. We got a whole chapter on erectile dysfunction because there's so much more that men can do than just the little blue pill. And that's something that if erectile function is not good, it really is a big deal for self esteem and confidence. And if men don't feel confident and comfortable with intimacy, that can start to affect relationships. And then we worry, why are they not paying attention to us? Do they think I'm fat? You know, I mean, it just, you know where our brain goes, right? And so this is a problem. And there really are solutions, more than just the pill, which can cause side effects and headaches. And it's not for everyone.

Well, yeah, and it's not addressing the root causes like you've mentioned. It's really not fixed the problem. It's like a Temporary band aid that you have all of the time, right? Yes, yes. So this is so important. I love that you're doing all this. So where can my listeners find you? Dr. Deb?

Yeah. So my website is called signaturewellness.org and we've got information about women's hormone health and men's hormone health. And there's a link to get the book on the men's. Men's hormone page.

Awesome. And I'll have those links in my show notes because I really want women to help their men. I know that men, like you said, they don't go to the doctor until it's really bad. So let's get them optimal so they can keep up with us because we're doing amazing things. So thank you so much for publishing this book and getting the word out and sharing your wisdom with everybody.

Well, thank you for the opportunity. I think it's an important message.

Yeah. Take care. Awesome. Wasn't that great? Such good information. We need to get our men healthy ladies. So I really want you to check out her book, why Can't I Keep Up Anymore? For men over 40. So much good information, you know, and they probably don't want to hear it from us directly, but maybe they'll read the book. Maybe they'll listen to the podcast. I would love it if you could get your guys to listen to this episode. So that would be awesome. But just know that hormone balance, or should I say hormone imbalance, is always the result of something deeper. So hormone imbalance isn't usually the cause. It's the result. So the cause is chronic stress, poor diet, not sleeping well, carrying too much weight, too much alcohol. The list goes on and on. Environmental toxins. So the hormones get imbalanced as a result of those other systems being imbalanced. So I would love for you to help your men get their hormones imbalance while you're working on yours as well. And you guys can both enjoy the second half of your life together, because why not? You should. You deserve it. You've worked hard, and now it's time to enjoy your life. Especially if your kids are, like, getting older and getting ready to leave the house. Like, it's now time for you to enjoy life. Right? So, love this episode. Dr. Deb is full of lots of great information, so check her out. Links are in my show notes, and then please hit the subscribe button. I would love for you to send me a review. You know, let's tell itunes that you want to hear more of this. Let's have a voice Be stronger together as women. And I just want to tell you, my sisterhood starts January 3rd. You're almost running out of time to join. So don't even think, think twice about it. You have to invest in your health and in yourself. And this is the program to do it. Because you're gonna finally get rid of that belly fat that's from your stress. You're going to sleep better, your gut's gonna get repaired, you're gonna figure out how to get rid of that brain fog and those anxiety feelings and all that stuff that's been creeping up, especially since COVID But you know, a lot of it is hormone imbalance. But I unlock the secrets, like getting you back into balance. And it's my seven week program, Renew you Sisterhood. We're kicking it off for the new year. I'm super excited because it's the only comprehensive transformational program that I have seen out there led by a physician. So that you have guided, you have support, but also has a community, a sisterhood of women supporting you. And you have somebody to rely on and you're all in this together. We're in this together. And it's such a beautiful transformation. And then we keep it going. There's the longevity piece where we keep maintaining and you know, it's just a beautiful program. So don't even think twice. You need to make this investment in yourself. The new year is here. It's time for a new you. So go to my website, drtabitha.com 3A's T A B A T H A, no eyes and sign up for renew you sisterhood. I will see you there. I'm gonna walk you through week by week, tell you what to do. There's no questions, there's no guessing games. You're gonna figure out you're going to teach your body how to be a fat burner, how to go from a sugar burner to a fat burner, and how to be metabolically flexible and how to get those hormones into balance without using prescriptions. So such an amazing program. The women who've gone through it just shine. They, you know, they are going to be your big sister. They are going to support you and get you through the program. So come join us. It's a beautiful community. And our next round starts January 3rd. So I will see you there. Bye guys. Have a kick ass week.