Transcript
Dr Jolene Brighten [00:00:00]:
Where I realized that women's medicine is.

Dr Jolene Brighten [00:00:02]:
Always done to them.

Dr Jolene Brighten [00:00:03]:
Not with them, not for them, not in partnership with them. But be a good girl, take your medicine, scoot your butt down the table. Here comes the speculum.

Claudia von Boeselager [00:00:12]:
This episode is brought to you by Lila Quantum tech in the past two centuries, our understanding of longevity has revolutionized from a mere 30 years average lifespan in 1800 to nearly 80 years today. We've made incredible strides. Now it's time to embrace the future of aging with Leela Quantum tech. Leela Quantum tech brings you products charged with quantum energy. Designed to restore balance and vitality, these products can help in managing stress, improving sleep quality, and promoting mental clarity, contributing to a younger biological age. Our modern lifestyles can accelerate aging, and EMF radiation is everywhere. With Leela Quantum tech, you can combat this trend and focus on utilizing the balancing effects of quantum energy to maintain your youthfulness and shield yourself and your loved ones well being. To bring balance to your everyday life, boost your health and vitality, visit laylac.com, that's le elaq.com, and embark on a journey to a longer, healthier life.

Claudia von Boeselager [00:01:27]:
And for you, dear audience, get a 10% discount on Leela Quantum tech products with code longevity ten. That's longevity 10 at checkout today.

Claudia von Boeselager [00:01:46]:
My guest today is Dr. Jolene Brighton. Dr. Brighton is a hormone expert, nutrition scientist, and a leader in women's medicine. She's board certified in naturopathic endocrinology and trained in clinical sexology. She is the author of is this normal? A nonjudgmental guide to creating hormone balance by eliminating unwanted symptoms and building the sexual desire you crave. She is completely dedicated to uncovering the root cause of hormonal imbalances and empowers women worldwide to take control of their health and their hormones. Dr.

Claudia von Boeselager [00:02:17]:
Brighton is an international speaker, clinical educator, and medical advisor within the tech community. Dr. Brighton, welcome to the longevity and lifestyle podcast. I am so excited to have you with us today.

Dr Jolene Brighten [00:02:29]:
Yeah, it's so great to be here. I'm excited for our conversation and a continuation of when we met up when I was abroad.

Claudia von Boeselager [00:02:37]:
Exactly. Our last in person meet was on the steps at a later hour, starting to drizzle in London rain, having a great laugh and chat as well. So very excited to have a bit of a more formal conversation here on the podcast, but we'll keep it nice and casual too. And it's such an important topic and everyone hears about hormones and there's so much sort of misguided or misinformation out there and I always point everyone in the direction. I'm like, if you have any questions, please follow Dr. Brighton. Please look at the work she's doing. She does it in such a fun way, beautifully educational, and really gets down to the nuts and bolts of things as well.

Claudia von Boeselager [00:03:13]:
So what I'd love to start off with, Dr. Brighton, is if you can share a bit about your background and what led you to specialize in women's health and with the functional medicine component as well.

Dr Jolene Brighten [00:03:24]:
Yeah. Okay, so you did that whole bio. I don't want to bore everybody, but I was a really sick kid. I was a kid that I had a lot of digestive issues to the point. I mean, they were like, maybe she's faking it. I had two endoscopies, and they finally found, after ten years of me going through all that, that I had h. Pylori causing my chronic gastritis.

Dr Jolene Brighten [00:03:46]:
And so I got really interested in.

Dr Jolene Brighten [00:03:49]:
Food as medicine when my provider said.

Dr Jolene Brighten [00:03:52]:
To me, you're going to just take.

Dr Jolene Brighten [00:03:54]:
This PPI for the rest of your life.

Dr Jolene Brighten [00:03:56]:
It's never been studied in women.

Dr Jolene Brighten [00:03:58]:
It's never been studied in young women who are developing, and you're just going to take it. This can be the rest of your life. It's fine. It's just one pill. You're going to be fine.

Dr Jolene Brighten [00:04:06]:
And I was like, no.

Dr Jolene Brighten [00:04:09]:
17.

Dr Jolene Brighten [00:04:10]:
I was like, no.

Dr Jolene Brighten [00:04:11]:
Funny thing is that, but I did let my other provider convince me that I should take the pill to fix my periods. That was partially a mistake, but also, I'm a first generation college student, so maybe not totally a mistake. So anyhow, I was like, well, wait a minute. Making observations about my food, one of my superpowers is pattern recognition and being able to say, like, okay, connect the dots here. When I eat these foods, which is what people know as a crap diet, like refined carbohydrates and sugar, chocolate, but like the bad chocolate guys, caffeine, these kinds of things, that my heartburn is worse, my stomach pain is worse. And so I just started to modify my diet. And my doctor, he was like, oh, my gosh.

Dr Jolene Brighten [00:04:58]:
How do you have no symptoms and.

Dr Jolene Brighten [00:05:01]:
You'Re not taking this medication? I explained to him, he totally dismisses me. I think that every woman. Leave us a comment. If this is you, has experienced at least one provider who's just like, whatever you're experiencing is not real. You don't know your body. I know it better than you because I talked to you for seven minutes.

Dr Jolene Brighten [00:05:17]:
So I was like, hey, I'm going to study nutrition.

Dr Jolene Brighten [00:05:21]:
Got really into nutrition science. Thought I would go and be a registered dietitian, so I concurrently studied the didactic track. The only difference is that I didn't do a six month residency to be a dietitian, which means I just didn't work in a hospital with it. But the big reason why I didn't is that I saw a huge disconnect in what was being given as advice.

Dr Jolene Brighten [00:05:40]:
To the patient and what the science.

Dr Jolene Brighten [00:05:43]:
Actually said, and that I am only so grateful that I studied both tracks because I'm sitting in one class where they're like, you need to eat a fat free diet if you want to prevent heart disease. And then I'm in my science class, and they're like, let us teach you about the atherosclerosis theory, the inflammatory theory of how we actually develop plaques in our heart. I realize I started to get nerdy, so let me just break that down. Just basically how the problem isn't the fat, the problem is the inflammation and the immune system dysregulation. Okay, this is like 20 years ago, and even now, we still see people.

Dr Jolene Brighten [00:06:21]:
Saying, you have to eat fat free.

Dr Jolene Brighten [00:06:23]:
You can't eat meat. You can't do this. And let me just say, if everybody's confused out there when it comes to nutrition on the Internet, yeah, I can totally see that. Know that the truth usually lies somewhere in the middle. And it's not sexy, it's not glamorous, it's not the kind of stuff that any algorithm on social media will ever favor, unfortunately. So I study nutrition, getting my master's in nutrition, actually was going to go get my PhD. Realized that I had a knack for breaking down the science to the individual, and that I didn't want to spin my wheels doing research, taking ten years to publish it, and another 20 years before a doctor actually does something with it. And so I came across naturopathic medicine.

Dr Jolene Brighten [00:07:12]:
I was going to be a medical doctor, and I was going to go.

Dr Jolene Brighten [00:07:15]:
That route, but I just hadn't been.

Dr Jolene Brighten [00:07:18]:
Served, and neither had my family. My long lineage of very fertile women had not been served by the medical community. And I just wanted to do something.

Dr Jolene Brighten [00:07:28]:
Different that integrated lifestyle and nutrition and.

Dr Jolene Brighten [00:07:33]:
Really looked at the cause of things. So this is like pre functional medicine. Functional medicine was, like, coming on the scene, but nobody was really talking about it. And this was the best track out.

Dr Jolene Brighten [00:07:48]:
There to really understand the root cause of medicine.

Dr Jolene Brighten [00:07:51]:
And I was going to study gut health, of course, right? Because I had all those problems, and I can relate to that. I am so glad that this was my interest, though, because when you go into the field of endocrinology, hormone health, I think a big problem is that.

Dr Jolene Brighten [00:08:05]:
Everybody'S like, we just need to fix.

Dr Jolene Brighten [00:08:07]:
Those adrenal glands, those ovaries, the pituitary. These are all endocrinorians, right? We're not looking at. But the gut dysfunction, what is going on with gut health and how that interplays. And the big turning point for me to decide to step into women's medicine.

Dr Jolene Brighten [00:08:22]:
Was sitting in class having a light bulb moment, where I realized that women's medicine is always done to them.

Dr Jolene Brighten [00:08:30]:
Not with them, not for them, not in partnership with them. But be a good girl, take your medicine, scoot your butt down the table. Here comes the speculum. Not even asking for consent. May I please insert the speculum? Just so much. And my blood still boils about it.

Dr Jolene Brighten [00:08:47]:
Because even in having been in practice.

Dr Jolene Brighten [00:08:51]:
For over ten years now, not a whole lot has changed. Not a whole lot has changed. And the things that I will say that I proudly have influence over is the conversations about birth control, which I stuck my neck out on a long time ago.

Dr Jolene Brighten [00:09:08]:
I got a lot of hate, a lot of, man, when TikTok came out.

Dr Jolene Brighten [00:09:14]:
I mean, there were providers trying to get popular off the back of attacking.

Dr Jolene Brighten [00:09:19]:
Me, yet saying the same thing that I was.

Dr Jolene Brighten [00:09:24]:
You know, a lot of my colleagues are like, oh, my. Like, you have taken so much heat over the years.

Dr Jolene Brighten [00:09:29]:
I'm like, yeah, but look at how they talk about it now.

Dr Jolene Brighten [00:09:32]:
Look at how they're on YouTube making.

Dr Jolene Brighten [00:09:35]:
Videos, trying to navigate that conversation in.

Dr Jolene Brighten [00:09:39]:
A much more conscious way, in a way that actually serves the person.

Dr Jolene Brighten [00:09:42]:
Like, I did what I came to.

Dr Jolene Brighten [00:09:44]:
Do, and I'm going to keep doing it. And as much as they might hate me for it, I think about how.

Dr Jolene Brighten [00:09:50]:
I talked about libido and the pill.

Dr Jolene Brighten [00:09:54]:
How it affected my body, how it has affected so many of my patients, and I got so much hate. People were like, I mean, gynecologists are like, we're the experts of the pill. And I was like, no doubt that you can write that script all day, every day, but when it comes to actually root cause discussions with your, like.

Dr Jolene Brighten [00:10:12]:
The pill, ain't it? Is it a tool?

Dr Jolene Brighten [00:10:14]:
Do we need it? Sure. But the reality is that I was.

Dr Jolene Brighten [00:10:18]:
Talking about all of know a decade.

Dr Jolene Brighten [00:10:20]:
Ago, and I've been getting all this hate, and the New York Times just came out with an article and was, hey, this. This sex drive pill connection is real. And I'm like, you want to know one thing that I'm going to say.

Dr Jolene Brighten [00:10:32]:
Is that if you just believe women.

Dr Jolene Brighten [00:10:36]:
When they say they know their bodies, they just need you to listen.

Dr Jolene Brighten [00:10:40]:
If you just listen, the science will.

Dr Jolene Brighten [00:10:43]:
Catch up and validate what they're saying. It always is catching up, validating their lived experience. But when a patient comes to you and they're telling you their lived experience and you're like, well, the science doesn't support what's happening. So that's not real. That is such a disservice and such a hindrance to the progress that we can make in women's medicine.

Dr Jolene Brighten [00:11:03]:
I love that.

Claudia von Boeselager [00:11:04]:
And I think that's so important. And for some women listening, or even men and women, let's say listening, I've been looking into the research as well, and I've been so shocked about the impact of the pill, but so many people don't understand it. And I was at a presentation on functional genomics and the impact on women's health and how hormones are broken down and how it's so important to know instead of just blanketing with HRT or with the contraceptive pill, I would love if you could break that down for people listening to understand. And I know in your first book, beyond the pill, you broke this down as well. But it's such an important topic. And these vulnerable teenage girls are just listening to doctors and some of them are even saying, you don't even need to have your period anymore. Just continue for 30 years on this pill and then good luck trying to have kids in your late thirty s, forty s, whatever it might be. So can we take a little bit of a rabbit hole, deep dive into this so that everyone can understand what are we talking about here and why it's so important to pay attention?

Dr Jolene Brighten [00:12:01]:
This is such a great question and a great point that we are, okay, here is basically how it goes, right? I think this is the experience that.

Dr Jolene Brighten [00:12:11]:
So many people have had.

Dr Jolene Brighten [00:12:12]:
You go to their doctor, you say.

Dr Jolene Brighten [00:12:15]:
I have hormone issues.

Dr Jolene Brighten [00:12:16]:
I have period problems. I am having irregular periods. I'm having acne, I'm having painful periods.

Dr Jolene Brighten [00:12:21]:
They say, do you want to have a baby?

Dr Jolene Brighten [00:12:23]:
Or they don't even ask you because they're like, my bias says that at your age, you shouldn't have a baby yet.

Dr Jolene Brighten [00:12:28]:
So if the answer is no to the baby, you are given the pill and they say, come back, see you.

Dr Jolene Brighten [00:12:35]:
When you wanted to have a baby, then we'll discuss it then we'll work you up then. But if you say, yes, I want.

Dr Jolene Brighten [00:12:40]:
To have a baby, they're going to work you up, they're going to refer.

Dr Jolene Brighten [00:12:45]:
You, they're going to try to understand what is driving your symptoms. Maybe not acne so much, but these irregular periods, these painful periods, these things that relate back to fertility.

Dr Jolene Brighten [00:12:57]:
To me, I think that is a huge disservice. And.

Dr Jolene Brighten [00:13:04]:
It'S just baffling to me that.

Dr Jolene Brighten [00:13:06]:
You would reduce a woman to her.

Dr Jolene Brighten [00:13:09]:
Reproductive capacity to whether or not she wants to have a baby. We know that more and more women don't want to have babies. Newer generations are like, not so interested in that, or it's something I'm still.

Dr Jolene Brighten [00:13:20]:
On the fence about.

Dr Jolene Brighten [00:13:21]:
And to say to them, well, if you don't want a baby right now, then the best health care you're going.

Dr Jolene Brighten [00:13:27]:
To get is essentially none. Just the pill, right?

Dr Jolene Brighten [00:13:31]:
You're just going to get the pill and we're going to send you on your way.

Dr Jolene Brighten [00:13:34]:
Now, is that to say that the.

Dr Jolene Brighten [00:13:35]:
Pill doesn't help in certain situations? No. So pregnancy prevention pill is really good at that. PMDd, some people, it'll help with their PMDD, which is a very extreme, extreme form of PMs. And I say that not so that people are like, it's just bad PMS. But to understand that suicidal ideation, the propensity to have suicidal thoughts, can accompany the pmdd patient.

Dr Jolene Brighten [00:14:02]:
And in some of them, using the.

Dr Jolene Brighten [00:14:05]:
Pill actually gets their life back, where their cycle has been taking two weeks out of every month, where they're depressed.

Dr Jolene Brighten [00:14:11]:
They'Re having physical symptoms and feeling horrible.

Dr Jolene Brighten [00:14:14]:
Endometriosis is another thing that the pill can sometimes be used to stop cycling, because every time someone cycles, they have urinary symptoms, they have constipation, they have endobelly where they're bloating. There are times that we can use this for symptom management, but never is there a time ever, in my opinion, that you should pass someone the pill without asking why they have the symptoms and doing them the service of working.

Dr Jolene Brighten [00:14:39]:
Them up and understanding it.

Dr Jolene Brighten [00:14:41]:
We should have forthcoming conversations to say.

Dr Jolene Brighten [00:14:45]:
Hey, listen, this is to manage your symptoms.

Dr Jolene Brighten [00:14:48]:
This isn't fixing your period. A huge myth that medicine has perpetuated. This isn't fixing your period.

Dr Jolene Brighten [00:14:55]:
Just because you bleed every month doesn't.

Dr Jolene Brighten [00:14:57]:
Mean that when you come off, you won't be having irregular cycles again. So we need to be honest of when we're doing symptom management and when we're actually doing treatment on the underlying issues.

Dr Jolene Brighten [00:15:08]:
That being said, as you said, when.

Dr Jolene Brighten [00:15:11]:
Women decide to come off the pill, and this is a big reason why so many women are like the pill.

Dr Jolene Brighten [00:15:16]:
Made me infertile is because they were.

Dr Jolene Brighten [00:15:18]:
Put on it for symptoms, symptoms that.

Dr Jolene Brighten [00:15:20]:
Pointed to conditions that we understand are not getting diagnosed.

Dr Jolene Brighten [00:15:26]:
The delay in diagnosis for endometriosis, adenomyosis for PCOS, is huge.

Dr Jolene Brighten [00:15:32]:
I mean, PCOS patients, they're going to.

Dr Jolene Brighten [00:15:35]:
Go to two to three providers before somebody doesn't just try to slap the pill on them and actually does something for them. And then when they do get the diagnosis, they're likely to just be offered the pill and maybe metformin. Despite new guidelines coming out saying nutrition and lifestyle are the two places where you start. This is the initial therapy.

Dr Jolene Brighten [00:15:53]:
Yet, to be fair to doctors, it's.

Dr Jolene Brighten [00:15:56]:
Really tricky when you've never been trained in nutrition and lifestyle, or maybe you got 12 hours and that you consider expertise. Friend, I will tell you that is not expertise in nutrition and lifestyle. But they don't also don't have the time to talk about that. That's why we need integrative care.

Dr Jolene Brighten [00:16:11]:
So back to your point about processing.

Dr Jolene Brighten [00:16:15]:
Things we don't know. Okay. This is the bottom line, is that we know less about this medication that's been available for generations than many of the others that are on the market. So the studies haven't been done because, in part, that anytime you question the pill, you're accused of being anti feminism. Right. And anything that isn't favorable, at least where I sit in the United States, can be used as fuel to the fire of those who are trying to.

Dr Jolene Brighten [00:16:40]:
Take away access to the pill, which is just all of this Stifles science.

Dr Jolene Brighten [00:16:46]:
It's problematic. And I want to just say, for clarity's sake, I think we should always have access to birth control and medications.

Dr Jolene Brighten [00:16:55]:
Because if you choose to use it, that's your choice. And if it's all that you can.

Dr Jolene Brighten [00:17:01]:
Use because of where you're at in the world or what is going on in your situation, you should also have that access. But when you come off the pill, these things like PCOS, endometriosis, adenomyosis, fibroids, cysts. I mean, some of these are almost all of those.

Dr Jolene Brighten [00:17:18]:
They can contribute to infertility. But nobody told you that.

Dr Jolene Brighten [00:17:23]:
They told you in school, right? You can get pregnant any time of the month. You should be super scared. Your doctor's like, oh, my God, everybody. Unintended pregnancies can happen, like, at any moment.

Dr Jolene Brighten [00:17:33]:
And it's like, well, firstly, there has to be sperm.

Dr Jolene Brighten [00:17:36]:
Okay, check. Because sometimes I have patients who are in same sex relationships, and they're like, yeah, my doctor just insisted that I was going to get pregnant. And I'm like, they do know you.

Dr Jolene Brighten [00:17:48]:
Are married to a woman.

Dr Jolene Brighten [00:17:49]:
And they're like, yes. And yet they're like, it still happens. I'm like, why do they do this? It's crazy. There's just that whole idea of, like, I can get pregnant any time of the month. I talk about that myth in my.

Dr Jolene Brighten [00:18:03]:
Book, is this normal?

Dr Jolene Brighten [00:18:04]:
And then you do try to get pregnant and you realize you can't get pregnant anytime of the month. And that is really heartbreaking. But also that you've had PCOS brewing, you've had endometriosis brewing, you've had these.

Dr Jolene Brighten [00:18:17]:
Other conditions brewing that you should have.

Dr Jolene Brighten [00:18:19]:
Been working on a long time ago, but how did you even know to work on it? You didn't because nobody worked you up. And so we don't actually know bucket, which is what you were talking about with genetics and everything. Why do some people get so depressed with the pill? Why do some people feel better and their depression is gone on the pill?

Dr Jolene Brighten [00:18:37]:
Why do these things happen?

Dr Jolene Brighten [00:18:39]:
Likely it's going to come back to.

Dr Jolene Brighten [00:18:41]:
Genomics, but we don't understand that and.

Dr Jolene Brighten [00:18:45]:
Not to the degree that we should to be able to screen. And also, who funds the majority of studies? Not people that want you to screen and say that, well, we've been saying 50% of the population with no diagnosable condition is a person who should just take the pill. Best business move and marketing of pharmaceutical history. But then to have a study to come out and say, actually only 30% qualify or only 25% qualify, nobody is making money off of this, wants that. So there's that tricky component, right. The best we have, like, when I talk about depression, is let's go through your personal and family history. And if there is a history of depression, that doesn't mean the pill is completely out, but it means we need to monitor you. We need to make sure that it's working for you, because you deserve to live your life completely and feel your best as often as possible.

Claudia von Boeselager [00:19:39]:
Yeah, I mean, there's so many really important points I think you brought up there that I'd love to fine tune on. I think one is also sort of the myth you can get pregnant any time of the month. And I love, like, yes, sperm needs to be present. Really important fact, right? And that we're talking about a few days a month. And this one presentation I was also listening to was like, if you think about it, there's like a five, maybe six day window, depending on the woman. So that's 72 days a year where you have the potential of getting pregnant, yet you might be taking the pill for 365 days of the year. And there's also the health consequences. So I love your view.

Claudia von Boeselager [00:20:12]:
Like, let's look at the root cause. What is causing the condition in the first place? And not just blanket it with, oh, this pill will help it or whatever as well. But what is the cause breaking that down and then looking at it?

Dr Jolene Brighten [00:20:24]:
So let's say that there are women.

Claudia von Boeselager [00:20:26]:
Listening that are on the pill ten years, 15 years, maybe their late twenty s, thirty s, and they think, oh, someday in the future I might want to have kids. I don't know. But I've been on the pill for 15 years already, or whatever that number is, because I had acne, because I had irregular periods, whatever it is, my doctor back then told me, what would you recommend these women to do? Who should they talk to? What are the questions that they should be asking? And if they're not getting the right answers, should they go to somebody else?

Dr Jolene Brighten [00:20:54]:
Yeah. Well, if you're ever feeling like you're being dismissed, gaslit, you're not getting the.

Dr Jolene Brighten [00:20:59]:
Answers that you need, then get a second opinion. Get three second opinions, get a dozen.

Dr Jolene Brighten [00:21:04]:
Like, whatever it takes, advocate for your health.

Dr Jolene Brighten [00:21:07]:
So, firstly, if you are on the pill or any form of hormonal birth control that suppresses ovulation, do not do.

Dr Jolene Brighten [00:21:18]:
Fertility testing, do not get an amh, do not get an Fsh, lh, estradiol, progesterone, don't go testing these hormones. They should look bad if you are.

Dr Jolene Brighten [00:21:31]:
On the pill, because the pill, number.

Dr Jolene Brighten [00:21:34]:
One mechanism of action is to make.

Dr Jolene Brighten [00:21:35]:
It so you don't ovulate, suppress ovulation. How do we do that? We do it at the brain level.

Dr Jolene Brighten [00:21:40]:
We stop the pituitary from signaling to the ovaries. So FSH and lh, these are two brain hormones that orchestrate the menstrual cycle down. Your ovaries are going to look smaller, your amh is going to look dismal. That is a marker of ovarian reserve.

Dr Jolene Brighten [00:21:57]:
It is going to look bad.

Dr Jolene Brighten [00:21:59]:
And if your provider doesn't know what they're doing, because there are definitely providers out there. I've had patients come to me and they're like, I'm completely infertile. And I'm looking at their labs and I'm like, whoa, what's going on here?

Dr Jolene Brighten [00:22:09]:
Because what we'd expect in perimenopause is.

Dr Jolene Brighten [00:22:12]:
Fsh to be really high. If your estradiol is so low and they're like, well, I'm on the pill.

Dr Jolene Brighten [00:22:16]:
And I'm like, why did you wait?

Dr Jolene Brighten [00:22:18]:
Why did they order these tests? Don't do that. Because it is something that it's going to give you false data. So you need to wait. And in general, you're going to need to wait at least three to six months after coming off the pill before testing these things. It is something that if right now.

Dr Jolene Brighten [00:22:37]:
You'Re on the pill and you know.

Dr Jolene Brighten [00:22:38]:
That in the future you want to.

Dr Jolene Brighten [00:22:39]:
Have kids and you are 35 or older, I think it's important to speak to a reproductive endocrinologist about possibly preserving your eggs. If you're like, I'm not ready.

Dr Jolene Brighten [00:22:54]:
I don't know, I'll be ready when I'm like 40 something.

Dr Jolene Brighten [00:22:57]:
Yeah, we should preserve the eggs.

Dr Jolene Brighten [00:22:59]:
Your fertility does not drop off at 35 like we've been told.

Dr Jolene Brighten [00:23:02]:
It's not just going to plummet, however.

Dr Jolene Brighten [00:23:05]:
Oxidative stress free radicals that we generate, things that we come into contact in.

Dr Jolene Brighten [00:23:10]:
Our environment, and endocrine disruptors are hating on your hormones. If you're smoking, stop that now. Just stop.

Dr Jolene Brighten [00:23:17]:
Okay. If you are drinking a bottle of wine a night friend, we need to get you some support, because that ain't it when it comes to your hormone health. And if you're listening to this and you're like, I don't care about ever having a baby, well, I still want.

Dr Jolene Brighten [00:23:29]:
You to listen, because the longer we.

Dr Jolene Brighten [00:23:32]:
Can get your ovaries working for you, making hormones for you, the healthier and longer you are going to live, potentially. Buses come along and you got to look both ways when you cross the street. So don't want to make any promises, but our ovarian hormones are antiaging and they are longevity hormones. So if you are on birth control and if you're not, okay, so let.

Dr Jolene Brighten [00:23:58]:
Me just say, antioxidants, you need to.

Dr Jolene Brighten [00:24:00]:
Be bringing them into your diet if you're on birth control. We understand that birth control can deplete.

Dr Jolene Brighten [00:24:06]:
Things like vitamin C, vitamin E, and.

Dr Jolene Brighten [00:24:10]:
Mess with coq ten, which coq ten is declining as we age. And so these things are very important for protecting ovarian health. Things that protect ovarian health. So if you remember my talk from the health optimization summit, they protect mitochondrial health. So every biohacker bro out there is.

Dr Jolene Brighten [00:24:29]:
Like, oh, we got to get, like.

Dr Jolene Brighten [00:24:31]:
Love up those mitochondria. They don't say love up. They use more bro terms. I don't know, but that's what I say. Love up the mitochondria. Your mitochondria are just fueling your ovaries. They're very concentrated in. Your ovaries.

Dr Jolene Brighten [00:24:45]:
Your heart and your brain are the other tissues they're very concentrated in. So the things that you do to take care of your ovaries also take care of your brain and your heart. Oh, and your hormones from your ovaries also take care of your brain and heart.

Dr Jolene Brighten [00:24:56]:
So please keep listening, even if you.

Dr Jolene Brighten [00:24:59]:
Don'T want to have a baby. So we want to eat foods that are high in those nutrients. One of the easiest, no brainer ways.

Dr Jolene Brighten [00:25:06]:
To do this is plants rainbows on the plate.

Dr Jolene Brighten [00:25:09]:
So looking at getting a variety, the.

Dr Jolene Brighten [00:25:12]:
Goal now, there was new research coming.

Dr Jolene Brighten [00:25:15]:
Out saying, like, 30 different plants a week. And that can be hard for people to be like, I have to eat all these different things. Not necessarily because you can start to incorporate different things. Like you can bring in seeds or cacao nibs and bring in just different little elements that you're just sprinkling on your food, that it isn't necessarily giving you high antioxidant overload kind of situation, but also eating these things because they're going to support your gut health.

Dr Jolene Brighten [00:25:45]:
So we've got our nutrients.

Dr Jolene Brighten [00:25:48]:
It's been since the 70s, it's been documented that birth control depletes nutrients. And I've just seen so many providers out there be like, yeah, so just tell people to eat right. I was like, oh, eat right and exercise. I can't roll hard enough on providers who are just so flippant of like, just eat a good diet. What does that Jan, like, what does that mean? Do you even know what that means? Probably not, because you didn't get educated in it.

Dr Jolene Brighten [00:26:13]:
And the majority of people, we should.

Dr Jolene Brighten [00:26:16]:
Be educating in school how to eat in that way. But this is so intangible. So that's why when you are taking birth control, you do need to be much more aware of your diet. Nutrient density is key. So in my other book, beyond the pill, I give you recipes, I give you a meal plan, I take you through how to build a nutrient dense diet.

Dr Jolene Brighten [00:26:36]:
The other thing is gut health. Now, when it comes to gut health.

Dr Jolene Brighten [00:26:41]:
We'Ve got research to show birth control is associated with Crohn's disease. So that's an inflammatory bowel condition. There have been studies saying it's very hard on the intestinal lining, so leading to intestinal hyperpermeability, or what's commonly known as leaky gut, and that it can.

Dr Jolene Brighten [00:26:58]:
Mess with your microbiome, because while you swallow that pill, not all of it gets digested.

Dr Jolene Brighten [00:27:04]:
And absorbed and processed through the liver, some of it still makes its way to the large intestine. We don't have great studies on all of this, but what I am very cautious about and thinking about is that we know, and we've known that gut health is vaginal health.

Dr Jolene Brighten [00:27:21]:
And there's more and more research coming.

Dr Jolene Brighten [00:27:23]:
Out about the microbiome of the endometrium, the microbiome of the tubes and not just the vagina, okay? The microbiome of the entire reproductive tract playing a significant role in miscarriages, in infertility. So if you are messing with your microbiome in an unfavorable way, you best be doing things to take care of it. So that's not to say, like, jump off the pill right now and be afraid.

Dr Jolene Brighten [00:27:50]:
That's to say you're on something that.

Dr Jolene Brighten [00:27:52]:
Isn'T favorable for your gut. Right. There's lots of people out there taking medications we know are not good for gut health, but they have to be on these.

Dr Jolene Brighten [00:28:01]:
So what can we do now?

Dr Jolene Brighten [00:28:03]:
Someone might give me an eye roll when I say eat fermented foods, but it's so important. It's not just about fermented foods. For prebiotic or for the probiotics. Yeah, I'm about to say pre, post pro the probiotics. It's about your gut also making the postbiotics and helping with short chain fatty acids.

Dr Jolene Brighten [00:28:26]:
We want to be eating as women.

Dr Jolene Brighten [00:28:29]:
25 grams of fiber a day. 25 grams.

Dr Jolene Brighten [00:28:33]:
And not all at once.

Dr Jolene Brighten [00:28:35]:
Okay. And if you're not eating that much, I recommend start with 5 grams a day and increase that every week until you get to 25 grams. And that is just about supporting your gut health. You may need to also consider bringing in things like turmeric and ginger to help squash inflammation that's happening there. And so there's a lot. I have a whole fertility chapter in beyond the pill because there's so much to talk about, and I honestly could just write, like a whole book on this topic alone. But the big takeaway is there's absolutely things that you can be doing now.

Dr Jolene Brighten [00:29:11]:
And if you were put on the.

Dr Jolene Brighten [00:29:13]:
Pill for symptom management, it is a good idea to go investigating.

Claudia von Boeselager [00:29:19]:
So, yeah, I hope everyone feels very inspired with that. To understand, look at the root cause, if it's that as well, and then what you can be doing. So highly recommend also Jolene Dr. Brighton's book beyond the pill to find out more information on that, too. I'd love to shift a little bit to hormone imbalances and understanding. You know, what are the leading factors that you see amongst your patients or in the wider populations as well? And obviously, we talked about nutrition and lifestyle, but what are concrete things that people should be more aware of? How is it impacting their health by having these hormonal imbalances? And what are some actions that people should really be looking at straight away if they notice some of these symptoms?

Dr Jolene Brighten [00:30:05]:
Yeah. Okay. So there's, like, so many directions we could go with this. Right? I first want to validate people that.

Dr Jolene Brighten [00:30:11]:
Hormone imbalance is real, but what hormone are we talking about?

Dr Jolene Brighten [00:30:16]:
Right. So you see a lot of people out there talking about hormone imbalances, and I don't think there's anything wrong with that. We just have to get specific as providers. Are we talking about hypothyroidism? Are we talking about PCOS? What are we talking about here?

Dr Jolene Brighten [00:30:31]:
And so we need to understand what.

Dr Jolene Brighten [00:30:35]:
Hormones are actually driving the symptoms that you're having. That's what I take people through. So my book is this normal? We stepped away from birth control, and I'm like, listen, maybe you never did the pill. Maybe it's your teenage daughter. Maybe there's so many scenarios in life that don't revolve around birth control. Let's talk about these specifics. And so I see hypothyroidism and polycystic ovarian syndrome as two major things that women are struggling with and often not getting the help that they need.

Dr Jolene Brighten [00:31:06]:
So for people who don't know polycystic ovarian syndrome or PCOS, shocker.

Dr Jolene Brighten [00:31:13]:
We haven't studied it well enough to completely understand what causes it. We do know that gut dysbiosis is playing a role, like everything, right? But also that there is insulin dysregulation. Roughly 70% of those with TCOS have hyperinsulinemia. So high insulin or insulin resistance. And there is also a high androgen profile. So this is where it's like, I'm losing hair on my head, I've got cystic acne, I'm growing hair on my body where I don't want it. And all of this can result in irregular periods because of an ovulatory cycles. So the irregular periods are because you're not ovulating.

Dr Jolene Brighten [00:31:52]:
The problem is ovulatory dysfunction.

Dr Jolene Brighten [00:31:55]:
If your provider. So, everybody, I just want you to put your thinking cap on.

Dr Jolene Brighten [00:31:59]:
If your provider says you're not ovulating.

Dr Jolene Brighten [00:32:03]:
Okay, you have PCOS, you're not ovulating. That's why you don't have a period. So I'm going to give you the.

Dr Jolene Brighten [00:32:07]:
Pill that prevents you from ovulating, and I fixed your period. How does that make sense?

Dr Jolene Brighten [00:32:14]:
Is it inducing withdrawal bleed that could potentially prevent endometrial hyperplasia that could potentially become cancerous after years of not menstruating?

Dr Jolene Brighten [00:32:23]:
Yes.

Dr Jolene Brighten [00:32:24]:
However, that's not the same thing as fixing your period. So, with PCOS, the other thing that we have to think about is. So I talked about the insulin component. There can also be an adrenal component where you're actually making your androgens by way of the adrenal glands. Interestingly enough, roughly 50% of our testosterone production is coming from our adrenal glands.

Dr Jolene Brighten [00:32:46]:
This is why when you are postmenopausal.

Dr Jolene Brighten [00:32:49]:
And I'll see people say, like, oh, when you enter menopause, your ovaries aren't making testosterone anymore, so game over. However, some are going through, and not just PCOS, women. Some people go through late perimenopause and menopause, and they start having these hyper androgen, these high androgen symptoms. And the reason is because the adrenal.

Dr Jolene Brighten [00:33:10]:
Glands, they ain't quitting. Okay.

Dr Jolene Brighten [00:33:12]:
That doesn't mean you might not need hormone replacement therapy, but they're not quitting. Okay. So take care of your adrenals now. And also understand that can be a.

Dr Jolene Brighten [00:33:18]:
Place where testosterone comes from.

Dr Jolene Brighten [00:33:21]:
In addition to all of that, though, we know that there is a high rate of mental health issues with PCOS.

Dr Jolene Brighten [00:33:27]:
So depression and anxiety, there is a.

Dr Jolene Brighten [00:33:30]:
High amount of cardiometabolic issues. So I already talked about the insulin resistance leads to diabetes, but also digestive, or, excuse me, not digestive, but cardiovascular health. And I am thinking digestive health. And people are like, where does that come from? Because I'm thinking about metformin and how that's used for insulin, and that could be a side effect. I'm, like, getting ahead of myself in my own brain, but any condition that has insulin resistance or cardiovascular issues. Exactly. You knew exactly where I was going. You were going to risk brain health as well.

Dr Jolene Brighten [00:34:03]:
And so I'm just touching on one area of hormone imbalance, where the consequences, they're pretty dire if you do nothing.

Dr Jolene Brighten [00:34:13]:
Hypothyroidism, same.

Dr Jolene Brighten [00:34:16]:
Hypothalamic amenarrhea, losing your period, not making enough estrogen, same. Like, all of these hormone imbalance conditions have consequences outside of reproductive health, outside.

Dr Jolene Brighten [00:34:29]:
Of whether or not you want to have a baby.

Dr Jolene Brighten [00:34:31]:
You want to have a baby, and that's all you're thinking about. Like, I fill you and at the same time, understand that you are so much more than just a baby making machine, and you have every right, again, I'm going to say it again, you have every right to live your best life to the fullest capacity.

Dr Jolene Brighten [00:34:49]:
And that's what we should be aiming for with women.

Dr Jolene Brighten [00:34:52]:
Yes.

Claudia von Boeselager [00:34:53]:
And, yes. Love that. And I think a lot of challenges are, and I speak to a lot of friends. Many have kids, and they're like, oh, I'm just so exhausted all the time. It's just because of lack of sleep or just this or it'll be better then. And it doesn't change. And it's year after year, and I just see the progression. And I'm like, you need to really get on top of this.

Claudia von Boeselager [00:35:14]:
And I try to point them in the right direction and support them on these journeys as well. And so much is with the hormones, but they're like, oh, well, I went to my doctor.

Dr Jolene Brighten [00:35:22]:
The bloods look okay.

Claudia von Boeselager [00:35:24]:
Who wants to be okay, first of all? And second of all, did you really do full hormonal test panels? So what are the panels people should be asking for as part of their annual checkup, if you will, if not more frequently, to be able to really understand what is going on and if there is some deficiencies that need rebalancing?

Dr Jolene Brighten [00:35:44]:
Yeah, so@drbrighton.com. I have a whole article about hormone testing that really goes into this in detail. As you bring up fatigue and you talk about annual screening. A thyroid panel, I think should be part of every annual screening, especially as we get into our 30s, because it's more likely we're going to have thyroid dysfunction.

Dr Jolene Brighten [00:36:03]:
And the reason why this is so.

Dr Jolene Brighten [00:36:05]:
Important is that we know roughly 50%. So in the United States, the current statistics we have, say 27 million have thyroid disease, and roughly 50% walking around.

Dr Jolene Brighten [00:36:14]:
They don't even know it.

Dr Jolene Brighten [00:36:16]:
And hypothyroidism, fatigue is one of the big symptoms. And I want people to understand that when they come up with these. So there's the reference ranges or the references that are in the research, and then a lot of labs will give a reference range that's like, this is.

Dr Jolene Brighten [00:36:32]:
Based on the population we're seeing.

Dr Jolene Brighten [00:36:34]:
We know from vitamin D research how problematic that is, because a lab would.

Dr Jolene Brighten [00:36:39]:
Be like, my patient's in Alaska and.

Dr Jolene Brighten [00:36:42]:
Their vitamin D is 19. That's fine. And then another lab in the sunnier place is like, no, the cutoff is 30, and with thyroid, it's similar. But here's the thing to understand about.

Dr Jolene Brighten [00:36:53]:
Thyroid, if that's how we're setting reference ranges.

Dr Jolene Brighten [00:36:57]:
Well, in the United States, when do.

Dr Jolene Brighten [00:36:59]:
People get blood work done? When they are sick or when they are elderly.

Dr Jolene Brighten [00:37:04]:
But it is mostly sick people, right? Because it has to be justified. You have to feel completely awful before your insurance will pay for it. I'm, like, brought to you by the people saying preventative. What? Like, we should be screening this ahead of time. The number one cause of hypothyroidism, much.

Dr Jolene Brighten [00:37:22]:
More common than graves'disease, but both number one cause is autoimmunity.

Dr Jolene Brighten [00:37:28]:
With hypothyroidism, what we see, the pattern is thyroid.

Dr Jolene Brighten [00:37:33]:
Antibodies come up first. Okay? If we see that we need to.

Dr Jolene Brighten [00:37:37]:
Intervene, we need to start doing things to get the immune system happy.

Dr Jolene Brighten [00:37:42]:
Chill.

Dr Jolene Brighten [00:37:43]:
Stop kicking your own butt. Okay? This body is where you live. Stop this. So we need to work on that aspect, because otherwise the progression is from antibodies. We go to tissue destruction. That is where the antibodies flag the thyroid, which is a butterfly shaped gland at the front of the neck. And then the immune system is like, oh, it's like the tree cutters. I don't know if you've ever seen this.

Dr Jolene Brighten [00:38:05]:
I grew up where there was, like, logging.

Dr Jolene Brighten [00:38:08]:
I'm old even just saying that. And they go put an X on the tree. And then the guy knows I got, man, I cut this tree, right? Like, we're flagging where we're going to cut. And the immune system is the same. We get the antibodies that flag. Once it's tagged for destruction, the rest immune system comes in, destroys that gland. After we've destroyed enough of the gland, now we find ourselves unable to produce hormones. Now the pituitary starts screaming, that's the tsh at the thyroid gland.

Dr Jolene Brighten [00:38:36]:
And now we get the diagnosis of hypothyroidism. But all that time, we could have prevented, we could have saved a gland, and potentially, sometimes life gets the best.

Dr Jolene Brighten [00:38:45]:
Of us, but also we could have.

Dr Jolene Brighten [00:38:48]:
Saved that person a lot of time. Because you're not feeling good all that time, but your labs are looking normal. That is one thing that I would say annually.

Dr Jolene Brighten [00:38:58]:
Be looking at that. Vitamin D. Absolutely.

Dr Jolene Brighten [00:39:01]:
Be looking at that. At least annually. Take a look at your fasting insulin and hemoglobin.

Dr Jolene Brighten [00:39:07]:
A one C, not a fasting glucose.

Dr Jolene Brighten [00:39:10]:
I could care less about your fasting.

Dr Jolene Brighten [00:39:12]:
Glucose because maybe someone cut you off.

Dr Jolene Brighten [00:39:17]:
On the way to the lab and that stressed you out. And then you get to the lab, and you're like, I don't trust this lab tech. They're like, oh, maybe you're scared of it. Is it clean or they're coming at me in a needle. What is all of this? This is all a good reason for your body to spike your blood sugar. That's normal. That's absolutely normal.

Dr Jolene Brighten [00:39:33]:
What I want to see is, are.

Dr Jolene Brighten [00:39:35]:
You becoming insulin resistant? Because that starts first and then the hemoglobin, a one C, which is a marker of what your blood sugars look.

Dr Jolene Brighten [00:39:43]:
Like over the last three months, then.

Dr Jolene Brighten [00:39:45]:
That starts to creep up. So these are some things to think about when it comes to FSH, estradiol, progesterone. There are certain times of the month we test this, and we don't necessarily have to do this annually. I don't think it's not absolutely necessary in every single person. And it's also something, too, that once you get to perimenopause, like, you're in.

Dr Jolene Brighten [00:40:08]:
Late perimenopause, I'm like, why are we.

Dr Jolene Brighten [00:40:10]:
Spending our money there? Because we know if your periods are regular, your brain, your FSH is up, and your ovaries are calling it quits. We don't necessarily have to be chasing that down if we also understand your estrogen metabolite. So if we understand ahead of time, what's your propensity towards things? But why bring all this up about perimenopause is that there are providers who will absolutely obstruct somebody from getting hormone replacement therapy because they can't afford to.

Dr Jolene Brighten [00:40:38]:
Do the lab work.

Dr Jolene Brighten [00:40:39]:
It's really a problem in the United States. So they're denying them, like, $10 worth of estradiol and progesterone for the month. That's not necessary. If you're in perimenopause, you don't have to have those hormones tested. Now, if you are younger than 45, I may be interested in wanting to investigate things, because if your period is gone, you shouldn't be in menopause yet. That's not normal. So I may want to investigate things, but nothing should really obstruct you from getting those hormones if it's for the treatment of perimenopausal symptoms. And I mean that by saying you don't have to get an estradiol, you don't have to get a progesterone if you're not ovulating regularly.

Dr Jolene Brighten [00:41:20]:
We can't even test progesterone at the correct time of the month. It's a waste of money and a waste of time and a waste of a scary lab trip for some people.

Claudia von Boeselager [00:41:29]:
I mean, HRT is so important as well. But I want to jump into your latest book, Jolene, which you brought out last year. Is this normal? And part of your qualification is in sexology, which I love as well. Can you talk about the background to that? Why did you become so fascinated about it? What inspired you to write this book and to share a little bit more about with my audience about it?

Dr Jolene Brighten [00:41:52]:
Absolutely. The beginning of the book is all about sex. Some people are really mad about that with me where they're like, I just wanted to talk about hormones. And I get in and she's telling me what's a normal vulva and what's not, and how to orgasm and how to fix my libido. And I'm like, because I am asked.

Dr Jolene Brighten [00:42:08]:
So much about it. And I'm going to say in writing this book, I did have a moment.

Dr Jolene Brighten [00:42:14]:
Where I was like, let's put this in the back. And I'm like, I just feel like this is one more apology, that we are sexual beings and even the World Health Organization is like, pleasure is such an important component to everyone's health, so we should be talking about it. And so rather than apologizing that we have a vulva or that our libidos.

Dr Jolene Brighten [00:42:34]:
Are different or orgasming looks different than.

Dr Jolene Brighten [00:42:37]:
What we were all told in sex.

Dr Jolene Brighten [00:42:38]:
Ed, I was like, I'm going to.

Dr Jolene Brighten [00:42:39]:
Put it up front. So I have been asked so many sex questions over the years. Sex therapist was one of the like, that would be a fun thing to.

Dr Jolene Brighten [00:42:51]:
Be early in life, but I think.

Dr Jolene Brighten [00:42:54]:
I didn't understand how much science actually goes into it. And I was definitely a very much mechanistic science nerd. Nutritional biochemistry was like, my thing. I'm like, yes, complex biochemical pathways. I love this. So with that, I decided to pursue. So now I'm a certified sex counselor.

Dr Jolene Brighten [00:43:15]:
I decided to pursue that because there.

Dr Jolene Brighten [00:43:19]:
Is almost no medical school out there.

Dr Jolene Brighten [00:43:23]:
That is doing a solid service for.

Dr Jolene Brighten [00:43:26]:
Practitioners and teaching them about sex. It's only after specialization that urologists will learn more. But there's just so many myths. And as providers, we bring our own baggage into the room and it is our job and our work not to do that. But when it comes to sex, it's really hard to do that if you haven't actually examined your biases and worked on those, really, I wanted to be able to more fully answer my patients questions, to understand models and ways of talking to people about sex.

Dr Jolene Brighten [00:43:59]:
That dropped the shame, made it judgment.

Dr Jolene Brighten [00:44:02]:
Free, and actually got them the help they needed. I think in health we talk so much about. I talk a lot. Let me just say that I'm going to just own this. Like you've asked me questions, and people are just like, damn, she was just talking. I love your insecurity. Well, it's also like, I'm just going to own this. I have ADHD, and my biggest insecurity is that I will just go and go talking about something I'm so passionate about.

Dr Jolene Brighten [00:44:29]:
Own it.

Claudia von Boeselager [00:44:30]:
Never change. Own it.

Dr Jolene Brighten [00:44:32]:
I know, but I will get really insecure where I'm just like, oh, man, am I talking too much. Well, thanks to my first grade teacher, Mrs. Greiss, who wrote on my report card that I talk too much and I would never go anywhere in life because I just talk too much. In retrospect, I get paid to talk all the time, all over the world, and I'm like, well, Mrs. Greg, you showed her. Suck it. So anyhow, we should go back to what we were talking about. So with sexual, you can.

Dr Jolene Brighten [00:45:04]:
You can give all of the information, you can do a lot of education, and really, when it comes to sexual health, it's actually so much more simple of validating people's experience, validating what they're saying to you, and then giving just.

Dr Jolene Brighten [00:45:17]:
The tiniest, just the most on point.

Dr Jolene Brighten [00:45:21]:
Information that they can implement right then and there. Not in your office, not right then and there, but, like, later. Go home, or at least somewhere private. You don't have to go home, but you can't do it in my office. Okay? So that kind of framework was just so good for me to be able to learn and then just exploring all of the science around it. And so I am a certified sex counselor, but I don't see people for just one on one counseling. I want to understand.

Dr Jolene Brighten [00:45:52]:
Here's the other thing, is that in.

Dr Jolene Brighten [00:45:54]:
Women'S medicine, I don't care what your credentials are. I don't care where you trained, you.

Dr Jolene Brighten [00:46:01]:
Most likely have the bias that there.

Dr Jolene Brighten [00:46:03]:
Is something pathologically wrong with someone who complains of low libido, of somebody who can't orgasm your first place as a provider. You're always like, make sure it's not a big, scary thing. But you are so inclined to pathologize what is actually normal in a woman's body. And so that was a big thing that I'm like, I want to be.

Dr Jolene Brighten [00:46:24]:
Able to do the workup and understand.

Dr Jolene Brighten [00:46:26]:
Is it your hormones? Is it your stress? Is it these other things? Or is it completely normal what you're experiencing? And I can actually help validate that for you. And so the book called, is this normal? That was actually after every single patient person on the Internet and person, you know, when I speak at a conference, there's like a line of hundreds of people waiting to talk to me. Not going to lie, it sometimes feels a little overwhelming by everybody listening. You are always welcome to talk to me after a conference, to talk to me in the airport. Just don't follow me in the bathroom, okay? That's my boundary. It happens. I actually have to bring someone with me. I'm going to just tell a story.

Dr Jolene Brighten [00:47:10]:
Because we were at health optimization summit, and if the person who did this is listening, it's okay. I'm not upset with you, and I'm not going to name you, but I was in the bathroom, and this person walked out. So the year before, people were following me into the bathroom, and I was like, I need a point person to help prevent this. And so we did that the second year I was there. And then I go in the bathroom, and somebody. Oh, no. I come out of the stall. So somebody had followed me in.

Dr Jolene Brighten [00:47:36]:
So we didn't actually totally handle it. But people have to pee, so how do you know? Right? Okay, so this person follows me in. I come out of the stall, she has this fangirl moment. It's like, oh, my God, I just need to hug you. And I was like, I need to wash my hands. I'm just like, this is so awkward because I'm a human, but everybody pees, so you should wash your hands, too, people. And so I had to wash my hands. And it's like, I love those moments.

Dr Jolene Brighten [00:48:03]:
Just like, not, were you listening to me pee? Because now I feel really insecure. Anyhow, everybody, you're always welcome to come and talk to me, but what I will say is that all these people, over a decade of my life, is this normal? Blah, blah, blah, blah is happening.

Dr Jolene Brighten [00:48:22]:
Is this normal?

Dr Jolene Brighten [00:48:23]:
I'm experiencing this. Is this normal? Is it normal, too? And there's a good percentage of the.

Dr Jolene Brighten [00:48:29]:
Time where it is normal, because when.

Dr Jolene Brighten [00:48:32]:
We talk about normal, what is normal? It is a bell shaped curve. Okay? This is just statistics. Not to give anyone trauma. If you went through statistics, I had to go through three or four statistics classes. Oh, my gosh. But that's it. It's a bell shaped curve. And the people that are smack dab in the middle, they're called normal.

Dr Jolene Brighten [00:48:50]:
And the people who are a little bit on the sides, they're also called normal. And the people that are outliers, that might be their normal when we're talking about sex.

Claudia von Boeselager [00:48:59]:
So that's a really good point, too. Let's talk about women and sex as well. And some of the difficulties or challenges or insecurities that you're seeing, I'd love if you could expand on that as well. So for people listening that they're like, oh, I'm not the only one. What are some of the biggest aha's that women have been having learning from you?

Dr Jolene Brighten [00:49:19]:
Only about 18% of women report that they can orgasm with vaginal penetration alone. 18%.

Dr Jolene Brighten [00:49:27]:
And what is that based on? Their anatomy?

Dr Jolene Brighten [00:49:30]:
Something you cannot control. It's basically the distance of, like, the clitoris and the vagina. And that was predetermined in utero.

Dr Jolene Brighten [00:49:37]:
So blame your father, I guess.

Dr Jolene Brighten [00:49:41]:
That's not you. You're not broken. But there has been a big myth.

Dr Jolene Brighten [00:49:45]:
For a long time where it is.

Dr Jolene Brighten [00:49:47]:
Very male centered sex education that we receive because it's based on, like, you should only have sex if you want to have a baby, and the only way to it is with a penis. Okay, so who does it serve to tell women that the way that they should be orgasming is vaginal penetration? It actually serves men. But this is what I will say when you talk to men. Men are like, I want her to feel pleasure. I want her to feel happy. And they feel this tremendous pressure because society is like, you should be a stallion that can go forever and so desirable and please every woman. And they're like, I don't actually know because nobody taught us about the clitoris. So the clitoris is the primary way that women orgasm.

Dr Jolene Brighten [00:50:28]:
And you don't run out of orgasms like some men do. And that is another myth where men will think, like, if she's orgasming on her own or orgasming first, she's using up her orgasms, and then there will be, like, nothing left for us. And in fact, women who masturbate, they actually report greater relationship satisfaction. So they're not masturbating to have that. They are satisfied with their partner. They're happy with their partner, and so they have a propensity to masturbate. And in addition, if she orgasms first or however you get there, that doesn't mean things end. And I think that men, a lot of the times they're like, I ejaculate, then I'm flaccid.

Dr Jolene Brighten [00:51:08]:
Therefore we're done. We all try to relate to others as we know our own self. So those are some of the things that I will say really helped a lot of people in understanding that. And I list, like, there's lots of different ways to orgasm because it's a neuronal and brain event, right? It's a neurological system. So an orgasm. Some people, the people who can think off, let us know. I'm just like, how? Teach me, Obi Wan. I need to know, how do you do this? But there's a lot of ways to have an orgasm.

Dr Jolene Brighten [00:51:45]:
But the primary way is going to be through clitoral stimulation. And in the majority of medical textbooks.

Dr Jolene Brighten [00:51:52]:
That are out there, there are not actually true clitoral diagrams.

Dr Jolene Brighten [00:51:56]:
Doctors are not even being taught about what the clitoris actually looks like. So if you feel like you're in the dark, I talk about the clitoral conspiracy in the book. This was orchestrated by medicine to keep all of us in the dark about the clitoris, which is why I included three diagrams of the clitoris in the book, so that people would know. And I overlaid a vulva on top of it and was like, people need to know and then have a right to know. All people should understand this if you are going to have sex with a Volvo owner, friends know the Volvo terrain and communicate. Ask them what they like.

Dr Jolene Brighten [00:52:31]:
So I think that's been one of.

Dr Jolene Brighten [00:52:33]:
The big shockers to people to learn.

Dr Jolene Brighten [00:52:36]:
That.

Dr Jolene Brighten [00:52:39]:
It'S actually an outlier to orgasm by vaginal penetration alone. That means no one ever touches your clitoris. Okay. Sometimes people are like, no, but I do. And then they get into explaining, and I'm like, yeah, well, there's clitoral stimulation happening there, so you are not alone. You are not the only one. If clitoral stimulation has to be your mecca to the orgasm.

Claudia von Boeselager [00:53:04]:
Yeah, I love that. That women are multi orgasmic.

Dr Jolene Brighten [00:53:07]:
Right?

Claudia von Boeselager [00:53:07]:
I mean, it's such a gift. Ladies, just, like, tap into this. There's so much more delights out there available. But I want to also pick.

Dr Jolene Brighten [00:53:17]:
Sorry, go ahead. Oh, yeah.

Dr Jolene Brighten [00:53:18]:
I was just going to say, well, and I talk about in the book the times where you're more likely to experience multiple orgasms, or it's more worthwhile to try to go after them, because I think there's also. The other thing I'll say is I talk about the myths in the book when it comes to libido, being in the mood, what's normal, what's not, and also vaginal dryness and self lubrication and arousal fluid. This is something where I really just.

Dr Jolene Brighten [00:53:48]:
Don'T understand how men don't feel like.

Dr Jolene Brighten [00:53:51]:
It'S so inappropriate for them to go on the Internet and say the things they do. But also, I'm secondhand embarrassed for you.

Dr Jolene Brighten [00:54:00]:
Because you're on the Internet being like, oh, only postmenopausal.

Dr Jolene Brighten [00:54:04]:
Women need lube. Or if she needs lube, she's not the one. And I'm like, don't you know how hormones work and how they cycle and how these things change? As they say in the book, a lube free bedroom is where good sex goes to it. That's what I was going to say. But on to the next question.

Claudia von Boeselager [00:54:23]:
It's beautiful. I love that quote as well. As we're finishing up today, Dr. Brighton, how can women better advocate for their hormonal health within the current healthcare system? And what are some resources and tools? We've obviously talked about your books and Dr. Brighton.com as well. Where can people educate themselves more men and women? I will say yes.

Dr Jolene Brighten [00:54:47]:
Okay, so you asked two questions there. One about how to advocate with your provider. And I definitely want to get into that. And for people, I talked about nutrition. I talked about lifestyle things. I have a free resource. It's drwritton.com, hormonekit. If you go there and you grab that, you're going to get a meal plan, you're going to get recipes, you're going to get more in depth information of me just teaching you foundational stuff that you should be doing every day.

Dr Jolene Brighten [00:55:14]:
I hate using the word should, but these are the things we should be doing if we want to have phenomenal hormone health. So to answer the question about how to advocate for yourself with a provider, there's very specific things that when you.

Dr Jolene Brighten [00:55:26]:
Learn to say and do, you can.

Dr Jolene Brighten [00:55:28]:
Move things faster with your provider.

Dr Jolene Brighten [00:55:30]:
So number one is when you're asking.

Dr Jolene Brighten [00:55:33]:
Them for things, they're dismissing you in the office. Ask them. So if you've come in specifically and you're like, I believe I have this condition. And they're like, no, you don't. Here's a prescription, or we'll see you in six months or whatever, let's just watch a wait.

Dr Jolene Brighten [00:55:44]:
You ask them what's in your differential.

Dr Jolene Brighten [00:55:47]:
And what have you done to rule that in or rule that out? You ask them straight up.

Dr Jolene Brighten [00:55:54]:
And why I say to do this.

Dr Jolene Brighten [00:55:56]:
As a first place is you speak their language. So unfair that you have to speak medical jargon. So unfair. But it'll help get them in that mode of like, what is my differential? What things do I think? So differential is, hey, here's the top things that this could potentially be, and this is what I got. And this is how we've ruled it in and ruled it out. Like, oh, if it was endometriosis, I would expect you to have more period pain. But you can say like, well, lower stages of Endo may not have that, and I am having difficulty with bowel movements, so that could be a sign of endo. Not everybody with endo has period pain.

Dr Jolene Brighten [00:56:32]:
So what have we done to really rule this out?

Dr Jolene Brighten [00:56:34]:
You can start to have a conversation that way.

Dr Jolene Brighten [00:56:37]:
Let's say just for the sake of endo, that just using this, an example, but you can use it with anything, is that you're asking for an MRI. So this is a form of imaging that if the people are trained well, they can pick up endometriosis and adenomiosis on it, non invasive way. There's no radiation, and it doesn't require surgery like laparoscopy, which is the current gold standard of how they're doing it. So maybe you're saying, hey, I want an MRI.

Dr Jolene Brighten [00:57:04]:
And they are like, no, I don't think you need that.

Dr Jolene Brighten [00:57:07]:
Well, what you need to say to.

Dr Jolene Brighten [00:57:09]:
Them then, is, I am requesting an MRI.

Dr Jolene Brighten [00:57:13]:
Please write in my chart that I am requesting this imaging, and please write the reason you are denying this imaging to me. I'm going to request my chart notes.

Dr Jolene Brighten [00:57:21]:
At the front, and I'll be taking those to a second opinion.

Dr Jolene Brighten [00:57:25]:
They're going to be like, hold on, I got to document this. I got to put this down. And there's going to be oversight on why I'm making this decision. And some providers are going to write in there, non compliant patient, patient, hypochondriac. They'll write, and if they're mean and spiteful, they'll sometimes write mental health stuff in there, too, which can really make it a challenge with the next provider.

Dr Jolene Brighten [00:57:49]:
But this is where it is so.

Dr Jolene Brighten [00:57:52]:
Unfair, and I have to tell you, but I understand its work, is that you have to keep advocating for yourself and find a provider who listens. Thank God we have social media now, because I feel like two things.

Dr Jolene Brighten [00:58:05]:
With social media, you can find people.

Dr Jolene Brighten [00:58:08]:
Telling stories about really great providers, people they've worked with, so you can connect, and you can also find providers online.

Dr Jolene Brighten [00:58:15]:
And those providers will often show you.

Dr Jolene Brighten [00:58:18]:
Who they really are. So I caution people that if you see a provider who has built their social media off of call outs, shaming people, attacking people, but then they tell.

Dr Jolene Brighten [00:58:31]:
You, oh, I'm patient centered.

Dr Jolene Brighten [00:58:33]:
And I'm always about my patient.

Dr Jolene Brighten [00:58:35]:
First, you showed us who you are.

Dr Jolene Brighten [00:58:38]:
And if you are that person on the Internet where you think it's okay to say, like, this influencer is such.

Dr Jolene Brighten [00:58:43]:
An idiot, you're going to be that.

Dr Jolene Brighten [00:58:45]:
Person in the office, because it is very hard for people to be different, be different in different contexts, in different situations. I always believe you should show up and just be who you are. And I think that these people have. And so I say that because I've seen people say, like this person with this big platform, I went and saw them. It was the worst experience of my life. Even though they said all of these.

Dr Jolene Brighten [00:59:10]:
Things, people say one thing and they.

Dr Jolene Brighten [00:59:13]:
Are not self aware to even see that they are acting completely different. So if you are looking for a provider, I would say get on social media and start looking at hashtags, start searching these things for these different providers, and you don't have to necessarily go to them, that you can just see what are the kinds of things they're telling you. Start writing down those questions, start writing down those things that you want to ask and interview that future provider with. And then the last thing we'll say is in, is this normal? I gave you lots of checklists that I said, it's unfair. You have to speak the medical jargon. These checklists that are in there will help you.

Dr Jolene Brighten [00:59:50]:
So with PCOS, for example, there's a checklist in there, and I tell you how it's diagnosed.

Dr Jolene Brighten [00:59:55]:
If your provider is like, I don't think you have PCOS, because I don't. You're like, hey, wait a minute, I checked off all of these things and I know the Rotterdam criteria, and it doesn't sound like you will be so savvy that you will force change in medicine. And I have always said this, and I believe this, that me out here talking all the time, I'm never going to change doctors minds. I am not going to change medicine as one individual healthcare providers in the system can't change it for the better. They can change it in their own practice for the patient, but it will be patients who are the people who pay demanding better that will actually change medicine for the better. So understand, even though this sounds so exhausting, and listen, I've been through it with providers myself, and I always have to remind myself when I advocate for myself, I make it so much easier for the next woman coming in the room behind me.

Claudia von Boeselager [01:00:45]:
Beautiful. And thank you for all the work that you're doing to reshift the way that medical practice is taught and all that you're doing and that you've expanded your reach into with the nutrition component as well. Because as you were saying, if they've even been trained 12 hours in their whole medical career, and it's just these foundational lifestyle interventions that are so important and advocating, and the checklist are such a brilliant idea that you included in the book as well. So thank you so much. Where can people follow you on social media? What are your handles? Et cetera?

Dr Jolene Brighten [01:01:15]:
I guess there's me on social media too, right? So you can follow me at Dr. Jolene Brighton. And Brighton is brighten and I'm like all over social media. We've got Instagram, TikTok threads, YouTube. I'm not on Twitterx, I'm not there, but just about everywhere else you can find. But my main hub is drbrighton.com and that is what I have been just so pleased that women will call the Google of women's medicine because you will find so much evidence based information on how to manage your care outside of a medical practice, outside of the doctor's office, but also know how to advocate for yourself and when it's time to go to the doctor's office.

Claudia von Boeselager [01:02:05]:
Yeah, and you also managed to portray things in such an entertaining way as well. So highly, highly recommend following checking it out and obviously, Dr. Brighton's amazing books. Is this normal and beyond the pill as well? Dr. Brighton, do you have a final ask or recommendation or any parting thoughts or message for my audience today?

Dr Jolene Brighten [01:02:25]:
I want everybody to just really own the fact that you are the only person who lives in your body. You are the only person who knows you're normal. And if anybody is gaslighting you, break up them just like you would with a bad boyfriend. Life is way too short to ever not fill your absolute best, and you won't always feel your best, but gosh.

Dr Jolene Brighten [01:02:48]:
We should be really working towards that. Yes.

Claudia von Boeselager [01:02:52]:
Thank you so much for coming on today. Love what you're doing. Never stop. Keep perfectly explaining and helping and being the bold self that you are. So thank you so much for all your work.

Dr Jolene Brighten [01:03:04]:
Such a great.

Dr Jolene Brighten [01:03:05]:
Thank you. I appreciate this conversation.

Claudia von Boeselager [01:03:07]:
So wonderful.

Dr Jolene Brighten [01:03:08]:
Thank you.