Latest / Tone It Down / Feel Empowered at Every Stage: Dr. Anna Cabeca on Thriving Through Menopause & Hormone Changes

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Feel Empowered at Every Stage: Dr. Anna Cabeca on Thriving Through Menopause & Hormone Changes · Tone It Down

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  menopause is natural and mandatory and it's a blessing to be able to go through it,
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  suffering is optional and it is no more a disease than puberty is a disease. We shouldn't
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  be suppressing menopause we should be supporting it.
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  This is your weekly girlfriend chat, the kind that we all crave, where we can show up exactly
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  as we are, laugh until we cry, get honest about the things we're navigating and all the
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  private girl talk that we need more of. No pressure, no perfection, just real women like us,
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  sharing real stories with real connections. Over the years of Tonedab, I've learned that the most
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  transformative moments don't always happen in a workout, they happen in those conversations before
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  and after. When we realize we're all going through something, when we feel seen, and that's what
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  Toned Down is built on. My intention is simple to help you tune back into yourself, to quiet the
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  noise and to remind you that you're allowed to evolve. This is Toned Down.
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  Hello my friends and welcome back to another episode of Toned Down, that exact little
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  dose that you need in between your Toned Up workouts and your Toned Up app. I'm really excited for
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  this week's episode because it's Dr. Anna Kabeca. She's been a friend of mine. For quite some time,
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  we didn't interview a while back on the big silence podcast and you want to definitely listen to
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  that. I'll put that link in the show notes. Dr. Anna Kabeca lives in Dallas and we've met each other
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  briefly as passing, just passing by on an escalator at a biohacking conference once. And then
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  finally we got to meet in person and hug and she brought her daughter and it was just so much
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  fun. And I just wanted to introduce you all to her because it's exactly the information that
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  you've been asking. So if you don't already know already, if you go to Karina.com slash message,
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  you can leave a voicemail. It can be anonymous or not. And I was listening to so many of these
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  and everyone's like, what do I do about the menopause belly? What do I do about losing energy,
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  brain fog, all this stuff? We just deep dove into so many different things that we all usually
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  don't talk about. It was such a fun conversation. And we it's like very honest and uplifting look at
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  what it really means to thrive through Perry menopause and beyond. And Dr. Anna shares her
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  incredible personal journey from losing a child and being diagnosed with early menopause at the
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  age of 39 to reversing her diagnosis naturally and having a baby at 41. And we cover everything
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  from hormones, cortisol, the 3am wake up, you know, if you know, to intimacy, vaginal health,
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  and these supplements, every woman should have and need and know about. So this episode is really
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  warm. It's really warmed my heart. It's empowering. And so reminder that your body is not broken.
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  It's transforming. And the most vibrant chapter of your life is still ahead. And I truly,
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  truly believe that being 45 myself now and being in the wellness industry since my early 20s,
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  there's so many incredible things happening and so much information out there. And before we jump
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  into this episode, I want to make sure to do a little giveaway because we all love some giveaways.
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  So Dr. Anna Quebeca, we're going to give away three care packages from Dr. Anna Quebeca.
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  We've got her keto green protein shake, the mighty maca superfood, the jolva,
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  revitalizing cream. When you get it, you'll know. And a little note from me. So three of you,
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  make sure you take a screenshot of you listening to this podcast, share it with someone,
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  and share it with app, turn it up, and out Karina Don and something is coming your way.
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  But most importantly, coming your way is this episode, which is full of so much knowledge.
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  All right, I love you. Welcome back. I was going to say the big silence podcast, but that's
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  what you were on last time. Tonitown podcast. So happy to have you here. It's Dr. Anna Quebeca,
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  the girlfriend doctor. I am thrilled to be here with you and especially in this beautiful space.
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  Yeah, energy is amazing. I know. And finally to be in here in real life, I think the only time
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  we met in life was I was going down an escalator and you were going up an escalator at Dave Asperus
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  Biohacking conference here in Austin last year. So that is true. Yep, that was our moment.
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  Gosh, but you know, when we have these conversations, you are my podcast me on the big silence.
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  And it just feels because there's such intimate conversations, it feels like I really know you.
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  Yeah. And today's world where there's so much connection online and through digital,
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  there's so many people we get together like we've met before, right? Nope.
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  But obviously, I thought you would be amazing to be on Tonitown for the Tonitown ladies
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  because you are the girlfriend doctor. And we have a lot of questions. And as you know, I have
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  stepped back into the sole owner of Tonitown also the CEO. And when I ask these women questions,
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  what they want to talk about, what they want to learn in this stage of our life.
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  Knowing that when Tonitown was founded, I was 27. And now I'm 25.
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  Now I'm 25. It's time. Time is coming back. Wow. And now 45. And everyone we've all grown
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  up together and all these beautiful transitions in life. And I think a lot of times the messaging
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  is kind of is off. Like this is a beautiful part of our life. And like I get to be here. We're
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  here and we're living it. And there was something that you said, it's you cannot heal a body that
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  you hate. That's right. And that is what this conversation is for to better understand ourselves
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  to love ourselves. But before we get fully into all the questions we have for you. In our last
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  conversation, we touched a little bit on you and your journey, but not so much in depth. I didn't
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  ever ask you and I want to know how you chose this line of work. If I would say the line of work
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  chose me. And that's usually what happens. Yeah. I was such a big advocate for women's health in
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  general. And you know, watching my mom suffer with heart disease from early 50s. She was 52. I was
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  16 and she was undergoing cardiac bypass surgery. And she only made it 15 more years. And she
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  struggled for the many of those years. And so I had wanted as a young woman to really study
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  women's health. And so that led me in this area. But the integrative perspective of women's health
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  as I approach women's health. And I think it can't be done otherwise. I mean, I learned in the
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  Western medical system at Emory University as a gynecologist and obstetrician. I was like, okay,
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  that's the gold standard. I'm going to know everything. I'm like, shoot, my doctor's bag is still
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  empty. But my own journey and the journey of my patients really took me down the road of integrative,
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  more of an integrative approach. You also had your own early menopause, early period menopause
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  of 39. Yeah. And that's such an interesting story or a part of your life too. Can you talk about
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  that and what you believe caused early onset menopause? And then you came back from that?
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  This is something that I hadn't studied. But one of the things, Karina, that you know, we hadn't
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  suffered an accident in our life. I'll tell you, it was March 12, 2006. And my 18-month-old son
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  was in a tragic accident and he didn't make it from that moment. And I was still breastfeeding him.
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  From that moment, that tragedy, I never had another drop of breast milk. My body went complete
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  shutdown. And from there diagnosed with infertility and then early menopause, so post-traumatic
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  infertility and early menopause. And you know, it was a swirl of devastation at that time.
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  That sense of like being swallowed up by darkness in so many ways. And then sometimes very hard
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  to see a way out of it. And I just knew that I had to, had to keep taking one next right step
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  out of time. And so as part of that journey and being a solo physician in small town,
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  southeast Georgia, I took a sabbatical for my practice and took my girls who were seven and ten
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  at the time on a journey around the world. And in that journey, and I would say looking for answers,
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  but mostly there's the Buddha saying, everywhere you go, there you are. I went around the world to
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  figure that out. Still here. Still me, still all the stuff. But as a result of many things, medicinal
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  foods, practices, mindset shifts, and the grace of God reversed early menopause. And naturally
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  conceived the child I was told I would not, I'd never be able to have. So I had her at 41. She is
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  now 18. I'll be 60 this year. And that's the reason we're in Texas. She's in the rodeo and she
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  barrel races and whole bending. We've got horses and I haul horses on the weekends.
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  How much? Well, I knew you had horses learn that, but she barrel, oh gosh, I'd be fun to go to.
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  Oh, you definitely have to wicked barrel racer. Yeah, she'll go to state championships this year.
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  So hopefully nationals. Yes, she will. She will. So PTSD, let's just touch on that a little bit more.
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  Is do you think that's the main cause or do you know any science behind that? So for those who
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  do have early menopause? So the many reasons for early menopause stress and trauma and that
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  complete and I have I have dug into understanding this aspect because I didn't understand what was
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  happening to me. Yeah. And the concept of ever being able to reverse that was not even in my
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  consciousness. Yeah. And it was not in my consciousness. Six round of fertility medications failed
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  every single one with no varying response. Early, you know, infertility diagnosis, early
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  menopause diagnosed at 39 like there's no coming back from that at that time 2007 was given
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  that information. It was like, okay, there's no chance, right? There's no chance. God sends a
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  humor, you know, like, okay, we'll prove you wrong and here and understanding that was really the
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  whole HP axis system, whether it's acute trauma, chronic everyday trauma, there's a physiologic
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  consequence to that that really overrides your entire hormonal, we say, hypotheramic pituitary
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  adrenal gonadal index like this entire communication system. And so for me, that's what was shutting that
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  down and still had menopausal levels of FSH and LH and that was the diagnosis and since in working
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  with women, it's looking at, okay, what is shutting down the ovaries? What's making the ovaries not
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  feel safe to produce hormones to create reproduction, right? And from that perspective, now as, you
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  know, with the additional training I've had and experiences, the approach I take when I'm looking
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  at someone who has a diagnosis of premature ovarian insufficiency or uses call it premature ovarian
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  failure. But when they have this diagnosis, I have a 19 year old client, I've had 37 and a 41 year
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  old client also, but was able to reverse those diagnosis, those infertility and early menopause
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  diagnosis that was post COVID. So there was autoimmune stuff that we had to deal with and was able to
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  get them cycling again and one pregnant. So very happy about that. Now with this 19 year old with
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  early menopause, we have to look at autoimmune issues, the autoimmune issues, the underlying
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  infectious issues, what's happening with the ovarian function, what else could be going on there. So
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  there's a complex, when it comes to this diagnosis at a younger age, there's a complex
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  ideology. Yeah, many causes. You mentioned post COVID. Do you see a correlation with early menopause
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  being triggered from COVID? Yes. I've seen that over and over and over again.
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  I did ask my OB-GYN that because that was when I started to go into Perry and I was like,
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  we've talked about this a little bit. I'm going to dive into it more and I asked her, have you seen
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  anything? But this was in 2022, mid 2022, because I noticed my periods about 2021, end of 2020 to 2021,
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  I was skipping every three months. And again, not wasn't real knowledgeable, thought it was just
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  stress, but then anxiety went up to the point of like being physically sick, night sweats. I just
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  thought I had COVID all the time because I was just sweating like crazy at night. Did you get
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  vaccinated? I got vaccinated and a booster. And a booster. Okay. And so how did that correlate with
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  your periods? It did. It correlated. Yeah. I've seen a lot. I've had this 17-year-old patient who
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  post-vaccine had an ovarian system, anxiety, and was put on birth control pills to address that
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  there was nothing about clearing spike protein or addressing the immune system. I think that's
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  so important. It doesn't matter how long go you pad it, whether infection or injection.
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  Yeah, I still had the infection after the injection. Yeah, but yeah, definitely it was, and I
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  it's a sensitive topic, obviously, for those, but I did notice immediately that's when my symptoms
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  started. You're not alone. You're not alone. Absolutely. I've seen that over and over and over again.
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  It was fully in menopause in October 2022. Based on FSH and LH levels and periods. Yeah.
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  But we go back to that trauma thing. If you know my past and just trauma throughout life,
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  that could also be something that caused it. I mean, I'm perfectly, I've been, I've worked through
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  all of the anxiety, emotionally, anxiety, the weight gain of 40 pounds, 30 to 40 pounds.
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  I stopped weighing myself because I was working out, eating right, and because you also had,
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  during your time, was it you were up to two or two or two or 240 pounds? Yeah.
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  Yeah, and that's really tough. Actually, I want to play this community question because that's
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  going to dive us into the next question. And I have so many questions on the voicemail or voicemail
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  that you can leave. But a lot of it was surrounding this topic. So let's go. It's very cool. You
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  do that voice messages. Yes. It's fun. I love it. I love to hear people's voices. I know. So
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  this is Selena. I will go up to the question because this is four minutes. Selena, you're amazing.
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  And thank you for all the kind words. Let's go. I am a static for this journey. I love that we have
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  all grown together. And like you said, Mary's, Mary's divorces, losses, changes just with our bodies.
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  And I would love nothing more than for there to be some sort of focus on post-menopause workouts.
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  And I want to do menopause, or pay menopause during the pandemic.
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  And I'm just starting to learn how to adjust my workouts and just my food in order to get.
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  I wouldn't say my body back, but yes, my body back. And the fact that you went through menopause
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  early, I'm sure that you can 100% relate. And cardio is not the answer for us anymore.
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  Walking in and got strain training in on nutrition. And so long message, but if there could be
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  any sort of focus on that phase of life. So let's dive into and you have talked about the changes
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  as we go into a pair of menopause and menopause. Changes in the way we move our body and what we eat.
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  And it's so and win, right? Yeah. Most importantly win. Because as our body changes and menopause
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  and menopause, but in the perimenopause time period, we become more insulin resistance. And
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  in other words, like Brian is like, okay, you know, you're coming into the the winter season. So
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  let's store all the fuel that you absolutely can. So your body becomes more insulin resistant.
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  At the same time as your let's say muscle building, anabolic hormones start to decline,
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  DHA, progesterone, testosterone. So all that's declining. It can be that fatigue. You're fighting
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  your body shifting. It's in a transformation time period now. Like I want to emphasize menopause
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  is natural and mandatory. And it's a blessing to be able to go through it, suffering is optional.
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  And it is no more a disease than puberty is a disease. It's an like we wouldn't and we shouldn't
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  be, you know, suppressing puberty. We shouldn't be suppressing menopause. We should be
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  supporting it, supporting these natural changes, augmenting, replenishing our hormones and
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  focusing on it in this type of way as the body changes. Because there is a neurologic rewiring. And I
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  think that leads us into the highest, most intuitive wisest places of ourselves. And it's part
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  of this next, this next season in our lives. I say I'm 60 this year. So the second half of my
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  life is going to be a wiser wiser happier version of myself. Yeah. It is true. And I want to touch
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  on wiser and happier and how you just have to learn how to treat the symptoms because I have
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  realized if you just let yourself go down one path and you're having this anxiety, you're like,
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  well, this is just my life now. But it doesn't have to be. If you treat it, work on it, recognize it,
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  you can fix it and you can be very, very happy and joyful. Yeah, you absolutely can be. And I think
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  it always comes into empowering your body as naturally as possible through nature. Like you can
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  never be mother nature. Yeah. Right. So right now in my online community group, we're doing a
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  catch your sunrise challenge. Like get outside, get sun on your skin and your eyes first thing
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  in the morning, ground outside. And let's see, because the biggest issue in our community in this
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  menopausal age group and postman pals age group is sleep issues. I'm like, okay, starts with a good
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  morning routine. Let's get outside and ground. And nature is good medicine. So we can't biohack,
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  we can't biohack mother nature as much as I have all the gadgets to. Right. I know. We got to do
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  this stuff, like getting outside, intermittent fasting, no more snacking, really restricting carbohydrate
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  intake, but using food as medicine. And that's where I really, like I create medicinal menus,
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  thinking of supporting phase one and phase two detoxification, hormonal support, anti-inflammatory
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  support. So that's where food as medicine and then supplement beyond that. But activity and
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  lifestyle, we know that muscle is magic in menopause. So to keep getting stronger. I talk about
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  muscle all the time. And as we age, we lose a small percentage every single year. And we want our
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  muscles to be strong, to live to not fall when we get older. There's so much, you know, so I
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  definitely weightlifting is such an important part of my lifestyle right now. And I notice how
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  different it is and to keep, you know, to have enough protein to keep, you know, my muscles fed
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  the way that they need to. I totally want to see your gym. Okay.
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  Can we, you mentioned insulin, but can we talk about the glucose and insulin management and
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  carry in menopause? Yeah. And this is critically important because what the symptoms,
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  so as a gynecologist, women come in during this time period with the anxiety, the mood swings,
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  the hot flashes, but as a gynecologist, they're coming with the irregular, irregular cycles.
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  The PMS, the irregular cycles, the breakthrough bleeding, maybe they're having more discomfort
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  within our course, but they're always coupled with not sleeping well. I'm feeling anxious.
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  Where did this monster in me come from? And I say, key sign that people don't talk about for
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  perimenopause is when you only hate your partner two weeks of the month. When it's only two weeks of
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  the month, yeah, it's your hormones. Yeah. These are symptoms because physiology affects our emotions
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  and, you know, affects our behavior. So it works both ways. So during this time period,
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  we're becoming more insulin resistant and hormone levels progesterone declines by 75% from
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  age 35 to 50. And that's a neuroprotective hormone and helps us sleep. And it's a precursor to
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  supporting GABA and keeping triptophan active, which is needed to make serotonin to make melatonin.
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  So it's this cascade of hormones? I look, I actually still use, you gave me one, the
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  progesterone cream. What's it called in balance? Yes, balance. And then I loved it. And so I ordered
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  off your website. And I will notice when I don't take the don't use it that I don't sleep as well.
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  So advocate of progesterone. Yeah, yeah, absolutely. And that just kind of that balancing calming effect.
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  And then the cream I put in try peptide too. So it also helps with and pregnant alone,
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  which is also another neuroprotective hormone. So with this decline as we're losing this 35 to 50,
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  like we're going to feel it. So the key is get out, you know, like the all the lifestyle hacks get
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  outside more produces much oxytocin. I like to talk about oxy increasing oxytocin versus stress
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  management, right? Like it's we have enough to manage as it is. We don't need to manage our
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  stress too. Let's just focus on things that bring us joy and happiness, peace, gratitude. Yeah,
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  those are more powerful hormone is oxytocin. So that's the key queen mother hormone.
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  But as these progesterone and estrogen decline, these hormones are necessary for gluconeogenesis
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  in the brain for the brain to use glucose as fuel. So as these hormones are declining, our brain
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  starts starving for fuel and these neuroendocrine symptoms start increasing. That's the mood swings,
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  the irritability, the brain fog. Why'd I go in this room? What's the name of my middle kid? I mean,
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  what's going on? These are common symptoms that are happening during this time. But if we switch to
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  using ketones for fuel, that's not hormone dependent to all those symptoms go away.
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  Yeah, I love oxytocin. And you've been on say that it's the most important hormone.
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  I've met people like, oh, there's like, there's just been stuck in that negative mood. And for
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  someone who doesn't know how to switch on something that like just doing something that can increase
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  your oxytocin and your mood immediately, what would you tell someone to go do besides
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  step outside and get some sunlight? What are some other ways that maybe someone doesn't think of
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  that can increase oxygen? I think the first thing is that and I had a client and I'd been working
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  with her a long time gorgeous, like curly hair, big eyes, beautiful. And she was always struggling.
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  She was negative. She was moody. She was depressed. And I finally asked her, I said, what do you like
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  about yourself? And she said nothing. And I said, my God, you've got this gorgeous hair and
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  your smile. And she goes, oh, I do love my hair. And she brightened up. I'm like, can you focus on
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  the gratitude you have for this beautiful head of hair? Because you can't heal a body you hate.
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  And so you find something about yourself that you really love. And there's so much about each of us,
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  even when we feel like, you know, the darkest deepest pits of despair. But there's so much. And we
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  just focus on that one thing. And like, when you walk, and I told him, when you walk by the mirror,
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  look at your hair and smile. Wasn't interesting because we can easily have a list of things we hate.
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  And that's what we focus on because all these little thoughts, the 80,000,000 thoughts per day,
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  a lot of them are repetitive and negative. Right. So what have you made a list of the things that
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  you love about yourself? And I bet you can actually keep building that list, especially once you
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  open up that side of thinking of, let me think about love and gratitude versus what I hate.
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  Absolutely. So everyone listening to, like, just start doing that. You'll be so much happier.
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  Okay. So so many questions about this. I could probably go through half the voicemails,
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  cortisol, our dear cortisol. So cortisol management, a lot of questions about
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  minobelly. Ladies are like, oh yeah, what is happening? And I'm experiencing too, I think.
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  Yeah. And it is a normal, beautiful process. It is a shift, right? It is a shift. And this is where
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  reproductive hormones that build muscle keep bones strong start to decline. And insulin and cortisol
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  increase. These are working against us. These are cortisol's a catabolic hormone. It breaks down
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  muscle. It breaks down bone. So recognizing that. And then like, okay, you know, how do I up level
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  to manage my cortisol more? What puts me into a, you know, the peaceful, grateful state? These
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  are things that make a huge difference. They really are. So again, for years, and as a trauma
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  survivor with PTSD, I'm suffering with PTSD. And I don't have PTSD. I have post-traumatic growth.
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  So I'm in that stage of post-traumatic growth. You are too. We are, you know, good.
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  Well, even when you talk about your son, it's, you still see it in your face and in your body.
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  And yeah, it's something that is part of you, part of, and you're growing through it.
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  And with it, say there's no way over it, no way under it, only can go through it. Yeah.
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  So we don't want to spike our cortisol. Oh, but then when you get the repairment of
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  those and your anxiety is flying and cortisol is spiking and that 3am wake up when cortisol is
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  spiking and then you're not sleeping, what do we do? Yeah. So we have to be really conscientious about
• 26:13
  what is increasing our cortisol throughout the day. So is it that cup of coffee that I hid here?
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  Am I serious? Is it that cup of coffee? Is it that, you know, stressful thought or, you know,
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  you're picking up your phone first thing in the morning? You're already in work mode first thing,
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  versus starting, and that's a high cortisol physiology. The way you start the day is the way you
• 26:33
  end your day versus you wake up. You do a deep breathing, grounding exercise. For me, I always ask
• 26:39
  myself three questions before I open my eyes in the morning. And it's like, where did I see love
• 26:44
  yesterday? Where did I feel love? Where was I loving? Okay. So that's part of my one question, love.
• 26:49
  What am I grateful for? And where did I laugh? What could I have laughed? Like, hope was funny.
• 26:55
  And focus on those things. Love, gratitude, and laughter. Those all increase oxytocin and as a result,
• 27:01
  because there's oxytocin goes up. Cortisol goes down. So now you shift to this alkalinizing,
• 27:07
  really, and they're anabolic healing, regenerative physiology. You start your day with that.
• 27:13
  Get outside, catch that sunrise. I mean, if I can anything to improve our physiology,
• 27:18
  getting outside, getting that morning sunrise in your eyes, take off your glasses before you
• 27:23
  put context on, get as much light into your eyes morning sunlight as possible. That's going to
• 27:29
  shift your physiology and we can't hack our mammalian brain. We've got it. And so this is an
• 27:34
  important trigger. So focusing on oxytocin increasing activity. And I call it like microdose oxytocin
• 27:40
  throughout the day. Yes, we can prescribe it. But you can microdose it with playing your favorite
• 27:46
  song like midday on the way back from work. You can play your favorite playlist that gets you,
• 27:52
  you know, that this joyful and peaceful. You're playing with your pet. You're walking outside in
• 27:58
  nature, checking on your garden, doing things that increase oxytocin as a priority, even for one
• 28:04
  minute, like one minute micro snacks throughout the day. That can make a huge difference in your
• 28:09
  physiology. So you go from one of breaking down, breaking down muscle, slowing down your metabolism,
• 28:15
  increasing inflammation to building muscle, creating health, rejuvenation, vitality. And that will
• 28:22
  help with the menobelli. Other things we certainly know, we need to have good multivitamins,
• 28:28
  minerals, electrolytes, polyphenols. I use a lot of adaptogens. So my product might be Maka.
• 28:34
  It's organic Peruvian Maka and adaptogenic blend with a lot of polyphenols to help with antioxidant
• 28:42
  anti-inflammatory detoxification support and adaptogenic support. So this is critical to help us
• 28:49
  support our adrenals and help counteract that cortisol that just wants to keep going.
• 28:56
  It's almost as simple as a mindset shift of, again, make that little list. Not you have the
• 29:02
  things I love about my selfless and the things that raise my cortisol, like things I love to do
• 29:08
  because even that I love that waking up in the morning, because for myself, even sometimes I wake
• 29:13
  up and I'm like, where am I? What day is it that you're like scrambled? So maybe even before
• 29:17
  catch yourself before that spike. And I love that focus on the positive and the I get to do.
• 29:24
  And this is what I have and the people I love and I am loved. I am safe. Those are some of the
• 29:29
  mantras that I like to use in the morning. Even in those deep depths of darkness, there's always
• 29:35
  something. And there's always something. And that may be the single, you know, ray of hope that
• 29:41
  helps get you out of it. And in a world today with GLP ones, like, I wasn't big in wagovi,
• 29:48
  and we're having this conversation that weight loss is more about understanding your hormones.
• 29:53
  So what would you do say to someone who's like, I should just go on a GLP one, but what's your
• 29:59
  opinion on someone who goes on that versus looking at the root cause? You always have to look at the
• 30:04
  root cause or the way it's going to come back. Yeah. In my practice in Dallas, I will prescribe
• 30:09
  GLP ones, but they're all understanding what's causing this again, mold toxicity.
• 30:14
  And there's so many microplastics and that those are our besages, stress as an obesity, nutritional
• 30:20
  deficiencies, toxic burden. Those are all our besages. So we can use GLP to change a habit per
• 30:27
  saying to help with GLP production. But if we don't address the underlying reason, those are the
• 30:32
  patients that come back in having had a GLP course lost 60 pounds gained back 80. And that's
• 30:38
  devastating. Like we don't need to do that. Having been very heavy in my life, like I really pay
• 30:44
  attention to that. So I think when we're using GLP ones, we have to address the underlying causes.
• 30:51
  We have to support detoxification. We have to support adrenals. We have to look at epigenetics.
• 30:56
  Is there toxins in the home? The air, mold is a crucial obesity gen. I mean, mold issues are
• 31:02
  toxic to the system. Hormones, neurologic effects of clearing those from our system. It's really
• 31:09
  important. Now GLP has been around for 20 years. The concept is low cardiometabolic supportive doses
• 31:18
  for those who need it while also getting the lifestyle and nutritional hacks because that is,
• 31:26
  I mean, that's critical for longevity. Otherwise, it's just another risk factor.
• 31:33
  What are your thoughts on glutamine and weight loss? So glutamine is very gut nourishing.
• 31:40
  Like I love supplements, glutamine, carnitine, creatine. These are in acetate, especially if we have
• 31:48
  high cortisol, inositol is beneficial. And again, big on adaptogens. So for gut support, if we
• 31:56
  have issues with IBS, irritable gut, glutamine can be very supportive, aloe, of course. And then
• 32:04
  using like a combination of BPC 157 for those wondering, how long does perimenopause usually last?
• 32:11
  Well, it depends. It depends. And our, you know, in our spiroffs, a book on endocrinology that we
• 32:17
  all learned as OB-GYNs, it's said two to 10 years. I'm saying five to 15 years. Five to 15 years.
• 32:24
  And it really depends. And when for women who are smokers, it's 10 years earlier.
• 32:30
  endometriosis 10 years earlier. And I think those of us who have had adverse childhood experiences
• 32:35
  or PTSD, it's earlier. Now these are, there are things that we can reverse. And that's so there's
• 32:42
  always a variant resuscitation in the longevity space we look at supporting all our glandular
• 32:47
  production. So ovaries, adrenals, for the long term as much as possible, keeping them as healthy
• 32:53
  as possible. So we're, for my story, and this is why I'm so passionate about it, because where I was
• 32:58
  diagnosed with early manopause infertility at 39, reversed it, then full blown like perimenopause at
• 33:05
  48. That's where I created my keto green method. And my magic manopause program is what I call it.
• 33:11
  So that was at 48. Then I finally went through menopause at 56. So keeping that ovarian function
• 33:17
  that long is a longevity marker. And that's important. That's healthy. So many women who also
• 33:24
  post-COVID were like, OK, I'm not having my period anymore. We work on this regenerative nutrition,
• 33:30
  lifestyle, hormonal, and detox. And we work to clear any inflammation or consequences from COVID.
• 33:37
  And their period starts coming back like, oh, I really didn't want my period back.
• 33:40
  I'm like, I'm good. But that is a marker of longevity. So that's a really good thing.
• 33:46
  Yeah. So one of the things that in our, I'm really big on a sexual health and intimacy and
• 33:52
  oxytocin. Oh, good. Well, oxytocin is a result of sexual health and intimacy. So I was
• 33:59
  interviewed by this podcast host. And he's in his late 30s. He's been married like over 10 years.
• 34:05
  And he was asking, you know, about sexual, you know, I'm an advocate. You're an advocate on
• 34:10
  sexual health post-menopause. I'm like, are, are people really having sex or are they really,
• 34:17
  like, is it just like, you know, are they, you know, and the question was like, he had a hard
• 34:22
  time conceiving of older adults having sex, well post, you know, well post-menopause.
• 34:28
  Has anyone heard about assisted living? It's like the most high STDs. Yeah.
• 34:35
  Yeah, that's something. Oh my goodness. And I was like, of course, and it's in a weight
• 34:38
  increase oxytocin. I've seen so many couples too go from being roommates to lovers again,
• 34:44
  right? You have to address the issues that cause that disconnect, just comfort, disconnect,
• 34:49
  and issues of desire. So those issues, like with vaginal dryness and continents, odors, like,
• 34:55
  I mean, you know, that's an area of my interest. But anyway, so I had the very next day after that
• 34:59
  interview, I had this beautiful patient in my practice, she's 74 years old. She's been married 50
• 35:04
  years. And I asked her, and I told her, I said, I got this question. I'm like, I know I've women
• 35:09
  in their 60s, 70s that are, you know, having great sex. And she goes, oh my god, this last year,
• 35:14
  she goes, I've been married to my husband for 50 years. And this last year, since we fixed
• 35:19
  things down there, we are having the best sex. We are closer than ever at 74 years old.
• 35:26
  50 years of marriage. I was so, I'm so inspired. I love that. So anyway, I asked him. I said,
• 35:34
  well, after we've done the interview, so off they are, I said, well, you know, tell me what's
• 35:38
  going on? Like, how is your marriage sex life? He goes, well, you know, yeah, like, you talked
• 35:42
  about, she never wants to initiate sex. I said, well, what do you do after you have sex? And he
• 35:46
  goes, well, I'll scroll through my phone and fall asleep. And I'm like, see, that is the number one
• 35:51
  problem. Oxytocin, well, with sex, oxytocin and prolactin make you sleepy. And for her, it makes
• 35:58
  her want to connect an intimacy. Right. And then she sees him uninterested. I'm interested. And
• 36:03
  she's disconnected. Right. Like, okay, well, the most pleasure you can give her is that time
• 36:08
  after sex. You know, it's so interesting to just overall in relationships. I sometimes, not a
• 36:14
  sexual example, but sometimes watching a movie together with my husband is a moment we do something
• 36:21
  together. And it annoys me if he's on his phone the whole time. And he's like, what, you're just
• 36:26
  watching a screen. I was like, but we're doing it together. Right. Right. And I think it's important
• 36:31
  that you recognize that because we have to express what turns us on and what turns us off.
• 36:37
  And using the language that he understands, you can say, do you know that really turns me off
• 36:43
  when you start watching, you know, you're on your phone like, and because now I'm turned off
• 36:48
  sexually towards you. Like instead of like being present, even if we're watching a movie, maybe
• 36:53
  we want to talk about it or hold my hand or do this or snuggle sit next to each other versus
• 36:58
  there is no connection. No connection. Nothing's going to happen later in the room. Right. And I
• 37:03
  think expressing that, like using a language that he understands, say, you know, really makes me
• 37:07
  also really makes me happy when we're just sitting here together, cuddling and I can feel it. Yeah.
• 37:12
  What many people don't realize that we have those mere neurons inside the bedroom, outside the
• 37:17
  bedroom, we're having sex and we're thinking of our grocery list. We're like checking. Okay, I'm
• 37:22
  going to having sex with my husband because I'm checking this box off on my list or I don't want him
• 37:26
  to see me in this position. I've got some more roles here. Or you know, are my wrinkles showing?
• 37:30
  Maybe I need to be on my back instead of on top. Like what, you know, you're thinking these things,
• 37:35
  those mere neurons are, I mean, we have mere neurons. So those are communicated. Those are perceived.
• 37:40
  We are energetic beings as much as we are physical beings. And so you need to feel that, that unspoken.
• 37:46
  Yeah. They feel those unspoken things. Now would be nice if they could feel when we're like,
• 37:51
  oh, touch me here, touch me there. You know, I wish you would do this and you're saying that in your
• 37:55
  mind, hoping he's a mind writer, mere neurons don't work that way. No, I mean, he doesn't know that
• 37:59
  I'm over here boiling inside because he's on his phone and this is an intimate moment for me.
• 38:04
  Right. But it's communication. It's communication. And he's like, why do you care? And it's just
• 38:10
  expressing it in a way like you have mere neurons and you feel that he's disconnected in that way.
• 38:15
  And that turns you off. Yeah. And beyond that, it makes you angry. But then he gets defensive when
• 38:20
  you say it makes me angry. You know, it really turns me off. What really turns me on is when
• 38:25
  you're just caressing my leg, you were commenting, really, I feel that you're present with me during
• 38:30
  this moment. No. All right. Communication. Communication. ABCs for sexual, like my private,
• 38:36
  also have a program sexual CPR and I'll give you a link. But it's a, you know, five-week program
• 38:40
  because when someone says I don't really desire sex or I'm having issues, you know, that's a seven-hour
• 38:45
  discussion. So I created an entire program around it. But you know, I say with CPR,
• 38:50
  they're the ABCs, airway breathing, circulation for cardio, pulmonary resuscitation, CPR.
• 38:56
  For sexual CPR, we have the ABCs, but it's except, except where you are now, except
• 39:01
  how you look because your partner is looking at the areas they love, they're looking at you,
• 39:05
  they want to please you, they want to make you happy, except and then be as be present,
• 39:10
  being in that moment, since they focus, don't do your grocery list. Stay very present with touch
• 39:16
  and use your voice to communicate, voice sounds, physicality to communicate what you like,
• 39:23
  what you want more of, what feels good, what you're feeling. And that helps keep you in your
• 39:28
  body and be present. And the third is that, see, communication. Yeah. So you had a quote,
• 39:34
  the vagina is essential for life and we need to keep it healthy. Absolutely. So we've been talking
• 39:41
  about it a bit, but let's now talk about the health of the vagina and aside from sexual health.
• 39:48
  Yes. And there's so much more. And also really the health of the vagina and the bladder,
• 39:55
  because the microbiota and the urethra from where we pee, because many women are struggling and
• 40:00
  it's perimenopause, menopause, recurrent urinary tract infections, incontinence when you
• 40:05
  cough and sneeze so much so that it's, you know, it's more of a joke like, oh, I'm going to laugh,
• 40:11
  I'm going to pee my pants, right? It's like literally. And so we don't realize and we didn't
• 40:17
  until recently understand as we've been able to identify certain strains of the vaginal bacteria,
• 40:25
  microbiome, and the urethral and bladder microbiome. And these are the same, the very specific
• 40:31
  lactobacillus species. And there's four or five different strains that are key. Compare to the gut,
• 40:37
  we want hundreds of strains of bacteria, the more diverse, the better. The vagina, very,
• 40:42
  very low diversity in these lactobacillus, but what's happening as we age, that
• 40:48
  genovaginal bulvar urethral tissue becomes less moist, less glandular secretions, so less
• 40:55
  nourishment for the healthy bacteria, the pH, which is naturally supposed to be acidic, 3.5 to 4.5,
• 41:02
  starts to increase to more alkaline. And so after sex, you may notice that fishy odor,
• 41:07
  that ammonia odor, well, even in general, with that increase in pH, you're more susceptible
• 41:13
  to bacterial infections, a bacterial vaginosis infection, which often standard medical care
• 41:18
  will say, well, here's a prescription. And we really want to work on restoring that healthy
• 41:24
  microbiome and the hormones. So for me, topical DHA is one of the reasons I created my product,
• 41:30
  Jolva. So DHA works at the cellular level to convert to testosterone in estrogen. So it doesn't
• 41:36
  just help with the mucosal layer that estrogen works on. It works all the way down to the muscularis
• 41:43
  to help with the contractility, the elasticity, the function of the vagina, so improving
• 41:49
  sensation, improving sex drive, improving orgasm, all in pleasure, and that natural elasticity. But
• 41:57
  the missing piece, until recently, was being able to repopulate the good healthy vaginal
• 42:03
  microbiome. So that hormonal support, whether we're doing vaginal estrogen to testosterone DHA or
• 42:09
  topical, and don't forget clitoristannis, the most important real estate. We don't want problems
• 42:14
  there. And then adding a vaginal target, vaginal and bladder targeted probiotics,
• 42:20
  our key, and it's been game-changing for patients. I think that's so important with the UTIs,
• 42:26
  too, which can be awful, and we'll make someone not want to have sex, but really just taking
• 42:32
  focusing on that health, too, is really important. And I have a question about UTIs, but
• 42:36
  I want to go back to for pap smears, how often? Because I thought it used to be every year,
• 42:41
  and then all of a sudden did it change every three years, if you...
• 42:45
  Yeah, so when we were using glass slides, we were doing them every year. Now we have the liquid-based
• 42:52
  chromatography methods to visualize for pathology, cytology to look at pap smears. And so we've
• 42:58
  had them for over 15 years now. So the recommendation shifted a few years ago, and some I agree
• 43:03
  within some I don't. If you've done a pap smear, the liquid-based pap smear, and they've done
• 43:08
  HPV typing, and it was negative, then you're fine to wait. I'm saying two to three years, and
• 43:14
  depending on your risk factors and stress level, because we know stress affects our immune system,
• 43:18
  and post-COVID, we're seeing these turbo cancers. So I'm really passionate about pap smears for
• 43:24
  till we die, and even Medicare will pay for a pap smear every two years, that had a patient
• 43:29
  72. And physicians have to ask questions. This goes back to, I'm not going to ask an older woman
• 43:33
  about her sex life, because I just don't want to think about it. Type thing that this young man,
• 43:38
  this young interviewer asked me, but it like realized, people are prejudiced in that way.
• 43:44
  And so I had a friend, a lovely woman, 72 years old, and via sex life, on hormones,
• 43:52
  been seeing hormone physicians, and she called me up. This was in February, to May of 2023,
• 43:59
  so pandemic, post-COVID vaccine, and she said, I'm having vaginal bleeding. I said, what did
• 44:06
  your doctors say? She said, well, I said, what did your pap smear show? What did your ultrasound
• 44:11
  show? And she said, no, the doctors are just thinking it's my hormones, so they keep adjusting
• 44:16
  my hormones. And at this point, she'd been bleeding for three to six months. I said, go in,
• 44:23
  demand a pap smear and ultrasound. She had stage four cervical cancer. I asked her, when was
• 44:27
  your last pap smear? She goes after menopause, they said, I didn't need it anymore. I'm like, you
• 44:32
  had new sexual partners. You know, like, this is, that's a ridiculous and so many people are told
• 44:39
  if they've had a hysterectomy, oh, you don't need a pap smear. If they had their post-manopause,
• 44:46
  oh, you don't need pap smear. The screening guidelines have decreased, but the caveat,
• 44:50
  the fine print, is if you have been with, you know, if you have any high, like what's considered
• 44:55
  high risk. Personally, if you've been monogamous your entire life, one partner, and they've been
• 45:01
  monogamous the entire life with you and you never had an abnormal pap smear, okay, you're low risk.
• 45:05
  I'd still do your pap smear every three to five years. But if you've had more than one sexual
• 45:10
  partner, any history of an abnormal pap smear, the older we get, the issues with our immune system
• 45:15
  come into play. And so that can allow these viruses. Well, now we see post-pandemic, what we
• 45:21
  call turbo cancers. And that's what happened to her. Now, thankfully, she's been doing so much
• 45:25
  integrative and functional stuff. So she has outlived her diagnosis. She's now almost 76.
• 45:31
  Still having that sex life. Yeah. That's, I've never heard the term turbo cancers. And we don't
• 45:36
  have to dive into that, but that's very interesting. Yeah, Bobby's dad healthy as ever. And within a
• 45:43
  year gone with a very rare cancer, that's a different conversation. But uh, UTIs. Yes.
• 45:50
  So I've heard you talk about how an undiagnosed UTI, because sometimes you can't feel it. Yeah.
• 45:56
  But has led to dementia-like symptoms. Yeah. Explain that. Yeah. No, absolutely. And you definitely
• 46:03
  recognize this now. I learned way back in early 2000, because I was caregiving my father at that time.
• 46:09
  And he was like sharp as a tack, great memory, great, um, sense of humor. And all of a sudden,
• 46:17
  he was getting disoriented and irritable. And, you know, one of the things was part of the
• 46:23
  differential is to check for a urinary, and he was having incontinence. I'm like, Dad, you probably
• 46:27
  have a urinary tract infection. We cleared up that urinary tract infection. His cognition was back
• 46:31
  to normal. But this is a very common thing in the geriatric population. This chronic low-grade
• 46:37
  inflammation, creating dementia type symptoms, memory, brain fog issues. And caregiver may think
• 46:45
  it's just, you know, it's their dementia's worsening. But it could be that UTI until it gets
• 46:49
  into their kidneys, now they're in the hospital, antibiotics, and may or may not come out. So this
• 46:54
  is not an uncommon scenario. This is so important. And, you know, parimenopause and menopause,
• 47:01
  the risk for infections increase. But this is why we have to do the probiotics. We have to do
• 47:06
  the hormonal topical therapies. And we have to, like, part of my protocol to prevent UTIs
• 47:13
  is vitamin C, anywhere between 2000 to 4000 milligrams per day. Lots of fluids, right?
• 47:18
  dilution is the solution to the cholineous juice fluid, though. Not cranberry juice.
• 47:23
  Not cranberry juice, yeah. Not sugar. And probiotic. And then using the topical hormone for me,
• 47:30
  recommend Jolva. And so using that around the urethra, et cetera, and being after sex. But being
• 47:36
  able to completely nip those urinary tract infections. But if it goes undiagnosed and
• 47:42
  knows symptoms, how long can someone have something until it becomes a real issue? And
• 47:47
  it depends on their immune system. Yeah. Depends on their immune system. What they're doing,
• 47:51
  they're diet, if they, you know, it can flare. But they can go undiagnosed for a long time.
• 47:58
  So what would you say for someone just beginning in their, you know,
• 48:02
  pregnant pals or just the basic supplements that you say without going to, you know,
• 48:07
  your doctor may prescribe you other stuff or hormones and such. But just supplements,
• 48:11
  they should have a cabinet. So, you know, what I think of core supplements. And where I see
• 48:17
  the biggest differences in my life and others, right? In the biohacking space, our cabinets can get
• 48:22
  pretty people. And then it becomes a little overwhelming. So I'm like, I always say I'm like
• 48:27
  the basic fatty biohacker. Like, don't overwhelm me. Totally. For me, adaptogens and greens. So for
• 48:34
  me, for mighty maca plus, that's like foundational, you know, recommended in hundreds of functional
• 48:40
  medicine practices. But it 30, combination of 30 superfoods that help in multiple areas. So
• 48:45
  that's key. So I'll and think of, you know, bias towards my product that I created. But think of
• 48:51
  greens, alkalinizers, fiber, brush ground, flaxse. Think about those things in your nutrition
• 48:57
  plant in your diet. When we think of other biohacking principles and key supplementation,
• 49:03
  fish oils. So unless you'd really like to eat a lot of sardines and things like that,
• 49:07
  you probably want to supplement with good high quality fish oils that have been third party
• 49:12
  tested for heavy metals and are from a sustainable source. That's really important. You know,
• 49:17
  make it three fissials are good for cognition or good for brain or good for anti-inflammatory.
• 49:22
  With the exception of you do not, if you are very inflamed, maybe, you know, you have joint pain
• 49:27
  or thridic pain, IBS symptoms. And we start giving you fish oils. It can oxidize. So it becomes pro
• 49:34
  oxidized in an inflamed body. So you really want to work on getting down inflammation. That's why
• 49:39
  the polyphenols, the adaptogens, the dietary changes are really important. Magnesium is the third
• 49:46
  supplement that I really recommend. So a magnesium glycinate or end-of-or-felt-three-and-eight
• 49:52
  combination to cross the blebring barrier. Because I see the best results, release in better sleep,
• 49:58
  release in restless legs syndrome, things that really plague women in mid-lice, distressing to
• 50:04
  distress, anxiety, emotions, and then vitamin D, of course. So as much as possible getting sunlight
• 50:12
  on as much of our bodies as possible to get natural vitamin D, we get a lot more than vitamin D
• 50:17
  from the sun. So it's important to be in nature and experiencing that. And when we're taking a D-3
• 50:23
  supplement, it has to be paired with K2. So vitamin D always with K. So DK combination and depending
• 50:31
  to get your levels up to optimum would be important to test and measure. And why the K and the D
• 50:38
  together? Because vitamin D says deposit calcium vitamin K says where. And we do not want deposits
• 50:44
  in our breast tissue and our cardiac vessels anywhere else. We want calcium to go into our bone,
• 50:50
  into our, you know, into our system where we can use it. So that's important. So K is so critical
• 50:55
  for that. And there's so many benefits for vitamin K in general. Probably what else do I really,
• 51:00
  like a part, you know, vitamin E also mix, Tokotron, all vitamin E's because they're breast healthy,
• 51:06
  brain healthy, also anti inflammatory iodine is another big one because all we've been iodine
• 51:14
  deficient. Many of us in our diets, depending on how much seaweed sushi we're eating, that oftentimes
• 51:19
  we're iodine deficient because I mean, even with healthy diets of iodine because bromine, which
• 51:25
  is in much of the bread or grain, fluorine, chlorine, all three push out iodine and iodine is necessary
• 51:33
  for every receptor. So it's necessary for estrogen receptors to work, our thyroid receptors to work.
• 51:39
  So in iodine deficient situations, it's not just about thyroid disease, about hormonal insufficiency
• 51:46
  and balance, HPA access abnormalities. So iodine you can focus on iodine rich foods, certainly
• 51:54
  can supplement with a clean form of iodine. And you just start really small doses. A little bit
• 52:01
  goes a long way for some women with breast cysts or variances. We may use topical iodine too.
• 52:07
  My cabinet just got full. Oh, I would expect these to be in your cabinet.
• 52:12
  Some of them are, but I'm going to make a list. Okay, well, Dr. Ennecafeca, thank you for having
• 52:17
  this conversation. I feel like we've gone through a lot and even this being our second,
• 52:23
  well, technically third, as I was on your podcast too. But we're going to everyone find you,
• 52:29
  and is there any one last thing that you just have to say to someone listening?
• 52:35
  Yeah, I would say, especially turning 60 this year, and my life is, has more colors, more
• 52:41
  dimensions than I would have ever imagined at this time. And honestly, then my mom got through
• 52:45
  experience. And so I want to really encourage everyone. There's a fork in the road every single day
• 52:51
  of our lives. We have a choice that we can make. We can move towards hell, or we can move towards
• 52:56
  illness and disease. We can move towards love and joy and gratitude, or we can move towards
• 53:01
  anger. Hey, these are our choices. We absolutely get to make that choice every day. So in realizing
• 53:07
  that, you know, we get to be here together on this earth. What is your one next right step?
• 53:14
  And I would encourage you to make it and realize investing in yourself because that is the best
• 53:21
  investment that you can make. So to never lose hope, and to always, really, to always keep,
• 53:28
  keep going, no matter what, pick sometimes some days is just like, I just gotta do something,
• 53:32
  gotta keep going. And have fun. I love that. I want to give your audience my website,
• 53:39
  and also some free gifts. So at our, at our private insider page, so for your audience, it's
• 53:45
  drana.com. So drana.com forward slash tribe. Okay, so drana.com forward slash tribe. And I've
• 53:53
  got some free gifts and like my 10-day breeze through menopause course they can do for free.
• 53:58
  And amazing. Okay, we'll put that in the show notes too. Thank you so much for being here,
• 54:03
  for coming down from Dallas. My pleasure. And I love the conversation and I always learn so much
• 54:10
  for you. Thank you. Yay. Thank you. Thank you.