Ditch PMS, with Dr. Tabatha Barber

It's not normal to have heavy periods, painful periods. It shouldn't be wiping us out. It shouldn't be changing who we are as a person and our ability to function. Those are signs that you have hormone imbalance.

If you want to live like you matter, ditch the pills, look great, and feel freaking amazing. You're in the right place. I'm Dr. Wendy Trubo.

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Welcome to the Five Journeys podcast. Live like youe Matter. Dr. Tabitha Barber is triple board certified in obstetrics and gynecology, menopause and functional medicine, and is licensed to practice in over half the country. She's the host of the Gutsy Gynecologist show, where she shares her wisdom and knowledge with women everywhere to reclaim their health. She's also a keynote speaker, mentor, wife, mom, and grandma.

Holy moly.

I'm so excited to have you here. And I can't believe you're a gram.

I know. It's like, the best thing ever. I promise you, it's better than having your own kids because you get to spoil.

Well, especially when they get grumpy. You're like, you can have it back. Yeah, exactly.

It's so good.

So welcome to the show. We're gonna talk about hormones today because lots of people struggle with them. So when we talk about hormones, how would you. I mean, everyone always says, oh, my hormones are off, or, oh, my thyroid's off. How do you define it? And which ones are you talking about? Like, let's get on the same page.

Yeah. I think these are all really good questions, and I think a lot of women don't realize that hormones could be referring to a lot of other things and not just estrogen. You like? Estrogen's the queen bee. Everybody thinks that's the main hormone in women. Hormones are also referring to your thyroid hormone that you're producing, your insulin, that your pancreas is producing, like, so many hormones, your stress hormone, cortisol. But the biggest thing that I want women to understand is that when your sex hormones are imbalanced, it's usually the result of something else going on somewhere else. It's not the cause of your issues, it's the result. And so it's usually issues with your gut, issue with too much toxic burden, issues with your adrenal glands, issues with your thyroid. Those in turn, create dysfunction in your sex hormone production and lead to hormone imbalances. So what I see over and over in my practice is, you know, women coming to me because they're not, quote, unquote, on the right sex hormone medication, right? They're not on the right hormone replacement, the right bioidenticals, and it's because they're not taking care of the other systems. They're just trying to keep their sex hormones balanced. And you can't do that if you're not fixing the root cause of the issues. So it's kind of like you're constantly chasing this lab value and these different levels of hormones when you haven't really addressed the root cause of the issue.

Well, what are some of the common symptoms that people will show when they've gone off the cliff, when they've asked too much of their body, when they've really gotten too far? What do they see?

So the pattern I see over and over with women is it starts with bad pms. Bad PMS leads to heavy periods, heavy periods and breast tenderness. And then they're more irritable, and then they're fighting with their spouse, and then they have no libido. And you get into this pattern that goes. Goes on and on, and eventually you start to feel fatigued, and you don't have any drive for life. You don't want to get up in the morning and do anything. And I, and I have a lot of women who get to the point where they're like, I just don't want to get out of bed. I have no interest in my husband. I could care less about my job anymore. Like, I'm just not happy. And I don't know what's wrong with me. I'm doing everything I've done, and, you know, it's no longer working. And that is your body, like, finally reaching its breaking point. So the problem with conventional medicine is that we don't teach patients to listen to all of those symptoms as warning signs from your body. That woman's body has been screaming at her for like, two or three years. Probably those heavy periods are your body's way of saying you have too much estrogen, you don't have enough progesterone, you're making too much stress hormone, your gut is a mess. And if we could say, stop and help patients listen and get in tune with those and treat symptoms as messages instead of annoyances to be covered up, then we can finally make some headway and not get to the point where, you know, we're dealing with Chronic fatigue and autoimmune conditions and all of these chronic ailments that really don't need to happen. Wouldn't you agree?

Right.

I always love to say to my patients, if a lion's chasing you, you're not going to want to have sex. It's a bigger problem. We need to address that. You know, your adrenals are gonna run the show. Especially at our age. Not that you look it, or I don't think I look it, but at our age, that the adrenals are really taking over a lot of the work on hormone balance. And so if your adrenals are stressed, they're not going down that sex pathway, they're going down stress. So you sort of by definition have a hormone issue because your adrenals are upset.

Exactly. And every day I hear, well, you know, I'm just like everybody else. So because we are overstressed, and that is our quote, unquote norm, people think that it's okay and that our bodies should be able to handle it. And I say, like, even if you're handling it mentally, that doesn't mean your body is handling it physically. It does not. Like going from dusk until dawn, the minute you wake up, being just mindless and go, go, go. That is way too much, you know, on your sex hormones. You're constantly pumping out cortisol and adrenaline to handle taking care of your, your deadlines, reading emails that are stressful or even over exercising. Like, I get people working out, trying to train for marathons and all this heavy duty exercise and you're just pumping out cortisol non stop. Like you mentioned, you're stealing your progesterone, you're stealing your body's ability to make your sex hormones. And so it's very common for women to be imbalanced. And I'm sure you would agree, like when we went to medical school back in the day, this kind of stuff wasn't talked about, right?

No, no, we never talked about it.

I don't think it's talked about now. Let's level the playing field a little bit. It's not talked about now. I mean, the other point I think to add to what you're saying is I think part of the issue is, yes, what's going on today. But even if people have an amazing lifestyle today, it's the accumulated 40 years of, of past abuse that has caught up. It's, you could, they could be meditating 24, 7, but if the last 40 years was they were working 14, 16 hours a day or whatever, Else then you have to address that, you have to rebalance that.

Oh my gosh. Yeah, I couldn't agree more. I think that's a super important point, that it's the accumulative effect. It's really not what you did yesterday or last week. It's what you've been doing for years to lead you down this dysfunctional pathway. I see that all the time as well. It's like I did all the stuff, I took care of the kids, I got a successful business, I've, you know, I've been going hardcore non stop and now all of a sudden I can't function. It's because your body will allow it and keep up with you for so long. It will beg, borrow and steal from all of your other systems to stay in balance. But then you reach that breaking point of like, you're just depleted. You got no, no iron left, you got no B vitamins left. Your gut is a hot mess and your brain will reach point and say, enough is enough. We're not gonna do this anymore. We're not gonna keep pumping out cortisol. I'm gonna downregulate these systems and we're gonna like get back into restoration mode. Right. And we have to listen to that. That's where we're falling short, is we're not listening to what our body needs.

Yeah, 100%.

I want to actually, I thousand percent agree with you. And we talk, I know in our practice we talk about listening to your body and listening to the signals. People believe that PMS is normal, that it's a Motrin deficiency, ibuprofen deficiency, that having heavy periods is fine. That's just how life goes.

Well, their friends all had it and their family.

So I want to really get to the basic what is actually normal, what is common? And maybe then we'll talk about optimal. So what's common? What you're talking about is what's common and what we see in the world. And then there's like the. What are we human beings built that we can actually optimize our health?

This is so important for women to understand. Yeah, so important. Like, just because we're all experiencing it doesn't mean it's normal. It's not normal to have heavy periods, painful periods, calling into work or not going to school or college because of your period. We're supposed to be able to live in harmony. We should probably have a couple days where we're a little more low key on the energy because we are physically bleeding and losing some iron but it shouldn't be wiping us out. It shouldn't be changing who we are as a person and our ability to function. And those are signs that you have hormone imbalance. I like to explain to women, like when you're riding an estrogen roller coaster of extremes with estrogen imbalance, imagine dropping from a one story building. It hurts, but it's not as bad as dropping from a 10 story building. So when you go from extremely high estrogen, it drops really low right before your period. That huge drop feels terrible. It feels like pms, irritability, breast tender, all these terrible feelings. If you're on a smoother curve and you don't have such a significant shift in the levels of your estrogen if they're in the optimal range and then they drop so that you can shed that lining for your period, that just feels, oh, okay, that's a little different. But life's not like being interrupted or anything like that. That's normal. That's what we should be feeling. So to your point, Ed, we have to teach, especially young girls, we have to teach women to embrace the idea of using your menstrual cycle as your vital sign, as a gauge of how healthy you really are and not some thing to, you know, just be ignored and push under the rug. So I would love for women to embrace the idea of, hey, hey, I get to have my period every month. I get to know what my body's doing and I get to know if I'm in balance or if I need to fine tune some things. Because you can go so much farther that way. Right?

Right. In our society, it's normal to have hot flashes, it's normal not to sleep X, Y and Z. Like that's all normal. And when you look at nature based societies, women actually just stopped having periods and didn't have all these symptoms.

Yeah, perimenopause is not a thing. In Japan, women just stop.

Yes. The book you two wrote together is so key because we did not see all these hormone imbalances 50 to 100 years ago. And it's because of these endocrine disruptors. It's because of the environmental toxic burden on our body. Our liver is so big, busy trying to handle all of the alcohol and all of the plastics and all of the pesticides and all of the crap that it's being exposed to all day long. It can't even metabolize our estrogen. It can't even do its basic job. And so you're right, there shouldn't be 10 or 15 years of crazy hormonal swings, of perimenopause. I didn't learn about that in medical school. Twenty years ago, it's because it wasn't common. But now everything's in plastic, right? Every food that we buy and purchase and make, it's all in plastic. Everything we drink is in plastic. And our body is just bombarded like it never has been before. And you add that with the chronic stress, you know, you get the leaky gut and it's just this miserable imbalance.

Well, this is why I call the adrenals the liver and the gut the medical holy trinity. Because the chronic stress will shut down the liver's ability to detox, and that will also shut down the gut's ability, ability to do its job. And now you have the whole system shut down. And don't forget, your adrenals are what are producing your female hormones in menopause. So your adrenals are like, I'm busy, I'm busy. Don't ask me to do that. So you're not getting your testosterone and your estradiol because you're utilizing it in the cortisol like you call the cortisol steel. But let's talk about the liver a little bit more, Tabitha, because you referenced it just now. Like, what does the liver have to do with all this? Because women are thinking, well, why are we talking about the liver? I want to talk about my hormones. Talk about the liver, please.

Oh my gosh. The liver is key. It's so important. And you know, women need to understand that the liver takes something from its active fat soluble form to its inactive water soluble form once your body's done utilizing it so that it can be removed from your body. So your liver has a really important job of once you're done using your hormones, of deactivating it and helping it remove. And your body, your liver needs certain vitamins and minerals to be able to do this process, which we just, you know, we don't have enough of. We don't eat a good enough diet, we don't absorb it in our gut. All kinds of issues. So estrogen dominance is a really big deal nowadays. And it's because of the reasons we mentioned, but it's also because your liver cannot metabolize your estrogen out of it, its active form appropriately. So, you know, we have three major estrogens that go down these pathways after they've been used. We want it to go to the liver to be hydroxylated and methylated and incent to your stool and urine. But what's happening is your liver is so busy processing all the alcohol you drink because we've been in pandemic for two years and taking your Tylenol PM every night to sleep and all the food you've been heating up in your plastic plastics, like your liver is busy doing all of that. And so the garbage never gets taken out. Your estrogens get backed up, they go down other pathways. And the most concerning pathway is one called 4 hydroxy that is actually damaging to our DNA and our cells and it can increase our risk of developing cancer. So it's really important for you to have those estrogens going to the liver and being appropriately detoxified because if that doesn't happen, they go down the other pathway. And so sometimes it's just you need more magnesium and B vitamins. You know, for me personally, I have a couple gene mutations. I have MTHFR and a COMT mutation, so I don't process my estrogens well. And what did that look like? That looked like me hemorrhaging through my pants one night at a girls night out because my estrogen was way too high, you know. And so I see this picture time and time again of women drinking two or three drinks a night to handle their stress. Right? I deserve it. I had a hard day. The kids are too much. This helps me fall asleep. And that is really taxing on your liver. And that contributes to this estrogen dominance picture. And so you add that with the stress like we talked about, you add that with the xenoestrogens, and it's just a setup up for disaster. And so what I noticed this is, you know, I've seen this time and time again is women, they're on the birth control pill a long time, they can't tolerate it anymore for whatever reason, it's usually gut issues. So they transition over to an IUD or an ablation to try and get rid of the heavy periods and the painful periods. If that doesn't work, they get the hysterectomy and then a few years later they're diagnosed with breast cancer and everybody's shaking their head. I don't know what the problem was. I was healthy, I didn't have any issues. You did have issues. You had estrogen dominance for over five years that nobody addressed. And now the result is, you know, breast cancer. And so we need to take a step back and say, are we actually doing women any service by burning their organs, removing their organs, handing them these medications that aren't really getting to the root of the problem? Or do we need to stop and learn how to test hormones, Learn how to understand hormone imbalances? Because as Wendy knows, gynecologists aren't hormone experts. Gynecologists are trained surgeons. Right. We spent four years learning how to cut and sew you up, how to deliver your baby, how to repair you after you tear and have an episiotomy, how to do procedures in the office for abnormal pap smears. Like it was hands on. I was gonna do something with my hands, and I loved it. But that's not always the answer. The answer is actually like learning the endocrine system and like you said, how it's all interconnected and how our adrenals and our thyroid and our gut and everything are affect what women are experiencing. And until gynecologists wake up and accept that fact and start to, you know, treat patients in a different way, we're not going to make any headway on breast cancer or any of that stuff.

The thing I always love to talk about with people on that, Tabitha, is I always love to. Excuse me. Bring it back to the gut, because I know we're going to talk about the gut. And I always like to say to people, you know, we do a lot of stool testing and it tests the beta glucuronidase. And I always love to say, look, this is putting you at risk for breast and uterine estrogen dependent cancers, because let's sort of back into that. That beta glucuronidase in the gut is not helping you get rid of your hormones. In fact, it's helping you recycle toxic hormones. So can you talk about how the gut relates to hormonal balance A little bit? Because, I mean, I love beta glucuronidase, but you probably can tell a little bit more story on that.

Oh, that's why I call myself the gutsy gynecologist, Because I truly believe it all begins in the gu. Not balance your hormones unless you balance your gut. Just like you said, there are bacteria that you do not want to have too much of that will make an enzyme that will cut the garbage tag off that your liver works so hard to put on there. You know, like I said, your liver's trying to get rid of those estrogens. It puts that garbage tag on and it goes to your stool, and those enzymes from that bacteria will cut it off and you'll reabsorb that estrogen. That's fine. If you're menopausal and you want a Little more estrogen, and it's the right kind of estrogen. But most of the time where I see it is estrogen dominance, perimenopause. Women don't need to be recirculating that estrogen. They really do need to be getting it out of their system. One of my favorite bacteria, I suppose it's made from yeast species is Saccharomyces boulardae. So that's often in probiotics. And it will help bind and help get those toxins out and those used up estrogens and things like that. So I love women to be on a probiotic. You know, people say, oh, not everybody needs to be on it. But I believe in this day and age, we all need support for our gut. I just, I have yet to meet a person who doesn't. And so it really does matter what's living in your gut, what those bacteria are doing. Like you said, they make this enzyme. So I think for a lot of people, just knowing that is like. Like, wait, what I thought, you know, they just digested our food. They do so much more. And without the right bacteria, we can't absorb the vitamins and minerals we need for your liver to do its job. We can't absorb the healthy fats to even make your hormones in the first place. Like, everything starts in the gut. It's so important when the women sit.

Across the desk from you or on the other end of the phone and they say, I eat really well. I'm actually finally sleeping, but I'm not losing any. Wait, because this is where. This is what, Right? What do women care about? Their hair, their gut? Only because it's fat and because their skin, right? So your hair, skin, nails. And if they're not balanced, if your gut's not balanced, if your liver's not balanced and your hormones aren't balanced, you won't be able to be at your weight that you expect to be. That I think is really. Because what's happening, if you have inappropriate beta glucuronidase in your gut and you're going back and recycling toxic hormones, your liver, your already poor, overloaded liver is like, can't cope with that. Let's store you in the fat. So now all these women are walking around with extra fat, and it's not the best fat. It's angry and it's inflammatory fat. So I think when we tie it back to what does that look like on the ground? It means you're not losing your weight, which I think really gets women's attention. Like if you can't lose weight, we're talking to you. It's a hormone, toxins, fat issue.

Yeah, I hope everybody heard that, because you really do need to get the gut balanced in order to lose weight. See that all the time. With weight loss resistance or weight regain, you know, it is so much more than calories in, calories out. It has to do with inflammation in your body at the cellular level, your cells being able to do their job. What I see a lot of is women have this chronic gut dysbiosis. They got the wrong bacteria living in there, and they have leaky gut because they're chronically pumping out cortisol from their stress. They' synthetic hormones. They're taking NSAIDs for their painful periods, like Motrin and ibuprofen, that kind of stuff. And so, you know, they're developing food sensitivities. Their immune system's reacting to everything that it's seeing. It's not supposed to be seeing all this undigested proteins and different things. And our immune system's reacting. It's trying to protect us. Right. Like our body is always trying to do what's right for you. It might not be what you want, but your immune system's reacting because it's coming in contact with things from the leaky gut that it shouldn't. It's putting antibody tags on stuff that it shouldn't. And now you're reacting to stuff that isn't inflammatory in and of itself. You got people reacting to broccoli and almonds and Brussels sprouts. You should be able to eat that food. But because your immune system is pissed off and confused, it's reacting to everything it's seeing. And so you have to. I tell women, you have to heal that gut. You have to remove those triggers that are confusing your immune system and angering it. And once that all happens, your immune system will calm down. Those antibodies will almost always go away. You can reintroduce those foods. That's not a lifelong sentence of, oh, my gosh, I can never eat broccoli again.

Right.

And so I feel like patients piecemeal things together, and so they get frustrated because stuff doesn't work. You know, they say, oh, I did food sensitivity. That didn't work. I did a gut regimen that didn't work. I did a thyroid thing that didn't work. It might be because you're not doing it in the correct order or simultaneously in the right way, because it really does matter that we, like I said, heal the gut while calming the Immune system, helping it forget it was angry and then trying to reintroduce stuff. And if you're going to try and get your systems balanced without doing that first, it's just not going to work. Right.

Amen to that.

I think besides seeing a functional medicine doctor, because obviously, well, according to all of us, that's the best, but that's not always accessible to people. What are the top three things people can do in terms of either food or lifestyle? Whether you're menstruating or you're in perimenopause, what are the top three things that you would say just for people to, to start even thinking about?

Oh my gosh, you're right. Most people don't need a functional practitioner. I mean, I don't want to say that because I want to keep a job. Right. But honestly, there is so much that basic stuff that we're not doing that we could be doing and that is seriously cleaning up the diet. We have to stop eating this standard American diet out of boxes and bags. Like if it didn't look like it grew out of the ground or came from a mother, don't eat it. It needs to be in its natural. You need to eat your vegetables every day. You need to eat the rainbow, you need to get your clean, lean proteins in. That is key. Stop eating from the middle of the grocery store. I only shop from the periphery, you know, nothing out of the boxes and bags. For women, you have to quit drinking so much alcohol. Like literally our bodies were not made to process more than one to two drinks max. And if you're drinking every day like that one drink, like have your glass of wine if that's your thing. But more than that, you're actually adding to the problem. And there's better ways to de stress so we can talk about that, That's a major thing. And then really understanding that you are in control of your thoughts and your thoughts are in control of your physiology. So if you can reel in all this mindless activity that you're doing all day long and actually stop and deep breathe and process and accept your body and love your body and give it some self care, set some boundaries on your time and on your energy. Like I, I try to schedule my energy more than anything because I only have so much energy and if it's negative energy, I don't have time for it. So that to me is like the biggest thing women can do. You can clean up your diet, you can decrease the alcohol, but until you start to set boundaries and be more mindful through your day and get in that parasympathetic mode of rest and digest. You're always going to be chasing disease in my book.

Well, we most certainly appreciate your time and your energy, so thank you to.

Yeah, yeah. Thank you so much.

So where can people find you? What do you want to promote? And we'll make sure everything is in the show notes.

Oh, yeah. So go to Instagram or TikTok. Now I'm doing Tik Tok because I'm crazy at the Gutsy gynecologist. My website, Dr. Tabitha T A B A T H A. It's all A's, no eyes. And I have an awesome ebook and it's the Gutsy Gynecologist's guide to balancing your Hormones. So it goes in a little more depth of the gut, the adrenals, the brain, all of the stuff we talked about, the liver. So check that out. It's a great resource.

Awesome.

It's amazing.

Thanks for listening to another episode of the Five Journeys podcast live. Like youe Matter. Dr. Tabitha Barber was our guest today and we've been so privileged to have you on. Thank you.

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