How Food, Hormones & Shame Are Destroying Your Sex Life l Ft. Will Cole

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Throughout human history, our ancestors knew somehow, inexplicably, ineffably, that our gut was the seed of the soul somehow, that our gut and brain were somehow connected. They didn't have randomized control trials, they didn't have all the science that we have, but they knew from experience and experiencing people observation that there was some connection there.

You're listening to Sex with Emily. I'm Dr. Emily, and I'm here to help you prioritize your pleasure and liberate the conversation around sexual Today's episode is all about connection. The deep, often invisible link between your body, your emotions and your sex life. I'm joined by functional medicine expert Dr. Will Cole, and we're diving into a topic that's been quietly affecting so many of us. Shameflammation. If you've ever felt burned out, anxious, inflamed, or just off and you can't quite figure out why, this conversation is for you, we're breaking down the fascinating science of how emotional stress, unresolved, shame, and even trauma can manifest as physical symptoms in your body, including your hormones gut health and sexual vitality. Dr. Cole and I talk about how libido isn't just about sex, it's a reflection of your whole body health. We explore why so many people feel exhausted, disconnected or dysregulated and how lifestyle shifts, mindset, tools and nervous system support can help you come back into alignment. We'll also tackle the medical system's blind spots around sexuality, the guilt so many of us carry about pleasure, and why self compassion isn't just nice, it's a healing tool. My intention is to help you see your body as an ally, not an enemy. To understand how your emotional and physical wellness are deeply intertwined and to support you in reclaiming pleasure, energy and intimacy from the inside out. All right everybody. Enjoy this episode. Dr. Will Cole is an author, functional medicine expert and podcast host, most known for his popular podcast the Art of Being well. He founded one of the first telehealth centers in the world and has provided insight into the root of physiological, biochemical and hormonal causes of disease and chronic pain. He previously co hosted the Goop Fellas podcast and his insights are frequently featured on goop.com his latest book, Gut Feelings, is out now. Well, I just want to say I'm so excited that you're here and to introduce you to my audience because I'm such a fan of your work and your books and how you've been so innovative in the field of functional medicine, normalizing it for people and in some cases really introducing it to people, what it actually is. And I spend a lot of time on my show talking about how people's western medicine, doctors though they did the work and they work very hard, don't often have the answers for them that they need today regarding their health, around hormones and around so many things. So I think it'd be so helpful to start off for my audience. Just explain what you do as a functional medicine doctor.

Yeah, sure. So we started one of the first functional medicine telehealth centers 13 plus years ago. So this is all that I've done for the past 13 plus years is from 8am to 6pm I'm here. We have a brick and mortar telehealth clinic, but all our patients are remote. What we do differently in functional medicine and first of all, I think defining in the sense of it doesn't have to be either or, right? I think the best of both worlds, a both and not either or approach when it comes to healthcare is the best. And I think this tribalism within healthcare really doesn't serve anybody or we're like throwing pejoratives of like quacks or like whatever, corrupt money, whatever. It's more of, well, what's the most effective tools that causes them the least amount of side effects? Can't we just operate from that? Like really be data driven, but also being in favor of the patient and their health and not just disease management. And that's why functional medicine is not anti western medicine. It really is a part of it. And that's why leaders in conventional medicine like the Cleveland Clinic has a million multi million dollar functional medicine center. Hospitals like Cleveland Clinic are not spending millions of dollars on world renowned functional medicine clinics off of woo woo or quackery. They're doing it because the data speaks for itself and we have to have a both and not either or approach to health care. So I think just bringing people up to date on that, because if you're really still throwing slurs at functional medicine, you're on the wrong side of history. The first thing is we interpret labs using a thinner reference range. The labs largely, if you're looking at the conventional data and the basic biomarkers, the reference ranges are largely based on a statistical bell curve average of people who go to labs. People that go to labs aren't the healthiest bunch of people. So sadly that's why they're going to the labs. So there's a lot of people that know intuitively something's off here, like my anxiety, my depression, my weight loss resistance, my digestive problem, my hormonal, whatever we're talking about, they want, they want answers and they go to the doctor. The doctor runs these, the basic labs because they're trained to diagnose the disease and match it with a medication. So they're running the basic biomarkers. But the basic biomarkers will come back as like quote unquote normal many times or mostly normal. And they're told, you know, you're just depressed, take this antidepressant, or you're just getting older, or you're just stressed, you're just a new mom. All these well intentioned reasons. But what they're unintentionally telling the person is that they're a lot like the other people with health problems that they're being compared with. Comparing yourself to people with health issues is no way for you to find out how you can feel your best. So we're looking at optimal, not average in functional medicine. Like where does the body function the best? That's where we get our name. It's the functional range. Where does longevity, vibrant wellness reside? Which typically that optimal range is a thinner interval of numbers within that larger reference range. The second thing is we run more comprehensive labs. It's based off of health history. So we're looking at more advanced labs like underlying gut issues or chronic infections or nutrient deficiencies or hormonal imbalances or advanced lipid panels, whatever is needed from a data standpoint to get the pieces to the puzzle. And then we realize we're all different. And I think that's the third difference is that we really take into account bio individuality, which you really can't have a cookie cutter, one size fits all approach to getting healthy when it comes to these complex nuanced health issues. And we realize that health and health problems exist on a spectrum. By the time somebody is diagnosed with a chronic health problem like an autoimmune problem or chronic cardiometabolic issue, researchers estimate it's about four to 10 years prior to that diagnosis when things were brewing on this inflammation spectrum, this continuum between health and health problems or function and dysfunction. So that's really what functional medicine is. It is a both end approach, is evidence based. We're using food as medicine, we're using natural medicines, herbs, botanicals, all science based to support health medications when needed. Mind body techniques, trauma work, therapy, lots of advanced biohacking to really be tailored to the individual. What is their most effective option that causes the least amount of side effects.

So just to clarify for a minute, because I've had this experience where we might go to a lab and get tested, like if I go to Quest or one of the labs that your doctor sends you to go get blood work and then I'd look at them over the last year and each lab had a different normal range of what my testosterone should be or what my estrogen should be. And it was so confusing. And so most people are just like, well you're in a normal range, but that doesn't mean anything. There's so many other factors like what your gender, what your health history is. You have much more specific tests like I know the Dutch test which measures like urine and then there's stool tests. And I just think that those you are getting a lot more information about, about what you can kind of hone in on what's going on right, with people rather than just the standard means of tests. But also in your book you talk about the connection between what you eat and the way you feel. Let's talk about the connection between what you eat and the way you feel.

Anything that I write is about. It's really born out of my work with our patients and seeing so many stories and a lot of clinical experience, a lot of looking at labs and seeing the science and art of wellness, of how really to use data and the latest research. But then what's the heart of all of it? Like, what's the space in between the words and the data and, and getting somebody well and having this translate to life for real people? So that's what Gut Feelings is about. I mean, the name of the book, it has many layers from like a writing author standpoint is that we have this phrase that's in the human lexicon of like gut instinct and gut feelings. And I just feel it in my gut or butterflies in my stomach that somehow this is part of human existence and our vernacular. But what are the origins of it? That throughout human history, our ancestors knew somehow, inexplicably, ineffably, that our gut was the seed of the soul somehow, that our gut and brain were somehow connected. They didn't have randomized control trials, they didn't have all the science that we have, but they knew from experience and experiencing people observation that there was some connection there. That's known in traditional Chinese medicine, it's known in Ayurvedic medicine, and it's known throughout all traditional medicines. This connection and now research is catching up with antiquity that the majority of human health, at least to some degree, begins in the gut. I mean, there's layers to that. I mean, 95% of serotonin is made in the gut. That's our happy neurotransmitter. 50% of dopamine is made in the gut, our pleasure neurotransmitter. These things work upon the vagus nerve. The neurotransmitters are made in the gut. They don't necessarily pass through the blood brain barrier as we understand it, but they work upon the vagus nerve, which is the largest cranial nerve in the body. It's responsible for the resting digesting state. It's when people talk about a dysregulated nervous system, what they're typically talking about is an overactive sympathetic fight or flight stress state and an underactive parasympathetic or poor vagal tone or weak vagal tone. So a lot of what I work with my patients and what I'm talking about in gut feelings is a dysregulation of the neuroimmuno endocrine axis, or the connection between our nervous system, as I just mentioned, our immune system, chronic Inflammation is a product of that and the endocrine system, our hormones, and the sort of crosstalk, bidirectional communication line between those three systems. So the vagus nerve is what's innervating the gut brain axis mainly. It's a central part to many people that are struggling with mental health issues, autoimmune problems, metabolic issues, digestive problems, hormonal problems. It's a major factor, and there's a lot of gut centric components to that. But the book is really this conversation about the bidirectional relationship between mental health and physical health, that both gut and feelings, the physiological and the psychological, are both interplayed.

Don't go away, because after a quick break, Dr. Will Cole is breaking down the four plus one things we should avoid to take care of our bodies.

Most of our patients are dealing with these neuroimmuno endocrine axis issues. There are physiological things that will impact the system, like underlying gut problems, environmental toxins like biotoxins, like mold, bacteria, viruses. Issues will impact our physical health, will impact our mood, will impact away our nervous systems, regulated, will impact inflammation levels. But then conversely, the feelings side of gut feelings, the mental, emotional, spiritual factors like stress and unresolved trauma. How those feeling things will impact our physical health and the research around that is just wild. These things are literally stored in our body just as much as a food that doesn't love us back. Our body is a cellular library. And really talking about thoughts, words, emotions, and experiences will influence our biochemistry just as much as a food does. And these things that we're not just feeding our body with breakfast, lunch, and dinner, but what are we feeding our head and our heart on a daily basis, which is a lot more nonlinear. I mean, it's like, easier and more prescriptive for me to say, okay, these foods, these nutrients, do X, Y and Z. It's a lot more abstract and complex to talk about big, heavy topics like stress and trauma. How do we clear those and start serving our mind with things that love us back and retraining that it's important when you're dealing with autoimmune issues and digestive and hormonal problems, it's important to talk about both sides of this coin.

Yeah, and I love that you do that so well. In your book, I heard you say, like, you can't heal a body that you hate. And I always say you can't have great sex in a body that you hate. And you also say you can't shame your way into good health and you can't shame your way into good sex. Because as you know, we talked about it. Everyone should check out your wonderful podcast that I was on as well. The Art of being. Well, it's sort of the same thing. People are like, emily, give me a great sex position. What toy should I use? Tell me about this lube. But how have you dealt with shame and trauma? And I know you talk about shameflammation, which is just brilliant. Can you sort of explain a little bit about shameflammation which is sort of the, the more like mental psychological part of this health picture.

Yeah. So it's, it's that side of how does shame and things that cause shame, how does that impact our biochemistry? How does it influence that neuroimmuno endocrine axis? And it will influence it just as much as food or nutrients or you know, drink something, you drink something. Physiological psychological impacts of physiological. So the, the reality is shame and the research around shame, things that cause shame, which the big areas that I talk about in the book and that I see with telehealth patients is unresolved trauma and chronic stress and someone feeling inadequate, they're eating foods that don't love them back because they're busy and stressed. There's a lot of shame flammation with that. And then of course with unresolved trauma, most people can understand that there's a lot of shame around that. But also the health related shame and orthorexia, which is disorder to eating around healthy foods and shame around people's bodies like you said, or shame around food and their relationship with food. These are complex things, but all will contribute to shame. Inflammation like stressing and shaming yourself about healthy food or health and wellness isn't good for your health. But yet this is the complex conversations that we need to have with people even within good topics like wellness or health, you know, nutrition, all this good stuff, if it's not put into context, used in a way that serves you, it can be abused. Good things can be used in a way that's not right for you. I think that really educating people with this, not for them to then stress about the shameful information, but to really be empowered to say look, let's great create a greater awareness on what I'm feeding myself on a daily basis with as far as my head in my heart, like what are the things I'm taking in online or what are my boundaries with myself? What are my boundaries with technology? What are my boundaries with health and wellness and what's serving me? And more isn't Always better. I talk about in the book the research around self compassion, which self compassion in many ways is the ultimate antidote to shameflammation. Because there is one study that I talk about in the book of how they the researchers had people do a stressful event. The two activities, it was math and public speaking, which apparently stresses a lot about a lot of us out. So there could be a lot of shame, like oh my gosh, I'm not good enough, I'm inadequate, I'm overwhelmed, I'm never going to be successful at this. So they measured these interleukin 6 inflammation levels io6 they people had higher inflammation levels that had stress and shame around these things, embarrassment around these things. But the people that practice the most self compassion, which it's really hard to have a lot of shame when there's self compassion. It sort of buffers and mutes it and heals it and like a salve on it, people that practice the most self compassion had the lowest inflammation levels. So these aren't just some theoretical woo woo things. These are measurable practices that we can integrate in our life and retrain our neuroimmuno endocrine axis by practicing things like self compassion and gratitude. And I talk about many other tools that have like very many esoteric connotations but actually have very physiological implications when we consistently practice them.

I love that you tie that into the book and show people that everything that we are thinking and feeling and doing is living in our body, impacting our mental health, our physical health and our sexual health. So I love the studies around self compassion. It truly is the antidote to all of this shame. It really is. Like, yes, you might not feel great about what you're eating or about how you handled a certain task, whether it was math or public speaking. But in that moment, how do you say, like, I did the best I could today, I did the best that I could do for myself. Loving yourself, and that's what we're talking about here, is really the more self compassion and self love we can have, the easier it's going to be to get healthy overall.

And I think too, to your point, loving yourself where you're at now doesn't necessarily mean you're accepting where you're at. Like sometimes it's knowing, okay, this is where I'm at right now, being almost compelled to want more for yourself and not beating yourself up for being inadequate, but saying, how can I lean into things that love me back? And a lot of this has to do with retraining the nervous system. We have deeply ingrained things, self sabotaging behavior as many of us do from early on that we kind of learn and we need to unlearn that and retrain it. But these are the things that we, that we work on with patients and for the from a book standpoint these are accessible. Like most of the tools on the feeling stuff are free or low cost for people to really if they're consistent with it, they really can see amazing changes to start to shift their biochemistry through retraining that neuroimmuno endocrine response.

Let's say people have an unhealthy relationship with food or they keep eating things that don't make them feel good and they're like why do I have to have chocolate three times a day? Don't really understand it. And I love that you have a great way of reframing it that it's like literally these foods are not loving you back. And it's not that you're giving up something and it's going to be horrible that you can't eat chocolate, but look at what you can do. And it's sort of a brilliant reframe if you can kind of talk about those exercises of it's hugely important.

And that's why the subtitle of the book is healing the shame fueled relationship between what you eat and how you feel. So part of that conversation that I wanted to have in the book is this, I think toxic tribalism within diet culture. What people would call toxic diet culture and then I would say equally toxic anti diet culture that it may be the phrase the road to hell is paved with good intentions. I think that the rebound, opposite, polar opposite response but ends up being the different side of the same coin is this equally toxic anti diet culture which the diet culture is all about. Eat less, workout more restriction, obsession, shaming your way into health. As you mentioned, like the back of the book, I've got feelings. I say you can't heal a body you hate. Sustainable wellness has to be born out of self respect and loving your body enough to nourish it with things that love you back. But then the flip side is this phenomenon on social media and within certain areas of wellness or nutrition that there's quote unquote, no such thing as a bad food and eat whatever you want and it's not going to impact your health and it can create a lot of of disordered eating around that too because it kind of removes all basic logic when it comes to nutrition. And you look at the majority of the human race right now the vast majority of people have a metabolic issue and have things that food directly feeds, food feeds disease and you can't ignore that. So I think that you have to have a both and approach even with this is that yes, shaming your way into health is not sustainable. Menorah is ignoring basic nutrition facts either.

I got excited because you were getting to the point of you talk about the big four plus one which I've heard you talk about like that we should be avoiding. And I love the plus one. I got a lot to say about that. But just basic information because people are like oh, a little bit of pizza is fine, but what are the four? What should we be avoiding?

Sure. So these are the foods that are most likely not to love people back. Right. And this is not about restriction, this is about the person being curious. Just like you teach us to have sex IQ and be highly intelligent from a sex intelligence standpoint. I want people to have that same body intelligence for themselves. And this isn't about oh, I can't have that. Like I say to patients and I say it in the book, eat whatever you want but use meals as a meditation and as a medicine and you may find that it's different. Like you're going to be different than somebody else. And that's okay. There's a lot of bio individuality and this isn't about weight loss. Like if we all ate and worked out the same we still would all look different. And that's okay. There's a lot of bio individuality. But I want people to really being intuitive and mindful about what foods love them and what foods don't love them back. And I think we love to have these conversations around healthy boundaries when it comes to other people and everything is like gaslighting but the reality is no, we need the ultimate relationship when it comes to healthy boundaries is with ourselves and having self respect when it comes to things that don't love us back. And look there is legitimate like when you talk about medical gaslighting around on my patients and on many it's legitimate. But I think it's so flippant with anybody that disagrees with you. It's automatically gaslighting. It's not always gaslighting. Sometimes they just don't agree with you. And that's okay to have different opinions about things. But anyways, the foods that don't love people back most likely and I can get granular with the exceptions and the nuance but the inflammatory core four plus one because it's A drink liquids would be gluten containing grains, that's wheat, rye, barley, spelt, oats can be cross contaminated. They are mainly wheat. But it's the hybridization, it's glyphosate spraying of the grains. Humans would have consumed a different grain for thousands of years. So looking at gluten containing grains as disrupting the microbiome and raising inflammation, it doesn't love a lot of people back. It can love some people back. And the least likely to be inflammatory would be things like ancient grains that still has gluten in it, but just more ancestral and sourdough bread and sourdough grains because it ferments the grain proteins making it more digestible. And it's going to love more people back because it's less inflammatory. Second thing is added sugar. And being mindful of the labels, even nicer sounding euphemisms for sugar, like agave nectar, like higher fructose added sugar, absence of fiber can be problematic for many people because of the amount of metabolic issues and blood sugar issues that we face as a society which feeds mood issues and hormonal problems that will wreck people's sex drives. Like all of these things that I'm talking about will decimate some people's sex drives. So they think, oh, I'm broken or oh, I, it's just me and we talked about this on my pod. Like they think oh, I'm just, I just have a low sex drive. But it's not, it's. They're settling for something that is overcomeable and healable and optimizable. And these foods will impact estrogen and progesterone and cortisol and thyroid hormones which impacts libido. So looking at dairy, sugar grains, dairy would be the third one. And the better versions would be like fermented dairies, like cheeses, kefirs, yogurts, because the fermentation, just like the sourdough with the bread, breaks down the casein dairy protein making it less inflammatory. And the fourth would be industrial seed oils like canola oil, vegetable oil, soybean oil. My opinion is it's more of the over consumption of it and not so much that those oils are the devil, but that Americans don't eat enough long chain omega 3 fatty acids from whole foods and they eat too much packaged foods with high omega 6 industrial seed oils. So it's more of the ratios of omega 3, 6 and 9 more than just demonizing those oils by in and of themselves, that's the context around it. And the plus one is alcohol so it's really. I mean, I hate to sound like a puritanical teetotaler because I'm not, but I really want people to take a really good look at does this love them back or not. And the research is pretty clear. It's a neurotoxin. It's going to increase intestinal permeability. We all have different bio individual thresholds to tolerate these things, but we should at least look at how much does this love me back or not? The caveat for all of this is what researchers refer to as an evolutionary mismatch, an epigenetic genetic mismatch that humans would have not consumed these things in copious amounts. And our genetics haven't changed in 10,000 years. Our microbiome hasn't changed in 10,000 beyond years. So we are eating out of alignment with what we have evolved with and is triggering genetic predispositions and triggering problems like low sex drives and other hormonal problems, other neuroimmuno endocrine axis issues. Because we're eating out of alignment.

I kind of want to turn the focus into our libido and our sex drive. Are there foods we should avoid? Like, what do we need to know about what we're putting in our body and how it's impacting our libido, our sex drive? What have you seen in your patients when they start to avoid certain things or add certain things? What can we do right now to start impacting our sex drive for good?

Yeah, all this, the Core 4/1, like, get the better for you versions. Like, if you really want to keep them in and if you, if they work for you, the better for you versions that I mentioned, then get them. There's. I'm not saying it's, it's absolute or it's all or nothing. Again, this is about using your meals as a meditation and medicine. Eat it mindfully. Does it love you back or not? And avoiding those things. If it doesn't love you back, it'll be like a bad trade off. And that's the paradigm shift that I want people to have. I call it food piece in the book. And with patients, it's like, my patients don't care about not having things that don't love them back. They love feeling great more than they want something that's going to mess up how they feel.

I know that I've taken out gluten. I feel so much better. But for a lot of people, it seems like it's a lot of work. They're like, okay, so how do you know, like I took out gluten but I left in oils or I mean do they have to do it all at once? Like what have you seen in the order of events?

Most people to mitigate variables as much as possible and be their own end of one experiment, it would be to do what's known as an elimination diet, which it doesn't like, I hate that term. Like it's, it sounds so punitive. Elimination and diet, like both just. But it's just how are we mitigating variables statistically off of things that are most likely to disrupt the microbiome and not love most humans back? So yeah, going off of those for a while. It's not about calorie restriction. It's about switching how you're fueling your body, eating foods that love you back, nourishing calorie rich, nutrient dense foods and then bring one end at a time reintroduction is just as much as taking a break off of those foods because you want to see does it love me back or does it not love me back? I talk about it in the book. If people want a detailed experiment for themselves. Read my second book. It's called the Inflammation Spectrum, which is like based off of questions that I ask patients and can kind of see how we do this with re introduction. But I talk about it in gut feelings more basic because that book's less about like the nitty gritty granular nutrition stuff and more about like the relationship with food. It's more of like the heart and soul of it and healing your relationship with food. But the, I mean it's all of this stuff is inextricably linked to our sex drive and hormones. It really is. And it's not just about the things you're not having. Look at the foods that don't love you back. Because the body is amazingly resilient and when you give it a reprieve, it can start functioning the way it wants to function. And it's not having these things that are dampening its function. It's a amazing what the body can do when it has a break and it's not working so hard at just digesting things that don't love you back. And then it's all about like nourishing your body with delicious things that do love you back. Like what are things that can build strong hormones and can build proper signaling between all of your sex hormones?

What are those foods then? So what are the people was like, Emily, is there an aphrodisiac? Are there supplements? What can I Take what's gonna make me feel the most turned on tonight? Like what? I don't know that I believe in aphrodisiacs. I'm like, if oysters turn you on, they are kind of sexy and look like, you know, female genitalia in some ways. And they feel good and they're sexy to eat because there's a few steps and watermelon too. What's your take on like the foods that are going to impact that? Your libido, your sex drive. If there's anything you could say, and I know you're like me, we can't say, everybody go run out and buy oysters or go out and take maca. Although that might help. Is there any kind of general rules or things that you notice that some.

Of it is the unsexy stuff that actually will make you feel sexy. So. And it's starting with the most unsexy word ever. It's in at least the top 100 macronutrients. It's like, oh yeah, give me some macronutrients. But the protein, fats and carbs, like really looking at, am I optimizing my protein, fats and carbs? Because that is the raw material you need for proper hormonal production, blood sugar regulation and communication within your body. So optimizing carbs, fiber rich carbs help with hormone detox and gut health. And where 20% of your thyroid hormone is converted in your gut. But also those fruits and vegetables are polyphenol rich, which are antioxidants, which really helpful for cellular health and hormonal communication. And they have vitamins and minerals too. Protein making sure you have enough, adequate, complete protein throughout the day, like around, depending on your height and weight and activity level and age. Around 30 grams of complete protein per meal. Most people are not strategizing. No, it will help with satiety signaling. You'll feel less hangry, your blood sugar will be more balanced, which is like a. Insulin signaling is a hormonal balance. But beyond that it will help your other hormones as far as your estrogen, progesterone, cortisol levels and thyroid hormones to be properly regulated. It's kind of a firm foundation glucose control for other hormones and brain function and healthy fats. Your hormones are made from fats. So you need fats like olives and avocados and wild caught fish and grass fed beef and these, these monounsaturated polyunsaturated omega fats and saturated fats to have proper hypothalamic pituitary ovarian testicular communication lines. So, yeah, it's that. That's the unsexy stuff.

Okay.

And then if you want to get, like, granular. I mean, look, I think oysters, these, like, cliched aphrodisiacs, mainly because they're mineral rich, I think is really what it is. Like zinc and copper can help with hormonal production. So that may be. I mean, I guess it does look.

Like you have to have a lot of oysters. You have to have, like, a lot of oysters maybe to get that. Stick around, because when we're back, Dr. Will Cole and I are shedding light on the complex world of hormones. Can we get into hormones a little bit? Because I know we actually even asked our listeners for some questions about hormones, and a lot of them were like, can you just explain testosterone? What foods help? I'm just gonna, like, list, like, what came in. Like, what foods can help boost estrogen? Do hormone sprays work? Was one of them. Do hormonal fluctuations affect men also? I just think that hormones is still so confusing for many people, and even the way you get tested for hormones. And again, I know this is a big topic, but being on a show where, you know, we're talking about sex, we talk a lot about testosterone, hormone replacement, that women also could benefit from it. So I guess my first question is maybe we could either start with, like, running down the hormones and how they affect our sex drive, like testosterone, estrogen, progesterone, and then maybe if there are specific foods that you do actually believe could help aid in hormone production.

Yeah, the main hormones. When you're talking about sex drive, libido, which I would then open that up to mood, it's very much still mood and energy, too. So it's not just about sex. It's about zest for life, is how many people explain it to me. I have a lack of zest for life, which includes sex drive. The main hormones are going to be estrogen, of course, and all its metabolites. So estrone, estradiol, estriol, progesterone, and all that's metabolites and testosterone and all of its metabolites like DHT and other androgens. And then I would add thyroid hormones to that too, because low thyroid hormone will really wreck your libido and energy levels and mood. So I would add that and cortisol very much a part of that as well. The point is, these are biochemical emails, and you need all the emails being sent appropriately because they are communicating within the systems of the body. So yeah, those sex hormones like estrogen, progesterone, testosterone are the most common ones you associate with libido. But it really is all the other ones. It's insulin with blood sugar regulation and it's thyroid hormone and cortisol. They're all intercommunicating that are influencing each other. So you really have to have a holistic view of this. So go back to what I said about macronutrients because that is foundational. You cannot supplement your way out of a poor diet. You have to start with that, that. But then if you're looking at specific, different like let's say herbs or science backed natural supportive tools to support hormone health, I think an easy area to talk about here would be adaptogens, which I do talk about in gut feelings at length. We use it, use them in telehealth patient protocols as well. You mentioned maca. Maca is one that has some decent studies around it. Other adaptogens like ashwagandha, holy basil or tulsi has been used. Both of those have been used in ayurvedic medicine for thousands of years. Hoshe Wu, like the traditional Chinese medicine, adaptogens can be helpful. Schischandra is another adaptogen. Even medicinal mushrooms can be beneficial here like lion's mane and chaga and turkey tail. And not that people need all of those things. But I am just saying these weird words for the only reason I'm just pulled to like educate themselves on and like maybe I'm bringing something like that, maybe adding some of this into my smoothie or taking some capsules that have these in. They all have their own therapeutic doses as far as the research is concerned. But start off low and slow, experiment with them. But they can be great at supporting the hypothalamic, pituitary, ovarian or testicular axis. So people are dealing with hormonal fluctuations. The great thing about adaptogens and the science around them is that they have a regulating effect. So if hormones are high or hormones are low or you know, kind of erratic, they have a stabilizing, modulating effect, Adaptogens do. So it's a good starting place, you know. And then there are specific ones like we use a lot of with low progesterone, which can impact a lot of things. When it comes to mood and sex drive and fertility. We look at things like chaste berry or Vitex that can be really helpful. Other adaptogens can be very helpful. Wild yam can be helpful for progesterone estrogen we look at estrogen dominance. We'll typically see we want to help with methylation and detox or something like dim and these sulforaphane compounds that can help with clearing out estrogen. Dong quai is a traditional Chinese medicine herb that can help with supporting healthy estrogen levels. So those are some herbs and botanicals for people to learn about and educate themselves. Again, it's not about adding in the supplement graveyard for you to take all of those. It's just about maybe one or two of those can be a supportive tool after you deal with food. You have to start with food.

Yeah. Okay. Well, I have a supplement graveyard. I love that term. I literally have one. And it's growing. It's massive. Will. I don't know what to do with it. It. Because I believe all these things. I'm like, I need ashwagandha. I need dim, I need E. I have them all, and then I stay on them and then I go off them. So for the last five or six years, I've started to look at, like, my hormones and perimenopause and fluctuation. I've been to different doctors, and it took me a long time to kind of figure out what. What actually worked. I told you, I went to a few clinics, and then the. The range was different. And I hear this all the time from my listeners who, like, I got my hormones checked and I was. Was fine. Do we send them to you, Will? Do we just blow up your lines right now of your telehealth clinic? Because even for me, to be honest, I'm still figuring it out. Like, did that work? Did it not? How do I know? And I am taking HRT right now. I do take progesterone at night when I remember. I take estrogen, testosterone, and I play with them all. And it's kind of hard to know. And then you run out of one. And, like. And then all my friends, all we talk about, like, do you take the patch? Do you insert it inside of you? Like, it's freaking overwhelming. Take the pellets. Yeah. Which I do do the pellets. I like the pellets because for me, I can just set it and forget it. I know that that's controversial for some doctors because you can't tweak it, but for me, I've got just jars of creams that if I fall asleep, don't forget to do it. It's a problem. And I have been in this and I'm paying out of pocket, and it's been really overwhelming. And I'm just wondering what would you recommend? Like, would it be a certain book of yours? Would it literally be calling your clinic and getting into or finding a functional medicine doctor? I always say go to find a hormone specialist or someone who specializes in this. It might not be your gynecologist, it might not be where you live. So like what do we do here? Because I know that you have the most up to date, cutting edge information and I know that you share the passion. You share the same passion about food and health and hormones that I do about like sex, sexual intelligence. So like I want to help the people. Like where do we start?

Right. And I think that's why another word for functional medicine is integrative medicine. Because we deal, we refer a lot of people to people in your space to deal with that. With the sex, sex therapy, we deal with the physiological things and they often will deal with like the practical things or the mind body things. And the trauma work, we deal with a lot of trauma specialists too and integrate with those when they're needed because all of this comes together. Right. So I mean, yeah, there are, this is our day job, 10 hours a day. People can reach out to us. Drwilcool.com, we have many new telehealth patient options, like group models. We have one on one with people that just run labs, I mean that aren't even like in a care plan. They're just doing labs to get some insight and answers. And we can coordinate with any local doctor that needs to be.

And we have amazing.

Yeah, so it's. And if they don't, if they want someone locally and they don't want someone, telehealth like us, go to functionalmedicine.org and that's the Institute for Functional Medicine, the Cleveland Clinic's functional medicine center. They're all the physicians there are trained through ifm. That's who's trained me and my team. So you can go to a directory there and if you want someone locally in your city, you can do functional medicine.org too.

Okay.

And then yeah, I think labs health history. For someone that's spinning their wheels, I would say test, not guess because I think that you can kind of shoot in the dark and it can become, it can become kind of erratic where you're just like experimenting and guessing and you don't really know. It's like basic based off of just what. There's like no concrete follow through and systematic plan. And I like organization and I like spreadsheets and I like data. So if I can see where these hormones, for example, are at. And we bring in an intervention and then retest. Also correlating that with how you're feeling, we can narrow down granularly what is the most significant needle mover. So we. Part of our job typically is weeding and editing down that supplement graveyard or whatever that graveyard is, so, you know, you aren't taking a crap ton of stuff. And, you know, like, these are my needle movers. Like, what do I need? And it's based off of how I feel and data. And there's no, like, second guessing about it.

Okay, that's great. We're going to put that in the show notes because you're going to be getting a lot of phone calls. I know. I hear, for example, from a lot of male listeners. You know, half of our audience are men. And they'll say, like, oh, they got into a certain age. And I know I often say, like, testosterone can drop after the age of 40. And so your penis stops working. That's when we get men's attention, right? They're like, what can I start doing? Would you say that that's true? And then would you. That you see that more and more that there is a testosterone thing. But then some guys I know have gone to maybe a regular clinic test, like, my testosterone's fine. Is it true that. Well, number one, that some men are fine, or are they maybe not getting the right kind of tests? If they are having some symptoms of low testosterone, yeah.

What would you say? So they're having low sex drive, low libido, erectile dysfunction, any other sexual or mood energy, weight loss, resistance. I mean, all this stuff's tied into it. And this is the caveat for a lot of hormonal problems, no matter who you are. Just because something's common doesn't necessarily make it normal. Like chronic health problems. Hormonal dysfunction, certainly ubiquitous, but we settle for it. Like, this is all a sign of accelerated aging. Like, there's nothing wrong with aging, but accelerated aging and guys in their 40s and 50s settling for things that used to be their 70s and 80s and 90s. That's the problem. Yes, testosterone decreases over time, but people are having tanked testosterone way too soon. And even beyond the number of their free or total testosterone, what's the signaling of those hormones? Because many people. It's not a production issue. It's a. Am I. Is my body even utilizing it? And look, we have the vast majority of guys and just people in general having insulin resistance, which is just one problem. But it's a big problem of things that will in part over aromatize testosterone into estrogen. So you'll see at higher estrogen levels in biological males and they feel like crap and they think, oh, it's just because I'm getting older. No, it's because you're insulin resistant and it's completely reversible or you know, largely optimizable. Let's just say that to be conservative. Many people settle for it because they think, you know, that's their thing and they hear these commercials and they think I just have to take a testosterone cream or whatever.

And that's more of a band aid, wouldn't you say? Like if you're calling 1-800-low-T you might just. Right. I know, really, like then you're getting a testosterone. And for women we can talk about this too. I've learned so much about how progesterone and your estrogen are also impacting each other and the testosterone like they're all playing together in a dance that's all friggin related. And it's all related. What would you tell women then about testosterone and estrogen? And we all need them all.

Yeah, we all need, yeah, Men, women, no matter who you are, estrogen, progesterone, testosterone are all needed in different amounts. So for women, testosterone is very much needed for sex drive and energy and muscle building and fat burning. So it is absolutely important. It's going to have a different optimal zone than men, but it is certainly important. And it's one thing that we have to optimize if we're dealing with these fatigue, weight loss, resistance, low sex drive, you know, if we're putting that under an umbrella. So we have to optimize that. That's why data is so important, because you can see these numbers improve and there's a place for hormone replacement therapy. You know, I, but we, we should start with asking the question why do I have this problem in the first place and get our body to produce it on its own. And when you reverse insulin resistance or support insulin sensitivity and decrease inflammation and support these hormonal pathways, it's amazing what when you do that, you, hormones can actually be produced endogenously, naturally and get your body do it now look, once you do that, here's a great example, someone's way better when they've done these important things that we do with patients. But then hormones are better but not exactly optimal. So at that point you could talk about precursors like pregnenolone or DHEA or herbs that can help with supporting hormonal synthesis and production and signaling. Or sometimes hormone replenishment is appropriate, like low doses of estradiol or progesterone or testosterone. There is a time and place for it, but it should be based on data and it should be a later option once you, you, you've done the foundational work. Because even if you need hormone replacement therapy, when you get the proper signaling and in the body working appropriately, you're going to typically need less of that hormone replacement there because the body's going to be better utilizing what you're giving it versus the people that are, like, just overdosing on these. You know what I mean? They're just copious amounts of hormone exogenous hormones when they don't necessarily need all that stuff because that can actually be problematic and cause hormonal resistance pattern because you're just flooding your cells with all of this extra hormones. Not based on labs, just based off of whatever a doctor telling you to do it.

I did see a functional medicine doctor probably five years ago, and it was very overwhelming. Like, I left with like a million supplements. There were so many problems. He wasn't that into the hormone replacement therapy at that time, but I think what he was trying to say is you need to build things up. But then over time, it got busy, the pandemic. I started taking hormones. So now I'm wondering if, like, what you're saying is that maybe I need to scale back and the. There's some more things I could do with my nutrition and supplements, because I'm hearing that maybe I'm bleeding on it too much or many people do. That's not your first line of.

No, it's not my first line of defense. And it should be based on labs. Look, I think you should be judicious about all of those things, right? Start with food, be judicious with supplements, and be judicious with hrt. And I think that starting off low and slow, building up allows you to not get that supplement graveyard or these things that you like. You're not even sure, like, so many people will be like, I don't know what's working. Like, like, I think I'm a little bit better maybe, but taking the edge off. But I don't really know what is the needle mover. And we want to do the best job we can to see, you know, okay, these handful of things are helpful for you. Normally, HRT happens after the other stuff to see what the body can do on its own. And then after you've gotten to a better place, but maybe you need some, like, a little bit of a boost, then the HRT can be that boost for some people.

Now I think I have to call your clinic when we hang up. The reason why I'm having you on, Dr. Wilkol, is you really were have been an innovator in this space. The fact that you've had this telehealth clinic for 13 years and you've written all these bestselling books, I feel like you really are somebody who can help people understand, you know, their bodies in a way that they might not be able to where they're living now or they can't find the doctors. I really appreciate the work that you do.

I love what I do and thanks for giving me the opportunity to talk about it.

I'm going to ask you, like the quickie questions that we ask all of our guests. We. There are just five quick questions, but is there anything else here? Let me just think that we really wanted to get to. Because I think you just, you really helped us a lot here and even myself, because I think that looking at the foods we're eating, understanding that, seeing what we can do, make sure we're moving our body, we're dealing with unhealed trauma, we're in therapy, we're understanding all the factors that are contributing to it is just important.

One thing I was going to say that I forgot to say earlier are nutrient deficiencies. Just real fast, about sex drive and energy that I wanted to just mention real fast and then we'll get to the cookie questions is that I'd be beating myself up if I didn't mention this. And I'm like, oh, man, I didn't tell the people. But iron is another major one. When you're talking about low libido, looking at iron, iron saturation and ferritin, which is stored iron, when you're talking about fatigue, brain fog, low libido, low hormone issues, I see that a lot. That. But vitamin C and copper, the mineral copper can help with iron bioavailability and absorption. So that's one thing. It's a very common deficiency that I think everybody should get their labs tested in addition to the other ones I mentioned. When it comes to hormone health, it's about the nutrients that make the hormones, too.

Now, that made me think of one more thing that I actually talked about in your podcast was what have you been seeing about birth control pills and women who have been on it it and then they go off it. Or maybe they're just on it because what I've heard is, what I've seen in studies over the years is that you're on a pill and that's going to impact your hormones. It could be for life. Like it's really hard to get back to the normal range or whatever it is and it can really be a disruptor. So how have you worked with women.

Yeah.

Who have been on the record and what's your take on it?

You know, I'm pro choice when it comes to people having informed consent with whatever they want to do for their bodies. But I think, think the key term there is informed consent. I think many people are given these pills without any really robust, open, full spectrum conversation with their prescribing doctor. They're just given to it for any number of reasons. Maybe it's contraception, maybe it's some hormonal problem, maybe it's their acne and they're just like given these pills and they're on them forever and it's just like, just take them and look, there's no full conversation on this. Could do this, this and this. Because this could cause this, this and this and then make the right decision between you and your doctor. The problem is it's just given out like candy in many ways. Like it's just flippant. Like everybody's on it, just take it. And it just, I see people that really do have a difficulty coming, coming off of it and trying to conceive later on or trying to get their hormones and just feel good. Nobody like if you're on hormonal oral contraceptions for anything other than contraception, if you're doing it for other purposes, hormonal skin issues, you don't have that problem because of a birth control deficiency. So why, if you're on it for some other reason, let's ask the question, why do you have the problem in the first place? So I'm not anti it. I just think that there's a lot more effective options that causes people the least amount of side effects. Like we said at the top of the conversation that it could be a tool within the toolbox for some people who want to be on it. But they made that decision because they knew all the facts. And I think that there's just a lack of full fact acts in these conversations. And there's other forms of birth control. Like many, many women decide to do the copper IUD because it's non hormonal and it does cause some low grade like local inflammation. It just doesn't work for everybody. If you have A copper allergy or whatever. But for the average person, that's a consideration to talk to your doctor about. Or of course, condoms. Like there are other forms of birth control that aren't going to impact your biochemistry as a woman that many of our patients find to be better alternative than throwing off their hormones and being on a pill for years on end.

Thank you. And then is there finally like one thing when we're talking about sexual health that you've seen in your patients overall over these years that you think was like the biggest thing that they did or they changed to help them? I know this is a big question to help them start to move the needle and start to feel more desire. Was it just getting tested through you and getting on the path? Was there a certain change in their diet or exercise? Was there anything that you've seen? Like this is a good place to start for many people.

Yeah. I mean, look, I think the more abstract, like non, like more abstract thing. Is that how you mentioned the back of the book? You can't heal a body you hate? I know that's more conceptual, but I just. All of this has to be born out of self respect, not out of obsession. So we need to check ourselves. If you're not coming from that intention, check yourself. Like check yourself with that. So that's more conceptual but like practical stuff. I think organization and basing things on data is hugely helpful because you can edit down what you're doing and you can compare and contrast it and you are not shooting in the dark and like hoping something's working. So I think that that's testing and tracking and having someone outside of yourself to manage these things or at least collaborate with you on these things can be hugely helpful because then the granular, nitty gritty stuff, it's going to look different for different people. There's a lot of like science and art and evolving that will happen over the course of that time. But I think the commonality that I see for people that are successful and see it through, that put in the work and the consistency to work on this project, that's them. And not in an obsessive way, but just in like a nourishing respect way about themselves.

Thank you, Very helpful. Okay, so here's our big quickie questions or a little quickie question. Just whatever. And it could be anything. Like whatever first comes to your mind. What's your biggest turn on?

Wow, we're getting personal. Dr. Emily Morris.

But it could also just be like the wind blowing.

I'm just joking. I'm just joking. You can ask me anything. What is it? You know what it is? It's being. This is so lame. But I like, I'm a pretty introverted person. This isn't going to be quickie, but I like chilling out at home and like, and just hanging out with my wife and like not having anything on the schedule, which I'm so like scheduled throughout the week. I like not having a schedule on the weekends. That's like hugely like great for my nervous system, which is a huge turn on.

So with you, biggest turnoff.

Unkind people, intolerant people.

Okay, what makes good sex?

I would say connection throughout the day. You know, it's just like even if I'm texting my wife in between patients and like I'm not with her physically, but just like we can stay in touch and communicate, I think that makes the best sex.

That's great. Something you would tell your younger self about sex and relationships that I think.

What our culture puts out there is in form of movies or images that guys see growing up. It's not the reality. And I think that we need to empower men specifically because I'm coming from a man's perspective of really, how do we, if we're heterosexual, male, but no matter who we are, how can we respect our partner and not see what we can get out of them? But how can we really love them to be the best, highest version of themselves? I think is the big paradigm shift that we need to have in relationships, no matter what type of relationship you're in. Because I think it's. We live in such a self serving, selfish, greedy culture that it is like such. It's unsustainable and like sex is still sex, but, but it's just typically really it's not fulfilling. I think from a, like, I don't know, I think from a loving standpoint, unconditional loving standpoint.

Mm, that's beautiful. What's the number one thing you wish everyone knew about sex?

I'm putting my functional medicine hat back on now. Here is that I would say many people settle for a sucky sex life and they think it's just their lot in life or it's just who they are. But I can't tell you. When you look at data and you see estrogen, progesterone, thyroid, cortisol, all these numbers off and you're like, no wonder. Who could have a great sex life with numbers like that. It's like you have to optimize these things to have the sex life that you were created for or have this thing that's your birthright. That's a normal human thing. And accelerated aging isn't normal, but it's ubiquitous.

Thank you so much for being here. We so appreciate you. Thank you for all the information. It's really going to impact our listeners, I know. Deeply.

Thank you.

That's it for today's episode. Thank you so much for listening to Sex with Emily. And if you love the show, please, like, subscribe and leave a review wherever you get your podcasts. And hey, share this with a friend or a partner. It might just spark something. It usually does. You can find me on Instagram, to TikTok, YouTube, Facebook, and X. It's all at Sex with Emily. Oh, and I've been told I give really good email, so sign up@sexwithemily.com for free guides and articles and more ways to prioritize your pleasure.