Balancing Estrogen Dominance in Midlife: How to Rejuvenate Your Hormones for Optimal Health

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So thank you so much for being on with me today. I really want to get down and dirty and learn everything that you know about gynecology in 30 minutes or less.

Perfect. I am so honored to be here, though, Marcel. Like, truly, you are one of my trainers going into functional medicine, and I just appreciate all the work that you've done over the years for women. You're a rock star.

So thank you, thank you, thank you. So let's get down and dirty. You know, a lot of people still don't know about functional medicine and the difference between a conventional, or let me call it allopathic gynecologist versus what you do. Can you help the audience really understand the difference? Because I think, in my opinion, I'm going to be bold enough to see. I think it's kind of a little bit malpractice when we don't look at the whole picture.

Yeah, I mean, I couldn't agree. That's why I jumped ship and left that world. I could no longer practice that way once my eyes were opened and I understood. Understood how functional medicine actually heals women. So I like to explain it as you go to the gynecologist. You know, a lot of women will go for their annual exams or they have a complaint. You know, their periods are heavy or they're painful or they're having mood swings. Whatever your complaint is, you come to see me as a gynecologist, I have about 15 minutes to run through all your history.

Figure out and listen to your complaints, come up with a plan, and make that plan happen. And the plan is usually, here's the medication to cover up the symptom. It's kind of a band aid approach, or here's the procedure we need to do to investigate a little more or the surgery to treat something. And so it's just kind of this band aid approach where you're covering up symptoms and not really addressing the symptoms. So the trend that I started to see over the years was a woman would be on birth control pills for whatever reason. We go on them for a multitude of reasons. Eventually they could no longer tolerate it, or they were having breakthrough bleeding, having issues. They would try an iud, Then their periods would continue to cause issues. They would go for an ablation or hysterectomy, and then they'd be diagnosed with breast cancer. And so I'd watch these patterns happen. And as I started to study functional medicine, I realized, oh, my gosh, there's hormone imbalances driving these processes that we are not addressing. So If a woman is having symptoms, say of estrogen dominance, like heavy periods, we're getting rid of the symptom, right, by burning the uterus or removing it. That's what I was trained to do. But the hormone imbalance continues on and drives other disease processes and we are not even stopping to realize any of that. And I think what most women don't realize is gynecologists are surgeons. Right. I didn't study the intricacies of hormone balance in my residency. I was busy learning how to do a hysterectomy four different ways and doing C section and delivering babies and doing office procedures. So we're just looking to the wrong people for help in these situations. And I say, don't even be mad at your gynecologist. They just don't know. And we're asking them things they don't know. And we're getting mad when they're not giving us the help that we need because they're the wrong person. Right.

It was so interesting a few years ago. I still teach the hormone module for ifm, the Institute of Functional Medicine, and each year we're starting it actually this month to kind of look at peer reviewed articles. And I came across one two years ago looking at, there was a large, large study looking at the endometrium and the microbiome of the endometrium actually predicting dysfunction. That goes to your point Exactly. Which is that when we have a problem, we have to go to the cause of the cause. And that's why I love functional medicine so much, is medication will do. Yeah, it'll do. It'll stop it, perhaps. And then you've got other problems because of the medication, because we're not getting to the root of it. So I so agree with you. And it's so exciting that some of this information is coming to light now.

Yeah, I mean, I remember giving antibiotics for chronic endometritis, like abnormal uterine bleeding that, that we just couldn't fix. Like we couldn't fix it with the birth control pill. I put that in air quotes. And. And so we would eventually just give antibiotics and say, oh, that must have been an undiagnosed endometritis, like an infection in the uterus. And really it's because it's a microbiome problem. And it's like we do all of these things in medicine without a lot of thought or contemplation behind how it's actually working and what mechanism we're, you know, in intervening on. It's crazy to me. And same thing with acne, right? Like we give women doxycycline and tell her, take this every day for two years and it'll clear up your acne. Oh, yeah, we're kind of getting to the root cause, but not really. We know it's a bug problem or a bacterial problem, but we're not looking at the gut, we're not addressing the root cause of where it's actually coming from. So it's like we're still missing the mark pretty bad.

Yeah. I mean, what's so interesting though, is when you've done the work as long as you haven't and I have, is that the things that you see get better and they are so incredibly grateful because no one has been able to figure it out for you. I mean, let's talk a little bit more about why do you think so many women have such hormonal imbalance? Because we see it every day on all spectrums from the person that's still having periods, to the perimenopausal, to even the menopausal woman. I mean, I'm seeing it more now than I ever have in my history. What are your thoughts about all of this in terms of what's happening, why so many women are having these problems?

Yeah, so when I think back just to medical school, you know, which was 20 plus years ago, there was no talk about hormone imbalances that did not exist. There was no such thing as estrogen dominance. Perimenopause was taught to me to be like this one to two year time period right before your period stopped, where you had some hot flashes, night sweats, and maybe skipped a period or two. Like literally, that is how life used to be. And you know, what we've come to understand are there, there are a few things really driving all these hormone imbalances, especially just in the past 40 years or so. But they've only been acknowledged in the world of medicine for maybe like 10 or 20. Really. And what's happening, you know, this, a big part of it is the xenoestrogens and all the chemicals that we've created as man, they literally did not exist, you know, maybe 50 years ago. And now we have thousands of chemicals that our body is ingesting and absorbing and inhaling and consuming every single day that we just never have in history. Like our great great grandmothers did not heat their food in plastic and drink out of plastic and have plug in fresheners and candles around the house and just taking in all of these chemicals. And that really Drives a lot of our hormone dysfunct function. You know, now we're seeing man boobs and children with earlier puberty and poor kids who are obese. A lot of it is driven by all of these chemical disruptions. So I would say that is just a big one that I've noticed just, you know, coming out of training in, you know, the late 90s, early 2000s to now, it's such a huge difference. And I think it's because the food industry has really taken off. Like, it's really exploded. Everything is like, we want it quick, we want it now. Right? The other thing I've seen, especially in the last couple years, is our alcohol use and liver dysfunction. So, you know, I just don't think God created our bodies to drink alcohol every single day. And really, from all of this pandemic, we've gotten into habits of, well, I'm stressed. I'm going to have a drink. I'm bored. I'm going to have a drink. You know, and now we're drinking every night. And that is so taxing on our liver. And every time we have to metabolize or break down that alcohol or that Benadryl, the Tylenol, pms, all these things, we can't break down our hormones, so they get put on the back burner. And we, you know, we start to create this picture of hormone imbalance because we're metabolizing all of this alcohol. So I see a ton of that going on. And then our guts, right? That's my favorite part. That's why I call myself the gutsy gynecologist. Our sad standard American diet has really destroyed our guts to the point where we have the wrong bacteria living in there. They are causing us to reabsorb our hormones. We have yeast overgrowth that is contributing to fatty liver. Like so many things that we don't think about as women. And I definitely didn't think about as a gynecologist. I just. Let me tell you, you know, I was a surgeon. I did a ton of endometriosis surgery. I remember going into this abdomen one day, and there was a film, like a slimy film of scar tissue and infection covering all the bowels. And I just thought, that's not endometriosis. What is going on? And, you know, everybody's putting their two cents in in the room. The anesthesiologist, the circulating nurse, and everybody. And they're like, oh, that's Crohn's disease, or it's this and that. And we Weren't really sure.

But the most important part for your listeners to understand is that the bowels literally lay on the uterus, the ovaries and the tubes. There's no segmentation. They're not compartmentalized. And so all of that that was going on in the BO had scarred onto her pelvic organs and had destroyed her fallopian tubes, and she had lost an ovary during that procedure because everything was so scarred and such a mess from a gut issue. And we really don't put the two and two together. We think if you have a gut issue, you go to the gastroenterologist. If you have a GYN issue, you go to the gynecologist. And those guys don't talk to each other. Right. When literally everything that's happening in your gut is affecting your uterus, tubes, and ovaries, either directly because they literally live together or chemically because of the infections and inflammations that are sending out these chemical reactions into those areas or the other ways. Like, you know, this my favorite enzyme in the gut, beta glucuronidase. It's made by certain bacteria, and it can actually cut the garbage tag off your estrogen and cause you to reabsorb it. So, so many intricate things that we just don't even think about as conventional gynecologists. And that can be the game changer for women actually reversing endometriosis, fibroids, chronic pelvic pain, all these diseases. And, you know, the answers are there. We're just not looking in the right place.

Absolutely. And I think point to you is when I was very early in my career and I was seeing these women that always had symptoms of PID and we called it chronic PID at the time. Well, as it turned out, no, it wasn't that at all. It was, you know, chronic bowel dysfunction. And I was in a very conventional practice at the time and then started going over many years ago to more than I care to say on air and started looking at, wait a minute, there's a bigger picture here. You know, what's going on in the gut. And. And certainly all my contemporaries, they called us the granola head docs when we went to Grand Mountains, because it was like, okay, what do they have to say? You know, you're going to eat granola instead. But we got people better because we were looking at the. At the root of the issues, including, you know, many years ago, Helicobacter pylori. You know, we treated that in a very, very different way, because the research was showing that you could do that, and it was like, oh, my gosh, look at what they're doing now. Or probiotics. So the good news is those things are no longer seen as ridiculous. But the bad news is that still, you know, in gynecology, we don't think of a stool test being as important as, you know, a pap smear. And it is, in my opinion, because that really is going to lead us down a healthy path.

Yeah. And I think it's important for your listeners to understand that it kind of depends on what part of the country you're in as well. You know, I'm in an area of the country that a lot of people have not ever heard of functional medicine. And the gastroenterologists have never seen a functional stool test. You know, so when I order these tests on women and I'm giving them gut healing regimens, their. Their gastroenterologists are like, what the heck is this thing? You know? Whereas in other parts country, there are gastroenterologists actually ordering them. So change is happening, but man, is it slow. So you have to find somebody who knows about functional medicine, who's comfortable with it, because so much of it is interpretation. This is what I get all the time. I get people coming to me. I had a stool test, I had a Dutch hormone test, but nobody tells them what to do with it, or their doctor tells them, oh, I can't interpret it, or it's fine when it's really not. And so you really have to be careful about all these tests that you're just ordering without any proper guidance. Right?

Absolutely. I, I do a call on Monday nights with Kevin's group. I'm the kind of hormone specialist for that. And somebody was on the call saying my sex Hormone binding was 269, and my doctor said it was fine to not worry about it. And three other people said the same thing to her. And I said, oh, we probably do want to do something about that, because it's another marker. It's nothing serious, but we can do something about it to reverse it. But it is going affect your hormone balance.

So without a doubt. Oh, my goodness.

So it's still unfortunately part of, you know, the puzzle of what goes on in regards to all of that as well. So let's talk a little bit more about. I want to backtrack a little bit to the question of estrogen disruptors. Some of the listeners may not have a clue what that even means. So let's talk about what that is, because it's crucially important for people to understand what that scenario does and the implications of it as well.

Yeah, it's as simple as if these chemicals are getting into your body, they can bind to the receptors that your hormone was going to bind to. Say, you have trillions of cells throughout our body. And a lot of women don't realize this, or gynecologists. We have estrogen receptors in our brain, in our bones, in our skin, in our cardiovascular system, and nobody talks about that in conventional medicine. And so these chemicals get into our body and attach to these receptors, and they send a warped signal. It's not the exact signal. It's a little bit warped. And so it can stimulate growth, especially estrogen's a growth hormone. You know, it grows our breasts, it grows the hips, the fat on our hips, it grows the lining inside of our uterus.

And.

And you don't want that growth stimulation happening. And so that right there can drive that dysfunction. And, you know, just cleaning up your exposure to all these toxins that are coming in every day, that could be the difference between heavy, painful periods or not. You know, I've had multiple women who I. My only suggestion to start with was switching to organic tampons and pads or using a. A diva cup. And literally just getting rid of the toxins they're absorbing in their tampons was enough to stop their painful periods. And their women are amazed. I mean, I was amazed when I first learned it, and it was a game changer for me because I was on the verge of getting an endometrial ablation, and I prevented all of that by implementing all these functional medicine tools. So it can be pretty simple sometimes.

I just want to reiterate also that the average age of the young girls having their periods to start is going down. And the reason for a lot of that is secondary to the estrogen disruptors they're exposed to. So the plastics and water bottles, the plastic bags we put our food in, putting things in the microwave in a plastic container, there's very simple things that you can do. Be mindful of the Teflon pans that you're using in your kitchen and getting away from that. And they have some waterless pans. They are more expensive, but you can just buy one at a time until you can build it up. Those things are game changers, and they can make a huge difference for people. And there's also the mold issue that we have for so many people, too, because our houses are so airtight, you know, which is amazing for us. But if you have any black mold, what happens is we inhale that and could cause health problems. So the amazing news is we can change that and we can get better. We don't have to feel sick. And if you don't feel well, we have to figure out why. That's the key piece.

So, yeah, I mean, that's so important because conventional medicine is very much a disease focused model. They are managing your disease, they're trying to figure out your diagnosis and keep you there. Unfortunately, there's not the mindset of healing and thriving. And so if you see someone who's practicing functional medicine, they're going to get you well, you're going to get your life back and you literally can be well until your last day. There's so many amazing things you can do do.

Amazing.

Absolutely.

So let's talk about the birth control pill. You know, it's been something really controversial in the world of functional medicine a bit. People ask me this question all the time, and that is that, you know, women don't have great options if they don't want to get pregnant. So, you know, initially it's a wonderful option. It depends on your lifestyle and your sexual appetite as to what's going to work best for you. But using them, you know, is something that some women need and want and should use. But what about the long term effects? What about being on there for years and years and years? You know, that's where I get concerned in regards to what is it doing hormonally to us?

Yes, without a doubt. Like, this is a big passionate area of mine because I was on a birth control pill way too long because I didn't have informed consent. If I had realized that it was going to cause chronic leaky gut and vitamin and mineral deficiencies and help turn on my autoimmune condition of Hashimoto's and Raynaud's, I would have opted for something different, but I didn't know that. And so I'm not against the birth control pill. Right. I had a baby when I was 17 years old. I was a high school dropout. The only way I went on to become a doctor is because I was on birth control and didn't have another child. So I'm all for you having options and I just want you to have informed consent with those options and know what you're signing up for and know when to look for another option, you know, and change things up. So you're right. Birth control pills, they seem to be okay for certain women in the short term. Some Women can't tolerate them from the get go, but a lot of women can. And they can tolerate them, I don't know, three to five years. And then the cumulative effects start to show up. This chronic vitamin B deficiency and zinc deficiency and these other minerals that your body isn't able to absorb and you start seeing leaky gut and gut dysbiosis. And we know now that that can activate autoimmune conditions if you have the genetic propensities for those. And so if there are alternatives for you, it's worth looking into, you know, and it's sometimes it's something life altering as no libido. I remember I had a girl who was maybe 26, she just had her second baby. She went back on the birth control pill right away because they were done. Like she had two under two or something. And she came into my office crying that she hated her husband and she didn't want anything to do with them. And she couldn't understand why because he was such a good loving guy. And it took me a couple months and I finally, I was reading or studying something and I said, let's check your testosterone. And it literally was non existent. I said, okay, do an experiment with me. Let's go off the birth control pill for just two months. You're not having sex anyway. You hate your husband. Like, let's just see. And within four weeks she called and she was like, I need birth control. I love my husband. I feel like a different woman. I feel like myself again. And that was a really eye opening moment for me as a physician. Like the pill really does change us. It changes who we are, who we're attracted to, you know? You know, there's a study out that shows it changes the type of man we're attracted to. It makes us attracted to less masculine men. And so women are choosing their life partner on these sex hormones, these synthetic hormones. And sometimes that isn't necessarily the right decision and you know, that ends up in regret. So there's a lot that our body.

Goes through taking these synthetic hormones. And the other piece that women are confused about and that we confuse them as conventional gynecologists is we say, we're regulating your hormones. Take this pill, this will fix you. We're regulating you. And that is the biggest lie that is perpetuated out there. We are literally shutting down your hormone production. We're stopping the communication between your brain and ovaries. You are not making your hormones, you are not regulated. And women are really surprised to hear that. And unfortunately, a Lot of them don't learn it until they go off the pill and their period doesn't get come back. They said, where did my period go? I said, you weren't having one that was all synthetically induced. You have not been making your hormones. And so if women knew all of this, I think they would say, oh, okay, well, let's talk about IUDs and condoms and diaphragms and, you know, other options like, let's do this or the rhythm method or whatever, because it is not that innocent.

Yeah, absolutely. And what do you suggest for women that are coming in that are on the younger side? They've been on the birth control pill for 10 years, and they say, you know what? I don't want to do this anymore. Because we don't. You know, that's the part that's so difficult. Some people don't want IUDs. And let's talk about the IUDs as well. You know, the progestogens and the IUDs versus the, you know, the copper tea or something like that.

Yeah. So I, I want to have a serious conversation about are you completely done having children? Do you want a permanent solution? And for some women, that is not a comfortable decision that they're willing to make. They. They don't ever have that final decision, and that's okay. But if you do, you know, a tubal or a vasectomy, those are, are good options. If you are completely done, I say I treat it like it's not reversible. There's times you can reverse it, but you want to treat it as it's not reversible. So the IUDs with hormones in it have synthetic progestins in it. And this is what we tell women as conventional gynecologists. There's a little bit of hormones in the iud. It works locally inside the uterus to keep the lining from growing too thick. So you either will have lighter periods, no period at all. Most people do just fine. There's a very small chance of it going through your uterus and having to be removed in the or. That's very uncommon. So that was my spiel for, like 15 plus years. The truth of the matter is that synthetic hormone is doing more than just preventing the lining of your uterus from growing because there's a big fat artery on both sides that are about an inch away from your ovaries. And that progestin goes directly to your ovaries and affects your hormone production. So for a lot of Women, it's not just that they're not growing the lining. It's that they're no longer making their sex hormones or they're severely altered in their production. And we don't acknowledge that in conventional medicine. And the IUD companies definitely don't acknowledge it. And so it's really common for women to gain weight, feel depressed, feel anxious, get acne, and we poo poo them. We tell them they're crazy. We tell them that couldn't possibly be. That's just working locally inside the uterus. It's not an issue, Marcel. It wasn't until I personally got an IUD and, and was so suicidal that I had thoughts of jumping out of my office window one day that I understood, and I removed it myself. And I said, okay, some the these patients are not lying. They're not crazy. This is real. And so what did I do? I. I tried the lower dose iud. So I went from the Mirena to the Skyla, and I had the same exact response, even with the much, much lower dose. And I gave it at least I don' five or six weeks. I was miserable. And I said, okay, I have to be done with this. And, you know, I just don't think a lot of gynecologists realize that when patients are saying these things, they're not. They're real. They really are real. They're not crazy. Their hormones are imbalanced. We might not have a diagnosis for it or know exactly how they're imbalanced, but we know they're being affected. So.

If that's you, if you can't tolerate hormonal birth control, a copper IUD might be a great option for you. There is no hormones. There is some literature out there, people saying that copper can exacerbate estrogen dominance. What I say to that is, let's fix your estrogen dominance. Let's get your hormones balance. And you probably won't have heavy, painful periods on a copper IUD Again, that is just a warning sign from your body. Your body's trying to tell you, hey, you're out of balance. Pay attention. Most women tolerate the copper IUD really well. It's like the most preferred method out there, and it's 99% effective. Like, it doesn't get better than that. It lasts 10 years, it probably would last a lifetime. I mean, honestly.

Yeah, I agree.

So it is a great option. And if you're not that sexually active and you can plan for it, barrier methods are great. You know, I used a diaphragm when I was 17 years old for probably two years and I didn't get pregnant. So if I could figure it out at 17, you could figure it out. It's. It's not that difficult or terrible. And there's like one size fist all now. It's so easy to get. So there are other options. We just don't necessarily push them or talk about them in the gynecology office.

One thing I wanted to point out is there is some literature showing that when you're on one of the IUDs with the progesterones in them, that actually decreases your own progesterone. So what happens then is if you have a low level anyway and you're on that, it makes it even lower, which really increases suicidal ideation as well as depression.

Oh, it feels terrible.

Yeah.

And you don't sleep, you're anxious and ugh, it's awful. Thanks.

So let's talk a little bit about what about those people that are wanting hormones and menopause. Because it's a whole different thing. And let's talk a little bit about synthetic versus non synthetic hormones. It has certainly in my practice, been a lifesaver for many women when we're kind of looking at all the pieces to the collision. So what are your, what's your take on all that?

So this is what I think is hilarious. We will give birth control pills to women until they turn 50. And then we freak out on them. You got to get off that. You're going to get cancer. And we take them off and tell them good luck. Like literally, that's how we're taught as gynecologists. How about, what are the effects of those synthetic hormones that you've just been on for 20 years? What has that done to your physiology? But we don't think about that.

That.

So what we've been trained to think is that hormones are only dangerous after menopause. And when I first was in medical school.

You know, everybody got estrogen at menopause. Like that was super common. Oh, you're going through menopause. Here's your estrogen. And then 2002 rolled out and this study was stopped abruptly. Freaked everybody out. The media ran wild, scared the doctors, you know, and everybody just stopped prescribing hormones overnight. And it was a disaster for women everywhere. Like, my heart still breaks for all those women that had their hormones abruptly taken away. I remember one woman, she was in her 70s, she had a stroke like the following week because she just had been taken off her hormones. And that Stuck with me. And I said to my attending, my trainer, like, do you think that's connected? And he was like, oh, no, that's not connected. And she haunts me to this day because it was totally connected that estrogen was protecting her cardiovascular system that whole time. And then it was abruptly removed. So that was just another little seed that was planted in my brain. So I go through training and I'm taught, like, be super cautious. Only use it if absolutely necessary. Lowest dose, shortest duration.

Only for hot flashes and night sweats, only vaginal estrogen for dryness. Like, very judicious. And so I come out and I inherit this mature type practice. The guy I'm replacing is 74 years old. He's delivered these women's babies, he's brought them through menopause, and they're all on their hormones. And I thought, what in the heck am I going to do with all these patients on hormones? And he wasn't scared of the WHI study. He knew better. And I learned so much inheriting that practice because I literally sat and listened to every one of those women and tell me why they felt they needed their hormones, why they were on them for 20 plus years, how their life was so much better than their friend who wasn't on hormones. And I learned not to be afraid of hormones. And so, you know, I'm practicing for a while and I'm give. I'm prescribing hormones a lot more frequently than the rest of my colleagues. And they're still deathly afraid. They don't want to, like, send in refills for me. They're like, what are you doing? And the studies start trickling down. And then, you know, the. One of the main creators of the Women's Health Initiative, that study that scared everybody incorrectly came out and admitted, like, they wanted that study to show hormones were dangerous. That was a biased study. They were wrong. They did a lot of things wrong. And we now understand, like, like the age. The population of women in that study is not the population that we would put women on hormones.

Right?

You know, this, like, the average age woman, I think, was 63. And the majority were obese and smokers and had cardiovascular disease. And so they were 10 years without hormones. And here we go and give them synthetic hormones and they have blood clots and strokes. Yeah, they're going to. Right? Like, we did not choose a good population or they did not when they did this study and they finally admitted all this, but the damage is done, right? But meanwhile, we have hundreds of studies saying the Complete opposite. The hormones protect our cardiovascular system and our brain function and our skin and our vagina and everything else. So it's. The tide is slowly turning. But I will tell you, most people in the conventional space are still very afraid of hormones and confused and they won't touch it with a ten foot pole. But for me, when the day that I was so depressed I wouldn't get off the couch was the day that changed everything. Like, I had three days that I didn't want to talk to my husband, I didn't want to run my virtual practice anymore. I was like, I'm done. Screw all of this. And on the third day, I realized I think my estrogen tanked and I put an estrogen patch on and within 24 hours I had my life back. And that was a clear sign to me that this is a game changer for women. And I had always prescribed it and helped women with it before, but I didn't understand it the way I do now. I get it. Like, some women literally cannot function when those hormones shift and go away. And I'm one of them. And I will fight for my hormones until the day I die because I. I'm not myself without them. And so many women, you hear this every day too. Like, I don't feel like me. I don't know what's wrong with me. What happened? Where did she go? Where did she go? And it's because you lost your hormones and they're part of who you are. And if men went through that, there would be no question, right? You'd get your hormones today, they'd be fully covered by insurance and everybody would tell you, good job. That's just not how it is for women, unfortunately.

And I can't reiterate this enough, I mean, the interesting thing is, if you look back at the study, just for the listeners here, the study was very skewed. Number one, it was a synthetic hormone. It was using Prempro, which is synthetic estrogen, and then a synthetic progestogen. And when we looked at the study, many of the women, in fact most of the women, were post menopause by 10 years. The women that were actually menopausal at the time did not have the health risks associated even though they were on a synthetic hormone. So it's really, really important. And because I teach this now, people, there are thousands now of studies, or let me say that differently, hundreds of studies now supporting everything that you're saying. It's helpful for the brain, it's helpful for the cardiovascular system. Now, if you have a history of breast cancer, that's a whole different story. But there's other things that need to be fixed in that scenario. But for many women.

For them, they describe it as, I can't be without them. I feel so different. When I was in practice, I would say to people, look, if you're still on the fence a little bit here after 5 years, go off them for a little while and then you can make a decision as to whether you want to stay on them or not. And they would come back saying, don't you ever, don't you ever take me off these again. And because they felt so good. And when you check hormone levels, we really do everything you're talking about. People can feel amazing into their 80s and 90s, and we have a culture that doesn't understand that, but we can be fit and spry and think properly, you know, long, long into our 80s and 90s, which is not what our culture tells us.

Process well, yeah, and, you know, people are saying that we're going against nature, whatever. And I try to explain, like, we as a society have advanced so quickly, our physiology has not had time to catch up. If you look at the lifespan of a woman, In 1900, we died at 48. Like that was our average lifespan. We did not live half of our life in the menopausal state. Fast forward to now. We're just at like our prime going into menopause. Women are running countries and running their families and, like, accomplishing all these incredible, amazing things. I am not ready to go on the porch and knit like, you know, if I was, maybe I would not need hormone replacement. But because we have advanced so much and we are doing all these amazing things, we have to keep our physiology up, keep up with us, you know, and so don't feel bad, have a complete, informed decision, have a conversation with someone who understands the true risks and benefits and alternatives, and then make a decision that sits well with you because at the end of the day, you have to live with yourself for the rest of your life. And this impacts everything. This impacts your relationships, how you interact with your children and your co workers and just you as a woman, everything about you will change without your hormones.

Absolutely. And the great news is, for many people, there are bioidentical options available at the regular pharmacy now. And, you know, as long as you're not allergic to peanut oil, you can get the progesterone. So, you know, we don't have to just expect that we can only get it through the compounding pharmacy if Finances are an issue. So it, you know, things have come such a long way.

Yes, exactly.

So tell the audience, please, please, please, how they can get in touch with you, because there are many women are going to listen to this and they're going to say, there's no functional medicine. Gynecologist close to me, I need help, perhaps even with hormone replacement therapy or looking at the big picture of stool testing and things like that. So how can they get a hold of you to see if you can their states?

Oh, yeah. Thank you. The best way is to just go to Dr. Tabitha.com. it's D, R, T, A, B, A T, H, A, no eyes, and just fill out our form to work with us. And you'll schedule a call with my team and they'll help you figure out, do you need to turn over all the pieces of the puzzle and see what the heck is going on with you, or are you doing pretty well and menopause is just taking you out at the knees? Do you just, just maybe need some bioidentical hormone replacement? So that is something that my team can help you figure out. And yeah, we're licensed in over half the country, so we can help a lot of women, which is pretty amazing. And I even work with women in states we're not licensed. We just work in a coaching capacity and help with all these functional pieces of it. But know that there is help out there. So if you're being dismissed, if you're being given bad advice, just keep searching. Like, like keep listening to podcasts like this. Reach out to other providers who have actually been trained in health and wellness because you should be able to feel amazing and enjoy your life.

Absolutely. Thank you so much. And thank you for all the work that you're doing for all these women because they really are needing it, especially in some of these towns that just don't have this available to them.

Oh, my gosh. My pleasure. Thank you so much.