Latest / Ageless and Timeless Podcast® / Dr Betsy Greenleaf, Urogynecology

Transcript

Dr Betsy Greenleaf, Urogynecology · Ageless and Timeless Podcast®

• 0:10
  Speaker 1: Good morning everyone. This is Michelle Hughes from Ageless and Timeless.
• 0:14
  Speaker 1: I have a wonderful guest today. I know I always
• 0:17
  Speaker 1: say that I always have great guests. But her name
• 0:21
  Speaker 1: is doctor Betsy Greenleaf, and she is well. She has
• 0:25
  Speaker 1: a very interesting story, but we're going to let her
• 0:28
  Speaker 1: tell it. But she is the first female certified euro
• 0:34
  Speaker 1: guynecologist in the country, So swallow all that. Betsy, good morning,
• 0:41
  Speaker 1: how are you.
• 0:43
  Speaker 2: I'm so excited to be here. Michelle, Thank you. I'm
• 0:46
  Speaker 2: so grateful to be talking with you today.
• 0:48
  Speaker 1: Well, we have a wonderful mutual friend in Susan Fox,
• 0:51
  Speaker 1: and Susan is an incredible accupuncturist here in the Bay
• 0:55
  Speaker 1: Area and Mill Valley next door to me and I
• 0:58
  Speaker 1: live in Timaran, So I met her and we've been
• 1:01
  Speaker 1: brainstorming with mutual connections and she'll probably come on the
• 1:05
  Speaker 1: podcast sometime in twenty twenty six. We're books solid, Betsy,
• 1:09
  Speaker 1: we got you in, but we're book solid for the
• 1:12
  Speaker 1: whole year. So congratulations for being one of our guests
• 1:15
  Speaker 1: in twenty twenty five. So, Betsy, tell us how do
• 1:19
  Speaker 1: you become a euro guynacologist? What is it end up
• 1:25
  Speaker 1: being the first woman to get certified.
• 1:28
  Speaker 2: Yeah, it's funny because starting back, even in gaynacology, I
• 1:33
  Speaker 2: never thought that that's what I was going to look
• 1:35
  Speaker 2: at all day long. And I remember back in residency,
• 1:37
  Speaker 2: I had a friend who was a podiatrist and we
• 1:39
  Speaker 2: were eating lunch and she was like, looks at me,
• 1:42
  Speaker 2: and I'm looking at her, and I'm going, how do
• 1:45
  Speaker 2: you look at people's nasty feet all day long? And
• 1:47
  Speaker 2: I thought she was going to choke on her sandwich
• 1:49
  Speaker 2: because she's like, do you realize what you're looking at
• 1:51
  Speaker 2: all day long? And I'm like, oh, you know, I
• 1:53
  Speaker 2: didn't realize it. So interesting enough, I actually started off
• 1:57
  Speaker 2: in general surgery and then really is attracted to women's
• 2:01
  Speaker 2: healthcare and switched over to obstetrics and gynecology and didn't
• 2:06
  Speaker 2: even know that eurogynecology was even a thing. And I
• 2:10
  Speaker 2: know a lot of people are like, what in the
• 2:11
  Speaker 2: world is that? And when I told my mom I
• 2:13
  Speaker 2: was going to do two more years of eurogynecology on
• 2:16
  Speaker 2: top ofstetrics and gynecology, she thought it was like European gycology,
• 2:21
  Speaker 2: like euro like euro Disney, like it was some kind
• 2:24
  Speaker 2: of fancy gynecology. And it actually has to do like
• 2:27
  Speaker 2: a combination of two professions of urology having to deal
• 2:31
  Speaker 2: with the bladder and the urinary system and gynecology having
• 2:34
  Speaker 2: to deal with the pelvic organs. And there's only fifteen
• 2:37
  Speaker 2: hundred eurogynecologists in the United States, and so it's especially
• 2:40
  Speaker 2: training beyond just e've been either enter it through having
• 2:46
  Speaker 2: training in obstetrics and gynecology or you enter it from urology.
• 2:51
  Speaker 2: So and it's a much needed specialty, especially when we
• 2:55
  Speaker 2: look at conditions like prolapse, which is where things start
• 2:58
  Speaker 2: drooping and dropping down like they do everywhere in our
• 3:01
  Speaker 2: body as we age. But fifty percent of women will
• 3:04
  Speaker 2: experience a pelvic prolapse at some point in their lives.
• 3:07
  Speaker 2: So we need a lot more eurog collagists out there
• 3:10
  Speaker 2: addressing these issues.
• 3:12
  Speaker 1: Is there's that fifty number mostly due to aging or
• 3:17
  Speaker 1: is there are there other reasons why prolapse occur so frequently?
• 3:21
  Speaker 2: Yeah, so they happen. It happens for a number of reasons.
• 3:24
  Speaker 2: And some people are like what might be thinking right now,
• 3:26
  Speaker 2: like what in the world is a prolapse? Well, what
• 3:29
  Speaker 2: happens is there's ligaments that hold our organs in our body,
• 3:32
  Speaker 2: and so like our bladder's being held up by ligaments
• 3:36
  Speaker 2: and it's kind of leaning on the vagina, the vaginas being
• 3:38
  Speaker 2: held up, the rectums being held up, and they're so
• 3:41
  Speaker 2: close together, they kind of all those organs lean on
• 3:44
  Speaker 2: each other and as age can definitely affect the tissue.
• 3:50
  Speaker 2: But the most common reason women have that is pregnancy
• 3:54
  Speaker 2: and childbirth. That's a lot of stressors on the pelvis,
• 3:57
  Speaker 2: and our pelvis is just basically an open hole to gravity.
• 4:01
  Speaker 2: So once those ligaments get damaged, there's not a lot
• 4:03
  Speaker 2: that they can you know, hold them up, so things
• 4:06
  Speaker 2: kind of just start drooping and dropping and coming down.
• 4:09
  Speaker 2: But in people, in women who have not had a
• 4:12
  Speaker 2: pregnancy or child birth, things like constipation can affect this.
• 4:17
  Speaker 2: Smoking we know, smoking affects all of our ligaments, and
• 4:21
  Speaker 2: certain medical conditions like autoimmune diseases can affect this too.
• 4:26
  Speaker 2: But I think the youngest person I've ever seen that's
• 4:29
  Speaker 2: had problems with a prolapse was actually a thirteen year old.
• 4:32
  Speaker 2: She was a gymnast, and from the actual impact of
• 4:37
  Speaker 2: you know, landing as a gymnast all the time, that
• 4:40
  Speaker 2: that actually affected things too. So sometimes we see that
• 4:44
  Speaker 2: if people are doing extreme lifting or anything that's going
• 4:48
  Speaker 2: to put a lot of pressure on their pelvis. We
• 4:50
  Speaker 2: can see that affect their ligaments.
• 4:52
  Speaker 1: And so how do you fix that?
• 4:55
  Speaker 2: Yeah, that's that is the key, And this is why
• 4:59
  Speaker 2: you may have heard a vaginal mesh because that was
• 5:03
  Speaker 2: a big thing that happened in like twenty twelve, where
• 5:06
  Speaker 2: there's not a lot of great ways to fix this.
• 5:09
  Speaker 2: So some of it can be doing your kego exercises
• 5:14
  Speaker 2: and strengthening your pelvic floor because sometimes the prolapse can
• 5:19
  Speaker 2: look worse than it is because our muscles have gotten weak,
• 5:23
  Speaker 2: and what ends up happening is we start losing about
• 5:26
  Speaker 2: eight percent of our muscle mass for every decade that
• 5:29
  Speaker 2: we live after the age of thirty. So people always
• 5:32
  Speaker 2: think about exercising their arms and their legs, but they
• 5:35
  Speaker 2: don't think about exercising down there. So having strong muscles
• 5:39
  Speaker 2: can sometimes help keep things in place better or can
• 5:44
  Speaker 2: help with if somebody ends up having to have surgery.
• 5:47
  Speaker 2: But even then, like once those ligaments are torn, there's
• 5:50
  Speaker 2: not a lot that we can do. There's different things
• 5:54
  Speaker 2: that we can do to affect the appearance, from the
• 5:57
  Speaker 2: kego exercises to things like vaginal rejuvee nation with lasers
• 6:01
  Speaker 2: or radio frequency things that will tighten up the tissue.
• 6:05
  Speaker 2: But even surgery, which we've learned because of all the
• 6:08
  Speaker 2: problems that happened with vaginal mesh. And the reason why
• 6:11
  Speaker 2: mesh was being used in the first place is because
• 6:14
  Speaker 2: even when you go into do surgery, it's not like, well,
• 6:18
  Speaker 2: like just fix those ligaments, because a lot of times
• 6:20
  Speaker 2: those ligaments are so thin or so torn there's really
• 6:23
  Speaker 2: nothing to sew them too. So they started using materials
• 6:27
  Speaker 2: like mesh to kind of reinforce the tissue. But they realized,
• 6:32
  Speaker 2: you know, hernia mesh has been used since the nineteen eighties,
• 6:35
  Speaker 2: and great when you're putting in the abdomen for the
• 6:37
  Speaker 2: hernia for hernia, but when you put it in the vagina,
• 6:39
  Speaker 2: it's a whole different area, and the vagina has to
• 6:43
  Speaker 2: be able to have some movement, and so these meshes
• 6:47
  Speaker 2: didn't work in that area. So they're still using somewhat
• 6:52
  Speaker 2: materials like mesh or natural materials to reinforce that tissue.
• 6:57
  Speaker 2: But we also know that having serve for these kind
• 7:01
  Speaker 2: of problems isn't like a permanent thing. It's not like, well,
• 7:04
  Speaker 2: when you have your appendix taken out because there's an issue.
• 7:07
  Speaker 2: You don't typically grow an appendix back. It's out and
• 7:10
  Speaker 2: it's done. When we're doing these types of surgeries for
• 7:14
  Speaker 2: the prolapse, we hope to get five to ten years
• 7:18
  Speaker 2: out of the surgery because there's just so much pressure
• 7:22
  Speaker 2: and gravity affecting that area. So we've unfortunately learned that
• 7:25
  Speaker 2: there's nothing permanent when it comes to treating these areas,
• 7:29
  Speaker 2: and some people, you know, surgery is an option, but
• 7:33
  Speaker 2: if somebody doesn't want to have surgery, or if they
• 7:38
  Speaker 2: are looking for something less invasive, there's also little devices
• 7:41
  Speaker 2: called pestories that can be worn in the vagina, and
• 7:44
  Speaker 2: a lot of times they look they come in all
• 7:46
  Speaker 2: kinds of crazy shapes and sizes, but a lot of
• 7:47
  Speaker 2: times they look like little frisbees and they kind of
• 7:50
  Speaker 2: fold up and they in certain just wedge in place
• 7:52
  Speaker 2: and hold hold things in place. So that's also another
• 7:56
  Speaker 2: non surgical option.
• 7:58
  Speaker 1: So is a pestury kind of like an eye that
• 8:00
  Speaker 1: you take it in and out when I mean, obviously
• 8:02
  Speaker 1: the IUD is for burst control, but is that what
• 8:06
  Speaker 1: happens with the pestory. You would put it in before
• 8:10
  Speaker 1: your day begins and then take it out in the evening.
• 8:13
  Speaker 2: Yeah, some people. Well so they're usually typically made out
• 8:16
  Speaker 2: of silicone and they can easily come in and out.
• 8:19
  Speaker 2: Some people don't have the dexterity to take them in
• 8:21
  Speaker 2: and out on their own. Though, the more you take
• 8:24
  Speaker 2: it in and out and clean it the better, because
• 8:28
  Speaker 2: what happens is the vagina, anything that's in the vagina
• 8:31
  Speaker 2: that's not supposed to be there, the body tries to
• 8:34
  Speaker 2: get rid of it, and we'll try to flesh it out.
• 8:36
  Speaker 2: So the longer one stays in, somebody might start making
• 8:40
  Speaker 2: a heavier discharge with that, and that can sometimes be uncomfortable.
• 8:44
  Speaker 2: But they're typically left in as long as three months,
• 8:48
  Speaker 2: where people can come into the office every three months
• 8:50
  Speaker 2: and have them change. But I always recommend that they
• 8:53
  Speaker 2: try to come in a little bit sooner. But there's
• 8:55
  Speaker 2: been no great studies on how how long is the
• 8:58
  Speaker 2: longest you can actually leave them in. I have to
• 9:01
  Speaker 2: say the worst case scenario I ever saw was somebody
• 9:03
  Speaker 2: who left it in it for a year. She was
• 9:05
  Speaker 2: a patient of another practice and she showed up to
• 9:07
  Speaker 2: my practice and was like, Oh, I forgot this was there.
• 9:11
  Speaker 2: And in one case, well one case I had somebody
• 9:15
  Speaker 2: it was fine. We took it out, we cleaned it,
• 9:17
  Speaker 2: and she went back to her normal activities. Another lady
• 9:19
  Speaker 2: that came in a year later where that happened. Her
• 9:22
  Speaker 2: tissues started to grow around it, and so it was
• 9:25
  Speaker 2: and she was not somebody that was healthy enough to
• 9:28
  Speaker 2: have surgery. So we basically left it as an almost
• 9:31
  Speaker 2: like an implant.
• 9:32
  Speaker 1: So, I mean, I'm going to ask a kind of
• 9:35
  Speaker 1: intimate question, but if you're having you know, sexual intercourse,
• 9:41
  Speaker 1: isn't they isn't it going to get very grubby and dirty?
• 9:45
  Speaker 1: With what I mean? I'm just being just really honest,
• 9:49
  Speaker 1: just thinking, Yeah, from a pragmatic standpoint, so I mean,
• 9:53
  Speaker 1: wouldn't it be better just to be using these things
• 9:56
  Speaker 1: more like an apparatus that you take in and out
• 10:00
  Speaker 1: and clean of course? And yeah, well i'm is that
• 10:04
  Speaker 1: what you would do with?
• 10:06
  Speaker 2: Ideally that would be the better way. But you know,
• 10:08
  Speaker 2: some people when it comes to sexual relations, some people
• 10:11
  Speaker 2: leave them in place when they're having sex and their
• 10:13
  Speaker 2: partners sometimes feel it or don't. And yeah, ideal some
• 10:19
  Speaker 2: people just take them out completely during intercourse. But yeah, ideally,
• 10:23
  Speaker 2: the more you can take it in and out and
• 10:25
  Speaker 2: clean it, the better.
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• 11:14
  Speaker 2: Yeah. Yeah, It's called a pestory pessori E.
• 11:18
  Speaker 1: E S A R Y P E s s A
• 11:23
  Speaker 1: R Y I A Y. Where do you get where?
• 11:26
  Speaker 2: Usually you have to be fitted for them at your gynecologists,
• 11:30
  Speaker 2: And like I said, they come in all kinds of
• 11:32
  Speaker 2: crazy shapes and sizes. Typically, the standard one looks like
• 11:36
  Speaker 2: a frisbee. It's usually like a little disc that folds
• 11:39
  Speaker 2: up in half and kind of slides in there and
• 11:41
  Speaker 2: then opens and wedges. But they can be as extreme
• 11:45
  Speaker 2: as looking like a cube for like very extreme prolapses.
• 11:49
  Speaker 2: And and typically the the larger and kind of crazier
• 11:52
  Speaker 2: shapes are a little bit harder to get in and
• 11:54
  Speaker 2: out on your own. But and that's usually managed by
• 11:57
  Speaker 2: a gynecologist.
• 11:59
  Speaker 1: So you said it's made of silicon. But isn't silicon
• 12:03
  Speaker 1: dangerous to the body? But I mean, isn't that what
• 12:05
  Speaker 1: happened with women who had silicon breast implants that they
• 12:09
  Speaker 1: had to have them removed because of the issues of
• 12:12
  Speaker 1: the material of silicon.
• 12:15
  Speaker 2: You know, So you know, and I being in the
• 12:18
  Speaker 2: health and wellness and integrated medicine world, I get kind
• 12:21
  Speaker 2: of crazy about what things are made out of. However,
• 12:26
  Speaker 2: the what they're these devices, and we kind of say silicon,
• 12:29
  Speaker 2: I don't know exactly exactly what it is. They are
• 12:32
  Speaker 2: like BPA free and and but are there like a
• 12:36
  Speaker 2: perfect healthy version that doesn't have toxins in it? I
• 12:40
  Speaker 2: don't know if there's one that exists. You know, I'm
• 12:42
  Speaker 2: always asking about that and the issues with the breast
• 12:46
  Speaker 2: implants that was actually and that could be argued back
• 12:52
  Speaker 2: both ways. I have my own personal opinions about it,
• 12:55
  Speaker 2: but and I've seen my own cases of you know,
• 12:59
  Speaker 2: breasted plant illness. But from a clinical research standpoint, all
• 13:06
  Speaker 2: the studies that have been done on breast and plants
• 13:09
  Speaker 2: actually and like I said, I don't have to agree
• 13:12
  Speaker 2: with it, but say that they're they're actually the material
• 13:16
  Speaker 2: is safe. But that's from a traditional research standpoint, which,
• 13:23
  Speaker 2: like I said, I don't personally agree with all.
• 13:25
  Speaker 1: That started out an allopathic medicine. So you know that
• 13:29
  Speaker 1: very often there's a little poetic license and how these
• 13:34
  Speaker 1: things are described as quote safe. So I mean, I
• 13:39
  Speaker 1: don't know. I'm not an expert. I never had any
• 13:42
  Speaker 1: and thank god, but I do know a lot of
• 13:44
  Speaker 1: women who had problems with and had to have them
• 13:47
  Speaker 1: remove because of the material. So anyway, so what part
• 13:52
  Speaker 1: of your practice is would you say is the most challenging?
• 13:56
  Speaker 2: You know, Like right now, what I'm focusing mainly is
• 13:59
  Speaker 2: on menopause treatment, and I think that really, I mean,
• 14:04
  Speaker 2: menopause has been around forever, but it's all of a
• 14:07
  Speaker 2: sudden become this really popular conversation. And I don't know
• 14:11
  Speaker 2: why it's good because I'm glad that we're talking about
• 14:13
  Speaker 2: it more because it needs to be talked about. But
• 14:16
  Speaker 2: where I find it frustrating is now you like basically
• 14:21
  Speaker 2: open up your phone, social media, the Internet, and everywhere
• 14:25
  Speaker 2: you go there's somebody that's talking about menopause, and I
• 14:27
  Speaker 2: don't think they're necessarily coming about it in the right way.
• 14:32
  Speaker 2: And what I find the most frustrating is I'm seeing
• 14:35
  Speaker 2: women who are getting overdosed on hormones like left and
• 14:38
  Speaker 2: right from other places, thinking that hormones are like the
• 14:43
  Speaker 2: panacea for all the issues in menopause. Where I always
• 14:47
  Speaker 2: teach you know, doctors and nurses and my patients, that
• 14:51
  Speaker 2: hormones are a tool in our toolbox, but they're not
• 14:54
  Speaker 2: the end all, be all answer to everything, and that
• 14:57
  Speaker 2: we have to still look at life's We have to
• 15:00
  Speaker 2: look at where inflammation is creeping in into our lives,
• 15:05
  Speaker 2: whether it's from inflammatory diets or things we're putting on
• 15:08
  Speaker 2: our skin, and that these are things that could be
• 15:12
  Speaker 2: affecting our hormones, and then just giving more hormones isn't
• 15:14
  Speaker 2: going to necessarily fix those problems. So I think it
• 15:19
  Speaker 2: becomes very, very frustrating. In addition, we have our traditional
• 15:24
  Speaker 2: medical organizations that are still too scared to talk about
• 15:28
  Speaker 2: hormones to women, because in two thousand and one, the
• 15:32
  Speaker 2: Women's Healthy Initiative study came out, where like a day
• 15:36
  Speaker 2: before that study came out, they were like hormones for everybody,
• 15:40
  Speaker 2: you know, kind of like the Oprah meme when you're like,
• 15:42
  Speaker 2: she's like a car for you, a car for you.
• 15:43
  Speaker 2: They were like hormones for you, and you and you,
• 15:46
  Speaker 2: And then the next day it was like, everybody needs
• 15:49
  Speaker 2: to get off their hormones because it causes heart disease
• 15:52
  Speaker 2: and breast cancer. And what we know today in twenty
• 15:57
  Speaker 2: twenty five is that that's not necessarily true, and the
• 16:01
  Speaker 2: problem was not hormones, it was the type of hormones
• 16:05
  Speaker 2: in those studies. So what people don't realize is that
• 16:09
  Speaker 2: not all hormones are created equally, and unfortunately, a lot
• 16:13
  Speaker 2: of the stuff that your insurance covers is incredibly toxic,
• 16:19
  Speaker 2: and I actually think it should be a crime against
• 16:22
  Speaker 2: women that those products are still on the market. And
• 16:26
  Speaker 2: then we have to take a step back and go,
• 16:27
  Speaker 2: why in the world are those products even on the market.
• 16:30
  Speaker 2: And it's really purely a business decision, because in medicine,
• 16:35
  Speaker 2: you can't patent things that are naturally occurring. So our
• 16:38
  Speaker 2: natural hormones that are in our body are not patentable.
• 16:41
  Speaker 2: So as a business, there's no money in selling natural
• 16:45
  Speaker 2: hormones because they can't patent and protect their companies. But
• 16:50
  Speaker 2: what they can do is take a naturally occurring hormone,
• 16:53
  Speaker 2: tweak that molecule, means like add something onto that molecule,
• 16:57
  Speaker 2: change the shape of that molecule, and then they test
• 17:01
  Speaker 2: it and see like it kind of works like human
• 17:04
  Speaker 2: you know, human hormones, and now they can patent it
• 17:07
  Speaker 2: and sell it to women. And that's what's in our
• 17:10
  Speaker 2: birth control, and that's what's in a lot of the
• 17:13
  Speaker 2: prescription based hormones. And we know that the Women's Health
• 17:17
  Speaker 2: Initiative study that showed to increase risk of heart disease
• 17:20
  Speaker 2: and breast cancer, they were using these non natural hormones
• 17:27
  Speaker 2: which we now know are very incredibly inflammatory and are
• 17:31
  Speaker 2: actually processed down a toxic pathway in the body that
• 17:36
  Speaker 2: can actually increase the risk of cancer and heart disease,
• 17:39
  Speaker 2: and that natural hormones and balance we don't see those things. However,
• 17:44
  Speaker 2: we're never going to have any big giant natural hormones
• 17:47
  Speaker 2: studies because there's no money in it. So it becomes
• 17:50
  Speaker 2: that it's crazy circle.
• 17:52
  Speaker 1: So if you're using compounding pharmacies, and I know they
• 17:57
  Speaker 1: do not have the same kind of money as the
• 17:59
  Speaker 1: farmersutical industry, So of course you're right, there's just not
• 18:04
  Speaker 1: and there isn't going There is not going to be
• 18:07
  Speaker 1: the kind of financial roi that you get when you're
• 18:11
  Speaker 1: dealing with chemicals and patentable Like you said, so I
• 18:15
  Speaker 1: agree with you, But who would ever want to put
• 18:17
  Speaker 1: if you have a choice of horses urine into your body,
• 18:22
  Speaker 1: which is what premarin is, and that's what was being
• 18:26
  Speaker 1: used for that study, right that, Yeah, as one And
• 18:31
  Speaker 1: there was no such thing as compounding hormones until after
• 18:35
  Speaker 1: that study, So it seemed like that that was kind
• 18:38
  Speaker 1: of a wake up call for a lot of these
• 18:42
  Speaker 1: more natural like using yams as an example for hormonal
• 18:46
  Speaker 1: which is more natural to the body. So how do
• 18:49
  Speaker 1: you educate your clients, your patients between using the traditional allopathic,
• 18:56
  Speaker 1: you know, pharmaceutical approach versus the compounding approach.
• 19:00
  Speaker 2: Yeah, so it's really more about trying to find the
• 19:03
  Speaker 2: sources of the natural hormones. And in fact, there actually
• 19:06
  Speaker 2: are some prescription natural products on the market, but people
• 19:10
  Speaker 2: don't really know about them. But I also like the
• 19:13
  Speaker 2: compounding because you can kind of tweak the doses because
• 19:18
  Speaker 2: I have also found that some of the doses that
• 19:21
  Speaker 2: we see on the in that are on the market
• 19:23
  Speaker 2: that our prescription based tend to be a little bit higher.
• 19:26
  Speaker 2: But more so even in that study was the the
• 19:29
  Speaker 2: progesterone was more of an issue. The synthetic progesterones are
• 19:33
  Speaker 2: probably the main cause of all the issues in that
• 19:36
  Speaker 2: study than the natural And so that's actually where I
• 19:39
  Speaker 2: tell people to take a look. If they're getting prescribed progesterone,
• 19:42
  Speaker 2: they want to make sure they're getting prescribed to something
• 19:44
  Speaker 2: called micronized progesterone. Because micronized progesterone is the natural version
• 19:50
  Speaker 2: of progesterone. It usually goes under the brand name of Prometrium.
• 19:55
  Speaker 2: It gets confusing because there's a madroxy progesterone. Is what
• 19:59
  Speaker 2: we see see is the synthetic version, the non natural
• 20:03
  Speaker 2: version that is incredibly inflammatory. It is usually associated with
• 20:07
  Speaker 2: a lot of the side effects that people think of
• 20:08
  Speaker 2: with progesterone, like like moodiness and weight gain. That happens
• 20:13
  Speaker 2: in birth control because unfortunately, we don't have any natural
• 20:17
  Speaker 2: hormone birth controls that are out there we do have
• 20:20
  Speaker 2: the option for natural hormone therapies, but not for birth control.
• 20:25
  Speaker 2: So a lot of the things that people see as
• 20:26
  Speaker 2: side effects are usually coming from these these synthetic ones.
• 20:30
  Speaker 2: So it's usually you know, looking what you're getting because
• 20:33
  Speaker 2: that's the one you can get as a prescription from
• 20:35
  Speaker 2: your you know, from your doctor, and maybe you know
• 20:38
  Speaker 2: it might be covered by insurance, it doesn't always.
• 20:40
  Speaker 1: See, the great irony of what you just said is
• 20:43
  Speaker 1: that progesterone is supposed to make you feel less moody,
• 20:47
  Speaker 1: and you know, if you're using the right form of yes, yeah,
• 20:51
  Speaker 1: and more energetic and you know, and.
• 20:53
  Speaker 2: You sleep better sleep.
• 20:56
  Speaker 1: So isn't that an irony that you're taking something that's
• 21:01
  Speaker 1: doing the opposite of what it's naturally intended to do
• 21:04
  Speaker 1: if you're using the right the right ingredients. Yeah, So
• 21:10
  Speaker 1: let's talk about a moment just about bioidentical hormones, because
• 21:15
  Speaker 1: I think there is a lot of confusion. And you're right,
• 21:17
  Speaker 1: you can customize if you're going to a compounding pharmacy
• 21:21
  Speaker 1: to the patient, which is, you know, one size does
• 21:23
  Speaker 1: not fit all. As a doctor, how do you determine
• 21:29
  Speaker 1: what dose did she give to a patient? So that
• 21:32
  Speaker 1: you know that you're doing the right thing by that patient.
• 21:36
  Speaker 2: Yeah, the easiest patient is the one that comes into
• 21:38
  Speaker 2: me that doesn't have has never been on hormones, because
• 21:41
  Speaker 2: they're the easiest one. What we do is we put
• 21:43
  Speaker 2: them on the lowest dose and we just adjust it
• 21:47
  Speaker 2: based on their symptoms. And this is where even my
• 21:51
  Speaker 2: very first hormone patient, I remember she was somebody where
• 21:55
  Speaker 2: I was checking her labs and we use the labs
• 21:58
  Speaker 2: as kind of a reference that we're doing the right thing.
• 22:01
  Speaker 2: But the labs don't always tell you exactly what to do.
• 22:04
  Speaker 2: Like for example, this was a woman who was in
• 22:07
  Speaker 2: her early sixties. She had no sex drive, hot flashes,
• 22:11
  Speaker 2: she was losing her hair, she was having you know,
• 22:15
  Speaker 2: vagile dryness, like everything you know.
• 22:17
  Speaker 1: You can think of all symptoms.
• 22:20
  Speaker 2: Yeah, And so I started her on a hormone called DHA,
• 22:24
  Speaker 2: which interesting enough is over the counter. But that's that's,
• 22:28
  Speaker 2: you know, just an interesting fact. And she was taking
• 22:31
  Speaker 2: it every single day, and I put her on the
• 22:33
  Speaker 2: lowest dose and I check them in a month later,
• 22:36
  Speaker 2: and now her hair loss got worse, her sex drive
• 22:40
  Speaker 2: came back, but she was so pissed off at her
• 22:42
  Speaker 2: husband that she didn't want to have sex, and her
• 22:45
  Speaker 2: hot flashes got worse. So we checked the labs and
• 22:49
  Speaker 2: her testosterone had gone through the roof, her estrogen gone
• 22:51
  Speaker 2: through the roof, and she was on the lowest dose.
• 22:54
  Speaker 2: So then what I figured out over time is we
• 22:57
  Speaker 2: adjusted where she wasn't taking it as frequently, and she
• 23:03
  Speaker 2: came back, and I think we got her down to
• 23:04
  Speaker 2: where she finally was just taking it twice a week
• 23:07
  Speaker 2: and she was reporting no hot flashes, Her mood was better,
• 23:12
  Speaker 2: her hair had come back, her sex drive was back.
• 23:16
  Speaker 2: Everything was good. But then when we checked her labs,
• 23:19
  Speaker 2: her labs looked like she was too low. And so
• 23:22
  Speaker 2: this is what I when I also teach, I teach
• 23:24
  Speaker 2: practitioners how to do this. This is where I'm like, the
• 23:27
  Speaker 2: labs are just a suggestion, a weird a go because
• 23:30
  Speaker 2: even people your labs, your normal might look completely different
• 23:35
  Speaker 2: than my normal, and as long as you're feeling okay,
• 23:39
  Speaker 2: you start to track over time like, okay, well these
• 23:41
  Speaker 2: are my normal. When I'm in this range, this is
• 23:44
  Speaker 2: how I do so. Fortunately, too off and I see
• 23:48
  Speaker 2: practitioners who are not trained well in this. They keep
• 23:52
  Speaker 2: just adjusting beasts on those laboratory values and then they
• 23:56
  Speaker 2: never quite get it right in people's hormones all over
• 23:59
  Speaker 2: the place. You got to kind of take like the
• 24:01
  Speaker 2: whole picture into a.
• 24:05
  Speaker 1: I just want you to know that what you're saying
• 24:07
  Speaker 1: is like preaching to the choir. But the last podcast
• 24:11
  Speaker 1: two weeks ago, doctor Amy hornhaman, Yes, but she's the
• 24:15
  Speaker 1: thyroid fixer, she said something very important and I keep
• 24:20
  Speaker 1: repeating it to everybody. It's the question how do you feel?
• 24:25
  Speaker 1: It's not what are your labs saying? That's and that's
• 24:29
  Speaker 1: like you said, it's a guide, but it's not the
• 24:32
  Speaker 1: end all and be all. You've got to ask the
• 24:34
  Speaker 1: patient or the patient has to tell you how do
• 24:37
  Speaker 1: I feel? And if I start taking something, how do
• 24:39
  Speaker 1: I feel differently than I did before we started this?
• 24:43
  Speaker 1: So that seems to be the guiding parameter for using hormones.
• 24:49
  Speaker 1: So yeah, but you can trate, you know, up and down,
• 24:53
  Speaker 1: and it also can depend on other things going on
• 24:56
  Speaker 1: with your body, like microbiome, which we'll talk about in more,
• 25:00
  Speaker 1: or your stress levels or your immune system and whether
• 25:05
  Speaker 1: or not you're you know, you're healthy at that time,
• 25:08
  Speaker 1: and you can go from you know, having the flu
• 25:11
  Speaker 1: to being healthy again, and it's going to change your
• 25:14
  Speaker 1: hormonal pathways exactly. This is really tricky. I mean, you're
• 25:19
  Speaker 1: you're it's almost like you're a detective.
• 25:21
  Speaker 2: Yes, the giant puzzle that you're like one piece at
• 25:25
  Speaker 2: a time.
• 25:26
  Speaker 1: Yeah, And the human body is a giant puzzle because
• 25:30
  Speaker 1: it can be very depending on all those things we
• 25:33
  Speaker 1: just talked about and others. So well, I asked you
• 25:36
  Speaker 1: the you know, the menopause question the most challenging part
• 25:40
  Speaker 1: of your practice. So have you been able to figure
• 25:43
  Speaker 1: out a protocol from menopausal women that you want to
• 25:46
  Speaker 1: share with us?
• 25:47
  Speaker 2: Yeah? So what I've been able to figure out. And
• 25:49
  Speaker 2: this has also been great because I've been the test
• 25:51
  Speaker 2: subject too, because this is all the stuff that I've
• 25:53
  Speaker 2: been through. I was really surprised at how much. And
• 25:57
  Speaker 2: you mentioned it before. The microbiome plays into all this,
• 26:01
  Speaker 2: because you know, people go to their doctors and they're like,
• 26:03
  Speaker 2: I'm having any symptoms like low energy, low sex drive,
• 26:06
  Speaker 2: Just give me hormones. And sometimes all the hormones in
• 26:10
  Speaker 2: the world don't fix the problem because we have to
• 26:13
  Speaker 2: go back and take a look at what's happening in
• 26:17
  Speaker 2: our microbiome, which are the bacteria that live on and
• 26:20
  Speaker 2: in our bodies, and even further, take a step back
• 26:24
  Speaker 2: and looking at our stress levels. And so because here's
• 26:28
  Speaker 2: the thing that I found is the pathway by which
• 26:31
  Speaker 2: we process our hormones is the same pathway that we
• 26:36
  Speaker 2: process our stress hormones, except for it chooses like it's
• 26:40
  Speaker 2: either sex or stress, and they can't coexist. So when we,
• 26:45
  Speaker 2: you know, our immune systems were or our hormone systems
• 26:50
  Speaker 2: were made perfectly in that as cave people when we
• 26:53
  Speaker 2: were kind of walking across the savannah and maybe we
• 26:56
  Speaker 2: were digesting our food and thinking about going to runoff
• 26:59
  Speaker 2: with our honey into the bushes or something like that,
• 27:02
  Speaker 2: Like that's all a nice relaxed state. That's good. Our
• 27:05
  Speaker 2: sex hormones are working, our digestion is working, our immune
• 27:08
  Speaker 2: system is working. But then all of a sudden, a
• 27:11
  Speaker 2: lion jumps out of the bush, and this is not
• 27:13
  Speaker 2: the time to be reproducing, digesting, healing anything. This is
• 27:18
  Speaker 2: the time to fight or flight. And so when our
• 27:21
  Speaker 2: stress system kicks in, all of our resources go into
• 27:25
  Speaker 2: making stress hormones so that we can overcome that stressor
• 27:29
  Speaker 2: But then what happens is either we fought off that
• 27:31
  Speaker 2: lion or we ran away from them, or we stayed
• 27:33
  Speaker 2: so still that the lion like ignored us and walked by.
• 27:36
  Speaker 2: We're then supposed to go back into that relaxed state
• 27:40
  Speaker 2: where everything is functioning again. However, in today's day and age,
• 27:44
  Speaker 2: I say that that our stressors, our lions come in
• 27:48
  Speaker 2: different different factors. There are you know, are inflammatory diets,
• 27:52
  Speaker 2: you know, eating the poor standard American diet. It could
• 27:55
  Speaker 2: be emotional stress, it could be financial stress. It could
• 27:59
  Speaker 2: be toxins in our environment that we're putting on using
• 28:04
  Speaker 2: our you know, our cosmetics, and we didn't know that
• 28:06
  Speaker 2: they snuck in there their illness. We saw it during
• 28:11
  Speaker 2: COVID during the pandemic. We saw so many people with
• 28:13
  Speaker 2: their hormones that were stabilized for years and the other
• 28:17
  Speaker 2: hormones went kind of wacky because COVID is a stressor
• 28:21
  Speaker 2: on the system, even the vaccine. So either one we
• 28:24
  Speaker 2: were showing it was throwing off people's hormones. So the
• 28:28
  Speaker 2: key to like menopause and for men andropause is not
• 28:32
  Speaker 2: just the hormones, but let's look at where the stressors
• 28:36
  Speaker 2: coming from. Not getting enough sleep is a big one.
• 28:40
  Speaker 2: So you know, they found that actually getting less than
• 28:43
  Speaker 2: six hours of sleep a night actually increases your risk
• 28:46
  Speaker 2: of obesity by thirty seven percent, and that goes up
• 28:50
  Speaker 2: to about fifty three percent if you get five or
• 28:52
  Speaker 2: less hours of sleep. So, and we know it does
• 28:56
  Speaker 2: throw off the hormones, you know, not drinking enough fluids,
• 29:00
  Speaker 2: getting enough exercise. So going back to the very basics,
• 29:05
  Speaker 2: which sometimes we think like, oh, those don't really have
• 29:08
  Speaker 2: that big of an impact, but lifestyle has a giant
• 29:11
  Speaker 2: impact on our hormones and our health. And then where
• 29:15
  Speaker 2: I get where I start to geek out a lot
• 29:17
  Speaker 2: is on this microbiome connection. And so you know, going
• 29:22
  Speaker 2: back to these are the bacteria that are on our skin,
• 29:25
  Speaker 2: they're in our mouth or in our gut, and for
• 29:26
  Speaker 2: women they're in the vagina. There's a different environment in
• 29:30
  Speaker 2: each one of those areas of our body, and it
• 29:32
  Speaker 2: keeps us in balance and keeps us healthy. I found
• 29:36
  Speaker 2: out the hard way when I entered menopause and I
• 29:39
  Speaker 2: started having problems with anxiety and depression that kind of
• 29:43
  Speaker 2: seemed to come out of nowhere, and was being put
• 29:46
  Speaker 2: on antidepressants that weren't making much of a difference. And
• 29:49
  Speaker 2: then I was also getting sick all the time, and
• 29:53
  Speaker 2: I was seeing all these doctors and nothing was working.
• 29:55
  Speaker 2: And then it was right around that time I started
• 29:58
  Speaker 2: entering the functional and greative medicine world, and I was
• 30:01
  Speaker 2: studying this, and all of a sudden, I went, wait
• 30:03
  Speaker 2: a minute, this all has connection, Like my immune system
• 30:07
  Speaker 2: and my mood is connected to my microbiome, my gut health.
• 30:11
  Speaker 2: And so this is where I really dove into myself,
• 30:16
  Speaker 2: you know, getting off the inflammatory dot foods, like cutting
• 30:19
  Speaker 2: down on sugars and processed foods and eating more whole foods.
• 30:23
  Speaker 2: I tell people that the four things you should eat
• 30:26
  Speaker 2: are if your food has walked, flown, swam, or grew
• 30:32
  Speaker 2: at some point, that is something you should be eating.
• 30:34
  Speaker 2: Because doritos don't grow on trees. There's no free ranged twinkies.
• 30:38
  Speaker 2: So you know, Because why does this connect to the
• 30:41
  Speaker 2: gut is because ninety percent of your happy hormone serotonin
• 30:44
  Speaker 2: is made in your gut, and if your gut is off,
• 30:47
  Speaker 2: you're more prone to anxiety and depression. Right, eighty percent
• 30:51
  Speaker 2: of your immune system is made in the gut, and
• 30:53
  Speaker 2: so if it's off, you're more likely to get sick.
• 30:56
  Speaker 2: So we do know that there's a very strong gut
• 30:58
  Speaker 2: brain connection and stress from the brain can affect the gut,
• 31:02
  Speaker 2: so meditation and relaxation and doing things with friends can
• 31:07
  Speaker 2: help with relaxation that improves your gut quality and your
• 31:11
  Speaker 2: gut healing, and so then that lawed me down. This
• 31:16
  Speaker 2: also kind of this rabbit hole of looking at the
• 31:20
  Speaker 2: research and there wasn't much, but now that we're starting
• 31:22
  Speaker 2: to see more, is this connection between the gut microbiome
• 31:26
  Speaker 2: and the vaginal microbiome and sex drive. Because the body
• 31:32
  Speaker 2: is very smart, it's smarter than we are sometimes. So
• 31:34
  Speaker 2: if things are off and let's say we have an
• 31:37
  Speaker 2: overgrowth of bad bacteria in our gut from our poor diet,
• 31:41
  Speaker 2: or we have an overgrowth of bacteria or yeast in
• 31:44
  Speaker 2: our vagina, there's this feedback loop through the vagus nerve,
• 31:47
  Speaker 2: which is one of the main nerves in the body,
• 31:49
  Speaker 2: going back to the brain and it tells the brain like, Okay,
• 31:52
  Speaker 2: it's not an ideal time to be reproducing. So the
• 31:56
  Speaker 2: brain doesn't know the difference between you just want to
• 31:58
  Speaker 2: have fun with your partner versus you want to actually
• 32:01
  Speaker 2: try to make a child. So it's the brain. The
• 32:03
  Speaker 2: process is the whole thing. It's the whole thing. So
• 32:06
  Speaker 2: the brain goes, okay, well there's inflammation going on in
• 32:09
  Speaker 2: the gut or the environment in the vagina is not
• 32:13
  Speaker 2: quite right, so let's dampen all processes of reproduction. And
• 32:17
  Speaker 2: so this is now again a stressor, and stressed and
• 32:20
  Speaker 2: sex can't coexist. So now what ends up happening is
• 32:23
  Speaker 2: we see the hormones get affected, we see sex drive
• 32:26
  Speaker 2: get affected. In our younger people, we get see their
• 32:29
  Speaker 2: fertility get affected. And so there is this kind of
• 32:33
  Speaker 2: brain gut vagina connection all through these microbes, which is
• 32:37
  Speaker 2: incredibly fascinating to realize how these have such a you know,
• 32:42
  Speaker 2: a play on how our health is working on an
• 32:44
  Speaker 2: everyday basis.
• 32:46
  Speaker 1: So that is such a good explanation. And you know,
• 32:49
  Speaker 1: so recently in the last two years, the microbiome has
• 32:54
  Speaker 1: become the hottest topic in all of functional medicine. And
• 32:59
  Speaker 1: now the the microbiome, the gut brain connection is you know,
• 33:04
  Speaker 1: evolved from that. So explaining it the way you just
• 33:07
  Speaker 1: did is really helpful. And now you've got this other
• 33:10
  Speaker 1: going down south to the vagina, which is something that
• 33:14
  Speaker 1: hasn't really been discussed, Like you said, so one question
• 33:18
  Speaker 1: I had is, you know, if someone is having a
• 33:22
  Speaker 1: libido issue and they just don't feel that either they
• 33:27
  Speaker 1: have dryness or they don't feel like having sex. What
• 33:30
  Speaker 1: are the two things that you would right away do
• 33:33
  Speaker 1: for that person, for that patient two things.
• 33:36
  Speaker 2: I don't know if I can narrow it down to
• 33:38
  Speaker 2: do things well. I think number one, I would look
• 33:41
  Speaker 2: at lifestyle. But if it's a dryness issue, Okay, if
• 33:45
  Speaker 2: it's a dryness issue and their postman apauzle, then we
• 33:50
  Speaker 2: need to start looking at doing things to rejuvenate the vagina,
• 33:54
  Speaker 2: because that's the other thing, because what happens is when
• 33:58
  Speaker 2: the vagina starts to as we age, our vaginal tissue
• 34:02
  Speaker 2: starts to thin out, and when it thins out, we
• 34:05
  Speaker 2: start getting more discomfort with it's not as elastic. It
• 34:10
  Speaker 2: can feel like cut glass. It's dry, it's uncomfortable, and
• 34:16
  Speaker 2: it's not supporting our microbiome because we need that thick
• 34:21
  Speaker 2: tissue when we were younger to basically provide a food
• 34:25
  Speaker 2: source for the healthy bacteria and the vagina. And when
• 34:28
  Speaker 2: it thins out, the bacteria, the healthy bacteria basically starves
• 34:32
  Speaker 2: to death because it lives off of the actively sloughed
• 34:34
  Speaker 2: cells that contain glycogen, which is our food source. So
• 34:38
  Speaker 2: now we got to talk about doing something to rejuvenate
• 34:41
  Speaker 2: the vagina. My favorite happens to be lasers. And why
• 34:46
  Speaker 2: I like lasers is because it uses light energy to
• 34:50
  Speaker 2: penetrate the tissue and it causes like a microscopic injury,
• 34:53
  Speaker 2: and the body responds to that by flooding the tissue
• 34:57
  Speaker 2: with growth factors. So it's almost like a bio where
• 35:00
  Speaker 2: it's stimulating the vagina to regrow and collagen and elastin
• 35:05
  Speaker 2: kind of reform and make it back to the way
• 35:08
  Speaker 2: it was when we were like twenty Why I like
• 35:12
  Speaker 2: lasers is because you can do it without using hormones. However,
• 35:17
  Speaker 2: lasers are not always affordable for everybody, and it's not
• 35:19
  Speaker 2: covered by insurance, so there's a whole range of things
• 35:23
  Speaker 2: anywhere from using topical hormones, whether they're compounded or prescription.
• 35:30
  Speaker 2: Though the prescription ones there's only one on the market
• 35:34
  Speaker 2: called Invexie that is not often covered by insurance, but
• 35:38
  Speaker 2: the only estrogen ovule that is bioidentical that's prescription. Otherwise
• 35:43
  Speaker 2: you have to use the non bio or you have
• 35:46
  Speaker 2: to use compounding pharmacies. But even using testosterone and the
• 35:51
  Speaker 2: vagile tissue can help keep it healthy or DHA, which
• 35:54
  Speaker 2: is a precursor hormone to testosterone and estrogen. But you know,
• 35:58
  Speaker 2: some people get really nervous about you using hormones, and
• 36:01
  Speaker 2: you know, I understand, especially if they've had any kind
• 36:03
  Speaker 2: of issues with the history of cancer. And some doctors
• 36:07
  Speaker 2: are perfectly fine with them using and I would say
• 36:09
  Speaker 2: to check with your doctor first. But that's when in
• 36:12
  Speaker 2: twenty fourteen, we had the first vaginal laser that came
• 36:15
  Speaker 2: to the United States, and it was brilliant because we've
• 36:18
  Speaker 2: used lasers for skin since the nineteen eighties. So the
• 36:21
  Speaker 2: fact that they were like, oh wait, we can apply
• 36:23
  Speaker 2: this to the vagina, like that made so much sense.
• 36:26
  Speaker 2: And that actually then opened the floodgates to the regenerative world, saying, well,
• 36:31
  Speaker 2: what else, if lasers work, what are the things that
• 36:34
  Speaker 2: we're doing regeneratively can work down there? And then we
• 36:37
  Speaker 2: saw the development of machines that use radio frequency, which
• 36:41
  Speaker 2: are sound waves, to generate heat that will stimulate that
• 36:44
  Speaker 2: tissue to regrow using platelet rich plasma where they extract
• 36:49
  Speaker 2: your blood and take the growth factors out of your
• 36:51
  Speaker 2: blood and then apply it back into the vagina. And
• 36:55
  Speaker 2: then there's a couple of different over the counter products.
• 36:57
  Speaker 2: Because then the pandemic happened and those things that I
• 37:00
  Speaker 2: talked about are usually practitioner administered treatment, so people weren't
• 37:05
  Speaker 2: able to get out to their doctors to you know,
• 37:08
  Speaker 2: have the vagina's lasered. So they then there were companies
• 37:13
  Speaker 2: that popped up with home therapies. And so there's a
• 37:17
  Speaker 2: company called Joylux which makes a product called v Fit,
• 37:20
  Speaker 2: which is a red light wand. And we know red light,
• 37:24
  Speaker 2: and you see that some people have these big red
• 37:27
  Speaker 2: light panels that they stand in front of. We know
• 37:30
  Speaker 2: that the frequency of light from red light stimulates our mitochondra,
• 37:34
  Speaker 2: which are the anti aging kind of powerhouses of our cells.
• 37:39
  Speaker 2: So it stimulates our cells to rejuvenate. So we know
• 37:43
  Speaker 2: that that works when you apply it externally. But now
• 37:46
  Speaker 2: we also have wands or that can be applied internally,
• 37:49
  Speaker 2: and even down to there was a company called CO
• 37:54
  Speaker 2: two Lift that created a carbon dioxide gel product that
• 37:59
  Speaker 2: can be applied to the tissue. And the where that
• 38:02
  Speaker 2: came out of in Europe, something called carboxy therapy is
• 38:05
  Speaker 2: very popular. That's where they inject carbon dioxide into your
• 38:09
  Speaker 2: tissue and it tracks oxygen and causes rejuvenation and anti
• 38:14
  Speaker 2: aging in the in the skin. But the woman who
• 38:19
  Speaker 2: started that company, she was like, I don't want to
• 38:21
  Speaker 2: have needles stuck on my vaginas. There a better way
• 38:23
  Speaker 2: to do this, and she worked with scientists that created
• 38:25
  Speaker 2: a carbon dioxide gel that can I applied be applied
• 38:29
  Speaker 2: topically to rejuvenate the tissue. So now we have so
• 38:32
  Speaker 2: and there's new things coming out every day, so you know,
• 38:35
  Speaker 2: we have the options from hormones to non hormones and
• 38:38
  Speaker 2: everything in between. So so it's not just it's not
• 38:42
  Speaker 2: just like keeping you know, as we age, it is
• 38:45
  Speaker 2: also keeping the vagina healthy so that it supports the
• 38:48
  Speaker 2: microbiome that then can help our libido, prevent us from
• 38:52
  Speaker 2: getting urinary tract infections, vent us getting vaginal infections. So
• 38:57
  Speaker 2: it all kind of connects together.
• 39:00
  Speaker 1: What is the name of the laser that you use
• 39:03
  Speaker 1: in your practice?
• 39:05
  Speaker 2: So, well, there's a bunch of different companies out there,
• 39:07
  Speaker 2: but the laser that I have is the Mona Lisa
• 39:09
  Speaker 2: Touch and that's the first one, but pretty much most
• 39:13
  Speaker 2: there's there's so many different companies that then came out
• 39:17
  Speaker 2: with their own versions, and pretty much a laser is
• 39:19
  Speaker 2: a laser, So, yeah, there's not one that's better than
• 39:22
  Speaker 2: the other.
• 39:23
  Speaker 1: And is there a downtime when you use the laser
• 39:28
  Speaker 1: because the skin is being a.
• 39:29
  Speaker 2: Bladed Yeah, so when we so, typically when someone's getting
• 39:33
  Speaker 2: their vagina laser, it's you usually get three treatment protocol
• 39:37
  Speaker 2: where they come in every like four to eight weeks
• 39:40
  Speaker 2: for a total of three treatments. If you're just doing
• 39:43
  Speaker 2: inside the vagina, it's usually just a two day recovery,
• 39:47
  Speaker 2: meaning no sex or swimming for two days. But if
• 39:50
  Speaker 2: we're doing the outside lips too, then usually it's like
• 39:53
  Speaker 2: a week downtime because it's a little more raw. I
• 39:57
  Speaker 2: will tell you having done it personally myself, and at
• 39:59
  Speaker 2: some point we're gonna get the video up on YouTube,
• 40:02
  Speaker 2: not the actual close up. We filmed it from above
• 40:05
  Speaker 2: when I was getting mine done. Just it's usually during
• 40:09
  Speaker 2: the procedure itself, sometimes you feel a little crampy. Usually
• 40:12
  Speaker 2: for twenty four hours you may feel crampy. It's usually
• 40:15
  Speaker 2: not painful. If the outside of the body is done,
• 40:18
  Speaker 2: we usually use a numbing gel or numbing medicine cream
• 40:23
  Speaker 2: on the outside so that it's comfortable, but then typically
• 40:26
  Speaker 2: like a day or two afterwards, there's not really much
• 40:29
  Speaker 2: discomfort other than the tissue is you know, kind of
• 40:32
  Speaker 2: raw and you have to keep some sort of bomb
• 40:35
  Speaker 2: or salve on it to keep it from getting irritated.
• 40:39
  Speaker 1: Yeah, it's just like doing it on your face, except
• 40:41
  Speaker 1: it and the intermit private area of your body. But
• 40:46
  Speaker 1: it just seemed like it would be so painful to
• 40:49
  Speaker 1: have that area be raw.
• 40:53
  Speaker 2: You know, It's surprisingly you heel very very quickly down there.
• 40:57
  Speaker 2: And the thought behind that is is a lot of
• 41:00
  Speaker 2: people rip and tear during childbirth, and so we're kind
• 41:04
  Speaker 2: of built to like quickly heal down there to be
• 41:07
  Speaker 2: able to overcome those things.
• 41:09
  Speaker 1: That's a good point. So what about the candida and UTIs,
• 41:16
  Speaker 1: how do you deal with those and what's the protocol
• 41:19
  Speaker 1: that you think is best not only let's talk preventatively
• 41:23
  Speaker 1: and then talk post you know, treatment wise and when
• 41:28
  Speaker 1: you already have the conditions.
• 41:30
  Speaker 2: Yeah. So you know, first of all, if you're postmenopausal,
• 41:35
  Speaker 2: or if you're on birth control, or if you're pregnant
• 41:38
  Speaker 2: pregnant in breastfeeding, you're not much you can do to
• 41:41
  Speaker 2: rejuvenate the vagina. But people on birth control and people
• 41:44
  Speaker 2: that are postmenoposele are at higher risk because of that thinning.
• 41:48
  Speaker 2: So number one, we have to do something to kind
• 41:50
  Speaker 2: of thicken the vaginal tissue so that it supports the
• 41:53
  Speaker 2: healthy microbiome. But then we have to look at where
• 41:57
  Speaker 2: is that bacteria coming from. And unfortunately, as women are rectum,
• 42:02
  Speaker 2: our vagina and our urethrow the tube wepe throw are
• 42:05
  Speaker 2: very close. And it's not necessarily some people think will
• 42:08
  Speaker 2: think it's a hygiene issue. It's no matter how clean
• 42:13
  Speaker 2: you are, it's just we have a tendency to be
• 42:16
  Speaker 2: able to pass bacteria back and forth. Of course, we
• 42:18
  Speaker 2: always tell people wipe front to back, and the reason
• 42:21
  Speaker 2: is you want to wipe away from the buttocks area,
• 42:24
  Speaker 2: the youal area because you don't want to bring that
• 42:26
  Speaker 2: bacteria closer to you. I tell people. Some people are like, all, like,
• 42:30
  Speaker 2: I can't do that. I tell pat just kind dry
• 42:33
  Speaker 2: in that area. But then the other thing is we're
• 42:37
  Speaker 2: looking at the pH of the vagina is often getting
• 42:40
  Speaker 2: thrown off, and that's a chicken or the egg thing.
• 42:43
  Speaker 2: Is is it off because there is bad bacteria there?
• 42:48
  Speaker 2: Or is the bad bacteria coming in there because the
• 42:50
  Speaker 2: pH is off? So actually one of the ways to
• 42:53
  Speaker 2: treat vaginitis without medication is actually to make the vagina worcidic,
• 43:00
  Speaker 2: so using products like boric acid, or there's some suppositories
• 43:04
  Speaker 2: that are made for women that actually have vitamin C
• 43:07
  Speaker 2: which is a little bit acidic and that helps to
• 43:10
  Speaker 2: kind of reset the vagina. I love boric acid, especially
• 43:13
  Speaker 2: in the summertime. If someone's going to be in a
• 43:15
  Speaker 2: wet bathing suit all day, I'll have someone kind of
• 43:18
  Speaker 2: throw one in Preventatively. I find that if there are
• 43:22
  Speaker 2: five patients that are getting recurrent urinary tract infections, especially
• 43:26
  Speaker 2: after intercourse, I will often have them use a boric
• 43:31
  Speaker 2: acid suppository after intercourse kind of reset that pH. But
• 43:37
  Speaker 2: the other thing is when I see women that are
• 43:39
  Speaker 2: coming with recurrent urinary track infections and recurrent vaginal infections,
• 43:44
  Speaker 2: then I have to take a step back and go
• 43:46
  Speaker 2: and look at the gut because we see that a
• 43:48
  Speaker 2: lot of times it's their gut microbiome that's gotten thrown off,
• 43:52
  Speaker 2: especially with yeast, because diets that are high in sugar
• 43:57
  Speaker 2: will have you overgrow yeast in the gut and it
• 44:00
  Speaker 2: just happens to kind of get into the vagina. And
• 44:03
  Speaker 2: so we can treat the vagina all you want with
• 44:05
  Speaker 2: like monastet and creams and stuff. And this is where
• 44:08
  Speaker 2: we see people where they're doing really well and they
• 44:12
  Speaker 2: use they you know, they get it itching or burning,
• 44:14
  Speaker 2: and then they use a medicine, they get better, and
• 44:16
  Speaker 2: then like two three weeks down the road, it comes
• 44:18
  Speaker 2: back again. Or this is sometimes a pattern I'll see
• 44:21
  Speaker 2: with urinary track infections where it's like they go on
• 44:25
  Speaker 2: like the three to five days of antibiotics and then
• 44:28
  Speaker 2: they're good, and then two three weeks down the road
• 44:31
  Speaker 2: it comes back and they keep going through this pattern
• 44:34
  Speaker 2: where it's back again, and so that ends up having
• 44:38
  Speaker 2: a source in the gut and then we have to
• 44:40
  Speaker 2: really go and evaluate what's happening with the gut and
• 44:44
  Speaker 2: trying to get that back on track. Now, I like
• 44:47
  Speaker 2: to use like fancy tests where we do what's called
• 44:49
  Speaker 2: stool microbiome testing where it can exactly pinpoint what's happening
• 44:53
  Speaker 2: in the gut and then target the treatment. But things
• 44:57
  Speaker 2: that people can do on their own without having to
• 44:59
  Speaker 2: do the fancy task is really get on a whole
• 45:02
  Speaker 2: food's diet, try to get away from the sugars and
• 45:05
  Speaker 2: yeast is an interesting thing because the presence of yeast
• 45:09
  Speaker 2: in the gut. They found that some of these microbes
• 45:12
  Speaker 2: actually have DNA that can control the human body. So
• 45:16
  Speaker 2: when yeast is present, it actually tends to give you
• 45:20
  Speaker 2: sugar cravings. And it's because the yeast wants to be fed,
• 45:24
  Speaker 2: so it likes to live off of sugar. So sometimes
• 45:27
  Speaker 2: if I have somebody that's getting a lot of sugar cravings,
• 45:29
  Speaker 2: I'm like, you know what, this is where you've got
• 45:31
  Speaker 2: to take control and you have to feed, like feed yourself,
• 45:35
  Speaker 2: not the yeast, and try to ignore those cravings. Eventually
• 45:39
  Speaker 2: they'll go away. But you know, eating whole foods. Like
• 45:44
  Speaker 2: I said before, fiber. Everybody hears a fiber is good
• 45:47
  Speaker 2: for you, No one ever asked, well, why is fiber
• 45:50
  Speaker 2: good for me? The reason why we need to be
• 45:53
  Speaker 2: getting twenty five to thirty grams at least a fiber
• 45:56
  Speaker 2: a day in the form of fruits and vegetables, more
• 45:59
  Speaker 2: so vegetables, is because that's what the healthy bacteria lives on.
• 46:04
  Speaker 2: The healthy bacteria lives on fiber. So if we're not
• 46:06
  Speaker 2: eating enough fiber we know Americans don't, we're not supporting
• 46:10
  Speaker 2: the healthy bacteria that's then going to fight off the
• 46:12
  Speaker 2: yeast and the bad bacteria. And the other thing is
• 46:16
  Speaker 2: getting more fermented foods in our diet. And luckily now
• 46:20
  Speaker 2: most of us can go to the supermarket and find
• 46:22
  Speaker 2: them very easily. But if you're really motivated, you can
• 46:25
  Speaker 2: make them your own. Your own. But there's yogurt, kaffir, kombucha,
• 46:30
  Speaker 2: which is fermented teaste, sour crowds, kimchi. Eating some sort
• 46:36
  Speaker 2: of fermented food every single day can actually make a
• 46:40
  Speaker 2: big change. I had a friend of mine who was
• 46:42
  Speaker 2: having all these gastro intestinal issues and I'm gonna throw
• 46:47
  Speaker 2: him under the boat right here, and I said, like,
• 46:49
  Speaker 2: let me test your gut microbiome, and he just never
• 46:52
  Speaker 2: got around to it. But he started drinking something called kavas,
• 46:54
  Speaker 2: which is like fermented beet juice, and he swears to
• 47:00
  Speaker 2: God it is the kavas that like cured him. And
• 47:02
  Speaker 2: I'm like, no, he got much better, and thank goodness
• 47:05
  Speaker 2: he did. Yes, it is the kvas. But it's not
• 47:08
  Speaker 2: just the fact that you added fermented foods into your
• 47:11
  Speaker 2: diet and now you basically repopulated your body with healthy
• 47:16
  Speaker 2: bacterias and that the body is going to work better.
• 47:18
  Speaker 1: So well, tell my viewers all the time that if
• 47:23
  Speaker 1: you look in your refrigerator. Make sure that you have
• 47:26
  Speaker 1: those exact products, sour kraut, yogurt that's unsweetened, and yes,
• 47:32
  Speaker 1: you can even buy lactose free yogurt. Now they may
• 47:36
  Speaker 1: coconut if you don't want to use milk, but definitely
• 47:42
  Speaker 1: don't do do not do sugar, don't do a fugart.
• 47:46
  Speaker 1: And then kafir and kombucha. Kim Chi I have a
• 47:50
  Speaker 1: hard time because it's very spicy, and yeah, well with garlic,
• 47:54
  Speaker 1: so I never mentioned. I always tell people, Yeah, if
• 47:56
  Speaker 1: you like that, go for kim chi because that's actually
• 48:00
  Speaker 1: one of the better ones. And then of course using
• 48:03
  Speaker 1: things like garlic and you know, the the the the
• 48:08
  Speaker 1: foods that are going to help to eliminate the bad guys. Yeah,
• 48:14
  Speaker 1: and then if you can do any thing with avoiding antibiotics, yes,
• 48:19
  Speaker 1: that's when you said that. Earlier, I thought, oh, the
• 48:22
  Speaker 1: problem with these yeast infections and these vaccinal that they
• 48:27
  Speaker 1: always the first thing they want to do is give
• 48:29
  Speaker 1: you an antibiotic.
• 48:31
  Speaker 2: And that's that's what I see all the time with
• 48:32
  Speaker 2: these urinary track infections too, and like they they practitioners
• 48:36
  Speaker 2: often reach for cipro, which drives me crazy because one
• 48:40
  Speaker 2: course of cipro can throw off your gut for a
• 48:42
  Speaker 2: whole year.
• 48:43
  Speaker 1: It's like an atomic bomb.
• 48:45
  Speaker 2: Yeah, and so it's and then that's why then you
• 48:47
  Speaker 2: end up just getting more infections because now you've affected
• 48:49
  Speaker 2: your immune system. So it's like, I mean, there's a
• 48:52
  Speaker 2: role in place for for antibiots. We need them, but
• 48:55
  Speaker 2: we probably don't need them as much as were using.
• 48:58
  Speaker 2: I think in general we're seeing that people are trying
• 49:01
  Speaker 2: not to use them as much. But if you're on
• 49:03
  Speaker 2: that cycle of getting these infections and then getting better
• 49:06
  Speaker 2: and then getting infected, the antibiotical could be contributing to
• 49:08
  Speaker 2: throwing off that microbiome that's making you then get these
• 49:11
  Speaker 2: infections more often.
• 49:13
  Speaker 1: And yet that's what they prescribed for the very infection
• 49:16
  Speaker 1: that the antibiotists could be causing or at least making worse.
• 49:22
  Speaker 1: What about the the O shot that people talk about.
• 49:27
  Speaker 1: Have you ever done that and what do you think
• 49:30
  Speaker 1: of it? Yeah?
• 49:31
  Speaker 2: So some of it I think is a little bit
• 49:32
  Speaker 2: of placebo, but some of it So the O shot
• 49:35
  Speaker 2: in actually that specific name is actually a licensable name,
• 49:39
  Speaker 2: but it's many places do it. It's using platelet rich
• 49:43
  Speaker 2: plasma and using the growth factors from your blood to inject.
• 49:46
  Speaker 2: They injected typically in the antwer wall of the vagina
• 49:50
  Speaker 2: to kind of bulk up that area between the vagina
• 49:55
  Speaker 2: and the urinary system and the butter and the urethra.
• 49:57
  Speaker 2: And they also inject in and around the the glitterists.
• 50:01
  Speaker 2: And so the nice thing is it does have regenerative properties.
• 50:07
  Speaker 2: I think in some ways there's a placebo effect community
• 50:10
  Speaker 2: that people get it thinking like this is going to
• 50:12
  Speaker 2: like make their sex life so much better, and like
• 50:16
  Speaker 2: this is the answer. It works, but it works because
• 50:18
  Speaker 2: it's rejuvenating and making that tissue young and functional again.
• 50:24
  Speaker 2: So it's really just kind of stimulating your own body
• 50:26
  Speaker 2: to kind of heal itself. But and I don't want
• 50:29
  Speaker 2: to bust on placebo because hey, placibo, if it works,
• 50:33
  Speaker 2: it works, you know. So but you know, is it
• 50:36
  Speaker 2: a miraculous cure all for for sex life? It's another
• 50:40
  Speaker 2: tool in our toolbox. It's not you know, yeah, it's
• 50:44
  Speaker 2: not this like, okay, this is going to fix everything.
• 50:47
  Speaker 1: You know. The other day I was reading an article
• 50:49
  Speaker 1: and it said never ever douche. And when I was
• 50:52
  Speaker 1: growing up, that was what they told us to do.
• 50:55
  Speaker 1: And you know, basically, keep yourself clean. So what happened?
• 50:59
  Speaker 1: Why Why is douching not recommended now in the current day,
• 51:04
  Speaker 1: and historically it's always been a protocol.
• 51:09
  Speaker 2: Yeah, So, well, number one, it'll throw off the microbiome
• 51:12
  Speaker 2: because you're like washing away a lot of the good
• 51:15
  Speaker 2: bacteria that are in there. The other thing that they
• 51:17
  Speaker 2: get concerned about is for women who've never had any
• 51:22
  Speaker 2: kind of surgery down there, like a hysterectomy or anything.
• 51:24
  Speaker 2: We're an open system, meaning that the vagina is kind
• 51:27
  Speaker 2: of connected to the cervix, which is the opening of
• 51:30
  Speaker 2: the uterus, and there's just a cavity in there, and
• 51:33
  Speaker 2: then beyond that, the Filippian tubes are open into the
• 51:36
  Speaker 2: abdominal cavity. So there is the risk that if you
• 51:39
  Speaker 2: douche and you put too much pressure on the fluid,
• 51:43
  Speaker 2: the fluid could go from the vagina through the uterus
• 51:45
  Speaker 2: out the Filoppian tombs into your abdominal cavity. So you
• 51:48
  Speaker 2: could be washing bad bacteria and yeast into your abdominal
• 51:52
  Speaker 2: cavity and that is not a good infection to have.
• 51:56
  Speaker 2: So that's pretty serious. So, you know, do I use
• 51:59
  Speaker 2: them on patients medically in certain situations? I do, and
• 52:04
  Speaker 2: we either instruct them to do it very gently but
• 52:09
  Speaker 2: in the right and I would not tell people to
• 52:11
  Speaker 2: do this at home just because. But in a medical situation,
• 52:15
  Speaker 2: sometimes we'll use like a watered down peroxide because that's
• 52:19
  Speaker 2: peroxide is actually naturally found in the vagina. When healthy
• 52:22
  Speaker 2: bacteria is there, healthy bacteria will make peroxide. So sometimes
• 52:27
  Speaker 2: we'll use a very light like peroxide or even vinegar
• 52:31
  Speaker 2: is not terrible.
• 52:33
  Speaker 1: But baking soda or vinegar is what I've always heard.
• 52:37
  Speaker 2: Yeah, the baking soda not so much, because the vagina
• 52:40
  Speaker 2: is very acidic. The vagina has so like the pach
• 52:43
  Speaker 2: of water is seven, where the pH of a normal
• 52:46
  Speaker 2: vagina is three point five to four point five. It's
• 52:50
  Speaker 2: very acidic, and so baking soda would make it would
• 52:54
  Speaker 2: lower the acidity, which you know, I still have not
• 52:57
  Speaker 2: figured out most things in nature. I kind of underst
• 53:00
  Speaker 2: and why they work. The only thing I have that
• 53:01
  Speaker 2: figured out is semen is very basic. It's it's seven
• 53:06
  Speaker 2: to eight on the on the pH scale, which that
• 53:09
  Speaker 2: and that's why some women have problems if they're having
• 53:13
  Speaker 2: sexual with men, they get and they can have their
• 53:16
  Speaker 2: pH or their vagina thrown off if they're if you
• 53:20
  Speaker 2: know if they have semen inside of them, it makes
• 53:24
  Speaker 2: their pH which supposed to be a cidic and it
• 53:26
  Speaker 2: throws them off and can sometimes increase their risk of infections.
• 53:30
  Speaker 1: Is that why they tell you to always try to
• 53:33
  Speaker 1: urinate right after you've had intimacy that you're because you're
• 53:37
  Speaker 1: trying to get rid of that that semen that could
• 53:40
  Speaker 1: be damaging.
• 53:41
  Speaker 2: Yes, well, that's more so from the friction of any
• 53:44
  Speaker 2: kind of sexual intercourse because of the vagina and the
• 53:46
  Speaker 2: urethra show close together that sometimes bacteria from friction can
• 53:50
  Speaker 2: get pushed up into the urethra the TBP through. So
• 53:53
  Speaker 2: the ideas by peeing after intercourse, we're fleshing out the
• 53:58
  Speaker 2: blurinary system and the urethra to try to not get
• 54:02
  Speaker 2: a urinary track and infection.
• 54:03
  Speaker 1: Yeah okay, so tell us about the pelvic store that's
• 54:08
  Speaker 1: your Yeah.
• 54:10
  Speaker 2: Yeah, so the pelvic floor Store dot or pelvifloor store
• 54:14
  Speaker 2: dot com. Yeah, that is is my baby. So I
• 54:17
  Speaker 2: was recommending products to patients and I would say, Okay,
• 54:21
  Speaker 2: go to this website and buy this, go to that
• 54:23
  Speaker 2: website and buy that. Because a lot of these health
• 54:25
  Speaker 2: products that are reputable are not sold on Amazon and
• 54:29
  Speaker 2: The other thing I have to tell you about Amazon
• 54:31
  Speaker 2: is we know that they're counterfeits. So I tell people,
• 54:33
  Speaker 2: don't buy your supplements, don't buy your health products off
• 54:36
  Speaker 2: of Amazon, but you don't know if you're getting the
• 54:37
  Speaker 2: right thing. Okay, beyond that, So one day I had
• 54:41
  Speaker 2: a patient that said to me, like, why do I
• 54:43
  Speaker 2: have to go to so many different websites? Why can't
• 54:45
  Speaker 2: there just be one where I could just go get everything?
• 54:48
  Speaker 2: And I went a little light bulb blah blah my head.
• 54:51
  Speaker 2: I'm like, wait a minute, that's brilliant. I don't know
• 54:54
  Speaker 2: how to make a website, but I'm going to make
• 54:55
  Speaker 2: a website. So I made a website, the Pelvic Floor Store,
• 54:59
  Speaker 2: and I basically put all the products that I recommend
• 55:02
  Speaker 2: or products that I find that I think are good
• 55:05
  Speaker 2: in one place.
• 55:06
  Speaker 1: So I had to go and source all those products though, right,
• 55:10
  Speaker 1: So this was a major effort on your part. You
• 55:14
  Speaker 1: have to have those products in your inventory, and then
• 55:16
  Speaker 1: you have to deal with all the shipping and the
• 55:18
  Speaker 1: processing of the financial side. So this is not like
• 55:22
  Speaker 1: some simple you make it sound so easy, like it
• 55:25
  Speaker 1: was just an idea, and all of a sudden, the
• 55:26
  Speaker 1: next day it was.
• 55:27
  Speaker 2: Well, I think we started off with like three products,
• 55:30
  Speaker 2: and then we keep adding them because I keep finding things.
• 55:33
  Speaker 2: And then I think the most painful thing is when
• 55:36
  Speaker 2: I've had to let products go. Like I have a
• 55:38
  Speaker 2: product line that I believe in, but it just isn't selling,
• 55:41
  Speaker 2: and I'm going to have to let it go. And
• 55:43
  Speaker 2: I'm like, so that's going to be the harder. That's
• 55:46
  Speaker 2: going to be the hardest.
• 55:48
  Speaker 1: How do you think a product wouldn't sell, Betsy, what
• 55:50
  Speaker 1: what's your theory on that?
• 55:53
  Speaker 2: I think that sometimes like this is a is a
• 55:56
  Speaker 2: I don't want to baden out the product. So it's
• 55:58
  Speaker 2: a prebiotic gel for the vagina. So it's basically to
• 56:01
  Speaker 2: help feed the healthy bacteria. And as a doctor, I
• 56:06
  Speaker 2: think that's great. I think from the complaints I've gotten
• 56:09
  Speaker 2: from patients is like they put it in and then
• 56:13
  Speaker 2: it melts, it becomes very drippy. So I think people
• 56:16
  Speaker 2: are like, it's drippy, it's uncomfortable, and I think that
• 56:21
  Speaker 2: that ends up being and they don't necessarily see maybe
• 56:25
  Speaker 2: the benefits from it as quickly as they see from
• 56:27
  Speaker 2: like a boric acid or a vaginal probiotic. So I'm like,
• 56:33
  Speaker 2: all right, you know, maybe it's time to let that
• 56:35
  Speaker 2: one go.
• 56:36
  Speaker 1: So well, is there a lot of our guests like
• 56:40
  Speaker 1: to offer the viewers or the listeners an incentive. Is
• 56:45
  Speaker 1: there anything that you feel you would like to suggest?
• 56:49
  Speaker 1: And like, basically it's to encourage them to know more
• 56:54
  Speaker 1: about you and what you're doing and your products. So
• 56:57
  Speaker 1: I don't want to put you on the spot because
• 56:58
  Speaker 1: if you're not comfortable, it's okay. But if there, if
• 57:02
  Speaker 1: there is anything, we have them. Michelle recommends, Yeah, so
• 57:07
  Speaker 1: we we put you know, your name is the wet
• 57:10
  Speaker 1: podcast Gate and your offer and then they use an
• 57:13
  Speaker 1: ageless the ageless code, so you know that you're getting
• 57:17
  Speaker 1: referrals that are going to have whatever your offer is.
• 57:21
  Speaker 1: So if you want to do that, I'm happy to
• 57:23
  Speaker 1: mention it here. If not, we can do it later.
• 57:26
  Speaker 1: It's up to you.
• 57:27
  Speaker 3: Yeah.
• 57:27
  Speaker 2: And in fact, actually I am just looking and I
• 57:30
  Speaker 2: do have a code. I have two. I have a
• 57:35
  Speaker 2: code here. It's ageless ten.
• 57:38
  Speaker 1: Oh.
• 57:39
  Speaker 2: So if you go, yeah, if you go to the
• 57:43
  Speaker 2: Pelvic floor store and you use code ageless ten. I'm
• 57:48
  Speaker 2: just going to make sure when we get off this
• 57:50
  Speaker 2: that it's working. That will get to ten percent off
• 57:54
  Speaker 2: anything and everything. Whether you want to buy one thing
• 57:56
  Speaker 2: or a bunch of things, so that will get to
• 57:59
  Speaker 2: ten percent off your entire order.
• 58:01
  Speaker 1: And tell us the website again for the pelvic.
• 58:03
  Speaker 2: Floor celvicfloor storm dot com out.
• 58:07
  Speaker 1: That's pretty easy. Yeah, I'm writing this down, but it'll
• 58:11
  Speaker 1: be on the tape here anyway, but I'll have my
• 58:13
  Speaker 1: assistance make sure that this goes on our website for you. Okay,
• 58:19
  Speaker 1: run out of time, and I knew this would happen.
• 58:22
  Speaker 1: And you're talking to someone who's as exciting and fascinating
• 58:25
  Speaker 1: as you, and you have so much knowledge. It's just
• 58:28
  Speaker 1: fun to brainstorm with you. If you in our partying message,
• 58:34
  Speaker 1: what would you like to share with our viewers today?
• 58:38
  Speaker 2: Yeah, you know, I think that the biggest secret to
• 58:42
  Speaker 2: first of being ageless and timeless is going back to
• 58:45
  Speaker 2: simple things like lifestyle and total wellness is like a
• 58:50
  Speaker 2: three legged stool. You can do everything you want to
• 58:53
  Speaker 2: the body, but if you're not taking care of mind
• 58:56
  Speaker 2: and spirit additionally, that three legged stool is going to
• 58:59
  Speaker 2: fall over. So it's going to be a balance of
• 59:01
  Speaker 2: all free to like live your best and vital life.
• 59:04
  Speaker 1: Yeah, that's lovely. Thank you so much, Bettie. Well, I
• 59:07
  Speaker 1: hope you have a wonderful weekend, and thank you again
• 59:10
  Speaker 1: for taking time for us today and for ageless and
• 59:13
  Speaker 1: timeless viewers. I'm sure they're going to be very appreciative.
• 59:16
  Speaker 1: We will do a couple of reels on Instagram and
• 59:19
  Speaker 1: Facebook probably, and so we're asking you to collaborate if
• 59:24
  Speaker 1: you don't mind, and then yeah, definitely, and we'll do
• 59:28
  Speaker 1: the opposite for you if you want to take any
• 59:30
  Speaker 1: part of our podcast or the whole thing. Do you
• 59:33
  Speaker 1: have a social media presence? Yes?
• 59:37
  Speaker 2: I do.
• 59:38
  Speaker 1: I do.
• 59:38
  Speaker 2: I'm doctor Betsy Greenleave in many different shapes and sizes
• 59:41
  Speaker 2: all over the internet. And I just just finally got
• 59:44
  Speaker 2: my regular doctor Betsy Green leap back. I got kicked
• 59:47
  Speaker 2: off Instagram. Oh talking about vaginas a couple of years ago.
• 59:51
  Speaker 1: Wow, today with Robert F. Kennedy, I think it's going
• 59:57
  Speaker 1: to be a lot different. Yeah, yeah, I have a
• 1:00:01
  Speaker 1: YouTube channel as well. Do you have you have? Are
• 1:00:04
  Speaker 1: you on YouTube? Yeah? Yeah? Okay, great, good, perfect, all right,
• 1:00:08
  Speaker 1: we'll do a bunch of mutual reciprocal collaborations. So thank
• 1:00:12
  Speaker 1: you again, Betsy, have a great, great weekend, and be
• 1:00:16
  Speaker 1: well and and and stay as as positive and upleat
• 1:00:21
  Speaker 1: as you are.
• 1:00:22
  Speaker 2: Thank you, thank you so much. I appreciate it.