Menopause, Hormones and Reclaiming Your Health

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I often tell patients what you should eat should fall into 4 categories. The things that you eat should have at one point walked, swam, flew or grew because there's no free-range Twinkies. There's no Dorito trees.

Okay, ladies, you've just about hit 40 and all of a sudden things are just like, what's going on? Is something happening with my body? Things are different. My hormones seem a little bit out of whack. Well, that's not just you. You're not alone. That could be happening. And to help explain what's going on and help solve a lot of these issues and get you back on track, I am so so excited to bring one of the most world-renowned experts in all things hormones, menopause, things of that nature, and to tell you what is actually going on and how to solve some of the problems and get your head around all the craziness and get you excited about what's to come and give you some clarity. One of my favorite people from New Jersey, our actual Speakeasy New Jersey leader, Dr. Betsy Greenleaf. Welcome. Welcome.

Thank you so much, Eric. I'm so excited to be speaking with you.

Yes. And for those that don't know you yet, they're going to get excited to get to meet you. And Betsy is a renowned, a premier expert in the menopause, andropause. She's a bestselling author, an entrepreneur. She's a multi-entrepreneur. She does lots of stuff. Spokesperson, innovative specialist in the female pelvic medicine and reconstructive surgery for over 2 decades. Definitely a trailblazer in all things there. She's sought out by a lot of people in the space. She's made history as the first female to achieve board certification in urogynecology. We'll have to get into that. She's also founder of the International Pause Institute, giving those in premenopause, menopause, and andropause their life energy and sanity back. The CEO of the Pelvic Floor Store, your online resource for pelvic health, and the founder of Pemversity, a woman's empowerment through education website. Her approach is holistic, focusing on body, mind, and spirit, guiding countless busy women to discover pelvic peace, inner strength, and reclaim their confidence. Yes, we all want that. All right. That was a lot. An incredible background. Every time I talk to you, you're like, I got this going on. I got this going on. I'm doing this now. I'm like, oh my God, how do you have time to do it all? Do you sleep?

I know it's entrepreneurial ADD.

Yeah, exactly. Well, before we get into all this stuff, I mean, there's always a story. I mean, you don't just magically wake up one day and be the world-renowned expert in menopause. Like there's a story to get there. And also I want to point out for those listening today, you know, if you're not female, you might be surrounded by loved ones that are, that you might want to make sure they listen to this podcast and/or, you know, join you and help give you some clarity. And also as entrepreneurs and owners, you know, Betsy's done a lot on the business side that's been really impressive, especially the social media front. So she's going to also drop in some great tips on that side to how to really scale And do some magical things. So that being said, let's reverse. I know you're in New Jersey now. Did you, were you always grew up in New Jersey? I mean, give a little of the backstory of younger Betsy back in the day.

Yeah. Yeah. Uh, you know, it's funny. I was born on Long Island, so I moved to New Jersey when I was 5 and have never left. I keep trying to leave and I keep saying that I wanna leave, but then I had to finally come to a realization that I really like New Jersey. Like that's a lot for a New Jerseyan to admit that we like New Jersey.

All right. That's great.

Yeah, it's just such a— like, as a location, it's so close to like New York, Philadelphia, DC. Like, at one point I had visited Mississippi and almost took a job there, and I remember people telling me in their spare time, they're like, it's so awesome, we drive 6 hours here and 8 hours there. And I'm like, within an hour I'm in New York, I'm in Philadelphia, I'm at the Jersey Shore, I'm in the mountains. Like, I, you know, have everything I need right here. You know, great airports. I can get anywhere else I wanna go.

That's like an hour circle. It's a lot of, okay. I didn't realize it was that central. That's great.

Yeah. Yeah.

Cool. So, I mean, you grew up, did you go to college out there and then how'd you walk down this career and how'd you ultimately get to where you are today?

Yeah. So I always had a tendency towards medicine. And so I did, I actually went off to American University in Washington, DC and then ended up a semester later back in New Jersey and just finished all my education. So I went, you know, college, medical school, fellowships. All here. I definitely, it's funny. I was always interested in medicine, but I wanted to become a veterinarian. I did like human medicine, but I liked animals at the time a lot better. But New Jersey doesn't have a veterinary school. So it's harder to get into a veterinary school if you don't live in a state that has one. So I applied to medical school as my backup plan and ended up going into medical school. And the funny thing was, I was like, once I was in medical school, I was like, oh, maybe I'll do pediatrics. That's kind of close enough to veterinary medicine in that. You know, the babies can't tell you what's going on and babies, they're cute. But I actually did not like working with the parents. The parents were very difficult, especially I think I found it incredibly frustrating, especially the inner city parents. And I don't want to sound judgmental, but like here were people that were getting free, like free milk or free formula, and they were watering it down because they didn't want to take the time to go get The free formula. And I just found it very frustrating. And gynecology was definitely the last thing I would have thought I'd ever do. Like, you know, people are always like, how'd you end up in gynecology? And you don't, you know, most people I would think aren't like, I hope I don't have to watch what I say on your podcast, but most people aren't like, hey, I'm going to look at vaginas all day long. You know? So that wasn't like—

Yeah.

That wasn't like, I was like, okay. But you become very desensitized in medical school and you don't even realize what you're looking at. And one of my favorite stories is I'm eating lunch in residency and I have a friend who's a podiatrist and, you know, we're eating lunch and I said to her, oh my God, how do you look at people's nasty feet all day long? And I thought she was going to choke on her sandwich. She's like, are you kidding me? She's like, what are you looking at all day long? And I was like, oh yeah, I kind of forgot. I actually didn't start in gynecology. I started in general surgery, went halfway through that and just found that general surgeons are amazing people, but they're like body mechanics. They just, you know, fix the body, get it done, on your way. There wasn't this relationship that building that happens in general surgery. And I was going around, you know, on rounds and I'm saying to people like, how do you feel now that your gallbladder's out? Like, how are you feeling now that your appendix is out? Like, I wanted this like more of emotional connection with my patients versus like, okay, let me get in there, fix it, and like never talk to you ever again. So that's how I ended up switching into obstetrics and gynecology. And then—

You're a people, I mean, you're a people person, so I can see that. Yeah. You're a people person.

Yeah. So it was like, kind of like general, like, hey, I want a general surgeon to be like that if I have to ever have my appendix out. But you know, like, you don't need your general surgeon to be warm and fuzzy.

Yeah. Let's grab dinner after you take the gallbladder out and, you know, let's hang out. Okay. So you're on your way of doing that. And then somehow you discover like, okay, this is fun, but there's more to life. There's so much more I have to give. How did you go from just being a doctor to, you know, this teaching around the world?

Yeah. So that actually came in, like, that took a very long time. I was in practice working for a hospital for 17 years doing reconstructive surgery and just kind of building my career and not knowing that there was anything else out there. And then I always kind of felt like I was missing a creative side of me because you can't really get very creative in gynecology. And so, but I still didn't know what else was out there. And I got to the point actually working for a hospital, I was Reaching the point of being unhappy and burnt out. You know, I was being told, see more patients, spend less time. And I wanted to kind of get off the merry-go-round, but I didn't know how to. And that's when I actually feel like the universe kicked in because I had a car accident. And so I had a car accident, I injured my neck and I could no longer do surgery because I couldn't be in the positions that we needed to be in with my neck for hours at a time. And sometimes when people hear that story, they're like, oh God, that's terrible. And I'm like, no, it's It's perfect because I wasn't gonna stop. And if I kept going the way I was gonna going, I was gonna burn out. So that forced me to actually go, all right, well, what's next? And what's been next has been so much fun. I mean, I've been teaching, speaking, I'm traveling. I went back to school and got my MBA, got a dual degree in strategic management, innovation, and entrepreneurship. So now I'm able to like kind of have my toes in like a lot of different things. I started an e-commerce store where I sell pelvic health products that I recommend to patients. And I mean, I could go, like, the list goes on with all the things that I've done. It was just crazy. And then not too long ago, like I thought I was done with clinical medicine. Like I'm retired. That's it. And I was teaching and speaking and somebody off— I was at a big national conference and somebody asked me a menopause question and I don't know what made me do it, but I blurted out that I was opening a clinic. And then after I said it, I was like, oh shit, like, why did I just say that? But then I realized I looked around and menopause was starting to become really popular and I didn't like how it was being treated. So, and I knew I could do a much better.

Just to get our head around this, how long ago is this now?

That was probably about 3, 4 years ago, about 3, 4 years ago.

Okay. So not that long ago, you're out there speaking, doing stuff. And all of a sudden, just interrupt for a second. It's funny because obviously we're talking to lots of entrepreneurs. Entrepreneurs being a speakeasy and everything else is, is, you know, I feel like, you know, when do we discover sometimes that we actually have this entrepreneur inside of us? Like, a lot of, especially think of the doctor route, right? And I'm so fascinated about the people in the space that I get to meet, like you and others that aren't your traditional, like, hey, I'm just going to go into the clinic. You're like exploded. Like, wait, I got so much more to offer. I'm an entrepreneur actually. You know, I was an entrepreneur like hidden in the suit of a doctor, but now you're more alive. Yes. Being what you're probably in hindsight meant to do, which is to be an entrepreneur that happened to have that skillset. Is that right? And then now you're probably exploding and loving life. And so, you know, so it's like, okay, the cape came off and here we are, Superwoman and all the things you can do. Okay. And your natural entrepreneur instincts pop up like that seminar. Sure. I could do it. Yeah. I could build it. It'll be ready next week.

Well, even my e-commerce store was so funny. That came about in 2018 is I was seeing patients and I was telling them like, oh, I recommend this product and You need to go to this website and buy this and that website and buy that. And one of my patients said to me, why can't there just be one place? And at the time, Amazon didn't— wouldn't carry a lot of these kind of products. And so I was like, yeah, that's a great idea. Why isn't there one place? I'll make a website. Not knowing at the time that I could probably have hired somebody to do it. Like, I didn't even know that. Like, so I actually YouTubed how to make a website. It took me 3 months. Because I would do it a little bit at a time. And then next thing you know, I had an e-commerce website, which only meant— I only intended it to sell to my patients. And I still to this day, I should, I really should ask my, the people that have bought from me, like how they found it. But somehow I now have international sales and I never actually marketed. I still have this day have not marketed that site. And that's actually on the list of things to do. Cause I'm like, if it's doing this well and I'm not marketing it and people are buying from Australia and England and all over the world. I'm like, can you imagine what would happen if I actually marketed this thing?

Yeah. Well, that's a good segue. So let's get into the why. Why are people buying from you, Betsy? Like, what are you teaching people? Let's get into pain solution, right? What are you talking about these days? What are you seeing out there as a big core issue?

Yeah. So I think anything around midlife care, because, and we're seeing menopause right now, like have its day. Like now all of a sudden it's kind of exploded on social media and in the media, but it wasn't like that before. And even like when, you know, I love to shock people by saying the word vagina, because to me it's no big deal. But usually everybody gets a little like, you know, will blush and kind of be like, oh my God, you said the V word. But there was a study in England that 65% of women are uncomfortable saying the word vagina, yet 80% of women will have a pelvic health condition at some point in their lives. And so what I was seeing in the office is people were coming in thinking they were the only ones having symptoms. You know, same thing with menopause. Like women just kind of thought like, all right, I'm getting older. You know, maybe the sex drive is dropping. Maybe I'm having some dryness and discomfort down there. Maybe I'm having moodiness and brain fog and lack of motivation. And people just kind of chalked it up to like, all right, well, I'm getting older and that's just the way it is. Where especially I think what's happening in the menopause world is we have a lot of Gen Xers hitting this age. Like, I think the baby boomers kind of just accepted it, but the Gen Xers were kind of like rebellious and were like, uh-uh, like, we're not gonna— this is not gonna be the way my mom was and we're gonna fight this and there's gotta be a better way. So I think that's why now there's a really big push for education and solutions to the feelings that people start having in their 40s and 50s where like every little ache and pain starts showing up and it's not just about getting older. So

yeah. Okay. I love it. So that big thing I heard there is, look, you're not alone. Clearly, obviously everybody goes through it. I don't know what people feel. Is it fear? Is it denial? Is it, they don't know what's going on? And, and like, so what are you doing now? What are some big tips and things you teach your patients?

Yeah. So I think the biggest misconception is that, all right, I'm getting older and maybe I'm going through this change of menopause and therefore hormones must be the answer. So we're just coming out of, you know, almost 2 decades of fear surrounding hormones because there was a study that came out in the early 2000s called the Women's Health Initiative that really scared the living daylights out of doctors and practitioners and patients, the use of hormones. And we now know that that study was not the best study in the world and that it was the type of hormones that were being used were the problem, that they were not natural and that they potentially caused issues with heart disease and cancers. But on the other end, people think, well, Then hormones must be the answer then. And if I take hormones, I'm gonna feel great. Well, what I like to teach to everybody, hormones are just a tool. It's a tool in our toolbox. They're not good, they're not bad, and they're definitely not the panacea. And what a lot of people are missing is the fact that there's a layer of stress and inflammation that exists in many of us that's not being addressed. And that's where we have to focus first, cuz if we can deal with the stress and the inflammation first, Then we can prepare the body so that it utilizes the hormones better. Because I see a lot of people who, you know, get prescriptions for hormones and then they come in and they're like, oh, hormones didn't work on me. Well, it's not that the hormones didn't work. It's that your body wasn't optimized for that tool to work well. So, you know, it just really is. And a lot of what I do in particular, and one of my passions is the gut and gut microbiome. So we have trillions of bacteria that live in our gut and it's that balance of bacteria that keeps us healthy. And we're now finding that if the gut is off, I could honestly say about 90% of medical conditions are either caused or worsened by a bad gut. So if we can, you know, balance the gut, a lot of times we can deal with, you know, sometimes those like the brain fog or the— let's— or here's another one. Anxiety and depression often shows up a lot after the age of 40. And 90% of your happy hormone is made in your gut. And so, taking hormones may or may not help that problem. What we really need to be doing, if we fix the gut, we can make more happy hormones. You know, not that there isn't a role for antidepressants. There's definitely a role for those medicines. I'm not saying like don't use those at all, but maybe we need to look at the gut and support that first.

Yeah. There's stuff that you got there because of their issues that you can fix easily. So, okay. So, that was a lot to unpack, a lot of good stuff because you're saying, you know, before you go down, it's almost like in my mind I'm thinking this timeline. Okay. Well, hormones is sort of like 3 steps down. Like, yeah, you're not even ready for that yet. Like we gotta go fix anxiety where you're at mentally. We gotta fix gut. Like what is the Dr. Betsy protocol? So somebody sees you, whether, I don't know, I don't know, like what, what is it, a course you have? How do they work with you? And is there a protocol that you can maybe share some ideas from what you do with your patients?

Yeah, so this, the signature protocol is actually called the PAUSE protocol. Yeah. Because not only are we kind of dealing with menopause and andropause, cuz I actually do see some men too, but and that's the men's version, but also By time we're reaching 40, 50, we're probably on the go so much that we're not focusing on our own health. And sometimes we just have to mentally take a pause and like, you know, focus on ourselves. So with that, I'm doing like this whole body system approach where we're looking at stressors in the life. Because I always talk to patients that total wellness is like a 3-legged stool, body, mind, spirit. As a physician, I can do tons of things to your body. But if you're not supporting the mind and the spirit, look at that 3-legged stool, it's just going to fall over. So we start going down the road of let's investigate where you need support in your life. Let's, you know, under like find out where the stressors are, see what we can do to change that. From a body standpoint, we're looking at inflammatory issues in the gut and microbiome issues in the gut and seeing if, you know, that's impacting. And then we're balancing all that and then And potentially we're adding the hormones and when we do, they work better. You know, it's like what's happening right now is I see peptides being super, super popular. And in fact, actually, I'm involved with a company that is creating a peptide course for practitioners. And I know especially in the entrepreneur world, that's a big hot topic about peptides. Yeah. But once again, peptides are just another tool. They're not gonna work if the body's not optimized to use them. So none of these things are panaceas. So.

Right, right. So everybody just wants the magic pill, you know, shoot, shoot a peptide in, take a hormone pill, everything's going to be great. And you're saying no.

And here, you know, the craziest thing, you know, what is the magic pill? Things that you don't even have to pay me for. Things like sleeping more, eating whole foods, drinking enough fluids, like decreasing stress, whatever that looks like for you, whether it's a hobby or a breathwork or journaling or whatever you like, enjoy. Like those things are all free and focusing on just those things, you can reverse so many problems.

Yeah. So why are people not doing it? Is it just because it's not easy, right? It's just, they don't, they don't know, they didn't realize it and they want the magic pill. Is that sort of the, you know, I don't have time.

Yeah. It's not sexy. It's definitely not sexy to be like, sleep, sleep more, you know, drink more fluid. It's not exciting. The brain likes things that are new. The brain likes things that are exciting cuz it produces dopamine. So like you're always hearing like, what's the newest trend? Because that's exciting. You know, it seems like, well, it seems almost too easy to just get 7 to 8 hours of sleep. You know, like, you know it, but how many people, especially entrepreneurs, how many people are doing it? Because I know I'm guilty of this. It's like, oh, let me get one more thing done during the day. Like, You hear some people say like, oh, I'll sleep when I'm dead, you know, like they just go, go, go, but just changing that can change a lot of things like libido. Sometimes I hear, you know, with sex drive, people are always like, I want a pill for sex drive, and the women come in, they're very upset because they're like, it's not fair, men have Viagra. And I'm like, Viagra, here we go. I'm sorry if I offended your audience.

No, let's get into

it. Viagra is not a horny pill. Like, let's just put it that way. It's not a horny pill. They don't have a horny pill because there's different things that turn people's brains on. Your brain is your big— your most important sex organ. You got to figure out what turns your brain on. Viagra is just a blood flow pill. That's all. Because like a man could take a Viagra and if he's not, you know, mentally stimulated, it's not really going to do much. You got to have that mental stimulation first to trigger the blood flow and it just aids in blood flow. So if someone is stressed or inflamed, I'm always talking about how sex and stress can't coexist. So even if there was a pill, like it would probably, you know, not work if you were really stressed, if you're working long hours, if you're always on the go, if you're eating inflammatory foods and fast foods, like it's just not going to happen because the body chooses 2 states, either chooses reproduction Which is sex drive and hormones, or it chooses stress and it can't be in both states at the same time.

Very interesting. So a couple things to unravel. I mean, it, I feel like there's probably a little bit of a placebo effect. Somebody takes a Viagra or for women's taking something similar, like mentally they're like, cool. Like I'm now in that state where I want to like get aroused or, you know, have, you know, go that route. So maybe that probably helps into it and takes away the stress. So a lot of people you're talking to, you're just like, look, you're not even ready for, I mean, obviously you're, you're helping them through your protocol. But like, it's almost like, wait a second. I want Dr. Betsy for the hormones and the sex stuff and this and that. And you're like, I'm not going there yet. Like, you know, what are you doing for sleep? Like fix your eating, fix your gut before we can go play in that space.

Everything you hear on this show comes back to one idea, proximity. I wrote the book on it. Literally, Proximity Pays, my bestselling book available now at proximitypays.com.

Yeah. A lot of times we're doing it simultaneously because nobody wants to come in and be like, I want hormones. And I'm like, no, I'm not giving you hormones. So it's a lot of times I'm like, all right, well, simultaneously kind of get this started, but really it's only going to work really well once we can balance out the gut, you know, decrease the stress, decrease inflammation. So.

Got it. Okay. I guess for somebody listening, I want to get to more of the emotional state, maybe a couple other tips if you have any on that end. What is the unknown that maybe signals that people aren't paying attention to that they should be paying attention to?

Yeah, I think the biggest thing is a lot of people kind of through their 20s and 30s, and we don't realize we've kind of gotten into this habit of abusing our bodies. And so, and our bodies are pretty resilient. And so the staying up, you know, late at night, the working late hours, the, you know, eating the crappy food, the drinking the alcohol, like that doesn't really— it's not really affecting us. And then all of a sudden we tend to hit the age of 40. That's when it can start. Some people, like I said, it's 50, some people's it's 60s. But You know, most of the time it's hitting 40, and all of a sudden the body goes, uh-uh, you can't do that anymore. So now all of a sudden they may be struggling. Like maybe they're sleeping and then they wake up and they just can't get going in the morning. And then they try to do coffee to try to get it going, but then that night they can't fall asleep. Like that can be an underlying cortisol issue. That can be an underlying stress hormone issue. Or they find, you know, you always hear about people who like They do things and then they injure themselves. And that, that may be a signal that like, you know, things are off because, you know, the body's gonna be— the body's gonna make you slow down because you're just gonna push it to a certain point and the body's gonna be like, nah, that's not happening anymore. This is where people start getting diagnosed with the cholesterol issues and blood pressure issues and diabetes and stuff. Well, that's like years of stress and mistreating the body, but it doesn't mean that you have to accept it. It's a sign to be like, okay, you know what? Now let's go try to reverse these things.

Okay. So you're seeing that. And for those that are noticing it, is it go back to what you said earlier? Like, well, step 1 is, okay, why don't you start with the basic, get more sleep? You talk a lot about gut health. I mean, what's, okay, what's 2 or 3 tips on the gut health that, you know, what is something we would notice is the same thing, stress, You know, I mean, you think gut health, you think, okay, well I'm having issues with going to the bathroom or other stuff, but like what is the gut health symptoms and what's the top 2 or 3 things you solve that with?

Yeah. Well, I would tell you the things that people don't often think of as gut health, and this has been proven time and time in research directly connected to gut, is mood. So depression and anxiety can be a gut health symptom. Immunity. So all of a sudden you're getting sick all the time. That's most likely gut health. And the one that people never think of is sex drive. They've done studies in both men and women, and if the gut is inflamed, sex drive will be affected because the body goes, oh, it's not the time to reproduce. So it will shut down all, all processes of reproduction, which includes sex drive, because your body doesn't know the difference between you just want to have fun with your partner versus you're trying to make another being. So it will shut it all down. A lot of people don't connect those. So I think, you know, getting that word out is going to be important. We really should— anything that's happening, we should always think gut. And it's funny that Hippocrates in 440 BC said, let food be thy medicine. And now I'm like, wow, like he knew back then. You know, the other thing is, yeah, we didn't evolve to have to do, take supplements, but really we should be able to do it eating food.

So yeah, the natural. And then, okay. So now I'm listening. I'm saying, well, shit, obviously you can't see the gut. You just have feelings that you're off and you may not realize it's the gut. So is there a recommended test that you say like, look, everybody should go out and Do these, I mean, what is your sort of stack of like a diagnostic? Like here's the 2 or 3 things you should go take.

Really prefer, like, I really like gut microbiome testing because I like to see it. Like I want to know what's going on and I can on that. It's, people are like, what does that entail? It's like a poop in the box test. So you get a little kit, you go into your bathroom. I know it's not fun. And you little, you poop in a little tray that looks like a French fry tray. And if you've ever done it, you're laughing at me right now because you know what it looks like. And then you take a little scoop You put it in the container and then FedEx comes and picks it up at your house.

Is there like a company or is there somebody that you recommend or do you have one of these? Like what would your go-to be?

Yeah, there's a bunch of companies that are out there that do it. And they're all good. There's none of them that are perfect, but they're all really good. I like, I tend to like GI Map, which is by a company called Precision Analytics.

I know I've been using Function Health for a couple of tests recently. I think they have a gut one, but I'm kind of tempted to get GI Map.

Yeah, a lot of people are coming out because they realize how important. There's another Vibrant Wellness has a good test. Some of the companies that are out there would let consumers order these directly. Some of them you have to order through a practitioner. So yeah, so there's a bunch of them. Now empirically, you don't necessarily need that test. I as a physician want to see it because I want to know what I'm tweaking. But empirically, you can just start changing the diet, like switching to more of a Mediterranean diet and off of processed foods. I often tell patients like you should eat one of four things. You're like. What you should eat should fall into 4 categories. The things that you eat should have at one point walked, swam, flew, or grew, because there's no free-range Twinkies. There's no Dorito trees.

And what are the 4 things?

Walked, swam, flew, or grew.

Flew or grew. Okay. I like that. So it had some kind of movement before it got, before it came to you.

Yeah, it was alive at some point, you know, and for the vegans, well then if something grew, then that's good. It's a little harder to talk about it because we do have healthy processed foods now. And I'm going to say it in quotes, ideally eating the whole foods is much, much better, but I also, I'm really big on getting enough protein in the diet. And so sometimes we're having to supplement that with shakes and bars. But

so your gut health is going to say, yeah, you got like, things aren't great. And you're at the end of the day, the solution is always going to be the same. It's going to be like, go hit those 4 targets.

Yeah.

But what are you afraid of seeing when you get a gut health test?

Yeah. A lot of what I see is something called a zonulin level. A zonulin level is indicative of an inflammatory leaky gut, meaning that leaky gut is almost like a coffee filter. Like the gut should be acting like a coffee filter. And then if you poured hot water over coffee grounds, it would filter through the filter. And on the other side, you'd get brown liquid coffee and you'd go, I recognize that as coffee. Well, if there's holes in that filter, And you pour hot water, then you go take a swig of your coffee, you're getting a mouthful of coffee and a mouthful of coffee grounds. It's kinda like if there were little holes in the gut and things are leaking through, what's coming through on the other side, the body doesn't recognize as nutrients even though it is food. The body will then develop an antibody reaction to what's coming through and that causes inflammation that can sometimes trigger autoimmune diseases. So it's— we have, we have to heal that lining. So zonulin is a direct measure of leaky gut.

I love that. Okay, cool. So we got to, you know, anybody interested, take a test, see how leaky your gut is. And maybe it'll motivate us to eat properly because we all fall into the habits of eating that yummy stuff that we shouldn't be eating. And then it all affects everything like you're talking about all the way through menopause and everything else that's going on. Okay. For those that are going through it and they're very aware, we talked about the blind spots. Now I want to talk about the awareness. What tips do you have for that audience? Or maybe even, you know, the loved ones that are listening, that are watching, you know, the men that are watching their loved ones go through things and how can we be more supportive?

I know that it becomes very hard because the men or the partners start like tiptoeing, like they're walking on eggshells, you know?

Yeah. Yeah. I noticed sex drive. Okay. So I guess I've just asked 2 questions. Let's start with the first one. Then we'll get into the men. You know, first the women that are now like hyper-aware, is it go back to the same sort of set of answers? Like, you know, you gotta deal with gut, you gotta deal with, you know, stress and that's gonna help you through this. Is it all kind of related to the same, same thing?

Yeah. So for the systemic symptoms of menopause, it definitely going back to the basics is gonna help. Some people do very, very well with hormones supporting it. Some people don't ever really need to take hormones. And I, I see 2 camps on social media right now. You have the people that are like, Everyone should be on hormones, and then you have the camp of like no, we weren't. We didn't evolve to have to supplement with hormones, and I think there's a little bit of a midline with that in that it's a personal decision and it's you know what's right for you. But I think the old school being scared of hormones that is going to cause cancer or heart disease, I think we need to kind of get away from that because it can really help with quality of life, and I think that's more important than like living better as opposed to. You know, living longer. And I tend to go more with the bioidentical hormones because they're very similar to what naturally occurs in our body. The hormones that I don't like, which were the ones that were in that study, they are not bioidentical. They don't— they're not equivalent to what's naturally in the human body. And the question always is like, well, why do they exist? And they exist purely for business purposes. And I'm not vilifying the pharmaceutical companies. They, they did what businesses do. You can't patent something that naturally occurs in the body. So let's make something that's kind of like what's naturally in the body and we'll just tweak the hormone and put some other compounds on it. And now like, ooh, look, it kind of works like natural hormones, but now I can patent it and protect my intellectual property and sell it and make money. That's what businesses do, you know, protect their IP and sell it.

That killed, that killed things. Wow.

Yeah. I don't think they knew when they developed these hormones that they don't get processed in the body the similar way as natural hormones. And that really became the biggest issue with them.

So if I'm listening to this again and I'm aware and you're saying, okay, well maybe Dr. Betsy says hormones could be good, the right hormones. What is it? What, what does it do for me? How does it help?

Yeah. So basically we do know from a standpoint of brain health that hormones are also like almost very similar to neurotransmitters on the brain. So it can decrease our risk of Alzheimer's, risk of Parkinson's. It's gonna help brain fog. It's gonna help with mood. You know, we do know that there's some effect on the cardiovascular system and protection of the heart and the blood vessels. From a standpoint of like pretty much bone health, you know, we You can actually die from breaking a hip. Like people forget that if you break a hip, your risk of dying is very high. So protecting against osteoporosis. And then even more so from my standpoint is something that they've renamed and is probably not the most fun to talk about, but it's called genitourinary syndrome of menopause. It's the dryness that happens to women's vaginas as they age. That is something that if you ignore, it gets worse, it doesn't go away. And so we do know we get shifts in the microbes in the vagina during this that actually increases our risk of recurrent urinary tract infections. And then potentially, then there's always a risk of dying from sepsis if that infection gets into our bloodstream. So that actually becomes a life and death type of issue. So it's not just about, you know, Making sex more comfortable though. But of course, if sex is more comfortable, you're more likely to do it. And then there is that added wellness benefit of happiness that can, that can happen with, with a healthy sex life. So I find that some women are very reluctant to rejuvenate the vagina, whether it's hormones or all the way up to lasers. We have so many different things that we can do because I think it seems vain or silly, but it's really— there's an underlying health issue that does keep you healthy long-term. So.

Got it. All right. So ladies, listen to that. Let's rejuvenate the vaginas through hormones and other types of cool things and more, more of that for all of us. That was really helpful to understand the hormone side. And then for the men, what tips do you have for the men?

You know what I find? And I don't want to sound sexist, but I do like in general, I find that men tend to be problem solvers. So the best thing that they can do for women is just listen. I know it's hard because they wanna solve it. You know, they hear their partners, their wives complaining, and they wanna fix the problem. And the best thing to do is just bite your tongue and listen and just kind of like empathize with them and be like, you know, maybe ask the question, what can I do to support you? I think that's probably the easiest and best question because First of all, they're not gonna expect it and it's gonna sound like super awesome. And then they're gonna go, oh, you know, cuz I see so many women that start to get defensive with their partners over this, that they, you know, their partners don't understand and they don't get it. And I think, you know, trying to understand and just being supportive is gonna be more important. And then I think in general with any relationship, it always comes down to communication because when we assume what the other person's thinking, that's where you, you get nowhere.

So. Yeah. All right, man. So listen up. We've heard that millions of times too. So just stop trying to fight it. Just do that. We all know that. Just let's shut up, listen, and be supportive. Yeah, that's right. But I appreciate that. Last quick topic is social media side and the business side. You know, you've done a lot of work with growing your business and social media and others that are other entrepreneurs that are listening. What are some kind of takeaways, tips that you've learned from all that?

Well, first of all, I will tell you in the topics that I talk about with sex and the vagina, I've learned very quickly how to get yourself kicked off of social media, because I've successfully done that a couple of times. But out of that, I've learned a lot about social media. And in fact, actually just wrote a book about it for specifically for health practitioners. It is geared toward— the title's geared towards doctors, but it's really good for any health practitioner. It's called Go Viral, Be Found. But the go viral actually in the title is crossed out because I really believe that the point is not going viral because I have friends that have like 8.4 billion followers, and it doesn't necessarily translate into more business. So I think the goal is really identifying your avatar, like who are the people that, you know, that you speak to, and then really catering to that group. And if you have a small group of dedicated followers, it's going to be much more important than having this giant following that really does nothing. So it's more about being found by the Right person than it is, you know, getting really big. So.

Thank you for sharing such amazing words of wisdom. Is there anything else that we didn't talk about that you wish we talked about today?

You know, just, I will add, and it's not very common that people know this, but interesting enough is I actually see male patients too. And the reason is like, well, how's a gynecologist seeing men? And what I found is women tend to be the ones that seek out healthcare first. And so I had so many female patients I was helping. They would start saying to me like, hey, can you help my like partner, my, my husband, my, you know, my brother, like somebody, the males in their lives. And in general, men don't usually seek care until there's something major going on. So what's been nice is that slowly we've added more men into the practice. And so we're looking at things with them when it comes to hormones and And low testosterone and changes that are starting to happen to them over the age of 40, because you guys don't get, you know, away scot-free on this. You guys have changes too.

Yeah.

Yeah. Yeah.

I love it. Well, cool. Well, that's good to know. So if you hopefully are inspired to see Dr. Betsy, learn more what she has, you can see all our information will be listed along with this podcast. So definitely reach out to her and thank you so much for joining us today.

Thank you.

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