How to amplify your hormones for pleasure - Interview with Sara Gottfried

Hello and welcome. I'm Alexandra Jade Johnson. And today we have a brilliant guest, Dr. Sarah Gottfried. Dr. Sarah is a Harvard educated physician. She helps women and men balance their hormones gracefully at any age, which is fantastic. And she's also a speaker and an author of the best selling book the Hormone Cure. And I just love her style, I love her flavor, I love her energy, her down to earthness. And she breaks all these ideas down so simply and beautifully for us to understand and it's amazing. So welcome, Sarah.

Oh, thank you, Alexandra. So happy to be with you. Thanks for the sweet introduction.

Yes, it's so great. I love how you're so smart and you break it down for us so that we can understand it and we can really be empowered and take control of our health. It's brilliant.

Thank you. I have to say, we gotta keep this fun. We've gotta keep it full of pleasure. And science isn't always full of pleasure. So I like to fill in the pleasure whenever we can.

That's awesome. Yeah, and I love it too. I love just on your brand too. You're just like, you got it going on. You got the sexy and you're like, yeah, I can be hot and gorgeous and smart and it's brilliant.

Thank you. Although I have to say my husband was threatening to take iPhone photos yesterday where I was not looking so hot and sexy. So I. I am just like a normal everyday woman. I just wanted to start off there.

Well, it's good to know because we all have those moments where we're super hot and delicious and moments where we're maybe not so hot and delicious.

That's right. I mean, we're always hot and delicious on the inside because it's really an inside job. In fact, I think you teach about this quite a bit, Alexandra.

Yes, definitely. Definitely. So I'd love to start off with the inside. So what is pleasure kind of on a cellular level? What's happening in our body and what does pleasure mean for you?

Well, I'm going to start with the short version because this can get more complicated. We can go as deep as you want. I think of pleasure as a bliss state, as a positive, emotional, psychological, physiological state in the body. Of course, men and women can have it, but one of the things I found in my work is that women tend to be more cut off from it, tend to be pleasure deficient. So what does it look like when you're full of pleasure? I would say there's a few starring roles that we can talk about. One is oxytocin. That lovely hormone of love and bonding and connection. And there's many ways to raise that. Hopefully we'll talk about that today. There's also dopamine. And dopamine is a really important happy brain chemical that represents pleasure and satisfaction, contentment. So people with addiction, for instance, tend to be lower in dopamine in the front part of their brain, their prefrontal cortex. And that's why they're always looking for the shiny new thing, whether that's for pleasure or they're self medicating with alcohol, drugs, work, whatever their addiction is. So that was a little all over the place. But I would say pleasure is this bliss state. And I think it's one of the best ways to reset your hormones so.

We can be in a state of bliss. Like on a biological level. There's hormones being released that literally we can wire ourselves to feel that.

Yeah, I love that you brought up wiring because this is something I think is so important. So if our listeners, if our viewers get nothing else today, I really hope that you'll hear this part. And that is we live in a culture that makes us rewire to stress, rewire to the stress hormones, especially cortisol. I talk a lot about cortisol, the main stress hormone. And what we want to do, what we're really designed to do, is to be wired to pleasure. So we've got to shift that focus away from stress, which is kind of the default setting in our culture, our hurry up world. Rush, rush, rush. Climb the career ladder. Do this, do that. Here's your to do list. Get it accomplished today or else you're a failure. And pleasure often gets neglected. It's sort of the lowest priority. And that's one of the worst things you can do for the Matrix, especially of the female body.

So talk to us about the female body because I think most of our listeners, there'll be some delicious men out there. But I think a lot of the women, as you said, for most of us we are pleasure deficient. So we're like, ah, give me, like we want more of it. So how. Talk to us about pleasure in the woman's body and why that's so important.

Yeah, well, so why don't we go back to cortisol first Because I think that's a really interesting story. And I can tell you, Alexandra, when I was in my 30s, I had this experience where I was definitely pleasure deficient. I was working as an obgyn. I was fat, frumpy, frazzled, and I blamed my husband for a lot of the things that were happening. I know a lot of women can relate to this. It's not about me. It's really. This is kind of every woman's experience. I was burning the candle at both ends, working mom, two kids. And I was doing that process that I just described of rewiring my body, the matrix of the female body, to stress instead of pleasure. And a lot of the things that I tried didn't work very well. Like, I tried sleeping pills. I tried pole dancing.

Nice sleeping pills and pole dancing.

Love it. I was desperate. Let me just put it. There's a lot to be said for pole dancing. I'm not knocking pole dancing, but what I did is I went to my doctor and told him what was going on. I had pms, low sex drive, my energy was really inconsistent. And he offered me a few things. He offered me, number one, why don't you take this nice antidepressant? Number two, how about a birth control pill? Because we all know that birth control pills solve every hormonal problem a woman has not. And then the third part, which was really humiliating, was that he told me I needed to exercise more and eat less. And he said it in a way that just made my skin crawl. Alexandra. He said, it's simple math. You went to medical school. Why can't you get it? You need to exercise more and eat less. And that was a defining moment for me because I realized he's wrong intuitively. That doesn't feel like the right answer. Why would I go on an antidepressant when I'm not depressed? I'm stressed out, but I'm not depressed. And it's going to rob me of orgasm, like one of the few pleasures I have. So I decided at that point to look at my hormones and what I found. The first thing I found was that my stress hormones, my cortisol, was about three times what it should have been first thing in the morning. Cortisol was pretty much running the show in my body. It was giving me a muffin top. It was robbing me of those happy brain chemicals like serotonin and dopamine that we just talked about. And it was making me see life in this way that was sort of glass half empty. I had a lot of that victim mindset, victim consciousness. And that also just keeps you from being able to fill the pleasure prescription. It took me about a month to fix my cortisol, and when I did that, everything else changed. Because cortisol is like the gateway hormone. It's the hormone that just changes everything. The cool part about cortisol is that pleasure rebalances cortisol. It's almost like a reset button to get cortisol where you want it to be. And I can get a little more specific with oxytocin, for instance. So within, say, 30 to 60 seconds of an orgasm in the female body, cortisol comes down, your thyroid gets more efficient, your estrogen gets into balance. So that's what's happening on a cellular level. There's a lot of other things happening in the brain and sort of this cell to soul philosophy that I have, but those are the basic key points that I want people to understand.

So I love that on the cortisol, pleasure decreases our cortisol, that is hot. And orgasm decreases our. I mean, obviously orgasm and pleasure go together, but. Okay, so let's talk about this. The orgasm.

We're just going to get right to it.

I know, right?

10 minutes or something.

We'll get to, like, sleep and energy later. We're going to start off with the orgasm. So what do we do about the orgasm? Because I know a lot of your work is, you know, low sex drive because you're like, just. If you're pleasure deficient and your cortisol's high, right? And you're just stressed, you're like, that's the last thing thing on my mind is sex. And please just don't touch me. I just want to go to sleep or do anything but do that. Yet this is one of the things that helps us. So what do we do about this conundrum?

Well, you know, it's funny. I've been taking care of men and women for 20 years. I've seen about 20,000 patients. So I listen really carefully, and I have a sense for how people struggle with this. I used to think that we had an epidemic of low sex drive. And then 50 shades of grey came out and I realized, oh, I think it's the sex on the menu. I don't think we have an epidemic here. But the point here is that when you're chronically stressed, what happens in your body is that your amygdala in your brain, kind of that. Some people call it the reptilian brain. The part of your brain that's constantly scanning for danger and threat in your environment that signals a message in your brain through the parts called the hypothalamus and the pituitary to tell your adrenal glands, the cute little glands in your mid back above your kidneys to pump out the cortisol. So that's what happens initially. Over time it can get more complicated. You can actually start to run out of cortisol. You can have high and low cortisol within the same day. We don't need to go there. But the idea here is that we've got to reset that system. And when you have an orgasm, when you get flooded with oxytocin and orgasm isn't the only way to do it. I think actually a cute pair of shoes can also do this. Jimmy Choo. Let me just say Jimmy Choo right here. So the idea here is that orgasm activates the limbic brain and it gets you to stop that hyper vigilance, kind of constantly scanning for threat and danger. And it actually turns off the part of the brain that does hypervigilance. So that's pretty cool. I mean, orgasm is the only state that actually does that in the female body.

Wow, that's amazing because we all have that. And I think maybe men have it too. But it seems like women, we're just always like, what could go wrong? Especially if you're a mother, you're always on what's happening, what's happening. And this is like amazing to do, right?

How often? Well, yeah, so some people say an apple a day. And I actually don't like the fructose in apples, especially if your metabolism is not working. So I would say an orgasm a day is a good way to go at least three times a week. And I'm not talking about that 30 second Hitachi wand type of orgasm. I call that a climactic sneeze. We want some real orgasm happening here.

Is that awesome? Those wands are pretty good though. But I'm excited to hear more about this. But I love my wand.

Yeah, not knocking the wand at all. I'm just saying we need an a la carte menu so that we're not having the same boring thing over and over again and desensitizing our clitoris. I'm a gynecologist. You knew clitoris was going to come in here somewhere.

Awesome.

But I think one of the important things to think about cortisol, I love to make these hormones come alive so that you, you don't get caught up in the biochemistry and your eyes glaze over and you want to go have some chocolate. What I think is important is to realize that cortisol is like the bad boyfriend that you had in high school or college. You knew it was a bad idea, but you went there anyway and it blew up in your face. Stress is like that when you indulge it. The cool part, Alexandra, is that it's not actually how much stress you have on your plate, it's your perception of it. So whether you're a mother and you're in that mode, kind of that hunter gatherer sort of taking care of the home, trying to keep your toddler from electrocuting him or herself, when you're in that mode, it's really hard to flip the switch toward pleasure. I almost feel like it's almost like a daily practice that we need to cultivate. And I'm not saying it needs to be, you know, full on, 30 minute orgasm once a day, but I do think that it's important for us to have touchstones kind of built into our days so that we get into the present moment and we really focus on pleasure. But I also, I wanted to say one quick thing because we know that you are married to a man who is quite famous for his work on how to meditate without moving to Himalayas. And I wanted to add here, with so much love and respect for Brian, that there's definitely ways to look at orgasm as a meditation. And I think it's actually rocket fuel for meditation. So if some of our listeners, I imagine, meditate already or they practice yoga or they've got some way that they cultivate mindfulness. And I think when you combine that with pleasure, it really activates bigger parts of the brain. It's almost like speed for mindfulness.

Yeah. So if we had to choose between orgasm or meditation, we could just go for the orgasmic meditation combined.

Well, you know, the beautiful thing here is that I don't think it's either or. I think that you can choose the forms of mindfulness that really serve you best. One of my favorite things is to have dark chocolate. I love that 80% raw cacao, for instance. And putting one of those squares on your tongue and closing your eyes and letting it melt. Not chewing, just letting it melt and just being all in that moment. I can do that with chocolate.

That's amazing.

I can't do it with raisins. So, yes, we want to figure out how do we really activate that part of the brain. It's part of that balance we want to create, not just with our hormones and with cortisol and with oxytocin and dopamine. We also want balance between the sympathetic nervous system, the on part of the brain, and the parasympathetic nervous system. So that's sympathetic is fight or flight, as you know, and parasympathetic is rest and digest. And you don't want to hang out too much in one or the other. What's ideal is to have them both on at the same time, which is what you get with orgasm.

I love that. Okay, so let's say somebody's watching, and they're like, I love all of this. This is amazing. But you know what? I'm feeling frazzled. I'm feeling fat and unsexy and not juicy, and I don't want to have sex, and. And life just. I know it's amazing, but it feels like crap. So what? That's a big thing. But I think it's pretty common in your practice as well. What are the main things that you recommend a woman to do other than read your book?

Well, my heart goes out to this woman because that's exactly where I was 10 years ago. And if I can do this, I promise you can do this too. I think an important first place to begin, Alexandra's, is to acknowledge that women in our culture tend to over give, tend to give until they drop. And whether that's something that you're doing in the caretaking of a child, or maybe you have a mission, you're working at a nonprofit, and you're logging long hours serving that mission. I think that we have this biological wiring that forces us to give, give, give. And Jen Loudon talks about this beautifully. I learned quite a bit about this from her. You know, the musters, the women who are just like, I must do this, I must do that. And then the other piece that I think is important is that we women tend to blame themselves when they feel like crap, when it feels like pleasure is some distant island that they're never quite able to get to. And so I want to say loud and clear that you want to check out the biology, because when you feel disconnected from pleasure, usually there's a biological reason. So, for instance, with low sex Drive, which 80% of my clients have, what I see with them is that they tend to be stressed. And when you're stressed, when cortisol's high, it robs you of the feedback loop that goes to your ovaries so that you're keeping estrogen and progesterone imbalance. It also interferes with the feedback loop that goes to your thyroid, which runs metabolism and weight and mood. And so what we want to do is we really want to make sure that women aren't blaming themselves and to say, it's not you, it's your hormones. So I think there's this grace, this beautiful, graceful moment when a woman kind of puts down that feeling of, why can't I do this? Why does it feel like I'm pushing a rock up the hill? I never expected life to be so hard. I just want to say, okay, let's hit the pause button, and let's look at your biology. Let's start first, really simply, with what I call the hormonal Charlie's Angels. And that's your cortisol, your estrogen, and your thyroid. So really simple, just to start with those three. And cortisol is like the queen. Cortisol sort of runs the show. And if you don't know where to start and you're overwhelmed, then start with cortisol.

Fantastic. Yeah. It's so amazing. It's so amazing. I love that you brought up the blaming, too, you know, because there's the mental component, right? The blaming, and then there's the. And there's the biological. And it's. I know. I've been there, too. I'm like, what is wrong with me? Like, you know, I should have a great life. But I feel, you know, and it's just not fun. But it's amazing how our biology impacts our thoughts, right?

Oh, so true. I mean, I would even say that that mindset, which I know really well, having been there myself, that mindset, you know, there's a lot of different ways to frame it. You could frame it as a sort of scarcity mindset or that it's just hard to kind of feel like the locus of control is internal. It feels like everything else in your external life is forcing you into this stress state. Whether that's a boss that you don't get along with or your 401k is not where you want it to be. I think it's so important to realize that that is a symptom. Like, it's a symptom of your hormones being out of balance. And the more that we can create hormonal harmony, the easier it is to rewire. It's sort of like this. It's like the small hinge that swings a big door when it comes to pleasure.

So it's not like. Because I think a lot of people, and even when I talk to people, they hear about the pleasure and stuff, and it just seems so ridiculous. Like, come on. Like, pleasure. I have 500 million things to do. But as you're talking about, it doesn't. Just little tweaks that we could make in our hormones would make a huge difference in our enjoyment of our everyday life, right?

Absolutely. And maybe what's helpful is to get into some practical tips here, because I know not everyone's going to dive into orgasm as the first prescription. So we've got a little something for all of you, my friends, okay? So one of the things that I think is really vital to understand is that it's easier to rebalance your hormones than to live with the misery of your hormones being out of balance. So that's cool. And it's not like some gigantic project. You can do this pretty easily. And there's this joke. I'm sure you've heard this joke. It's something like this. I'm going to paraphrase it where you say, okay, everyone should meditate for 30 minutes every morning. And if you feel like you don't have time to meditate, then you need to do an hour.

All the way.

And I can tell you, as a mother, I've got two daughters. One is 13, the other is eight. I've got puberty right next to perimenopause right now. So lots of fun and games in my household. And I can tell you that when you feel like you just don't have time for pleasure and it just feels like that's not going to happen, what we want to do is we want to take some baby steps. We want to break this down. So my little inner MIT bioengineer is going to come out here for a moment, if you can bear with me, and there's really simple things that you can do to start wrangling cortisol. And did I say this part already about cortisol? I had this interesting experience. Can I give a quick little tangent? That's what women do, right? We're not doing our linear thing. I'll come back to the linear apc. Here's what you do for cortisol. I had this great experience because I got an email from an old boyfriend about a month ago, and he said, hey, I was at the gym, I was doing the elliptical, and I was watching this Ricki Lake show, and there was this woman who looked a lot like you who was talking about cortisol and how we've got to manage cortisol, like the 401K. And she said cortisol was like the bad boyfriend that you did in high school or college. And I was just wondering, am I cortisol?

Oh, my God, that's hilarious.

He was definitely not cortisol. Let me just say, he was a lot of fun, lots of pleasure. But here's what you do. So I love to focus on how you can eat, move, Think and supplement as a way to change your hormones. So when it comes to cortisol, I've got this three step process which is based on functional medicine, integrative medicine. The first step is that you fill nutritional gaps. All of us generate these nutritional gaps based on genetics and how we live our life and how aggro we are. The second part to this of this three step process is that you want to try proven botanicals. Proven botanicals. And I'll explain what these are with cortisol. And then if that doesn't solve your symptoms, generally in four to six weeks with each step, then you move on to bioidentical hormones. And you know when you were asking a moment ago, Alexandra, about women who just feel like, okay, I don't have any room in my life for this pleasure thing, it reminds me of women who come to see me or work with me online who say, okay, that's fine. I know you're a yoga teacher. I know I need to hit the pause button in an active way, but can't we just jump to the big guns? And can't you just give me some hormones? And what I think is important to realize is that if you don't do that foundational work, you're going to have many more side effects. You're going to need higher doses of hormones, and it's not going to have the kind of benefit that you most want to have. So we want to do these foundational things. So here they are. Okay, so here's a little linear part. So one of the things that's most effective when it comes to high cortisol is to take phosphatidylserine. Phosphatidylserine. And the cool thing about Google is that you can spell that any way you want and it's going to show up as it'll be there on a Google search for you. So phosphatidylserine is an extract of plant membranes and it does this amazing thing in the body. At 400 milligrams, it reduces cortisol levels. It also increases lean body mass because one of the things that cortisol does is it messes with your insulin level. It's linked to insulin resistance, where your cells become numb to insulin. That's why you get that muffin top and metabolic syndrome, et cetera. So we want to start to kind of unravel that rewired to stress feeling. And I think phosphatidylserin is a powerful way to do it. I can't say taking phosphatidylserine is such a physical pleasure, but what it does is, within one hour, it can change your mood. I have so many clients who will work with me online or they're in my detox, and they'll say, I took that stuff. And within 30 minutes, I felt like a new woman. Like, I felt like all these possibilities opened up. Wow. So that's beautiful. Another thing you can do is dark chocolate. I'm a big fan of using food as medicine, food as information for your DNA, for your matrix, and this may be my most favorite study of all time on cortisol. We know that dark chocolate actually lowers your cortisol levels, especially if you eat it mindfully, like we were talking about earlier. So those are two things that work really well. If that doesn't help you solve the cortisol problem, the frat party that's going on in your body, then I generally recommend that you move to step two, which is to try a proven botanical. And this is all from chapter four of my book, where you get 97 ways to manage your cortisol in a new way. Rhodiola is one of the most proven herbs. It's funny, Alexandra. A lot of folks, I've been doing integrative medicine for a long time, and a lot of folks say, well, I've got these 17 adaptogens that I take every day for my adrenals and ashwagandha and ginseng this and panax, ginseng and red ginseng and eleuthero. The only one that's really proven with the best evidence in humans is rhodiola. I'm not saying those other things don't work, but we don't have good evidence when it comes to the female body. We've got a long history of uncontrolled medical experiments, and so I'm not a fan of that. I really think we need to go with the proven solutions. So those are the proven solutions. But I also want to bring in, you know, you are a goddess. Let's bring in the goddess here, because just as I don't think you can find the answer to health and optimal living in the bottom of a prescription pill bottle, I don't think that you can find the answer to health and optimal living in the bottom of a supplement bottle. So I think you've got to bring together, knit together different strategies for balancing the sympathetic nervous system, the on button, and the off button in your nervous system. And that's where pleasure comes in. How do we bring in more pleasure? Just kind of woven into our day because I'm not going to sit on a cushion for 30 minutes in the morning. That is not my thing. I tried it for a while when my kids were younger and they would climb all over me. And that worked for a while. But I like to have really efficient ways to activate pleasure. What I would love is if our listeners could come away from this conversation with a list of maybe three to five new ideas of how you can activate pleasure, how you can amplify it in your body.

Yeah, I love that too. And I love the almost as you're talking. It's like giving us the permission to say, like, pleasure is important, you know, like, really it is important. And biologically, we can feel delicious and have amazing energy and that it's. That we're worth it. Because I think that's a big issue for women as well, to not invest in their body and their hormones and, like, the research for it. And like, really, is it gonna make a difference? Because I know I've done it before. It's like, really, is it really gonna make that much of a difference? So I love that you're like, yes, you can.

It will. Well, yes. And this is not, you know, my expert opinion. This is actually based on thousands of studies ranging from imaging the brain at orgasm to looking at what happens when you're a regular meditator, how that changes the wiring in your brain, how it changes the white matter and the gray matter. So I think it's valuable not just to validate that this is an important pursuit and to say, okay, this is my digital prescription for you, but to say that I had many years, even though I grew up with a great grandmother who was a bit of a radical and believed that you had to have whole food, and she loved yoga as a way of accessing self realization. Even though I've always had that with me. I had an experience for the first 10 years in my medical practice where I would see women who complained about feeling overwhelmed, feeling tapped out, feeling like their energy was inconsistent, feeling like I'd rather mop the floor than have sex with my husband, or if I have mercy sex one more time, I'm going to shoot myself and I would tinker with their hormones. But I felt like I never really got to that tender place of suffering that so many of us have, that I certainly had when I was in my 30s until I started to understand pleasure.

So I'm curious on the pleasure. Like, what are some things that you personally love for pleasure?

Well, my kids are going to be home in a short while here. So moms always tend to go to their kids first. And I think this is relevant whether you're a mother or not. I think this is also. I've got a younger sister, for instance, who lives in San Francisco. I live in Berkeley. And she comes and really derives a lot of pleasure from hanging out with my kids, especially if they're behaving. And for me, it's almost like exercise. I really love to find ways to get into pleasure with my kids. So, of course, this is not. And we'll talk about the sexual part later, this is totally non sexual. But I know you know a lot about positive psychology, and I want to weave some of that in here, too. I was not always a happy mother. I just was explaining how I was actually pretty miserable back in my 30s when I was working too much. I struggled with motherhood. You know, it's painful to even talk about it. When I had my first baby, I was 32 years old, and I remember holding her and just like, oh, my gosh, I've wanted this baby for so long. And like, I couldn't connect to the love that I had for her. I had postpartum depression. I had a problem with all of my hormonal Charlie's Angels. So I want to say that when it comes to motherhood, I'm a big fan of Marty Seligman, who talks about signature strengths. And I feel like I'm just doing one tangent after another here, but what the heck, we're just going to bring this over. I love it. We're going to channel Virginia Woolf right here and Marty Seligman together.

Awesome. Great combo.

Yeah. So he's got this great exercise. In fact, I think you can do it for free on his website, where you identify your signature strengths, like the top five, the top seven strengths that you have. And my top strengths are. This will be a big shocker for you. Love of learning. That's number one. And love of beauty, sort of aesthetic beauty. And so what I realized is that I needed to do things with my kids that really activated my signature strengths. So I'm a little bit of a freak. You probably can tell that already. And one of the things I did is I started going to. I started doing dye workshops with them where I started learning about toxic dyes and how we, you know, we all sort of understand about how we need to eat organic food and yet we're wearing these toxic clothes. And I got interested in doing these natural dyes, you know, where you use local wildflowers and amazing products that are just around your house. And my kids loved it too. It was like an art project that we could do together. And it was pure pleasure. We've done like eight of them. I mean, it's just, it's so fun. And that's one of the things I do. But that's like a hard thing to do to schedule and it takes some time, etc. But here's something really simple. And I think I learned this somehow from Oprah or Gayle King. I can't remember where it came from, but I learned that when your kid first gets up in the morning, does your kid still sleep in a crib?

Alexandra, my kid sleeps next to me.

Okay. Okay. So maybe you have this. So in my house, I'm usually up early, I'm writing in my kitchen, and then my kids will come up and get ready for school. And I learned from Oprah or someone, you know, kind of like Oprah, about how you want to connect your eyes with your kid and just like shine the love lights and just like totally tune in and say, I am so happy to see you. It is such a pleasure to have this moment with you and how that's such an important gift for your child. It also works well on husbands. I found those are a few quick little things. And now I have a 13 year old who's in puberty. And when the oxytocin and the estrogen is going in the female brain, when you're 13, all you care about really is talking to your girlfriends or texting a little bit about boys and music. Those are like the key drivers, right? So we have this experience of driving to school and when I pick her up from school where we're listening to music, and when you're in your 40s, like I am, you get a little attention deficit. And so listening to rap or hip hop or, you know, whatever it is, blurred lines that seems to be on like every other song. It's hard for me. Like, I can't concentrate. But I've learned that the pleasure of, like listening to music with her and kind of sharing that moment and understanding why she loves the music and what it does for her and what the lyrics mean, like, that is a really immersive pleasure experience. So there's three quick ones with kids. I also practice yoga. You know, my yoga practice doesn't look like what it used to. I used to do 90 minutes of ashtanga almost every day, and I don't do that anymore. I know you practice yoga too, sometimes. What it is is yin yoga for five or 10 minutes, a sacral release on the mat, on the floor. And that's also pure pleasure for me, especially when I'm releasing my low back. I think there's something so important for women. I think we store so much in our pelvis. For me, it always goes into my right si joint. Oh, mine too. So we got to release that stuff, right? It's important.

Well, I love that you brought up the yoga, too, and like the movement, because I'm similar to you. I've been an athlete, and I used to be, like, you know, hitting the pavement and strength and just, like, intense. And now, especially as I'm in this pull pleasure thing, I'm like, I don't really want to work that hard. I like it, and it's fun to do, get a hit every once in a while, but I don't want to do it every day. And then I also realized a lot of the reason that I was doing it was because I wanted to look fit. And it was all about my body image. When I give that up, I just. I'm cool with just, like, chill yoga. So can you talk about the exercise and how that goes, how that goes with our pleasure, and how a woman can really find what does give her pleasure versus just exercising to lose weight or whatever the body image stuff is?

Absolutely. I mean, I think we could probably talk about this for a couple of hours, but I'll just try to hit some of the highlights. When I had that experience with my doctor, bless him, you know, that experience 10 years ago where he told me that I just needed to do the simple math of exercising more and eating less. It was at a time where I was running, and I was just as you described. I was someone who. I didn't feel like it was even worth my time unless I did four or five miles, I would track how fast I was running. I was very immature, masculine about it. I had injuries. I was about 25 pounds heavier than I am now. And what happens when you run or when you spin or you do one of those forms of exercise where you're really pushing your maximum oxygen capacity, VO2 max, is that you raise cortisol. And what I learned was my problem when I was in my mid-30s was that my cortisol was too high already. So I had this cortisol that was about 30 in the morning. It was about three times what it should have been. And when I went running, it would go even higher. Your belly fat, the visceral fat that you have in your belly has about four times the number of cortisol receptors as fat elsewhere. When you're raising cortisol so high, you're actually creating more of a muffin top. So when that doctor said to me I needed to exercise more, eat less, I really didn't feel like that was right. I needed adaptive exercise. I needed to really step into. I'm going to drop a little bomb here. I'm hoping that she'll take it. I needed to kind of find that higher feminine, higher masculine balance when it came to my lifestyle, when it came to mothering, when it came to working, and when it came to exercise and food. So I actually eat more calories than I did before. I think calories are relevant, but I eat the right foods for my matrix and I exercise about half as much as I used to. But it's pure pleasure. Pure pleasure. And sometimes yesterday I was on a treadmill running, and I was doing burst training. And I really love that. I can feel the growth hormone rising when I do burst training. And I usually go running with a girlfriend. And that's a beautiful thing, right? Because it's mostly therapy.

I'm thinking you get the oxytocin connection.

You get the oxytocin, you exercise. I mean, it's just like, win, win, win, right? I think the chief of psychiatry at Stanford one time said, if you're a guy and you want to improve your health, be with a woman. If you're a woman and you want to improve your health, hang out with your girlfriends, right? We know that this is a really effective way to kind of find that balance with higher feminine, higher masculine. So I can say a lot about this. I think adaptive exercise, Pilates, yoga, resistance training, I think those are really effective for some women. They love to dance. Another thing I do with my kids, my 8 year old taught me how to use the we and do just dance four. There I am, you know, I'm like doing J. Lo with her and she's beating me and we're laughing like crazy. And laughing lowers your cortisol. It raises oxytocin. Love that.

That is awesome. I love that. I just went to a dance medicine class, you know, just freestyle dance with Emerson. You know, he's a year today, actually.

Oh, Happy birthday, Emerson. Happy birthday to you, mama.

Oh, thank you. It's. Yeah, I wrote that in my calendar. Like, happy Mother's Day. It's my first year as a mother. That's amazing. And to all the mothers out there, like, happy Mother's Day. It was so Fun to take him to this dance class and see him, like, he's got his own dance. He's like. And it's so fun. And I love that you just had those ideas, too, of, like, how we can play with our kids and how we can just bring little moments. Because sometimes. Sometimes we get so wrapped up in our, you know, the rat race or the masculine. I love that you brought that up. You know, we can soften into our feminine and more like, what would my feminine goddess do right now? Which is different than our masculine goddess.

It's so true. And it's, you know, it's one of those things that you might be a little better at staying connected to this, but I fall into that barrel of immature masculine all the time. Right. And I'll hear myself, like, I be at home on a weekday with my kids, and I'll start to get into, did you do your homework? Did you do your reading? How about the reading log? Did you finish that? What projects are due? What quizzes do you have this week? And I'll hear myself, and I'll just be like, I sound like such a bitch. What would divine feminine do? How could I step into a different way of talking about this that is loving and full of pleasure and feels like a warm embrace? Which brings up hugs, another fantastic way to raise your oxytocin. And Paul Zak did this great TED talk where he says, based on the half life of oxytocin, you want to have about eight hugs a day. Wow. So eight hugs a day. That's another digital prescription for all of our listeners through Paul Zach. And quick little caveat. He didn't mention this, but you gotta hug a guy longer. So you gotta hug a guy about three times as long to get the same bounce in oxytocin. Because women are really good at making it. Men need, you know, you have to, like, pull the layers back a little bit more with men. They tend to be more resilient. You know, I'm gonna speak generally here. Yep. You asked about this earlier. You know, men don't have the same issues with hypervigilance that women do. They don't have the same vulnerability that women do. So that becomes this incredible, sacred opportunity for women to just really look at. Okay, am I rewired in some way to stress like, I was in that mom moment doing the homework whip, or is there something I could do in one minute to rewire to pleasure?

And it's fascinating because it is like a training, right? Like, we're in, especially for women as you know, my husband's super masculine and sometimes I can look at him and I want to be, sometimes I want to be like him, you know, like he's pretty awesome. But then I have to remind myself to come back to what is my divine feminine expression. And it's very different than his. And I feel like I've been in training for the last 15 years of coming, coming back home to me. And I know a lot of women have that right of just the, the masculine is rewarded often and the feminine sometimes isn't as rewarded. Like you're not. People aren't going to call you and say, oh, you had an awesome dance.

Party with your kid.

You're awesome. Right?

It's so true. And I love how you just frame this as kind of the 15 year old path, the 15 year practice. And really all of us are on that same path. Whether you're like Deva Pramal, I don't even know how to say her name, but I love her music. Whoever you are, whether you are a beginner or you've been doing this for a long time, I think we all have to connect back to that beginner's mind when it comes to pleasure and to realize that it's so important to figure out what's authentic for you. So, you know, I adore your husband. I think he's doing such important work in the world. Both of you are totally rocking your mission. Clearly your hormones are in balance, but his path is not your path. Right. So the more that we're really genuinely on our own path and we figure out, okay, Dr. Sarah just went through these 10 different tips for how I can rewire to pleasure. And seven of them just sound like ridiculous to me. But these three, I think I'm going to check those out like the we, Okay. I can do the J. Lo, you got to figure out what's true for you rather than I'm going to grow a startup because that's so rewarded in our culture. So I think it's so important to figure out, okay, what is true for you given your circumstances, your of DNA, your mindset, your mother wound, your father wound, you know, the whole gestalt.

Yeah.

And then a rocket and then rocket baby.

I love that. And I think, you know, that's come up so many in all of these interviews. It's that finding your authentic expression, you know, like, who are you and what are your gifts to really give to the world and then give them. And I love the signature strengths that you brought up. That as well. I love that test, for sure. I mean, my top ones are playfulness, creativity, and curiosity.

Like, ooh, I'm writing that down.

That's surprising. Anybody that knows me or if you've watched these series or seen the video, you know, that playfulness is probably one of my strengths.

No wonder you have such a happy marriage. So that those bid, you know, those are so good, I think, for managing your hormones, for not taking life too seriously. It sort of reminds me, I remember this guy I had a crush on when I was in college, also not cortisol, who said to me one time, he said, you got to lighten up. You're just so serious. You got to lighten up. And I wanted to smack him, but the guy had a point. It's true. When you are so serious and just hard driving and you're deadline driven and there's no room for any pleasure, it's like the last thing on your list. And so you never get to it. There's a cost. Like it's not. You know, I think a lot of women and men have this feeling that, okay, well, I'm just going to work hard, I'm going to do this thing. I don't have any room for pleasure. I'll focus on that a year from now or five years from now. But what we know is that it actually ages you prematurely. Can we have another quick science moment?

Absolutely. I love it.

Okay, so beyond cortisol, one of the things we know is that when you have high perceived stress and it's all perception, it's not the amount of stress that you have, it ages you as measured by your telomeres, those cute little caps that are on your chromosomes. That Elizabeth Blackburn, the goddess biochemist from UCSF, she's the one who got the Nobel Prize in 2009 because she found that premenopausal women. So this is those of us in our 20s, 30s, and 40s, premenopausal women with the highest perceived stress age 10 years faster than women with a normal amount of stress, who have playfulness and curiosity as their top signature strengths and are dancing with their son Emerson.

That's amazing. So this is, I mean, like, pleasure seems to be the way to go on all fronts.

Well, you know, the interesting part about pleasure, I'm going to explain it in another way because I love to talk about these prescriptions in different ways. Since we have so many different listeners and learning styles among the folks who are tuned in. I think of it this way. You know, I'm not saying that I want you to Only focus on cortisol. I'm not being overly reductionistic like that, because cortisol is just one piece of the puzzle. You know, it's a little more complicated, of course, but when we look at the body, when we look at root cause for why we have disease, we know that about 95% of disease is either caused by or worsened by stress. And when you look at chronic stress, I don't think it's helpful to reduce stress. I think the key is that we want to dance with it in a different way. And that includes what I would call kind of the upstream ways of working with that. So in the brain, in the control systems, the feedback loops that we have in our physiology, and also the downstream stuff like our cortisol level, testosterone, estrogen, progesterone, thyroid. So we want to integrate all these different parts. And the beautiful thing about pleasure is that it's like this horizontal. It's like this thread that picks up the downstream mediators like cortisol and inflammatory markers like interleukin 6. And it also works with the upstream part of the equation, the amygdala, the limbic system, the prefrontal cortex. So it's really cool that you can take something like pleasure and you don't need to know the biochemistry, you don't need to worry about your telomeres. Just focus on the pleasure. Case closed.

That's great. So I'm curious on the. You said the stress, perceived stress. And this is so fascinating to me because. Tell us more about that because how do we perceive stress in a different way? What's our framework? How do we change that? And why is that important?

Yeah, well, the interesting thing with stress, I'm not saying that I want you to rid yourself of all stress because we know that we need some stress. There's this famous curve that I can sort of see in my head like two guys names, right? Something, something curve, where if you plot your stress level as a function of productivity, we know that you need some stress to make yourself productive. So the curve is kind of like an upside down U where you want the sweet spot, you want that place where you've got the right amount of stress, so that it's called Eustress E U S T R E S S and you're productive. So you're feeling like, oh yes, you're in that Goldilocks position where you've got enough stress to move you forward and to rock that mission and really feel fully engaged and alive and optimal living. So you don't want too Little. And you also don't want too much. And what I find is that a lot of people are past that sweet spot where they're wired 247 and the iPhone is making them crazy, whatever it is. And I hope I'm not getting you into trouble with all this branding that I've been talking about.

Not at all.

The iPhone, it can actually. It's both a blessing and a curse. But the idea here is that you want to find that sweet spot for you, and it's a little bit different for everyone. It's different for me when my first child was a year old than it is now. You know, my kids parenting isn't as physically taxing. It's more psychologically taxing.

Yeah, totally.

But, you know, sort of, how do you stay at that peak part of the curve? It's peak performance. It's, you know, where you're not so overloaded. You don't have so much perceived stress that you are approaching burnout or you're starting to rob your supply of serotonin, or as my Assistant calls it, Dr. Serotonin, the lovely brain chemical that's in charge of sleep and appetite and mood. So everyone's a little bit different. I think we've got to experiment to sort of figure out what that looks like. I can tell you, when I launched my first book, the Hormone Cure, and we hit the New York Times bestseller list for two weeks, I was a little bit past that peak performance part of the curve. Let me be honest, I was sitting too much. We know sitting makes you fat and dumb. We've got to figure out, how do we shift the way that we look at stress. There's so many different ways to answer this. You know, one of the things that comes to mind is that when it comes to perceived stress, I think for a lot of folks, the goal is to develop that internal locus of control where you realize that you're not stressed because of that boss or because of, you know, something that your partner said to you. You are stressed because you're allowing yourself to have high perceived stress. Now, it takes a while to get to that point. Sometimes you got to get your hormones to be loving you up and supporting you before you can really take on that work. But I'm a fan of doing the physical, the biological reset, along with the psychological emotional reset when it comes to perceived stress.

Yeah, that's because you can't really do either. I mean, you could do either or, but I love the synergy of both of them. And, like, that's where I know, I've experienced miracles if I only work on my mind. Yet my nutrition's not there or whatever, it's not there. But when I do both of them, it's transformative.

Well, they're interdependent, which is so cool. You know, I think we're. We're heading to this really fabulous place when it comes to the way we look at health and optimal living, where we realize that you can't isolate these different parts. Right. I don't know if you noticed this, Alexandra, but our healthcare system is completely broken. And the idea that you go to the gastroenterologist when your gut's not working, and then you go to the heart doctor when your heart's not working, that system is failing. And we need to find a way to integrate all these different parts where we're up leveling our neurohormonal dashboard. That part that you were just describing of kind of figuring out the drivers, figuring out, okay, here's my emotional work that I want to do today or this week or this month. And you're also integrating all these different parts of yourself. Like, I've happened to see your refrigerator. Can we just talk about your refrigerator for a moment?

Sure.

Okay. We're going to have an Alexandria refrigerator moment. So, folks, I have seen this refrigerator. Alexandra does this amazing thing where she's got, like, these lovely. Are they bamboo bags where you have, like, all of your greens?

They're microfiber. Microfiber bags.

Love it. So you're so smart. What you told me is that you have someone who shops twice a week. Because I know you'd rather use that time to be a goddess. Not to say that we can't be a goddess at the grocery store. I personally find it very hard to be a goddess at the grocery store. But you have all this food that's readily available. The same assistant who buys it for you also prepares it and chops it and gets it ready. So when I came to your house and your husband made those amazing kale greens that were cooked in coconut oil with some fantastic pastured eggs, my husband started to have a bromance with your husband. That was a beautiful moment. And that's how you really. When you bring that nutrition together with loving up the bacteria in your gut, and you have that sort of foundation to then work on the emotional, spiritual, psychological pieces. You're right. That's where the miracles happen.

Yeah, totally. Thanks for sharing the love story.

Am I revealing too much? Am I killing all these. These confidential stories?

No, it's perfect. And it's literally like we. I mean, I love that you brought that up because taking for me, I have to. If I'm gonna really engage in pleasure, I have to be eating my kale. Like, I need to have. There's certain things in my diet I need my green juice. Like, I need those things in order to fully surrender and open up to it. So for me, it was like, okay, we're just not gonna eat out and we're going to have somebody come in and do all of our food. It's the same cost.

Yes, it is.

So it just makes more sense.

Totally. I wanted to add that. I'm so glad you added that because I don't want it to sound like we're totally fancy pants because we are paying someone to go do this. I can tell you, when I go out to eat, I spend so much more money than if I pay somebody to go buy some kale and chop it up. And I also want to say I'm so glad that you have those green smoothies and you realize that kale is like the fuel for your goddess work. Not everybody does. There's this gene that makes you taste the bitter taste when you eat things like kale. My husband has this gene. And even if you feel like, okay, that's never going to happen, I'm never going to eat kale and consider that pleasurable in any way. I want to tell you, when my husband was eating the kale that your husband prepared with the coconut oil and the eggs, he was practically licking the plate. He said to me the week before, listen, you've been feeding me Kale for 11 years now. I'm never going to like it.

That's amazing.

But there he was. Thank you, Brian. There he was. Just total pleasure. Total pleasure.

Yeah. I love that you're bringing that up too, because I think a lot of times we associate pleasure, and especially pleasure in our culture. It's like it's indulging in the, you know, the gallon of ice cream or whatever it is that you couldn't actually enjoy healthy foods. And I think, as you know and you teach, when you really kind of reset your system and your hormones and all of that, I wouldn't eat anything else. Like, I literally. I feel too crappy if I do.

Yeah, this is such a good point. I'm really glad you raised it. Should I do a little science? Absolutely. Correlate. Since I can't help myself. What we know is that if you're a cortisol driven person and by now you've figured out that I'm a recovering cortisol junkie. When cortisol's running the show and it's high, it gives you more sugar cravings. So not just the belly fat, the muffin top, the Buddha belly, It also is making you hear jungle drums, especially in the afternoon. You know, why is it between 2 and 4pm that we tend to, you know, want to have the latte or the ice cream? And when cortisol's high, I think it's hard to do what you just described, which I would maybe frame as being able to present value what that choice, what that food is going to do for you and do for the matrix of your body. So people who are able to dance with stress navigate stress in a way that really serves them. They don't eat for emotional reasons. They don't eat a pint of Ben and Jerry's. Now, I love Ben and Jerry's. Give me some chunky monkey. But I can tell you the first three bites are what I enjoy the most. After that, I'm going to have a carb hangover the next day. We've got to present value things like that. Carb hangover. How do we get to the root cause? How do we address the cortisol and the way that you're perceiving stress so that you're not there with the spoon standing in front of the freezer with the Ben and Jerry's. Right, sorry, Ben and Jerry. There I go again with another brand.

And then when we balance those hormones, then we're not doing. We're not doing that as often or, you know, because I definitely still have my emotional. And I'm kind of new, tired mom. But the two to four, I'm like the chocolate. And it's not just the square, like you said, the beautiful, seductive whatever. It's like, I want the whole, whole chocolate bar.

Yes, yes. No question. And if that happens, once again, I would say, darlin, don't look at this as a moral failing. Look at it as a message. Sort of a divine, feminine message. Is it that you don't have enough magnesium? Is it that your sleep needs an upgrade? Because we know that just one night of bad sleep raises your cortisol. And my heart goes out to all the women who have babies because how do you get a good night's sleep? None of my kids slept right. I mean, I know how that is to just be like, don't you dare take my Ben and Jerry's away from me. No, you don't understand. This is my lifeline.

No, I totally get, I totally get that. Oh my gosh, that is awesome. I love that. And for me it's also checking in like, and I think a lot of times we do that, the emotional eating. And I know a lot of women have that and it's a very common thing. And it's like, you know what, I need a nap or I need a hug, as you were saying, or I need to go dance or I need to move my body, whatever that there's, you know, there's only so much the chocolate can give us.

That's right. I mean, it's not going to improve the way your DNA is expressed. I mean, yeah, one square of dark chocolate, 80% cacao or higher, I'm all in.

I love that.

But it's, you know, I hope that our listeners have a sense of this menu, this a la carte menu that they can use to access pleasure. And I can tell you when I, you know, especially at night because women who overeat at night tend to screw up their leptin. Leptin is that hormone that tells you to put the spoon down. And it's a really important hormone that is a cousin to insulin and sort of is involved with blood sugar and the thyroid, a few other things. My next book is about this. So with leptin, one of the best ways to manage your leptin is to ideally not eat for about three hours after dinner and to go to bed with an empty stomach. So what else can you do when you're like, your inner saboteur is just like, hey, that Ben and Jerry's is there in the freezer. I think it's a really good idea for you to go finish it off. We want to attune to that inner saboteur and kind of have our list of, okay, here's my menu. I'm going to go take a hot bath with sandalwood essential oil and some Epsom salt because I know I'm low in magnesium. Or I'm going to call a girlfriend or I'm going to put a tiara in my head. I'm sorry, I don't have my tiara right here. And I'm going to tell my family that I'm off duty for the next 15 minutes. Like it's going to be me time. Like minimum self care time.

Brilliant. I love that. I love that. I watched a video on that too. Your tiara. I am off duty. I love that.

You know, sometimes your family needs a visual cue. My family certainly does. They're like, mom, can't tell me with this homework. I'm like.

I have this on. Don't talk to me.

It's a hard time. Yeah.

That's so great. Oh, my gosh. I love it. Well, so much incredible information. And I just looked at the time and I'm like, oh, my gosh, it's flying by and we're going to wrap up. But I, as you know, love you. I love your wisdom. I appreciate all your research to give us all this incredible goodness.

Thank you, Alexandra. The pleasure is mine. This is like pure pleasure for me. So thank you. You just rocked my oxytocin.

I know. I was like, oh, I have oxytocin flowing now.

I hope we did that for our listeners. That's my wish.

Tell us where we can find more about you and purchase your book and tap into your cleanses and all the things that you offer.

Oh, sure. So the best way to do my book is to go to thehormonecurebook.com and if you want to quiz, if you want to look at some of your hormones and whether you've got some issues with your hormonal Charlie's Angels, you can go to thehormonecurebook.com quiz. And then there's the mothership. Sarah GottfriedMD.com and that's where I talk about my detoxes that I run twice a year and lots of other freebies and other things.

Yeah, she's got some great videos on, just fantastic with her newsletter. I'm signed up.

It's great. Thank you.

Well, thank you. Thank you so much. And lots and lots of love and a big hug and kiss.

Thank you.

Thank you.

Bye.