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How Your Hair Changes With Your Hormones · We Are Spiraling

0:05
SPEAKER_01: This is Priya Anand, and we are spiraling.
0:09
SPEAKER_01: In this show, we use curly hair as a lens to investigate our world.
0:13
SPEAKER_01: You asked, so today's episode has answers.
0:16
SPEAKER_01: How do our hormones affect our hair?
0:18
SPEAKER_01: Some listeners have said that they became curly during puberty, but it hit them late, so having straight hair already felt like their identity.
0:25
SPEAKER_01: Others have noticed curls after chemotherapy or menopause, and some have lost their curls with age.
0:30
SPEAKER_01: Today's guest helps us understand how do your hormonal shifts affect your hair.
0:50
SPEAKER_00: I am an OBGYN and a menopause specialist.
0:53
SPEAKER_00: Um but maybe most importantly, I'm uh one of uh Priya's oldest friends, and it is such an honor and joy to be here.
1:00
SPEAKER_01: Actually, I was gonna say, like for the record, this is not a conflict-free interview because you are one of my very best friends.
1:07
SPEAKER_01: And one thing I realized this morning while I was getting ready for this interview is we also met through journalism, which is it feels a little bit full circle that I get to interview you, and we're in these like different, completely different roles from what I expected my life to be from reporter life.
1:23
SPEAKER_01: But we met at a community meeting, a neighborhood advisory commission meeting in DC, where Jordan was the college newspaper photographer and I was the reporter covering the meeting.
1:34
SPEAKER_01: And he got to leave after one hour of taking photos, and I was there until like midnight.
1:39
SPEAKER_00: And if people don't know, this is the single most boring meeting of all time.
1:43
SPEAKER_00: And Priya had to suffer through the whole thing.
1:47
SPEAKER_01: But I will never regret it because I got our friendship out of it.
1:50
SPEAKER_01: So it's one of the best things I could have achieved from the ANC in DC.
1:54
SPEAKER_00: Totally agreed.
1:54
SPEAKER_01: So tell us what relationship do your hormones play with your hair?
1:58
SPEAKER_00: I think it's a great question, and it's honestly not necessarily a straightforward answer.
2:02
SPEAKER_00: So I think what's really cool just generally about hair and you know, kind of what our hair looks like at any given moment is that it's really a window into what your body's hormonal, nutritional, metabolic state was at the time that that hair was formed.
2:18
SPEAKER_00: And I think that that's like just kind of a really cool little time capsule to think about.
2:23
SPEAKER_00: There are these distinct moments of transition that are involved with hormonal transitions.
2:28
SPEAKER_00: So puberty is a big one, pregnancy at postpartum is another one, uh, and menopause, you know, being kind of the big three hormonal transitions that a woman will go through.
2:37
SPEAKER_00: I'm obviously an OBGYN, so I could speak more to the hormonal transitions that women go through, but men also go through hormonal transitions and, you know, in some ways follow similar patterns.
2:47
SPEAKER_00: And so we do see those transitions happening at that time.
2:50
SPEAKER_01: What are some of the, well, let's get into men first because I feel like that might be a shorter conversation.
2:57
SPEAKER_01: Is that right?
2:57
SPEAKER_00: I think to some extent they're actually very related in a lot of ways.
3:01
SPEAKER_00: Yeah.
3:01
SPEAKER_00: So one of the biggest influences hormonally on our hair texture and growth is actually the hormone testosterone.
3:08
SPEAKER_00: And so we often associate testosterone as being a male hormone.
3:12
SPEAKER_00: And that is because, you know, it is the dominant hormone in in men and in terms of kind of you know determining the physiology and you know what a male body will look like.
3:21
SPEAKER_00: But women have testosterone as well.
3:24
SPEAKER_00: In fact, women actually overall produce more testosterone in their life than estrogen, which is a common fact that people don't know.
3:30
SPEAKER_01: Wow.
3:30
SPEAKER_00: And so the way that testosterone influences hair is, I think, really, really fascinating.
3:35
SPEAKER_00: Generally, when we think about, you know, particularly curly hair, I think that the first part is really like how the hair follicle actually comes out of your head.
3:41
SPEAKER_00: And so maybe you've covered this in the past, but you know, a straight hair, usually the hair follicle is kind of going straight in and out at a 90-degree angle.
3:48
SPEAKER_00: But then, you know, curly or wavy hair, it's gonna have a little bit more of a bend to it, almost like a hockey stick.
3:53
SPEAKER_00: And what happens in that situation is that the actual shape of the hair follicle becomes more of an ellipsis or elliptical than a circle.
4:02
SPEAKER_00: And so testosterone actually has a huge influence on how that process happens.
4:06
SPEAKER_00: When we think about these hormonal transitions, often testosterone is actually the primary thing that's that's changing.
4:12
SPEAKER_00: So if we think about men, for example, you know, usually at puberty, that's when testosterone production ramps up.
4:19
SPEAKER_00: And so we start to see darkening of body hair, we start to see body hair becoming more curly.
4:24
SPEAKER_00: And so even people who have straight hair on the top of their head, you know, their pubic hair or their armpit hair or their chest hair might still be curly.
4:31
SPEAKER_00: And so I think that that's actually kind of like a cool thing that unites all of us.
4:34
SPEAKER_01: We're all curly somewhere.
4:35
SPEAKER_00: We're all curly somewhere.
4:37
SPEAKER_00: That's exactly right.
4:38
SPEAKER_00: That should be the new tagline of the show.
4:43
SPEAKER_00: But what's really cool is that basically when testosterone starts to go up, it actually influences essentially how fast different sides of the hair follicle are growing.
4:53
SPEAKER_00: And so you can imagine that if one side of the hair follicle is growing faster than the other, it actually starts to produce this kink or this curl in the hair that produces, you know, more curly texture versus, you know, maybe you have a genetic predisposition where, you know, you have less of a response to that and your hair is going to be straighter.
5:11
SPEAKER_00: But, you know, these hormonal transitions are often characterized by massive fluctuations of testosterone.
5:17
SPEAKER_00: And so that's why I really think that it affects both men and women equally.
5:21
SPEAKER_00: Again, I usually see the women who are talking about the changes to their hair more than the men, but you know, we expect to see and the literature would suggest that it's kind of all the same stuff.
5:30
SPEAKER_01: So I want to go back to this idea you stated that the hair is a time capsule.
5:35
SPEAKER_01: Tell me more about that because I don't want to lose that thread.
5:39
SPEAKER_01: And I also find it a little bit fascinating because it's related to the fact that when you're really stressed and your hair is falling out, actually your hair might fall out like two to three months after that period of intense stress.
5:52
SPEAKER_00: Yeah, absolutely.
5:53
SPEAKER_00: So hair goes through these distinct phases of, you know, growth and maintenance and then shutting.
5:59
SPEAKER_00: And, you know, that's kind of a natural process.
6:01
SPEAKER_00: But when we have influences on various processes in our body, you know, hormones being, you know, one of the most obvious examples of that.
6:08
SPEAKER_00: And stress is a hormonal process as well, right?
6:11
SPEAKER_00: We have cortisol rising when we're stressed.
6:13
SPEAKER_00: It is going to influence essentially how long hair stays in each of these phases.
6:18
SPEAKER_00: And so I think the cortisol example is a is a great example that, you know, cortisol can actually blunt that growth phase of the hair.
6:25
SPEAKER_00: And so, you know, you might see those effects later on because the hair is still going to be there for a little bit.
6:30
SPEAKER_00: It still has to go through that full process.
6:33
SPEAKER_00: And then it's going to shed.
6:34
SPEAKER_00: And then it takes a couple of months to come back.
6:36
SPEAKER_00: And so, you know, one of the diagnoses, you know, here is telogen effluvium.
6:41
SPEAKER_00: And so that's kind of you like what we call the hair shedding that comes from like a stressful experience or just sort of a massive change in your body of some kind, like postpartum, for example.
6:51
SPEAKER_00: Um, and so what happens usually in that situation is that there's kind of like this massive shed.
6:55
SPEAKER_00: It usually happens over the course of several months.
6:57
SPEAKER_00: And then it takes a couple of months.
6:59
SPEAKER_00: Once that original process has resolved, the hair will start to grow back because it's almost like your body's resetting into this new hormonal state.
7:06
SPEAKER_00: But each of these phases is distinct in terms of representing what your body was going through at that time, whether it was a hormonal change, a stressful experience, a trauma, a nutritional deficiency.
7:17
SPEAKER_00: And then when that state changes, your hair turns into something new.
7:21
SPEAKER_01: Is this similar to how animals go through a molting process?
7:25
SPEAKER_01: Because we are publishing today, as we're after we do this interview, uh, an episode about curly animals and we talk about how they go through a molting process.
7:34
SPEAKER_01: So I'm just wondering, is that our human version?
7:36
SPEAKER_00: That's a really interesting question.
7:37
SPEAKER_00: Um what did you find in your research?
7:40
SPEAKER_00: What did they say was the influence in terms of the malting?
7:43
SPEAKER_01: Well, I actually asked the reverse of this question to Dr.
7:46
SPEAKER_01: Danielle Lee, who studies mammals.
7:48
SPEAKER_01: And I said, Hey, we're going to be interviewing a doctor about hormones and hair.
7:52
SPEAKER_01: And I'm wondering if animals have similar uh hormonal changes throughout their life in different stages, the way humans do, and if those affect hair, like what that process is for animals, right?
8:03
SPEAKER_01: Is there a mirror here or do they have like one time period?
8:06
SPEAKER_01: And she was like, Well, they molt.
8:07
SPEAKER_01: And I was like, Well, we try to avoid molting because we buy you know serums and rogues.
8:12
SPEAKER_01: We don't want to molt.
8:14
SPEAKER_01: And she was like, it would be cool if everyone molted together.
8:16
SPEAKER_01: And I was like, turkey colony would be booming even more.
8:20
SPEAKER_01: So yeah, I asked the reverse.
8:21
SPEAKER_00: But very seasonal.
8:23
SPEAKER_01: Very seasonal.
8:24
SPEAKER_00: It's it's a great question.
8:25
SPEAKER_00: I honestly don't know the answer.
8:27
SPEAKER_00: I I think that, you know, my general sense is that when animals are going through a molting process, there is almost kind of this like annual circadian rhythm to it that, you know, kind of, you know, go through different phases throughout the year.
8:41
SPEAKER_00: And, you know, to some extent that does happen with humans, but I think a little bit less so that, you know, we're not like going into hibernation or like shedding for the summer in the way that, you know, a big furry mammal might do.
8:51
SPEAKER_00: I think that it's more just representative of these large transitions that happen in in our life, um, like, you know, kind of sexual maturity of puberty, like going through a pregnancy and postpartum, like going through menopause, where your body essentially has to recalibrate to a new milieu.
9:07
SPEAKER_01: Are there other life stages as well that can produce these big shifts in the hair?
9:13
SPEAKER_01: Like what are all the possible life stages where this could happen?
9:16
SPEAKER_00: Yeah.
9:17
SPEAKER_00: I mean, I think that really anything that's going to potentially influence um any of those factors that I mentioned, hormones, nutrition status, uh trauma or stress, uh, are potentially going to lead to that.
9:28
SPEAKER_00: So, you know, the big natural transitions would be the three that I've already mentioned.
9:31
SPEAKER_00: But, you know, obviously a big one in the medical world might be going through a cancer treatment.
9:36
SPEAKER_00: And so, you know, we see obviously chemotherapy really affecting people's hair.
9:39
SPEAKER_00: You know, that's one of the most obvious uh symptoms that people have or side effects that people have from chemotherapy.
9:45
SPEAKER_00: And in some ways, you know, it's it's somewhat of a similar process that, you know, in in that situation, you have a medication that is actually inhibiting cells that rapidly divide, which includes your hair follicles.
9:56
SPEAKER_00: And that's what leads to the shedding of the hair.
9:58
SPEAKER_00: And so it's influencing the same kind of like growth pathway that, you know, would be influenced by hormones or your nutrition status, but in, you know, kind of like a toxic way.
10:08
SPEAKER_00: Um, so that may be, you know, one example that might come up.
10:10
SPEAKER_00: I think that the experience of trauma is not to be understated here.
10:14
SPEAKER_00: Like just like you mentioned, like anybody who goes through something stressful often has changes to their hair.
10:20
SPEAKER_00: And until that situation resolves, it it often won't improve on its own.
10:26
SPEAKER_01: You actually answered my next question, which is chemo curls and then shifts in the opposite direction.
10:32
SPEAKER_01: Because I've heard from several listeners who have asked uh this specific question, right?
10:37
SPEAKER_01: Their hair changed due to chemotherapy or their friends' hair changed due to chemotherapy.
10:41
SPEAKER_01: Because you mentioned that basically growth is inhibited and that affects the hair too.
10:45
SPEAKER_01: But I'm assuming treatments have not been made and advancements have not been made yet that can target even more which uh part of your body is affected by the medication.
10:54
SPEAKER_00: So there's there's a very cool new innovation, which which I'll I'll talk about actually that does help with this.
10:59
SPEAKER_00: Maybe you've heard of these cold caps.
11:01
SPEAKER_00: Have you heard of this?
11:02
SPEAKER_01: I've heard of the red light therapy caps.
11:04
SPEAKER_00: So that's a totally different thing.
11:06
SPEAKER_00: So the red light therapy is basically stimulating production and you know, kind of cell function that, you know, helps hair to grow back.
11:13
SPEAKER_00: And there's actually some decent science behind it.
11:15
SPEAKER_00: I usually recommend them to my patients.
11:17
SPEAKER_00: But specifically for people going through chemotherapy, there's this really cool thing that anybody who's gone through chemotherapy has definitely heard of this.
11:24
SPEAKER_00: And they're basically cold caps.
11:25
SPEAKER_00: And what you do is while you're getting your infusion of chemo, you wear this cap on your head that is extremely cold.
11:32
SPEAKER_00: It's like freezing.
11:32
SPEAKER_00: And what it does is that just like, you know, if you were cold and your, you know, your fingers get cold, what's happening is that your body is is closing off your blood vessels to try to essentially shunt blood back to your central organs.
11:46
SPEAKER_00: And so if you make your head really cold, it closes off all of those blood vessels that go to the hair follicles, thus limiting the amount of um of exposure to the hair follicles of the chemotherapy.
11:58
SPEAKER_00: It's essentially like you're creating a blockage.
12:00
SPEAKER_00: And I honestly, you know, I'm not an oncologist, so I don't know the exact numbers in terms of how effective this is.
12:05
SPEAKER_00: But, you know, I know patients who have gone through this.
12:07
SPEAKER_00: I have friends who have gone through chemotherapy, you know, and and they've had a positive experience with it.
12:12
SPEAKER_00: It is really cold.
12:13
SPEAKER_00: Like I think it's uncomfortably cold, but it is, I think, a really cool new thing that exists to try to limit that.
12:19
SPEAKER_00: And then obviously there's also all new different types of medications, you know, for depending on whatever the cancer is, that are more targeted, that are, you know, not kind of these broad, like just kill every rapidly dividing cell in your body.
12:31
SPEAKER_00: They're a lot more targeted in terms of like using immunotherapy, you know, to really like specifically find the cancer cells and and and kill them.
12:39
SPEAKER_01: Well, I'm glad to hear that there have been advancements because this is, you know, an additional traumatic layer of the process for a lot of people because hair is so tied to so many people's identities.
12:49
SPEAKER_00: I think that what it gets to though is that, you know, again, just this broader story that your hair, like what it looks like, what the texture is, you know, how full it is, how long it stays on your head, is all influenced by what your body is like in that given moment.
13:05
SPEAKER_00: And there's no question that going through a cancer diagnosis and treatment changes um those kind of physiologic processes in your body in an irreversible way.
13:15
SPEAKER_00: And so, you know, we might think about how your hormones might change.
13:20
SPEAKER_00: Like, you know, I take care of a lot of patients who have a history of breast cancer.
13:23
SPEAKER_00: A very common treatment after breast cancer is essentially medications that either sort of like completely get rid of the estrogen in your body or block the effect of estrogen on various parts of your body, you know, most notably the breasts, of course.
13:36
SPEAKER_00: And so people in that situation will have, you know, noticeable changes to their hair, you know, either fullness or texture, because again, estrogen is playing a role in how long our hair stays in the growth phase.
13:48
SPEAKER_00: Estrogen seems to also have a little bit of a counter-effect on that testosterone uh element that we that we started with, where you know, it's going to be a little bit of a counterbalance.
13:57
SPEAKER_00: And that's also what influences some of these hormonal transitions.
14:00
SPEAKER_00: And so, you know, when you think about somebody going through cancer where, you know, they are losing all of their hair in a lot of situations if they go through at least traditional chemotherapy, their body after that cancer, after that chemo is a very different body than it was before.
14:15
SPEAKER_00: So, in terms of the actual answer to the question of like, you know, which direction does it go, I don't think there's any answer to that question.
14:21
SPEAKER_00: There's some combination of genetics and then what your body looks like afterwards, but there's no question that your body's in a different state.
14:28
SPEAKER_00: And yeah, like we talked about, like your hair is going to be the the kind of most visible example of what your body's doing at that given moment.
14:36
SPEAKER_01: It's the most obvious mirror.
14:42
SPEAKER_01: You mentioned there are several factors at all times, right?
14:45
SPEAKER_01: It's your hormones, it's stress or any trauma you might be going through.
14:50
SPEAKER_01: It's also nutrition.
14:51
SPEAKER_01: So if someone is going through or they know they're going to go through one of these big shifts.
14:56
SPEAKER_01: Is there a world where you can kind of control the outcome by maybe manipulating your changing your nutrition profile for a while?
15:04
SPEAKER_01: And, you know, let's say you're like trying to get pregnant, let's say you're going through that process and you want to make sure your hair is, you know, you're afraid of the molting phase, even though it's gonna come back.
15:16
SPEAKER_01: What can you do to prevent that?
15:17
SPEAKER_01: Or do we have as much control?
15:18
SPEAKER_01: Is it placebo?
15:19
SPEAKER_00: I think we probably don't have as much control as we think, but I will say that I think that there's some common issues that come up that are often not addressed.
15:27
SPEAKER_00: So with the pregnancy example specifically, actually, often a lot of people love their hair in pregnancy because, you know, usually like estrogen's really high.
15:35
SPEAKER_00: Estrogen maintains our hair in the growth phase for longer.
15:38
SPEAKER_00: Progesterone is also very high.
15:40
SPEAKER_00: And, you know, there's like kind of no research about how progesterone influences hair, but you know, but generally we think about progesterone as being like a very positive relaxatory hormone in our body and you know, tends to kind of have a little bit of that anti-testosterone effect as well.
15:53
SPEAKER_00: And so a lot of people actually have really wonderful hair during pregnancy.
15:56
SPEAKER_00: It's usually postpartum that it really hits.
15:59
SPEAKER_00: And if you think about what's happening postpartum, I always describe postpartum to my patients as mini pause that essentially, especially if you're if you're breastfeeding or if you're lactating, you have a hormone that's called prolactin that's very high.
16:10
SPEAKER_00: And prolactin is helping the breast to produce milk.
16:14
SPEAKER_00: But the other function that it does is it essentially completely shuts down your ovaries.
16:17
SPEAKER_00: And so what happens is you go from having like the most estrogen and progesterone in your entire life during pregnancy to essentially having none.
16:25
SPEAKER_00: And what happens?
16:27
SPEAKER_00: So your hair texture is going to change.
16:29
SPEAKER_00: You're going to lose hair because you're out of that growth maintenance phase that happened with the estrogen.
16:34
SPEAKER_00: So, you know, postpartum, I think, is probably the hardest time to actually try to influence anything to answer your original question.
16:41
SPEAKER_00: I think that, you know, this is kind of like a natural hormonal transition and it manifests in a lot of different symptoms, not just hair.
16:48
SPEAKER_00: Anybody listening who's postpartum knows that it's not such a fun time.
16:52
SPEAKER_00: But it does get better.
16:53
SPEAKER_00: And, you know, there isn't necessarily something to 100% influence.
16:57
SPEAKER_00: I think that in terms of like the nutrition element of things, one common area that I feel like people don't necessarily think about, or that, you know, even like we in the medical establishment don't think about well enough is your iron status.
17:10
SPEAKER_00: And so a lot of women in particular are iron deficient.
17:14
SPEAKER_00: And there's a lot of really interesting research about like even the numbers that we use on labs are flawed based on how we actually record like iron deficiency for women.
17:24
SPEAKER_00: So a lot of women are iron deficient and they don't even know it, and their doctor doesn't even know it because when they check their levels, they're like, oh, you're fine, it's in the normal range, but it's not.
17:32
SPEAKER_00: And so that's a really common one that I see.
17:38
SPEAKER_01: Why is the system for tracking how much iron we possess so flawed?
17:43
SPEAKER_00: So, just like everything, I don't know if you know this, but nobody actually cares about women in this world or this country.
17:50
SPEAKER_01: Wow, I'm so surprised, Jordan.
17:52
SPEAKER_01: I'm so surprised.
17:53
SPEAKER_01: I've never thought of it before.
17:54
SPEAKER_00: And so, because of that, basically, what we have used to create our lab ranges for ferritin, which is, you know, kind of the most sensitive marker of iron iron status in your body, the numbers that we have used are based on just a population average that includes people and women that are iron deficient.
18:14
SPEAKER_00: And in general, women are iron deficient more than men because women have periods.
18:20
SPEAKER_00: And so, you know, you lose a certain amount of blood.
18:23
SPEAKER_00: A lot of women, you know, will experience significant blood loss every single month, or maybe even more frequently than that.
18:29
SPEAKER_00: And, you know, that is a common place where we lose iron because iron, you know, is very associated with our hemoglobin in our blood cells.
18:36
SPEAKER_00: And so when you take a population that is at baseline iron deficient, and then you say, oh, look, the average ferritin for all women, you know, ranges from six to 50, but men, it's, you know, 40 to 70, something is very off there.
18:52
SPEAKER_00: And so, you know, when I'm looking at ferritin, for example, I usually like to um have all of my patients like more like in like the 50 plus range.
19:00
SPEAKER_00: I think there's even evidence to say it should be higher than that.
19:03
SPEAKER_00: And that's because we shouldn't be using a range that includes people that have a quote disease to assess normal, but because we don't care enough about women's health to actually investigate what normal and optimal is in women, we end up with these flawed ranges.
19:17
SPEAKER_00: And this is true of a lot of different things.
19:19
SPEAKER_00: But I think that, you know, I've definitely seen this before, you know, because I had a lot of patients in menopause and, you know, hair changes and hair loss is a really huge symptom associated with menopause.
19:28
SPEAKER_00: And sometimes we get their iron to a good place, and that alone can make an enormous difference in terms of at least the maintenance of the hair.
19:37
SPEAKER_00: You know, I don't know the data in terms of kind of the texture of the hair, but I'm sure that there's something to that as well.
19:43
SPEAKER_01: Is this similar to also how I've had doctors say, like, ignore what the magnesium chart says on in your lab results and just like have magnesium because we're all magnesium deficient and the soil does not have, you know, our soil is just so different from what it ideally should be now.
19:59
SPEAKER_01: We've destroyed our planet.
20:00
SPEAKER_01: Yeah.
20:01
SPEAKER_01: Is this the same thing, basically?
20:02
SPEAKER_00: I think that this is true of a lot of different things.
20:04
SPEAKER_00: So I think that generally when we think about micronutrients in our diet, a lot of people are deficient in magnesium, zinc, vitamin D, and we don't really do a very good job of actually identifying these things.
20:16
SPEAKER_00: I also think that some of these things can just have positive effects, like magnesium, for example, a lot of people will take for sleep.
20:22
SPEAKER_00: And the worst case scenario is you pee out what is extra.
20:26
SPEAKER_00: So I agree with that.
20:27
SPEAKER_00: But I do think that iron is maybe a little bit different from the fact that we actually have a really good test to test iron.
20:32
SPEAKER_00: It's just that we're not using the right numbers to assess if it's right or not.
20:36
SPEAKER_01: It's it's so sad that this seems like a fixable problem and yet it hasn't been fixed.
20:40
SPEAKER_00: That is all of women's health.
20:42
SPEAKER_01: Yeah, I'm realizing this is what I hear from you whenever we catch up.
20:46
SPEAKER_01: There's a new layer to this.
20:47
SPEAKER_01: It's like this could be fixed.
20:49
SPEAKER_01: We could research this and it would be a solved problem, but no one spends the time or energy.
20:56
SPEAKER_01: Hi everyone.
20:57
SPEAKER_01: A quick note from me.
20:58
SPEAKER_01: When I made this show, I set out to research and solve a problem I personally care a lot about, which is that I love curly hair.
21:06
SPEAKER_01: I have curly hair.
21:07
SPEAKER_01: I'm fascinated by it.
21:08
SPEAKER_01: And I wanted us all to be talking about these stories as a window into so many other topics.
21:14
SPEAKER_01: And I also wanted to create better, easier products for myself and all of us.
21:19
SPEAKER_01: The result of the second part of this investigation is Myura, my curly and wavy hair care line that launches this fall.
21:25
SPEAKER_01: Myura is Sanskrit for Peacock.
21:27
SPEAKER_01: I picked that name because I find curly hair to be distinctive and captivating, and I want everyone else to feel that way too.
21:33
SPEAKER_01: We launched this fall, and if you'd like early access, you can join the wait list at MyuraBeauty.com.
21:38
SPEAKER_01: That's M-A-Y-U-R-A-Beauty.com.
21:41
SPEAKER_01: We'll also put the link in the show notes.
21:43
SPEAKER_01: Okay, back to the interview with Dr.
21:45
SPEAKER_01: Jordan Emon.
21:52
SPEAKER_00: Now, I can't come on this show and not talk about hormone replacement therapy, which is obviously my jam, but you know, thinking about Ways that you can think about really influencing and making a difference in terms of your hair.
22:05
SPEAKER_00: A lot of people will start, a lot of women will start having changes to their hair long before they, you know, kind of formally go through menopause.
22:12
SPEAKER_00: We define menopause as 12 months without a period, which is like maybe the worst possible definition you could have for menopause ever.
22:19
SPEAKER_01: How would you define it?
22:20
SPEAKER_00: So I would define it based on a constellation of symptoms associated with a drop in estrogen.
22:29
SPEAKER_00: And, you know, happy to get into what that means more.
22:31
SPEAKER_00: But what I mean by that is that women will experience the symptoms of menopause, maybe even a decade before they actually don't have periods anymore.
22:42
SPEAKER_01: Oh, interesting.
22:43
SPEAKER_01: I don't think most people realize that.
22:45
SPEAKER_00: Yeah.
22:46
SPEAKER_01: Is that what perimenopause is, though?
22:48
SPEAKER_00: But even perimenopause is, you know, kind of a controversial concept in some circles.
22:52
SPEAKER_00: But if you think about just biologically what's happening, you have hormone variability leading up to menopause.
23:00
SPEAKER_00: So there's kind of this like zone of chaos that people will talk about where, you know, your estrogen levels might be all over the place, your progesterone levels might be all over the place, leading up to ultimately stability, but no hormones.
23:12
SPEAKER_00: Like your ovaries are essentially stopped functioning.
23:15
SPEAKER_00: And the way that I always describe it to people is it's kind of like if you were driving a car that's running out of gas, that you know, sometimes you're gonna press on the gas and the car is just gonna lurch forward because it's like that last little spark of gasoline in the engine.
23:29
SPEAKER_00: And that's kind of what happens during perimetopause.
23:31
SPEAKER_00: And then sometimes you're gonna press on the gas and doesn't matter how hard you press, that car is not moving.
23:35
SPEAKER_00: And that's exactly what happens as well, that the ovaries are essentially running out of gas.
23:39
SPEAKER_00: The ovaries are stopping their functioning.
23:42
SPEAKER_00: And in the process, they can't work in the same efficient way that they used to work.
23:47
SPEAKER_00: So the reason why I would define menopause by this constellation of symptoms is we can put together based on what you're experiencing and what kind of things are going on with your body, you know, what actually is happening to the hormonal status of your ovaries, you know, the rest of your body.
24:04
SPEAKER_00: And we see that manifest, for example, in people's hair, that they might start having hair changes long before they quote formally go through menopause.
24:11
SPEAKER_00: So, what do we do for literally any other hormone deficiency in the body, like a thyroid deficiency or, you know, diabetes is an insulin deficiency, at least type 1 diabetes?
24:20
SPEAKER_00: We replace the hormone.
24:21
SPEAKER_00: And so this should be the same exact thing that we're thinking about for menopause as well.
24:26
SPEAKER_00: And again, we see massive changes with people's hair quality, texture, you know, their satisfaction with their hair when we start hormone therapy, because we're replacing the deficiency that is leading to the issues in the first place.
24:39
SPEAKER_01: I think when you say hormone replacement therapy, though, it sounds like a big kind of scary thing to the average person, right?
24:46
SPEAKER_01: I mean, do you run into that a lot in your practice that patients will have a misconception about it?
24:50
SPEAKER_00: There are a lot of misconceptions surrounding hormone replacement therapy.
24:54
SPEAKER_00: And a lot of it relates to some big headlines that happen associated with older studies in the past.
25:00
SPEAKER_00: You know, most notably there was a big study in 2002 that came out that really scared everyone from hormone therapy.
25:05
SPEAKER_00: Um, but you know, the the broad summary, you know, of everything that I would say about this is that if we look at the modern hormone replacement therapy that we use today, which is different than what was used in the past, for the vast majority of women, it is exceedingly safe.
25:20
SPEAKER_00: Women who take hormone therapy live on average five years longer than women who don't.
25:25
SPEAKER_00: So it literally extends your life and it decreases your risk of heart disease, Alzheimer's dementia, diabetes.
25:32
SPEAKER_00: It also can help with body composition.
25:35
SPEAKER_00: And most importantly, it helps you feel good.
25:37
SPEAKER_00: Like it feels awful to be in menopause.
25:40
SPEAKER_01: Yeah.
25:40
SPEAKER_01: I was just going to say it sounds like it not only increases the lifespan, but the quality of the life you get to have.
25:47
SPEAKER_00: Exactly.
25:47
SPEAKER_01: Which is more, honestly, more important than lifespan.
25:50
SPEAKER_00: That's exactly right.
25:51
SPEAKER_00: And that's, you know, like a big focus of mine is longevity.
25:53
SPEAKER_00: And I think that a lot of, you know, especially like kind of like the man fluencers in the like the bros in kind of the longevity world, you know, they really think about longevity from this perspective of I want to live longer and I want to live as long as possible.
26:07
SPEAKER_00: But I really think about it as exactly what you just said, which is really health span.
26:11
SPEAKER_00: Like, how can we help you live as healthy as possible for as long as possible?
26:15
SPEAKER_00: Because if you ask a million people, the vast majority of them are going to say, I would rather live fewer years but be healthy for that whole time than live longer, but spent 25 of those years in poor health.
26:26
SPEAKER_00: And women tend to live longer than men, but they tend to spend more years in poor health compared to men.
26:32
SPEAKER_01: Really?
26:33
SPEAKER_01: And what are some resources?
26:35
SPEAKER_01: If one of our listeners is going through a hormonal change that's affecting their hair, what are some resources they can seek out?
26:42
SPEAKER_01: Whether that's uh something they can change within their lifestyle habits, like we discussed, nutrition or a place to look for resources aside from your Instagram, which is an incredible resource.
26:54
SPEAKER_01: Honestly, I learned so much every day from there.
26:56
SPEAKER_01: What can people do?
26:57
SPEAKER_00: Yeah, I mean, I think that uh in a lot of ways, I think social media has become like the source of education for this topic because unfortunately a lot of medical professionals just really don't know about this very well.
27:08
SPEAKER_01: But then how do you sort?
27:09
SPEAKER_01: Because social media is a source of good information, but also a lot of trash information, right?
27:14
SPEAKER_01: So how do you sort on social media then between the fact and the fiction?
27:17
SPEAKER_00: It's really, really hard.
27:18
SPEAKER_00: And and I will say that I think that like my first sort of big red flag to look for in anybody is anybody who's offering a singular solution is is probably not the most knowledgeable person on this topic.
27:30
SPEAKER_00: Like at the end of the day, a lot of medicine in general, but I would say particularly thinking about like menopause, longevity, health span medicine, is let's prioritize you at the center of this decision.
27:42
SPEAKER_00: And there's a lot of different pathways that we can go here.
27:45
SPEAKER_00: And they might have different risks and benefits depending on kind of what is important to you and what's going on with your body.
27:50
SPEAKER_00: But I think that anybody who is introducing that nuance into the conversation is able to do so in an effective way, is already going to be a good place to start.
27:58
SPEAKER_00: But you're 100% right that it is, there's a lot of stuff on social media.
28:02
SPEAKER_00: And I think that unfortunately, like especially thinking about this hormone therapy piece, there's a lot of people that say a lot of crazy things about hormone therapy, you know, both good and bad, you know, things that like really aren't true about the benefits and things that really aren't true about the risk.
28:16
SPEAKER_00: So there's there's a lot of people, but I think like looking for people who will sort through the nuance, looking for people who are board certified in their specialty and really try not to go outside of that.
28:26
SPEAKER_00: I think that those are good places to start.
28:27
SPEAKER_00: You had mentioned kind of like what are some practical things that people can do.
28:30
SPEAKER_00: So I definitely think thinking about, particularly if they're going through menopause, like thinking about hormonotherapy and having uh a good discussion with with a clinician who's who specializes in that is really important.
28:40
SPEAKER_00: But I think that, you know, from like a nutrition standpoint, like I said, like it's not just the hormones and also our hormones are influenced by our metabolism and our metabolic state.
28:47
SPEAKER_00: So it sounds so silly, but like all of the basic stuff really does matter.
28:51
SPEAKER_00: Like eating a healthy diet, making sure that you are limiting as much as possible alcohol.
28:57
SPEAKER_00: This is always the one that people get really upset about because alcohol is so infused into our social norms.
29:03
SPEAKER_00: But there is literally no benefit to drinking alcohol.
29:06
SPEAKER_00: It is only a bad thing for your body.
29:08
SPEAKER_00: I think the only benefit is that it produces social contact with a lot of people.
29:12
SPEAKER_00: But a lot of people, I think, are used to this idea of like, oh, a woman can have one drink of alcohol a day and a man can have two drinks of alcohol a day.
29:19
SPEAKER_00: There's very reliable data that, you know, anything more than one drink a week already seems to produce pretty significant health outcomes.
29:27
SPEAKER_00: And I think that particularly when we think about your metabolic health and how that affects your hair, I think alcohol is a huge player in that.
29:33
SPEAKER_00: So if alcohol doesn't really do much for you and you can get rid of it, like that's probably one of the best things.
29:38
SPEAKER_01: I love a good glass of wine though.
29:39
SPEAKER_00: Yeah, of course, me too.
29:40
SPEAKER_00: Like I'm not, I'm not somebody who doesn't drink myself, but I just think you have to be really thoughtful about it.
29:46
SPEAKER_00: Like what I always tell people is, you know, it's fine to drink alcohol, but make it something really special.
29:51
SPEAKER_00: Like make it like your favorite glass of wine.
29:53
SPEAKER_00: Like, like not just you're drinking just because like you're out with the office and everyone's drinking and you don't really want to.
29:58
SPEAKER_00: So make it something you really like and make it social because social interactions is also one of the most important things we could do with our health.
30:05
SPEAKER_00: And I think that that is really for me like the number one benefit of drinking alcohol.
30:10
SPEAKER_01: What did we not talk about that we should have talked about?
30:13
SPEAKER_00: I think that what we didn't talk about is that there's a lot of other hormones that are not our sex hormones that also influence our hair that I think is just an important thing to touch on.
30:22
SPEAKER_00: So we started to touch on cortisol, but I think the other big one is thyroid.
30:27
SPEAKER_00: And so our thyroid is like our master metabolic regulator, and it very much influences how fast our hair grows, how fast we lose our hair.
30:36
SPEAKER_00: Having low thyroid or high thyroid can significantly impact the texture and the quality of our hair.
30:41
SPEAKER_00: And so thyroid issues, particularly in women, are very common, particularly around the menopause transition.
30:46
SPEAKER_00: And so hypoythyroidism is significantly more common in women compared to men.
30:51
SPEAKER_00: And autoimmune disease kind of goes along with that, also much more common in women.
30:55
SPEAKER_00: And so abnormalities in the thyroid are also going to influence the quality of people's hair.
31:00
SPEAKER_00: And people might notice changes to the texture of the hair that they might associate with being like more wavy or more curly, but it actually might mean your hair is more brittle and it's like thinning out and it's actually becoming a different texture because it's essentially losing its kind of support that it had before.
31:17
SPEAKER_01: So, how can people discern the difference between the two?
31:20
SPEAKER_00: Yeah, it's it's honestly very hard.
31:22
SPEAKER_00: Like perimenopause and hypothyroidism really overlap in terms of the a lot of their symptoms.
31:28
SPEAKER_00: And my suggestion is that if you are a woman in your 40s, you absolutely have to have your thyroid checked.
31:35
SPEAKER_00: Because, like, you know, there are some really obvious examples of hypothyroidism.
31:39
SPEAKER_00: Like, you know, people will have like just profound fatigue and they will have loss of hair and they might have constipation, they might have depression.
31:45
SPEAKER_00: But you know what else causes every single one of those things?
31:47
SPEAKER_00: Perimenopause.
31:49
SPEAKER_00: So you really just have to have your thyroid checked.
31:51
SPEAKER_00: It's like the only way of 100% checking it.
31:54
SPEAKER_01: And then quick little lightning round.
31:56
SPEAKER_01: Who's your curly hair icon?
31:58
SPEAKER_00: Um, okay, so I think my answer to this has to be my wife, who is secretly curly.
32:04
SPEAKER_01: One of my inspirations for that episode.
32:06
SPEAKER_00: Right, exactly.
32:07
SPEAKER_00: And, you know, so she straightens her hair.
32:10
SPEAKER_00: She's back to straightening her hair.
32:11
SPEAKER_00: I've only ever seen her curly once, but I think she looks beautiful both ways.
32:15
SPEAKER_00: I think that the reason that she doesn't go curly right now is because she's a doctor and we have two little babies, and even like the five minutes of extra time to get it all together in the morning is too much.
32:26
SPEAKER_00: But I'm sure that she'll be back.
32:28
SPEAKER_01: I'm excited for Sammy to come back.
32:31
SPEAKER_01: What are you spiraling about right now?
32:33
SPEAKER_00: Oh, in addition to all of the things we just talked about about women's health in general.
32:38
SPEAKER_00: Yeah, I mean, I I feel like I am I am just constantly spiraling about the ways that our society treats women and the priorities associated with the health of women, which is basically just an abysmal, endless pit of despair.
32:55
SPEAKER_00: And so I'm a very optimistic person by nature.
32:59
SPEAKER_00: This is true.
32:59
SPEAKER_01: Jordan is very optimistic.
33:01
SPEAKER_00: And so I'm really hopeful.
33:03
SPEAKER_00: And I think like these conversations and the stuff that you know people talk about on social media, I think is starting to change that.
33:10
SPEAKER_00: But I mean, the way that we started this conversation was basically like, we don't have any research about anything associated with women, and it's because nobody prioritizes it.
33:19
SPEAKER_00: And like that's, I feel like my entire purpose in this world is to try to educate and bring awareness to these things because women deserve so much better than the assumptions that we've made based on males' bodies.
33:31
SPEAKER_01: What do you want to stop spiraling about?
33:34
SPEAKER_01: Um, and you can take it in a personal direction if you want.
33:37
SPEAKER_00: Yeah, I know.
33:37
SPEAKER_00: I was I was kind of actually thinking about like more personal things.
33:41
SPEAKER_00: I think, like personally, I think that because of all of this and everything that I'm spiraling about and all the things I'm trying to build, I think I get very overwhelmed.
33:50
SPEAKER_00: And I think that, especially as an optimistic person, I I feel very ambitious and I want to do so much.
33:57
SPEAKER_00: And there's really only so much you could do.
33:59
SPEAKER_00: And I want to stop spiraling about that.
34:02
SPEAKER_01: Yeah, actually, so you are also an entrepreneur.
34:05
SPEAKER_01: You have your own practice, you're building out your social media.
34:10
SPEAKER_01: And so there's a lot we relate on here.
34:12
SPEAKER_01: And I think anyone listening who's doing multiple things at once can really, really relate to that.
34:18
SPEAKER_01: And one of my friends who's a founder and has been a founder since she was in high school, uh, very impressive, told me at the start of my journey.
34:25
SPEAKER_01: She told me, you know, every single day there's going to be such a long list of things you want to get done and wish to get done as an ambitious person.
34:35
SPEAKER_01: And you have to kind of decide at some point, like, what is realistic to get done today, and what is realistic to get done tomorrow and next week, and what are the most important things?
34:45
SPEAKER_01: And you have to know, like, I'm not gonna get to the last five things on this list.
34:49
SPEAKER_01: If miraculously I open one of them up because it fits my energy right now, great, but be okay with that because otherwise, yeah, you know, it's the classic, it's a marathon, not a sprint.
34:58
SPEAKER_00: Yeah, I mean, I would 100% agree with that.
35:00
SPEAKER_00: And honestly, it's been so fun to be going through this entrepreneurship journey together because I feel like we've been sort of building in in parallel tracks.
35:10
SPEAKER_00: And I I love when we text or call about you know our respective challenges and successes in that process because it is tough to go through anything alone, particularly something that is often as lonely as entrepreneurship.
35:24
SPEAKER_00: And so it's really nice to be able to share that.
35:26
SPEAKER_00: And I agree with that perspective.
35:28
SPEAKER_01: And I will just add for the listeners, and I'm sure you would agree with this, you know, if any of the health issues we talked about pop up in your mind as something you'd want to explore, talk to your doctor.
35:35
SPEAKER_00: Yeah.
35:36
SPEAKER_00: And maybe I might add to that, don't assume that your doctor actually knows what they're talking about in regards to this topic.
35:42
SPEAKER_00: And that's not to say, like, don't trust doctors.
35:44
SPEAKER_00: I'm not that person.
35:45
SPEAKER_00: I think that people who become medical professionals are by and large, like very well-meaning people.
35:51
SPEAKER_00: But going back to what I'm spiraling about, the vast majority of people just truly have never received any training about women's hormonal health.
36:00
SPEAKER_00: So, you know, you can love your doctor, but you can also find somebody who really is a specialist in this.
36:06
SPEAKER_00: And, you know, it's important to take that time to prioritize your health in that way.
36:11
SPEAKER_01: Our previous episodes asked, why are some animals curly?
36:15
SPEAKER_01: And how you formulate good hair care products.
36:17
SPEAKER_01: If you have a question you'd like us to investigate, tag us on social media.
36:21
SPEAKER_01: We're at We Are Spiraling on Instagram and TikTok.
36:24
SPEAKER_01: We are spiraling is produced by Citizens of Sound and hosted by Myra, the music by Love Gun.
36:30
SPEAKER_01: Talk to you soon.