# Why Your Period Turns You Into A Different Person (PMDD & PMS Explained)

https://www.youtube.com/watch?v=WG4GDLOiXsY
Translation: zh-CN

[00:00] Women aren't made aware of the different

[00:01] trade-offs that they're making when they

[00:03] go hormonal birth control. Dr. Sarah is

[00:05] a leading voice in female hormones and

[00:08] the brain. And in today's episode, we're

[00:10] going to be talking about how your

[00:12] menstrual cycle and birth control impact

[00:14] your brain along with daily habits and

[00:16] supplements [music] that can help you

[00:17] manage these symptoms. There's some like

[00:20] decent evidence that there's some types

[00:22] of like teas. So, if you have something

[00:25] chasteberry tea, for example, can help

[00:28] to promote a successful luteal phase.

[00:31] What can we do to support our brain and

[00:32] body during this time? Let me cheat. Let

[00:34] me give you two things. One,

[00:38] an IUD.

[00:39] Where do I even start with this? There's

[00:41] lots of things you can do for your PMS.

[00:42] First is just start with the basics. If

[00:44] I was somebody with ADHD, I would say

[00:46] track your cycle and track your

[00:48] symptoms. A lot of women have a worse

[00:50] experience [music]

[00:51] in the second half of the menstrual

[00:52] cycle um just because they lack

[00:57] But first, please don't forget to

[00:59] subscribe or leave a five-star review.

[01:01] It really helps us keep bringing you

[01:04] podcast guests that help you live a

[01:06] happier, healthier life.

[01:08] Thank you. Hi, I'm Dr. Sarah Hill and

[01:11] you're listening to Her Discussions

[01:12] podcast. Dr. Sarah, our community sent

[01:15] in so many questions about female

[01:17] hormones and the brain. But first, I

[01:19] want you to talk to you a little bit

[01:20] about what on earth made you so

[01:22] passionate about going into this. Yeah,

[01:24] so I've always been interested in

[01:26] motivation and just like why people do

[01:28] the things that they do. And so, I

[01:31] ultimately got my PhD in psychology cuz

[01:33] I was really interested in trying to

[01:34] better understand um the different

[01:37] motivations behind especially attraction

[01:39] and mating-related behaviors. That was

[01:41] my first um area of research. Uh and

[01:44] then, what really got me into hormones

[01:46] um was my experiences with the birth

[01:48] control pill. Um and, you know, I was on

[01:51] it for more than a decade in my life and

[01:54] then I went off of it and I felt very

[01:57] different than I felt when I was on it.

[01:59] And so, that led me into a sort of a

[02:02] deep dive into the effects of hormonal

[02:04] birth control on the way that women

[02:07] think, feel, and experience themselves,

[02:08] and experience the world. And then,

[02:10] ultimately, it's just kind of expanded

[02:12] into really trying to understand the

[02:15] hormonal foundations of um of women's

[02:18] behavior. That was

[02:19] an incredible answer. And I think

[02:21] something that so many of especially our

[02:23] community will completely resonate with.

[02:26] Well, obviously, you've got a second

[02:27] book out, which we will talk about a

[02:29] little bit later on, but I really loved

[02:31] about the first book. Yeah. So, the pill

[02:34] changes everything.

[02:35] >> Mhm. I really love cuz I think the the

[02:37] discussions around the pill now are

[02:40] super super super interesting, but I

[02:42] love that you really address that the

[02:44] pill changes

[02:45] everything, not just our mood and our

[02:47] brain, but also the way that women

[02:50] are able to progress in their careers

[02:52] and the the societal structures. Mhm.

[02:55] What are your personal opinions of the

[02:57] pill and like how do you navigate the

[02:59] almost like polarizing discourse around

[03:01] the pill at the moment?

[03:02] >> Right. Yeah, so, you know, I I think

[03:04] that it's a it's a complicated

[03:06] conversation, you know. I think that

[03:07] it's a really nuanced um it's it's it's

[03:10] a nuanced thing. So, on on the one hand,

[03:12] think that we can say the birth control

[03:14] pill um has been revolutionary, you

[03:18] know, and and it really has been. It's

[03:19] allowed women to be able to regulate

[03:21] their fertility in a way that allows

[03:23] them to be able to make plans, right? To

[03:27] to build careers, to get, you know,

[03:29] advanced degrees, and do all of these

[03:31] things that, you know, a lot of our

[03:33] great grandmothers and grandmothers

[03:34] weren't able to do because they didn't

[03:36] have the option to be able to say, "I'm

[03:39] not going to have children until this is

[03:41] finished." So, the birth control pill

[03:42] has been really positive for women. Um

[03:45] and then, you know, and so, that's one

[03:48] side of the discussion. And then, the

[03:50] The side of the discussion is um that

[03:52] when you change a person's hormones,

[03:54] which you do with hormonal birth

[03:55] control, I mean, it's going to change

[03:58] women and it has a lot more effects than

[04:01] just simply, oh, you know, you're not

[04:03] going to ovulate and therefore you're

[04:04] not going to get pregnant. Um, when you

[04:06] don't ovulate, you also don't produce

[04:08] sex hormones because that's the primary

[04:10] way by which women's bodies produce

[04:12] their own sex hormones. And so you're

[04:14] flatlining women's hormone production

[04:17] and you're giving them these synthetics

[04:19] that don't have the same effects on on

[04:22] you know, women's brains or the rest of

[04:24] their behavior. And this means that it

[04:26] changes women and it changes them in

[04:27] ways that extend far beyond, you know,

[04:30] whether or not they're just going to get

[04:31] pregnant or not. And and so because of

[04:34] this, you know, my whole position on

[04:37] hormonal birth control is this is this

[04:39] wonderful tool that we have, but women

[04:42] aren't made aware of the different

[04:43] trade-offs that they're making when they

[04:44] go on it in terms of they're not being

[04:47] educated about the ways that being on

[04:49] hormonal birth control changes, you

[04:51] know, everything ranging from the way

[04:54] that the their stress response functions

[04:56] to

[04:57] you know, there's different inflammatory

[04:59] immunological profiles of women who are

[05:01] on the pill versus off the pill to

[05:03] things like partner attraction, to

[05:05] things like mood and women need to be

[05:07] aware of these things so that way they

[05:09] can make informed choices about whether

[05:12] or not those trade-offs make sense for

[05:14] them depending on what they're doing in

[05:15] their lives at that time. It's really

[05:17] just about making people aware of the

[05:19] trade-offs that they're making and I

[05:20] think that a lot of times women aren't

[05:22] told this, you know, told this

[05:23] information and then a lot of women are

[05:26] meant to

[05:27] you know,

[05:29] women are led to feel crazy for having

[05:31] these experiences that aren't on the

[05:33] warning label of the pill and so you

[05:36] know, a lot of the book was just giving

[05:38] women information about what the

[05:39] trade-offs are that are being made when

[05:41] they go on hormonal birth control. And

[05:44] also, you know, for a lot of women it

[05:46] ended up being very edifying where it

[05:47] was just giving language to these

[05:50] experiences that they'd had that

[05:52] nobody'd been able to give them an

[05:53] explanation for. Yeah, that really

[05:56] resonates with me on a personal level

[05:58] with my experience with birth control

[05:59] because as a doctor I completely

[06:01] recognize the power of birth control

[06:03] pill precisely for women and I'm very

[06:06] hesitant of talking negatively about it.

[06:08] I recognize those powers and especially

[06:10] for some individuals who it works really

[06:12] really really well for. But I came off

[06:15] hormonal birth control maybe like three

[06:17] four years ago because and I ended up

[06:19] breaking up with my boyfriend which is

[06:21] like my boyfriend of three years which

[06:24] so it it anecdotally obviously we know

[06:27] anecdotal evidence is is very weak

[06:29] evidence but that it does reflect my

[06:31] personal experience.

[06:33] And then I had some quite bad side

[06:36] effects with many different hormonal

[06:37] birth controls I tried. So I haven't

[06:39] been on hormonal birth control for the

[06:41] last three four years and I always

[06:44] caveat that with saying I'm not

[06:45] anti-hormonal birth control but for me

[06:47] that was the right decision.

[06:49] Um however when I look back at like I

[06:52] was first put on birth control when I

[06:54] was 14. Oh wow. And I think about what

[06:57] decisions am I going to make when if I'm

[06:59] a parent and I have a daughter

[07:01] and I think

[07:02] gosh I do just want to wrap you in

[07:04] cotton wool to make sure you get through

[07:06] your education and you do not get I

[07:08] you're you're not ending up on you know,

[07:10] 16 and pregnant and coming out of

[07:13] long-term relationship I'm more

[07:15] comfortable with that added risk you

[07:17] know, not having that almost 100%

[07:19] certainty that I'm not going to get

[07:21] pregnant. I'm comfortable with that.

[07:23] Would I be comfortable with maybe my

[07:25] 16-year-old who might be sexually active

[07:28] >> Right. not having that 100%

[07:30] effectiveness necessarily with yeah. So

[07:32] what what would you say? First thing I'd

[07:34] say is that this highlights one of the

[07:37] really big motivations behind writing

[07:39] the book was that one I wanted to make

[07:41] women aware of what these trade-offs are

[07:44] because some women, as you noted, have

[07:46] perfectly positive experiences and and

[07:48] that's wonderful. Um but everybody needs

[07:50] to know what to be looking for um and

[07:52] being able to make those trade-offs. But

[07:54] the other motivation behind writing the

[07:56] book is that is is making us all aware

[07:58] of this so that way we can push for more

[08:00] options because we don't have a lot of

[08:03] options. I mean, I think that it's

[08:04] terrible that here we are in you know,

[08:06] 2026

[08:08] and women's options are if they're

[08:10] looking for something that's like pretty

[08:11] much like foolproof birth control, is

[08:14] hormonal birth control. Um there's a

[08:16] copper IUD, which is non-hormonal. Um

[08:19] and and that, you know, I I think is a

[08:21] pretty good option for a lot of women,

[08:23] but not all women because it does cause,

[08:26] you know, it gives you heavier periods

[08:27] at first. It can it can cause um really

[08:29] bad cramping at first. It's not pleasant

[08:32] have it put in. It's a little barbaric.

[08:34] Um but so there's that and then what are

[08:38] the other foolproof options? There's

[08:39] just not a lot of them. Um and you know,

[08:42] you can do things like the fertility

[08:43] awareness method and tracking your

[08:45] cycle. I wouldn't recommend that to my

[08:46] teenager um because the the fail rate is

[08:49] too high. And so, you know, we don't

[08:52] have to enough options. And so it is

[08:54] really tricky. And so, um you know, this

[08:58] is why I say, you know, here's this

[09:01] information, you know, and then you can

[09:03] make the decision about whether or not

[09:04] the making these trade-offs make sense.

[09:06] Like I have um I have a 19-year-old

[09:09] daughter and you know, and and these

[09:11] issues are very salient and so we've had

[09:14] to make these decisions just based on,

[09:16] you know, what's best for her given her

[09:19] circumstances. Um but I mean, this is a

[09:22] question every, you know, woman and

[09:24] every mother has to consider is like,

[09:26] all right, here are all of these

[09:27] trade-offs. Here are the available

[09:29] options. Like what are we going to do?

[09:31] Because I think that we can all agree

[09:33] that a lot of the um side effects that

[09:36] even the ones that I I discuss in the

[09:37] book, I mean, are are sure a whole lot

[09:40] less bad than an unexpected pregnancy at

[09:43] 16 or 17. I mean, that's like a much

[09:46] worse outcome um in many cases than um

[09:49] than some of the side effects I talk

[09:50] about um in This Is Your Brain on Birth

[09:52] Control or How the Pill Changes

[09:53] Everything Here in the or here in the

[09:55] UK. Um and and so it it's really about

[09:58] understanding what the risks and

[10:00] trade-offs are and then making those

[10:02] decisions based on what makes sense in

[10:04] your own life. And so um you know, I to

[10:07] that I say everybody has to answer that

[10:09] question on their own because I can't

[10:10] answer it for them. Um and also that we

[10:13] need to be pushing for more and better

[10:15] options. We've had so many community

[10:17] questions sent in. I think that just

[10:19] women wanted us to learn more about

[10:21] their brain and understanding their

[10:23] cycles better is an issue that a lot of

[10:25] the community were interested in. So,

[10:26] the first community question that we've

[10:28] had is how different is the female brain

[10:30] from the male brain in terms of

[10:32] motivation, focus, and problem-solving?

[10:35] Right. In in those ways our brains are

[10:37] very similar to one another. I mean, you

[10:39] know, when you under like to understand

[10:41] sex differences um and the differences

[10:44] between, you know, men and women, it's

[10:45] really taking a a

[10:48] bird's-eye view. The the

[10:50] Men and women are similar to one another

[10:53] in domains in which the evolutionary

[10:55] challenges that we've had to confront

[10:57] are the same. And a lot of the sort of

[11:00] what we would call in the evolutionary

[11:01] world, we call these adaptive problems,

[11:04] which is like anything that an organism

[11:06] or a person has had to do in order to be

[11:07] able to successfully survive or

[11:09] reproduce. We call that an adaptive

[11:11] challenge, right? And most of the

[11:13] adaptive challenges that men and women

[11:15] have been confronted with over

[11:17] evolutionary time have been the same.

[11:19] Right? We both had to avoid pathogens.

[11:21] We both had to avoid predators. You

[11:24] know, so there are a lot of ways in

[11:25] which our brains are the same. And when

[11:27] it comes to things like problem-solving,

[11:29] um our brains are very similar. Now,

[11:31] there are some like really small

[11:32] differences. Like, for example, we find

[11:35] that men on average are better at

[11:36] spatial rotation skills. And so, that is

[11:39] like if you're try to imagine like what

[11:42] a shape would look like if you rotate

[11:43] it, you know, three 300° this way or

[11:46] 150° that way. Men are better at being

[11:49] able to do that sort of thing. And on

[11:51] average And this is just everything that

[11:52] we're talking about is just on average.

[11:54] Um and and this is one of the reasons

[11:56] that we tend to see that men go into

[11:58] fields like engineering more is because

[12:00] this is a strength of theirs is being

[12:02] able to do these mental rotation tasks

[12:04] better than women. Women are better at

[12:06] object location memory. So, for example,

[12:09] after I leave this room, if you were

[12:12] were to give me a pop quiz and ask me

[12:14] like, "What did you see in that room?"

[12:16] I'd be like, "Okay, well, you know,

[12:17] there was a a Buddha statue over there

[12:19] on the right. And then there was these

[12:20] candles on the left. And I saw these

[12:22] little glasses in the back." When you

[12:24] ask most men about um you know, like

[12:27] like what they remember seeing in space,

[12:29] they they just don't encode it the way

[12:31] that we do. Um and they believe that

[12:33] these differences are the results of

[12:35] adaptations that we have um from hunting

[12:38] and gathering. And that for hunting

[12:40] that, you know, throwing a spear and

[12:41] being able to track animals requires

[12:43] being able to understand where objects

[12:45] are going in space. And that with

[12:47] gathering, it's more about remembering

[12:49] where the poisonous berry bush is versus

[12:51] the berry bush that has lots of um

[12:53] opportunities for feeding. Um and and

[12:56] and and women's uh greater um object

[12:59] location memory is also the reason that

[13:02] um a lot of times uh men and and

[13:04] children will be like, "Mom, where are

[13:06] my keys?" Or, "Sweetie, where are my

[13:08] keys?" Or, "Where where are my shoes?"

[13:09] Or, "Where is my coat?" Cuz most women,

[13:11] we know where it all is, you know? It's

[13:13] like we know where everything is. We

[13:14] know what's in the refrigerator. We know

[13:16] when we're running out of ketchup, you

[13:17] know? It's like we know all of that. And

[13:19] it's because our brains just pick up on

[13:21] that and encode it to a greater degree

[13:23] than male brains. So, I mean, there's

[13:24] small differences in sort of like

[13:27] problem-solving skills and different

[13:28] types of um strengths that we have, but

[13:31] they're really small. Like the big

[13:33] differences between men and women often

[13:36] times are those that stem from our

[13:38] different reproductive biology. And

[13:40] because women have this really large

[13:42] minimum investment in reproduction,

[13:44] because women, if we have sex, there's a

[13:46] possibility of pregnancy, which means

[13:48] that then we have a 9-month investment

[13:50] in pregnancy and then subsequent time

[13:52] spent lactating, etc., etc. And for men,

[13:56] the minimum investment in reproduction

[13:58] is just the act of sex itself, right?

[14:00] That that creates different um costs and

[14:03] benefits associated with short-term

[14:06] sexual behavior,

[14:08] um with uh you know, sort of choosiness

[14:10] about partners. Um and so you do get

[14:13] differences that way, but then you also

[14:15] get physiological differences because

[14:18] because women have to both, you know,

[14:20] have sex and attract mates, and then

[14:23] also be pregnant and lactate in order to

[14:25] successfully reproduce, that also

[14:28] creates all sorts of different

[14:29] challenges that the female body has to

[14:31] solve that the male body does not.

[14:34] Right? Because for men, reproduction

[14:36] just means attraction and having sex,

[14:39] right? And then they're done. And so

[14:40] that doesn't require any sort of special

[14:43] physiological gymnastics in order to

[14:45] reproduce. For a woman, like we have to

[14:48] be

[14:49] we have to attract mates and have sex,

[14:51] but then we also, you know, have to um

[14:55] you know, have an an embryo implant and

[14:57] and and successfully grow another human

[14:59] being. And that requires all kinds of

[15:02] physical gymnastics that the female body

[15:04] has to perform in order to reproduce.

[15:07] And what this has done, you know, is

[15:09] it's created these sort of two different

[15:11] developmental tracks. There's the male

[15:13] track and the female track. Um and and

[15:17] and the female track is characterized by

[15:20] um having a physiology that shifts

[15:22] between states that are optimized for

[15:25] attraction and sex, which is what we see

[15:27] in the first half of the menstrual cycle

[15:29] when estrogen is high and rising. And

[15:31] then the second half of the cycle is

[15:33] optimized for implantation and

[15:35] pregnancy. And so the whole reason that

[15:37] women cycle in the first place is

[15:40] because our bodies have to shift between

[15:42] these two states. One that's optimized

[15:44] for sex and attraction, and then one

[15:46] that's optimized for implantation and

[15:48] pregnancy. Male bodies don't have to do

[15:51] that, right? They're always optimized

[15:53] for sex and attraction. And because of

[15:55] that, it creates sex differentiation in

[15:57] our bodies and in our brains. On both in

[16:00] terms of being sensitive to these

[16:01] cycling sex hormones, it's responsible

[16:04] for the fact that we have cycling sex

[16:05] hormones. And then it also leads to

[16:08] different um adaptations that we have in

[16:10] the body from head to toe. Um where a

[16:13] body everything like our circulatory

[16:15] system, our immune system, um our

[16:18] respiratory system is sensitive to our

[16:20] cycling sex hormones because our body

[16:23] has to do different things when it's

[16:25] preparing for pregnancy compared to when

[16:27] it's not. And so sex differentiation,

[16:30] you know, for the most part ultimately

[16:32] stems from differences in our

[16:34] reproductive biology. Right? And it can

[16:37] create cascading um differences. But

[16:40] like generally we see these in the area

[16:43] of things like um mating behavior and

[16:46] mate choice and and you know, things in

[16:48] that domain. And then we also see these

[16:50] physical differences in the body that

[16:53] stem from the fact that men only have

[16:55] one one job that they have to do in

[16:57] order to reproduce and women's bodies

[16:58] have two. It's a classic example of

[17:00] averages, right? You know how science is

[17:02] just based on the generalizations and

[17:05] averages. I am the one who has no idea

[17:08] where anything is. I always say to my

[17:10] boyfriend, "Where's my phone? Where's my

[17:11] keys?" I also do have ADHD, so that

[17:14] probably does Yeah, into it. But also my

[17:16] boyfriend's an engineer, so then he fits

[17:18] into that stereotype. You know, the man

[17:20] probably the the spatial the better

[17:22] rotational visualization. Sometimes he

[17:24] explains, you know, he'll tell me

[17:26] something he's done at work and I that's

[17:28] just not part of I have no idea what I

[17:31] don't even know where to start. In some

[17:32] ways it's great that we're learning more

[17:33] about the female brain. In other ways,

[17:35] what do you think of the drawbacks of

[17:37] applying these almost stereotyped views

[17:40] of women's brains in today's society

[17:43] where we're not hand-to-gatherers when

[17:45] women choose not to reproduce.

[17:46] >> Right. Right. I mean, I think that we

[17:47] just really need to understand that

[17:49] whenever we're talking about men this

[17:51] and women that, that we are talking

[17:52] about averages and that the male brain

[17:55] and the female brain are more similar to

[17:57] each other than they are different. Um,

[17:59] but nonetheless, there are differences

[18:01] and I think that understanding and

[18:03] recognizing that anytime that we're

[18:04] talking about men this and women this,

[18:06] that we're saying men on average this,

[18:08] women on average that. And averages are

[18:10] really good at being able to

[18:12] characterize an entire population of

[18:14] human beings, um, but averages are

[18:16] really bad at being able to predict how

[18:18] any individual is going to respond to

[18:20] any given thing. And so just

[18:22] understanding that, um, that a

[18:24] scientific average isn't, um,

[18:27] prescriptive and it's not telling you

[18:29] what things should be or things or even

[18:31] how things are likely to be for you. Um,

[18:34] one of the things that I wrote in, uh,

[18:36] in in this is your your how the pill

[18:38] changes everything, um, is just this

[18:40] idea that, you know, you can look at all

[18:42] of these averages and I think that it

[18:43] does give help us and just better

[18:45] understanding the world on average. Um,

[18:48] but really when it comes down to like

[18:50] how you should live your life and how to

[18:52] understand yourself, the only data point

[18:54] that matters is you, right? And so if

[18:56] you don't fall into that neat tidy

[18:59] pattern that's predicted by the average

[19:02] of anything, um,

[19:04] know yourself, right? It's it's it's all

[19:06] about, um, understanding ourselves and

[19:08] learning the way that we respond to

[19:10] things, um, and I think that that's like

[19:13] the the most powerful thing that we can

[19:14] do. So, just understanding that. It's

[19:16] like just because on average X, that

[19:18] doesn't mean that you're going to X,

[19:20] right? Uh, that

[19:21] we we all need to um, understand sort of

[19:23] where we fall um, on any sort of a

[19:26] continuum. I think that's the one thing

[19:28] I'd want anyone listening, I wouldn't

[19:29] want them to set limits and beliefs on

[19:31] themselves in terms of maybe if you're a

[19:33] woman who finds yourself attracted to

[19:36] like engineering and you have that sort

[19:37] of brain. Right.

[19:38] >> It's don't set a limits and belief on

[19:40] yourself that you maybe couldn't do that

[19:42] cuz you're a woman, but

[19:44] under using these tools and the

[19:45] information that you have to

[19:48] to understand yourself better. And I

[19:50] think I know personally understanding my

[19:52] cycle and how that impacts my energy

[19:54] levels, how that impacts the ways in

[19:56] which I want to work has been super

[19:58] super super impactful in being more

[20:01] successful in the things I want to be

[20:03] successful in, but also give it practice

[20:05] in forgiveness with myself. And I think

[20:07] the listeners will be very interested to

[20:09] hear about your book. But first, we've

[20:10] got a section called buy or bye-bye.

[20:12] Basically, I'm going to ask you some

[20:14] questions. I'm going to show you some

[20:16] products, and you're going to tell me

[20:17] whether you would buy these products or

[20:19] say goodbye to them based on your

[20:21] understanding of female brain. First up,

[20:24] we have hormone balancing teas. Right.

[20:27] Okay, well, it depends on what it is.

[20:29] Uh, so like so just to give an example,

[20:31] there's some like decent evidence that

[20:33] there's some types of like teas. So, if

[20:35] you have something like chaste berry

[20:38] tea, for example, like that's one,

[20:40] there's a really good clinical evidence

[20:42] that shows that it actually can help to

[20:44] promote a successful luteal phase, for

[20:46] example. Um, and it's also there's some

[20:48] good evidence showing that it can help

[20:49] minimize some of the symptoms of

[20:50] perimenopause. Um, but I would just like

[20:53] look and see what is in your hormone

[20:54] balancing tea. Um, and then anybody can

[20:58] go, you know, sometimes people don't

[20:59] know that they can do this. You can pull

[21:01] up, if you go on your computer or on

[21:02] your phone, you can like look up PubMed,

[21:05] and it's a free database of um, of

[21:07] things that are published in the medical

[21:09] world and look and see about the

[21:10] ingredients and just like so if it's

[21:12] like a hormone balancing tea and it

[21:14] includes let's say and I'm just throwing

[21:15] this ingredient out there, dandelion

[21:17] extract and you're like dandelion

[21:19] extract does that actually do something

[21:20] for hormones? Pull up PubMed and do a

[21:23] search for dandelion extract and and

[21:27] then whatever your hormonal issue is and

[21:29] see what's been published on it and see

[21:30] whether or not there's some reputable

[21:32] evidence that suggests that it's good or

[21:33] not.

[21:34] >> I've started taking chaste berry for my

[21:35] like PMS / PMDD.

[21:38] >> Yeah, do you like it? I find found it

[21:40] revolutionary. It's really revolutionary

[21:43] good evidence as well. Yeah, really good

[21:45] evidence. It's so amazing right that

[21:47] there are these herbs because I think

[21:48] that sometimes herbs get this like

[21:51] you know this reputation of being

[21:52] woo-woo and that it's not really going

[21:54] to work and like there's really good

[21:56] clinical evidence and so many women like

[21:58] you have had this experience. I did I

[22:01] have had a really positive experience

[22:02] with it also with

[22:04] with I started getting when I was like

[22:06] 43,

[22:07] I was like getting hot flashes with

[22:09] coffee. Like if I drink a cup of coffee

[22:11] in the morning if I drink it inside, I

[22:14] would just like get a hot flash from

[22:15] drinking a hot drink in the morning and

[22:17] then I started taking I'm like oh this

[22:19] is the beginning of the end and so I

[22:20] started taking chaste berry and gone.

[22:24] Yeah.

[22:24] >> Amazing.

[22:25] >> We were saying with with PubMed the you

[22:27] know not all studies are created equal.

[22:29] However, some of the ingredients that

[22:31] you see in some of these hormone

[22:32] balancing teas, you will search those

[22:34] ingredients and they will not have any

[22:36] articles on PubMed.

[22:36] >> Yeah, no exactly. And I think that

[22:39] that's a red flag, you know? People

[22:41] don't realize that they have a lot they

[22:42] have the a lot more access to

[22:44] information at their fingertips than

[22:45] they know and going on to PubMed and if

[22:48] you do see if you go on PubMed and the

[22:50] thing that you're doing and it's saying

[22:52] that it's doing something health-wise

[22:53] for your body and you go on there and

[22:56] there's no articles that have been

[22:57] published on it, it's probably not a

[22:59] good ingredient. I would just say no

[23:01] thank you.

[23:01] >> Yeah, Herbal things and medical things.

[23:04] So, imagine driving is like a

[23:05] medication, but herb is like walking.

[23:08] So, if you travel somewhere by driving,

[23:10] you will get there quicker, but you may

[23:12] have more of a risk of having an

[23:14] accident. If you travel by walking, it

[23:16] will take you a longer time, but it's

[23:18] likely a little bit safer, but you may

[23:20] not. I like to use that analogy with

[23:22] herbal stuff. Like sometimes it won't be

[23:23] as effective as taking a medication.

[23:25] Some people who maybe have more severe

[23:27] symptoms will require medications, you

[23:29] know.

[23:29] >> Right. Yes. But if you are someone who

[23:31] has more moderate mild symptoms, maybe

[23:33] you've got more time on your hands, you

[23:34] can walk to your destination and it can

[23:36] be safer. That's how I cuz sometimes

[23:38] yeah, you're right. Herbs get herbal

[23:40] remedies get such a bad reputation.

[23:43] Yeah, it's all just being woo woo and

[23:44] garbage. And it's like, no, there's

[23:46] actually some really good ones.

[23:47] >> Yeah. Formulated for women supplements.

[23:50] I mean, I do think that that there are

[23:52] some of these that can be good um just

[23:55] in that they tend to address some of the

[23:57] the nutritional deficiencies that women

[23:59] um tend to have specifically because

[24:01] because we menstruate and because we

[24:03] create an endometrium and this

[24:05] endometrial lining every month, um our

[24:07] body does use different um you know, it

[24:10] it it depletes certain nutrients at a

[24:12] greater rate than male bodies do. And

[24:15] so, I do think that some of these can be

[24:17] good. Some of them, you know, they'll

[24:19] just like make a pink box and then

[24:21] charge you more for it. And so, just I

[24:23] would like try to get a little bit more

[24:24] information about what actually is in

[24:27] your formulated for women's supplement.

[24:29] Um but I but I do think that, you know,

[24:31] there there are some uh things that are

[24:33] sort of female specific. And so, yeah,

[24:35] so the right one, yes. Female specific

[24:38] supplements you have in your stack? No.

[24:40] So, I I don't take a female specific

[24:43] supplement. I actually add additional

[24:45] things in with So, I just take a regular

[24:46] supplement, and then I add additional

[24:48] magnesium because that's something that

[24:50] women need. I do additional iron because

[24:53] of menstrual bleeding and my ferritin

[24:55] levels get um low, and that's like your

[24:57] iron stores. Those will get low after

[24:59] I've had a couple of um heavy periods,

[25:01] and so I'll take um I take an iron

[25:03] supplement um that I I sort of cycle in

[25:06] and out of. Um and then I take an

[25:09] additional um uh B vitamin uh that I

[25:12] take in addition to that. Um and so I

[25:15] add, you know, some additional things in

[25:17] there just based on my own things that

[25:19] I've had issues with with uh

[25:21] nutritional deficiencies. But um

[25:24] otherwise, no. Not the pink box. I don't

[25:26] think the pink box, yeah. Yeah, a lot of

[25:28] times that's what they do. They'll just

[25:29] like make a pink box and then make it

[25:30] more expensive, you know, and it's like

[25:33] it's so silly. Morning-after pills.

[25:35] Yeah, I mean, I think that if you have

[25:37] unprotected sex and there's a

[25:40] possibility of pregnancy, so like if you

[25:42] know that you're not in the luteal

[25:43] phase, um yeah, I would totally take a

[25:45] morning-after pill if um if I if I

[25:48] thought that there was a chance that I

[25:49] was going to be pregnant and I didn't

[25:51] want to be pregnant. Um I don't I don't

[25:53] have any issue with those.

[25:55] Alcohol. Like uh so, this is one of

[25:58] those things where I can I can answer it

[26:00] as a scientist and I can answer it as a

[26:01] human being. So, as a scientist, yes

[26:03] yes. Um like when you look at alcohol,

[26:06] it doesn't have any positive health

[26:07] effects on the body. Um it can have

[26:09] positive social effects on people. Um

[26:12] and I think that sometimes there's a

[26:14] tendency within the area, especially of

[26:16] like medical um science, for people to

[26:20] focus only on the physical condition of

[26:23] the body, but then never think about

[26:25] mental health and the different things

[26:26] that help to support that. And we really

[26:28] saw this with the COVID lockdown. You

[26:30] know, with the COVID lockdown, it was

[26:32] just like about trying to prevent

[26:33] spreading of an of an illness, and

[26:35] nobody took into account the fact that

[26:37] sequestering people in their homes and

[26:40] is going to be really bad for mental

[26:41] health, and I I felt like there wasn't a

[26:43] a balanced enough approach taken there

[26:46] um because people were just making these

[26:47] decisions about the physical health of

[26:49] the body without without considering the

[26:51] psychological health of the the brain

[26:54] and and the mind in in of people.

[26:56] And so so alcohol like do I think that

[27:00] the health benefits of no alcohol at all

[27:04] outweigh the psychological and like

[27:08] sort of relational benefits that you can

[27:10] get from you know

[27:12] one night going out for dinner and

[27:14] splitting a bottle of wine with your

[27:15] partner or like meeting up with friends

[27:17] and having a drink with them, you know,

[27:19] and and doing that occasionally? No, I

[27:21] think that the I think that that there

[27:23] you can have a balanced approach to

[27:25] alcohol and have it end up creating

[27:29] a set up for a better life while also

[27:31] supporting your health. Um do I think

[27:33] that alcohol is necessary to have a good

[27:34] life? No, you know, I think that people

[27:36] can do no alcohol and do it really well,

[27:39] but for people who want to you know

[27:41] occasionally have a drink with a friend

[27:43] or or you know, with their partner when

[27:45] they're out for a good dinner, um then

[27:48] yeah. So like for me, um I do drink

[27:51] alcohol. I don't drink a lot of alcohol,

[27:54] but I do drink alcohol and I do it

[27:56] knowing what the risks are and then

[27:59] weighing that with the benefits that I

[28:00] get from

[28:02] having you know opportunities to connect

[28:04] with friends and connect with my

[28:05] partner. I'm the same. We had an

[28:06] incredible episode with a sober woman. A

[28:09] lot of things she was saying are you

[28:10] know completely true. I am someone who

[28:12] still drinks, but I definitely have a

[28:14] more balanced approach especially over

[28:16] the last few years. I think the the

[28:17] conversation around alcohol has really

[28:20] gotten bigger. But I read some really

[28:21] interesting research about drinking the

[28:23] differences in drinking in your luteal

[28:26] phase. Uh-huh. That actually and I get

[28:28] really bad PMS. That actually did make

[28:30] me rethink and it like what you were

[28:31] saying

[28:32] having that information and making an

[28:34] educated decision. Maybe if I'm meeting

[28:36] up with friends in my luteal phase, I'm

[28:38] probably thinking to myself, do you know

[28:40] what? Maybe it's better to stay on the

[28:42] lucky saints like the the alcohol-free

[28:43] beers tonight based on my cycle. Yeah,

[28:47] what what do you think about that?

[28:48] >> No, I I definitely like women tend to do

[28:52] worse with alcohol in the second half of

[28:54] the menstrual cycle.

[28:55] And I think they get worse hangovers.

[28:58] And especially during this time when

[29:01] progesterone is falling. So that's that

[29:03] last week of your cycle before you

[29:05] bleed.

[29:06] Your progesterone levels are falling. So

[29:07] you already have GABA receptors in your

[29:10] brain which are the receptors that pick

[29:13] up calming neurotransmission.

[29:15] Those are already feeling depleted.

[29:18] Because your progesterone levels are

[29:19] falling. And when progesterone is

[29:21] metabolized, it releases neurosteroid

[29:23] called allopregnanolone that stimulates

[29:25] these receptors. So these receptors are

[29:28] getting less stimulation because

[29:29] progesterone is falling. And then when

[29:31] you add alcohol which also stimulates

[29:33] these same receptors. And then when you

[29:35] get the withdrawal of alcohol after the

[29:38] alcohol wears off, you have these GABA

[29:40] receptors that are naked. They're not

[29:42] getting

[29:43] They're not getting stimulated by

[29:45] allopregnanolone. They're no longer

[29:46] being stimulated by alcohol. And it

[29:48] makes you feel terrible. And so women

[29:51] often times do get a worse

[29:53] alcohol experience in the second half of

[29:55] the cycle

[29:56] than they do in the first. Alcohol tends

[29:58] to cause more euphoria in the first half

[30:00] of the cycle because estrogen actually

[30:03] primes the area of the brain that's

[30:05] that's

[30:06] produces the experience of reward. And

[30:08] so you get more rewardingness of alcohol

[30:10] in the first half of the cycle compared

[30:12] to the second half of the cycle. But it

[30:14] also tends to be more if you're somebody

[30:16] who's prone to binge drinking, you're

[30:19] going to be more in trouble with that in

[30:22] the first half of the cycle than the

[30:23] second half of the cycle. And so it

[30:25] also, you know, it really depends on who

[30:27] you are and what your experiences are.

[30:28] So people who are having difficulty with

[30:30] alcohol and can't control themselves

[30:32] around alcohol,

[30:34] I would say do not be drinking in the

[30:35] first half of the menstrual cycle when

[30:37] estrogen is high. And especially, you

[30:39] know, when estrogen is rising and

[30:40] peaking near ovulation. That's going to

[30:43] be a time when your brain finds alcohol

[30:45] consumption incredibly rewarding. And if

[30:47] you're somebody who's likely to then

[30:49] start, you know, after you have one

[30:50] drink, like have another drink, and then

[30:52] another drink, and then another drink,

[30:54] you're going to be a much more prone to

[30:55] that in the first half than the second

[30:56] half. But then when the second half

[30:58] you're more likely to get a hangover.

[30:59] So, it's really all about understanding

[31:01] the way that your own body responds to

[31:03] alcohol.

[31:04] For many women it does shift across the

[31:06] cycle.

[31:07] Women also get worse, you know, uh being

[31:10] able to metabolize alcohol and manage it

[31:11] well

[31:12] during a perimenopause and the

[31:14] menopausal transition. And so, you know,

[31:17] it's like with anything with women, I I

[31:18] always advise people to track your cycle

[31:21] and track how you're responding to

[31:22] things over the cycle.

[31:24] And that'll help you better understand

[31:25] like your sleep needs and your

[31:27] nutritional needs and your alcohol needs

[31:29] because, you know, as we talked about,

[31:32] you know, the average is one thing,

[31:33] right? But then it's like how you

[31:35] respond to something can be totally

[31:37] different. And so, just understanding

[31:38] your own body's personal relationship

[31:41] with alcohol and and how your body is

[31:43] handling it, I think can also lead to a

[31:45] better

[31:47] sort of managing of your relationship

[31:49] with alcohol if you drink alcohol at

[31:51] all.

[31:52] That's really interesting you said about

[31:53] the differences in the follicular phase

[31:55] and I'll be interested to talk to you a

[31:57] little bit more about it later on about

[31:58] how

[32:00] in social media there seems to be this

[32:01] dichotomy arising of like the luteal

[32:04] phase is bad, the follicular phase is

[32:05] good. Yeah.

[32:06] >> And yet, which is so so so interesting

[32:09] and that nuance just a

[32:11] really good example of actually, you

[32:13] know, if you're drinking in your

[32:14] follicular phase, that could lead to

[32:15] more binge drinking.

[32:17] You know, those nuance points I think

[32:18] we're really missing in social media.

[32:20] So, we'll definitely have to come on to

[32:21] that a little bit later on.

[32:22] >> Yeah. Yeah, no. And in fact, you know,

[32:23] the the whole reason I wrote The Period

[32:25] Brain was because everybody like falls

[32:27] all over themselves to talk about how

[32:29] amazing the follicular phase is and and

[32:31] how great estrogen is. And and in the

[32:34] the luteal phase doesn't need to feel

[32:35] terrible. And progesterone is actually a

[32:37] really beautiful hormone that does these

[32:40] amazing things to our brain and to the

[32:41] rest of our body and and so I thought I

[32:44] thought it was time that it got called

[32:45] out, you know, for all of its positive

[32:47] effects. Nice. Okay. Next one,

[32:49] magnesium.

[32:50] >> Love magnesium. I love it. I could sing

[32:52] songs about it, you know, I could I

[32:53] could write a play about magnesium. No,

[32:56] I love magnesium. I think it's

[32:57] wonderful. It's wonderful for women,

[32:58] it's wonderful for men.

[33:00] Um there's lots of different types of

[33:01] magnesium and so what I would say is um

[33:04] if you're supplementing with magnesium,

[33:05] try to find a broad-spectrum magnesium

[33:08] cuz there's something like nine or 11

[33:10] different types of magnesium that are

[33:12] out there. Our body uses all of them um

[33:15] and so to to try to find a

[33:17] broad-spectrum magnesium supplement.

[33:19] >> We have

[33:21] creatine. I love creatine. I take it.

[33:24] There's really good evidence that it's

[33:25] helpful for muscle retention and keeping

[33:29] and building muscle strength, but also

[33:30] good research showing that it can have

[33:32] improvements in preventing cognitive

[33:35] decline and so yes to creatine. We spoke

[33:37] about this a little bit earlier, an IUD.

[33:40] All right. So here's what I here's

[33:42] here's my hot take on the IUD.

[33:45] Okay, so first of all, it depends,

[33:47] right? So there's two different types of

[33:48] IUD. There's a hormone IUD and there's a

[33:50] non-hormone copper IUD.

[33:52] Non-hormone copper IUD, if you're

[33:54] somebody who

[33:56] doesn't mind it, I think it's great

[33:58] because it you still ovulate, you get

[34:00] all of your full spectrum of sex

[34:03] hormones that are being produced.

[34:05] You feel like yourself and if you can

[34:07] get past the greater menstrual heaviness

[34:09] and cramping that women a lot of women

[34:11] experience with it, I say yes. I think

[34:13] it's great.

[34:15] Hormonal IUD is a little bit tricky.

[34:18] So

[34:19] >> [sighs]

[34:20] >> where do I even start with this?

[34:22] So the way that most birth control pills

[34:25] work is, you know, you take this daily

[34:28] progestin and it stimulates progesterone

[34:31] receptors in your brain and that

[34:33] prevents ovulation and then you don't

[34:35] get pregnant. Uh the hormonal IUD um is

[34:38] tricky because when some women go on it,

[34:41] they never ovulate and then when other

[34:43] women are on it, they continue to

[34:45] ovulate. And their experiences that they

[34:47] have when they're on the IUD is very

[34:50] much dependent on whether or not they

[34:51] ovulate or not. So for women who are not

[34:53] ovulating when they're on the hormonal

[34:55] IUD, um it feels pretty bad. Um and the

[34:58] reason is that here you have this thing

[35:01] that's that's releasing these low levels

[35:03] of hormone

[35:04] um and they're suppressing the HPG axis.

[35:07] So they're telling your brain is telling

[35:09] your ovaries not to ovulate. So you're

[35:11] not producing any sex hormones of your

[35:13] own. I mean, really low levels of sex

[35:15] hormones of your own. And you're also

[35:17] not getting any hormones from the IUD.

[35:19] Uh like you're getting really low levels

[35:20] of them. And so this creates this like

[35:23] sort of hormonal no man's land for women

[35:26] because women's bodies are used to being

[35:28] hormonal. I mean, we're hormonal. And so

[35:31] like

[35:31] >> not a bad word, you know? Yeah, it's not

[35:32] a bad word. It's a great word. And um

[35:34] and so to not be ovulating and then not

[35:37] having any like exogenous sex hormones

[35:39] that you're taking to replace that, it

[35:41] makes women feel pretty bad. Like a lot

[35:43] of them don't feel great. Um if you take

[35:46] if you put it in and you continue to

[35:48] ovulate, like I think it's great. It's

[35:50] just one of those things where you have

[35:51] to know. And what research finds, if you

[35:53] take look at women who are using the

[35:55] hormonal IUD, for the first year about

[35:57] 80% don't ovulate and only 20% do. After

[36:01] they've been on it for 5 years, about

[36:03] 80% are ovulating and about 20% are not.

[36:06] You know, and so it's one of these

[36:07] things where

[36:09] um the hormones in the hormonal IUD are

[36:11] low enough where some women will

[36:13] continue to ovulate, but some women

[36:15] don't. And um and so how it affects you

[36:19] is really going to depend on what on

[36:21] sort of how you respond to it. And so

[36:23] it's it's a really it's a really tricky

[36:25] one and it's one that, you know, women

[36:27] have this wide range of experiences on.

[36:29] Like some women love them, some women

[36:31] hate them, and um a lot of it has to do

[36:33] with whether or not they're ovulating.

[36:35] One last thing I'll say about this, and

[36:36] I know I'm talking about this probably

[36:38] too long, um but with the hormonal with

[36:40] the

[36:42] with the hormonal IUD, um research finds

[36:44] that the rate of experiencing um uh

[36:46] depression um after having it put in is

[36:50] is really high for teenagers. And so,

[36:53] what I would say is that for the

[36:54] hormonal IUD, this is one where I'd say

[36:57] not for teens, cuz the rate of um the

[37:00] the increased risk of developing

[37:01] depression after getting a hormonal IUD

[37:04] is like 300% higher for teenager. In

[37:06] adults, it's much lower. And I think

[37:09] that it's because with a teenager, you

[37:11] know, they're going through puberty,

[37:12] they're releasing all of these sex

[37:13] hormones that are helping to guide the

[37:15] pubertal transition. And so, for

[37:17] somebody who's a teenager, being in a

[37:19] state of low hormones is even more

[37:22] unnatural than what it is for an adult

[37:24] woman, and I think that that creates a

[37:26] lot of chaos in the system, and I think

[37:28] that that's why you see um teenagers

[37:31] having this really um heightened risk of

[37:34] experiencing uh depression in response

[37:36] to um in response to IUD. So, like it

[37:38] like, at the early on in our

[37:40] conversation, we talked about like what

[37:42] would you say to your teenager if

[37:43] they're sexually active? If I was

[37:45] putting my teenager on hormonal birth

[37:47] control, I would put them on a

[37:48] combination hormonal birth control pill.

[37:50] Those are the ones that have the lowest

[37:51] risk, especially mental health-related

[37:53] side effects in teenagers. I think this

[37:56] is such an incredible, interesting book,

[37:57] but my last point on birth control is it

[38:00] makes me really, really sad that we

[38:02] haven't worked out a way to predict how

[38:04] women will experience these side

[38:05] effects, because whenever I say that I'm

[38:08] I'm adamant I don't want to speak

[38:09] negatively about hormonal birth control,

[38:11] but women don't have

[38:13] 3 6 months of their life to just try

[38:16] something and see what happens, but that

[38:18] is what we expect women to do. We don't

[38:20] have much else to offer women than to

[38:22] say take this knowledge and then try

[38:25] something. If it works, it works. If it

[38:27] doesn't, at least you know the signs.

[38:29] Right. I look at my own life and I think

[38:31] God, if I if I was depressed for 3

[38:33] months, Right.

[38:34] >> that would be a huge that would have a

[38:36] huge impact on my career, like on my

[38:39] relationship, like so many different

[38:41] factors in my life, but that's you know,

[38:42] that's what we expect women to do. No,

[38:44] it is what we expect. It's so crazy. I

[38:46] mean, and and when you think about it

[38:48] and and that's what it is. It is like

[38:49] three three months of your life that

[38:51] you're going to be throwing away and and

[38:53] and we do, we need to get to a place

[38:55] where we're better able to predict who's

[38:57] going to respond what way to what

[38:59] formulation of hormonal birth control,

[39:01] so that way we can give better we can

[39:03] give women more informed choices and

[39:06] that way, you know, we can minimize the

[39:07] risk of side effects. Yeah. Finally,

[39:10] let's talk about the new book. So, what

[39:12] inspired the new book and what is if

[39:15] there's one take home from the new book

[39:17] that you just want everyone to know,

[39:18] what would it be? Right. So, so the the

[39:21] reason I wrote the book is one is as as

[39:23] we talked about, like everybody's

[39:25] talking about estrogen, estrogen,

[39:26] estrogen, follicular phase, ovulation

[39:29] and you know, it does all these

[39:30] wonderful things and we feel so good and

[39:32] look at this and then oh yeah, and then

[39:34] there's the luteal phase and

[39:35] progesterone, right? And then it seems

[39:37] like a bad guy and everybody thinks that

[39:38] it's awful.

[39:40] And um and it's not, you know,

[39:42] progesterone uh has these really

[39:45] beautiful neuroprotective effects. So,

[39:47] it's protective to the brain

[39:49] and it's also anti-inflammatory.

[39:52] So, it has these really beautiful

[39:53] anti-inflammatory effects in the body

[39:55] and and these are all things that we

[39:56] want, you know, it's like we want our

[39:58] brain protected, we want our bodies to

[40:00] be um shifted into an anti-inflammatory

[40:02] state and um and and so progesterone's a

[40:05] really wonderful hormone. Um and you

[40:08] know, so one of the things that I would

[40:10] want people to um well, I guess I'm just

[40:12] I'm going to I'm going to cheat. I'm

[40:13] going to give you two things that I

[40:14] think that people absolutely need to

[40:16] know. One is that progesterone is um an

[40:19] amazing hormone and you want to be

[40:20] producing it and and it does have all of

[40:23] these really beautiful effects. I'm I'm

[40:25] guessing, you know, right now there's

[40:27] some focus in the in the sort of

[40:28] menopause research looking at the

[40:30] protective effects of women's sex

[40:32] hormones on

[40:34] prevention of Alzheimer's disease and

[40:37] they're just looking at estrogen and

[40:39] that's a huge mistake because

[40:40] progesterone is neuroprotective and it

[40:42] has all these really beautiful effects.

[40:44] My guess is that in 20 years that we're

[40:46] going to be really dialing in on

[40:49] progesterone and prevention of dementia

[40:51] because I'm guessing that it is

[40:52] incredibly protective and that we're

[40:54] going to find that

[40:56] one of the reasons that women are at a

[40:58] greater risk of experiencing dementia

[41:01] now is because we're not experiencing

[41:03] pregnancy as much and that's a high

[41:05] progesterone state and that minimizing

[41:08] the number of exposures that we have to

[41:10] levels of high levels of progesterone is

[41:13] actually what's responsible for

[41:16] the number of autoimmune diseases that

[41:17] we're now seeing in women because again

[41:19] progesterone is anti-inflammatory and

[41:21] removing that break by preventing

[41:23] ovulation when we're on the pill or not

[41:26] you know, having any pregnancies or

[41:28] preventing being in a high progesterone

[41:29] state that way is the reason that we see

[41:32] so much autoimmunity in women and I also

[41:34] think that's why we're seeing this you

[41:35] know, this like huge number of

[41:38] Alzheimer's cases in women is because

[41:40] we're removing this really beautiful

[41:42] this really beautiful effect that

[41:44] progesterone can have on the brain and

[41:47] so progesterone is a really lovely

[41:48] hormone and so don't vilify it. So

[41:51] that's one thing. Two is that you know,

[41:54] as our hormones shift it does shift our

[41:57] brain and our body from a state that's

[41:59] optimized for attraction and sex and

[42:01] that's estrogen

[42:02] and then into a state that's optimized

[42:04] for implantation and pregnancy and

[42:06] that's what progesterone does and this

[42:08] means that we do become a different

[42:11] version of ourselves, a slightly

[42:12] different version of ourselves in the

[42:14] second half of the cycle compared to the

[42:16] first. Um, but it doesn't need to feel

[42:19] bad. You know, I think that a lot of

[42:20] women are under the impression that, you

[42:23] know, progesterone is is PMS and bad

[42:25] things and feeling cranky and and, you

[42:28] know, overly emotionally sensitive. And

[42:30] so, I wrote The Period Brain to help

[42:31] women better understand like what is it

[42:34] that your brain is trying to actually

[42:35] do? What is your body trying to do

[42:37] during this time? Because it doesn't

[42:38] make sense that 50% of the population is

[42:41] going to be feeling terrible and in the

[42:43] you know, pathologically 50% of the

[42:46] time. And so, um, I wrote this book

[42:49] after doing a deep dive to better

[42:50] understand what is it that our brain and

[42:53] body is actually trying to do and what

[42:54] does it need in order for us to feel

[42:56] really good during the second half of

[42:58] the menstrual cycle. And so, just really

[43:00] trying to understand um, and wrap our

[43:03] arms around the fact that there's two

[43:05] halves to our whole, right? We're not

[43:07] just one way as women. We are a moving

[43:09] picture depending on our cycling

[43:11] hormones. And And so, trying to

[43:13] understand what is it that progesterone

[43:15] is trying to create and then what can we

[43:17] do to support our brain and body during

[43:18] this time? What can we do to support our

[43:20] brain and body during this time?

[43:22] >> Well, you know, progesterone, just to

[43:23] give you, um, one example, you know,

[43:25] progesterone, because it is preparing

[43:27] your body for pregnancy, one thing that

[43:29] we know is that it raises our basal

[43:31] metabolic rate by 7 to 11%. And so, one

[43:35] thing that we need during this time is

[43:36] more food, um, because we're burning an

[43:38] additional, um, 140 to 200 calories a

[43:41] day during this time. And so, a lot of

[43:44] women, you know, they're having these

[43:46] food cravings and they're feeling really

[43:47] hungry during this time and they think

[43:49] that there's something wrong with them.

[43:51] And it's that their body's actually

[43:52] burning more calories. You know, but

[43:54] we're not told that as women. We're

[43:55] given this like one-size-fits-all set of

[43:58] nutritional guidelines where we're told

[43:59] you should eat this and you should sleep

[44:01] this number of hours and this is what

[44:03] you need for recovery. And that doesn't

[44:05] work for us. You know, it's like our

[44:06] nutritional needs change across the

[44:08] cycle, just meaning that we need more

[44:10] calories. You don't need to like, you

[44:11] know, eat certain types of foods over

[44:13] here and then not eat certain types of

[44:14] foods over there. Instead, it's just

[44:16] about making sure that we're getting

[44:17] enough to eat. So, we need to do that.

[44:19] We do need more rest and recovery time

[44:22] because our body is working harder. Our

[44:24] respiration rate is higher, our pulse is

[44:27] higher. If you're somebody who wears

[44:28] wearable like tech, um you'll see this.

[44:31] You'll see that your recovery tends to

[44:33] be lower in the second half of the

[44:34] menstrual cycle. It's because your body

[44:36] is working harder. It's building an

[44:38] endometrium. It's shifting all these

[44:40] gears in the body to prepare for the

[44:42] possibility of pregnancy, and that

[44:44] requires a lot of energy. And so, just

[44:47] making sure that you're really being

[44:48] gentle with yourself during this time.

[44:50] Make sure that you're getting enough

[44:51] sleep. Make sure that you're allowing

[44:53] adequate recovery time if you're being

[44:55] really physically active. Make sure that

[44:57] you're eating enough. And then also

[44:59] recognizing that our body's um

[45:02] threshold for what it considers to be

[45:04] something that's a danger lowers during

[45:07] this time. So, we're also more socially

[45:09] sensitive, where we're more likely to

[45:11] see something as a sign of a threat in

[45:13] the second half of the cycle compared to

[45:15] the first. And this is just an

[45:17] adaptation that our body has to prepare

[45:19] for the possibility of pregnancy.

[45:21] Pregnancy is a time of incredible um

[45:23] physical vulnerability for women. Um

[45:25] they can't get away from a saber-tooth

[45:27] tiger as quickly. And it's also a time

[45:29] where they become very dependent on

[45:31] their partners for access to things like

[45:33] provisioning and resources. You know,

[45:35] historically women didn't have jobs in

[45:37] an office when you know, we were

[45:38] hunter-gatherers for most of our time as

[45:40] a species. And women

[45:43] relied very heavily on their partners to

[45:44] get access to food and other types of

[45:47] resources, protection that they need

[45:49] when they're in this really vulnerable

[45:50] state of pregnancy. And one of the

[45:52] adaptations that we have is that our

[45:54] brain lowers the sensory threshold for

[45:57] what is considered threatening. We

[45:58] become more attuned to the possibility

[46:01] of threats. And I think that

[46:02] understanding that can really help us in

[46:04] our relationship with our partners

[46:06] because we're more likely to interpret

[46:08] things that they do as being signs of

[46:10] danger. Like do Am I safe in my

[46:12] relationship? Like Like is my partner

[46:14] going to leave? Like Like does the fact

[46:16] that they didn't empty the dishwasher

[46:18] when I asked them to? Like does that

[46:19] mean that they don't value me and don't

[46:21] love me and aren't going to stick

[46:22] around? Um and and obviously most of

[46:24] this doesn't go on consciously, but the

[46:26] unconscious brain is just like pinging

[46:28] anything that is a sign of a potential

[46:30] threat.

[46:31] And that, you know, being aware of this

[46:33] and understanding what our brain is

[46:34] doing during this time, I think it can

[46:36] be incredibly useful just in our the own

[46:38] narrative that we have with ourselves

[46:40] about what's going on. Like why am I

[46:43] Like you know, why am I so upset about

[46:45] this dishwasher situation? You know,

[46:47] it's like, "Okay, like my brain is more

[46:49] sensitive to signs of potential danger

[46:51] right now. I'm sensing that this might

[46:53] be a threat in my relationship. I should

[46:55] probably go talk to my partner and just

[46:57] feel reassured and get some extra

[46:59] reassurance is about how we're doing in

[47:00] the relationship." And then that's going

[47:02] to let me feel better and that's going

[47:03] to calm my luteal phase brain. And so

[47:06] just really understanding what our

[47:07] bodies are doing so that way we can take

[47:09] care of ourselves and understand

[47:11] ourselves and change the way that we

[47:12] think about um ourselves as well during

[47:15] this time.

[47:16] Well, I sometimes worry about the

[47:17] conversation about like luteal extra

[47:20] sensitivity in the luteal phase is it

[47:22] might lead to women dismissing their

[47:23] emotions more. And I I think the example

[47:26] you gave about the dishwasher is the

[47:27] perfect example. It doesn't remove the

[47:29] validity of maybe being annoyed at your

[47:31] partner that they didn't empty the

[47:33] dishwasher.

[47:34] It just helps you understand maybe your

[47:35] reaction to it. And yeah, it's so I just

[47:38] worry that sometimes it maybe feeds into

[47:40] this narrative that women's hormonal

[47:43] emotions are not as valid. No, it's

[47:45] valid. It's real. Like And And I mean

[47:47] And And we're picking up on something

[47:49] that's a sign of a that's the sign of a

[47:51] potential threat, right? And it's just

[47:53] like saying that, you know, so smoke

[47:55] detectors are are created to be super

[47:59] sensitive to any sign of danger, right?

[48:01] So, if you make microwave popcorn and

[48:03] burn it in the oven, right? You're going

[48:05] to There's your smoke detector is going

[48:07] to go off, right? And even though

[48:08] there's not a fire, your smoke detector

[48:10] was built intentionally to be really

[48:14] perceptive to any sign of danger, and

[48:16] that's wisdom right in the smoke. We

[48:18] don't want a smoke detector that doesn't

[48:20] notice when there's a fire, right?

[48:22] Because it's being too cautious about

[48:24] whether or not it alarms. And so, like

[48:26] there's actually a lot of wisdom and and

[48:28] and and it is valid. It's like we're

[48:30] picking up on a cue that that

[48:32] potentially could be a sign of danger,

[48:34] and it's probably not, but it could be.

[48:37] And so, I I don't I don't There's

[48:38] nothing invalid about the way that women

[48:40] are experiencing the world when they're

[48:42] in this half of the cycle. And in fact,

[48:44] like I said, there's so much wisdom to

[48:46] it. And I think that we need to move

[48:48] past the narrative that we've had for

[48:50] women for so long, which is that, oh,

[48:52] you know, it's hormonal and therefore,

[48:54] you know, it's it's it's um irrational

[48:56] or it's not real. And the fact is, like,

[48:59] no, it is real. And the only reason that

[49:02] we believe that there's anything wrong

[49:03] with it is because we've all

[49:06] somehow bought in to this narrative that

[49:09] was created by a bunch of sexist jerks a

[49:11] hundreds of years ago, you know? And

[49:13] like there's no reason that we can't

[49:15] flip the narrative and say, like, no,

[49:17] actually having, you know, two primary

[49:19] sex hormones instead of one is an

[49:21] advantage, and it allows us to look at

[49:24] things from multiple perspectives. And

[49:26] how you know, and like how, you know,

[49:28] men on the other hand are so simple.

[49:31] Like, how could we possibly trust them

[49:32] with important decisions when they only

[49:34] have one hormone and can only look at

[49:36] things from one perspective? Like, we're

[49:38] so much more advanced in that we're able

[49:39] to look at things from different ways.

[49:41] And um you know, so it'd be really easy

[49:43] to flip that narrative and totally turn

[49:45] it on its head. It's just nobody's

[49:47] thought to do it because all that we've

[49:48] ever heard is this idea that there's

[49:51] something wrong with having cycling

[49:52] hormones. I absolutely love that you've

[49:55] said that because I sometimes feel that

[49:57] when I'm in my luteal phase, and I do

[49:59] get quite bad PMS Mhm. PMDD, like and

[50:02] it's to the point it can be quite

[50:03] debilitating and impact my relationship,

[50:05] but then there's also points that I feel

[50:07] very, very, very grateful that I get a

[50:09] luteal phase and maybe I have It almost

[50:11] feels like emotions that have been

[50:13] bubbling under for the rest of the month

[50:15] suddenly get a chance to like surface

[50:17] and I get almost

[50:20] more in tune to those things. Like I

[50:21] have like a moment to really appreciate

[50:24] them. Like emotions aren't always bad,

[50:27] you Right. No, and in fact there we

[50:29] wouldn't have them if they didn't

[50:31] provide us with an advantage. Right, so

[50:33] having emotions is is is a wonderful

[50:35] thing. It helps guide our behavior in

[50:38] adaptive ways. And it really is a a

[50:39] really wonderful thing that we go

[50:42] through this period where we get more

[50:43] access to what's going on beneath the

[50:45] surface psychologically. I'm going to

[50:48] come on to a section called real or

[50:49] real. Okay. I'm going to show you a

[50:51] TikTok and I would love to just hear

[50:54] your thoughts on it.

[50:55] >> Men and women have different brains.

[50:57] Significantly.

[50:58] >> Wildly so. Wildly different.

[51:00] >> whole thing about you can't put your

[51:02] gender on your medical forms is just

[51:07] insanely stupid because gender matters.

[51:10] Like estrogen and testosterone, they

[51:12] matter when it comes to brain function.

[51:15] I published a study on 46,000

[51:19] scans looking at the differences between

[51:22] male and female brains and they're wild.

[51:25] Women have much better frontal lobes

[51:28] function, that much better blood flow to

[51:30] the front part of their brain. Which

[51:32] makes them Which makes them good

[51:34] leaders. If you think of the impulse

[51:37] control and collaboration and

[51:41] communication,

[51:43] and the one statistic that just hammers

[51:45] this home is who goes to jail?

[51:47] Men.

[51:49] 14 times more than women.

[51:52] But women get depressed twice as much as

[51:55] men because their limbic or emotional

[51:58] brain much busier than the male brain.

[52:03] And that's why in every human society

[52:05] women are primary caretakers

[52:07] for children.

[52:09] Um women have a bigger nesting instinct.

[52:11] So I told you we moved recently. And

[52:15] moving is much harder on women in

[52:18] general than it is in men because they

[52:20] feel like they lose their nest and they

[52:23] have to redo their nest and I was an

[52:25] army psychiatrist for 7 years and I used

[52:28] to always tell the guys, I'm like, when

[52:30] you move, you stay home and help her put

[52:32] the house together cuz she's going to be

[52:34] way happier

[52:35] uh

[52:36] for you.

[52:37] There's a lot happening there. So some

[52:38] of it, some of it yes, some of it no. So

[52:40] to start with male and female brains are

[52:42] vastly different from one another?

[52:44] No. Like they're more similar than they

[52:47] are different. And yes, there's

[52:49] definitely sex differentiation, no

[52:51] question about it. As I noted, you know,

[52:54] men and women have faced different

[52:56] evolutionary challenges just because of

[52:57] the differences in reproduction. Our

[52:59] brains are sensitive to sex hormones,

[53:01] our sex hormone cycle. I mean, there's

[53:02] all kinds of things that make male and

[53:04] female brains different. But there's

[53:05] also a lot of things that make male and

[53:07] female brains the same. Um second thing

[53:09] is that he conflates gender with sex and

[53:12] they're different. Um and so putting

[53:14] gender on a

[53:16] medical form,

[53:18] it doesn't need to be there. Biological

[53:20] sex does. And sex and gender are

[53:22] different. Biological sex refers to

[53:25] like you know, from an evolutionary

[53:27] perspective, biologically it's it's the

[53:29] size of your sex cells. So if you make

[53:31] large immobile gametes called eggs,

[53:34] you're a female. If you make small or

[53:37] mobile gametes, you're a male. Um and so

[53:40] that's biological sex. And that is the

[53:42] thing that is correlated to all of these

[53:44] different differences physiologically.

[53:46] And absolutely that's something that

[53:48] should be accounted for it in medical

[53:50] records because male and female bodies

[53:51] don't respond the same to things. And

[53:53] this is the reason that there's such a

[53:55] push for adding women into medical

[53:57] research now is because women's you

[54:00] know, they used to just study men and

[54:01] then apply all of the insights that they

[54:03] get from this research onto women and

[54:05] the women's bodies are not responding

[54:07] well and it's because biologically we're

[54:08] different. Our bodies work differently.

[54:10] And so so biological sex matters. Um

[54:13] gender also matters and is not

[54:15] necessarily the same as biological sex.

[54:17] And so

[54:18] um and so I don't like it when people

[54:20] call sex gender cuz it conflates the two

[54:21] things and and they're and they're two

[54:23] separate things and they're not always

[54:24] the same. So that's the other thing.

[54:27] And but yes, male and female brains do

[54:29] differ and there are differences and

[54:31] some of those differences are important.

[54:33] Some of those differences like with the

[54:35] activity in the frontal lobes, yes, we

[54:37] do see that that's true and yes, women

[54:39] also have our amygdala which is our fear

[54:42] center is more interconnected with the

[54:44] functionally interconnected with the

[54:46] rest of our brain than in a male brain.

[54:49] Our brains are also less lateralized so

[54:51] we get more communication between our

[54:53] two hemispheres than men do. Men tend to

[54:56] have denser

[54:57] less communicative corpus callosum. And

[55:01] so there are definite differences that

[55:03] create differences in behavior. Some of

[55:05] those like the thing with moving like

[55:07] that's never been I've never seen that

[55:08] in research. So I think that that was

[55:10] just him talking about a story that he

[55:12] had you know, an anecdote.

[55:15] So I don't I don't know about that. But

[55:17] some of the some of the other things,

[55:18] you know, within in terms of like the

[55:19] emotional differences, yes.

[55:22] And men are more likely to go into

[55:23] prison but that's also a result of

[55:25] testosterone and not just the frontal

[55:27] lobes because testosterone puts the foot

[55:30] on the gas pedal of being willing to

[55:32] escalate to win. And so when you're

[55:35] willing to escalate and escalate and

[55:37] escalate to win, that means you're also

[55:39] more likely to get into a fist fight or

[55:40] break into somebody's house or murder

[55:42] somebody because you're trying to get at

[55:43] some sort of a goal. So,

[55:46] um so, a little there was a little bit

[55:47] of truth in there and then a little bit

[55:49] of um sort of confabulation of things

[55:51] that I don't think are

[55:53] like accurate.

[55:54] >> Interesting. And I I think the really

[55:55] important point is there are more

[55:57] similarities than divisions cuz

[55:58] otherwise I think you you fall down this

[56:00] trap of really

[56:02] feeding into very gendered stereotypes

[56:05] that I don't necessarily think are

[56:07] helpful in today's society where we

[56:10] we're not we're not living hundreds of

[56:12] thousands of years ago even though like

[56:14] our evolutionary challenges might have

[56:16] been different. That's not the world we

[56:19] live in. One of the questions that we

[56:21] got was is there anything I can do for

[56:23] my PMS?

[56:24] >> There's lots of things you can do for

[56:25] your PMS. I mean, one is first is just

[56:27] is start with the basics. Um a lot of

[56:30] women have a worse experience um in the

[56:32] second half of the menstrual cycle um

[56:34] just because they lack what I call

[56:36] resilience to hormonal changes and that

[56:38] is that their cells um aren't able to

[56:41] quickly adapt to the vast um number of

[56:44] physiological changes that happen as

[56:47] we're shifting hormonal states. Um and

[56:49] ways that you can promote hormonal or

[56:51] resilience hormonal changes is just

[56:53] really taking care of the physical

[56:54] health of your body because the thing

[56:56] that promotes cellular plasticity is

[56:58] like low inflammation and um you know,

[57:02] and uh

[57:03] and being well nourished. So, making

[57:05] sure that you're eating um healthy

[57:06] foods, make sure that you're moving your

[57:08] body, make sure that you have healthy

[57:09] social connections um because that's

[57:11] also really helpful in not only

[57:13] supporting resilience to hormonal

[57:15] changes, it also helps to um promote

[57:17] fertility because your body will shut

[57:19] ovulation down if you aren't feeling

[57:21] supported and um and you have too much

[57:24] chronic stress. And so, anything that

[57:26] you can do to minimize chronic stress,

[57:28] but really just taking good physical

[57:30] care of the body. Um other things, you

[57:33] know, if you have really bad really bad

[57:34] PMS and like PMDD, things that I'm

[57:37] really excited about, one is um,

[57:39] cognitive behavioral therapy. It does

[57:41] seem to really be helpful to women with

[57:43] PMDD and PMS um, in terms of helping

[57:45] them reframe some of the um, luteal

[57:48] phase um,

[57:50] uh, ruminations that can happen. And so

[57:52] I'm excited about that as a non um,

[57:55] medication based option. The other thing

[57:57] I'm really excited about is stimulating

[57:59] the vagus nerve. And we're doing some

[58:01] research right now looking at vagus

[58:03] nerve stimulation using um, a device

[58:06] that stimulates the nerve that's right

[58:08] by your tragus, which is this little

[58:09] flap of this little flap of cartilage

[58:11] that we have in front of our ears. And

[58:13] um, and when you stimulate the vagus

[58:15] nerve it activates um, the

[58:17] parasympathetic uh, stress response and

[58:20] it helps to regulate bodily systems from

[58:22] head to toe and there's all sorts of

[58:24] really great work showing uh, vagus

[58:26] nerve stimulation in um, decreasing

[58:29] heavy menstrual bleeding, decreasing

[58:31] endometriosis,

[58:33] decreasing treatment resistant

[58:35] depression. I mean, it's it's it has all

[58:37] of these really wonderful effects on so

[58:39] many systems of the body and we have

[58:42] really good reason to believe it's going

[58:43] to be therapeutic for especially PMDD.

[58:46] And so we're starting a trial soon

[58:48] looking at vagus nerve stimulation in

[58:50] relieving uh, especially the

[58:52] psychological symptoms of PMDD. Um, and

[58:54] I'm super excited about that. I read

[58:56] some research about CBD in comparison to

[58:58] SSRIs in PMDD seems to have similar

[59:02] effectiveness but the CBD continues

[59:05] obviously when you stop SSRI the

[59:07] symptoms of PMDD come back whereas when

[59:09] you stop CBD the the symptoms continue

[59:13] like you continue to have the relief

[59:15] which is yeah. Something like CBT is you

[59:18] know, you're you're teaching your brain

[59:19] to think about things differently and

[59:21] the thing we always say in neuroscience

[59:23] right is this idea that um, that that

[59:25] neurons that fire together wire

[59:27] together. and so when you keep

[59:28] practicing thinking that way, yeah, you

[59:30] take it with you. And so even after you

[59:32] discontinue the therapy, you now have

[59:34] these new pathways that get activated

[59:36] when you're get into sort of that dark

[59:38] um PMDD spiral, um you can get yourself

[59:41] out of that spiral without having to

[59:43] continue to go on to therapy. So it's

[59:45] really yeah, really is great.

[59:46] >> Therapy often gets a bad reputation

[59:48] because of how maybe you don't see that

[59:50] instant Right. Yes.

[59:52] >> effects. And I would come back to my

[59:53] knowledge of walking somewhere or using

[59:55] the car. Like I think taking that walk,

[59:57] getting your steps in, it might take you

[59:58] longer to get there, but it's better for

[01:00:00] you in the long run. Yes, no,

[01:00:01] absolutely. Another community question

[01:00:04] that we had, how do your hormones affect

[01:00:06] ADHD throughout the menstrual cycle?

[01:00:07] What differences in behavior or symptoms

[01:00:10] might we see? Yeah, so um you know, ADHD

[01:00:13] a lot of it is driven by um changes in

[01:00:16] dopamine. Like that's one of the big um

[01:00:18] sort of the big neurotransmitters that's

[01:00:20] involved in um in ADD. And that's

[01:00:22] something that also gets modulated by

[01:00:24] estrogen. And so what what what women

[01:00:26] tend to see is that they do get changes

[01:00:28] in their symptoms across the cycle. Um

[01:00:31] it tends to differ woman to woman. Um

[01:00:33] and so if I was if I was somebody with

[01:00:35] um ADHD, I would say track your cycle

[01:00:37] and track your symptoms. And then learn

[01:00:40] about your own body's relationship

[01:00:42] between hormones and um and ADHD. And

[01:00:45] then I would just try to heavy load like

[01:00:49] the the you know, the the most intense

[01:00:51] workload and those types of things on

[01:00:53] your good days, right? Um cuz some women

[01:00:56] get really like when estrogen starts to

[01:00:58] fall, like early early luteal phase,

[01:01:01] they have a really difficult time um

[01:01:03] with managing their symptoms. Other

[01:01:05] women have like that that week before

[01:01:07] their bleeding, they have really bad

[01:01:08] symptoms. Other women get really bad

[01:01:10] symptoms um during their periods. And so

[01:01:13] um just really understanding what your

[01:01:15] own body's relationship, but yes,

[01:01:17] there's definitely um hormones will

[01:01:19] modulate your symptoms. There's no

[01:01:20] question about it because they impact

[01:01:23] signaling of the same systems that

[01:01:24] impact symptoms of ADHD. Um but like I

[01:01:27] said, there doesn't seem to be a lot of

[01:01:29] research consensus on who's going to

[01:01:30] feel what way when um because so many

[01:01:33] there it does seem to be a lot of

[01:01:34] heterogeneity in symptom worsening. And

[01:01:36] so just really keeping an eye um

[01:01:38] tracking yourself and then learning that

[01:01:40] way. Brilliant. It's been an absolute

[01:01:42] pleasure to have you on the podcast.

[01:01:44] We've been asking all our guests this

[01:01:46] question. So, Dr. Sara, what do you wish

[01:01:49] every woman knew by the time she was 25?

[01:01:51] >> By the time a woman's 25, I hope that

[01:01:53] she understands her cycles. So,

[01:01:54] understand your menstrual cycle, start

[01:01:56] tracking it early, learn your

[01:01:57] relationship between your hormones, like

[01:01:59] how you feel, your energy levels, um

[01:02:02] emotional sensitivity, etc. Um and so I

[01:02:05] would just start start really tracking

[01:02:07] and learning. Brilliant. Thank you so so

[01:02:09] so much.

[01:02:10] >> you for having me.