Episode 36: Estrogen Dominance Explained: The Link to Painful Periods and Mood Swings with Dr. Michelle Weeks

Are you experiencing painful periods, mood swings, or unexplained weight gain? If so, you might be dealing with estrogen dominance. (Previously episode 7 of season 2) 

In this insightful episode of TMI Talk, Dr. Mary Grimberg welcomes Dr. Michelle Weeks to dive deep into this often-overlooked condition that affects so many women.

Key highlights from the episode include a breakdown of what estrogen dominance is and its impact on the body, discussing the important roles of progesterone and estrogen throughout the menstrual cycle, and why the balance (or imbalance) of these hormones can lead to a variety of symptoms. The discussion also covers the perils of chronic stress, a common contributor to hormonal imbalance due to its effect on cortisol levels, and its downstream impact on conditions such as insulin resistance.

Listeners will gain a better understanding of the symptoms of estrogen dominance, including abnormal menstrual bleeding, fibro-cystic breasts, endometriosis, and more. Dr. Weeks also provides practical guidance on hormone testing, lifestyle changes, and dietary adjustments to manage estrogen levels effectively.

Takeaways and actionable steps:

• Consider getting your hormone levels tested on specific days of your menstrual cycle (Day 3 for estrogen, Day 18-21 for progesterone) for accurate assessment.
• Explore the Dutch Test if you have irregular periods or are on birth control.
• Start managing stress effectively through mindfulness practices like meditation, which can lead to balanced cortisol levels.
• Begin supporting your liver with cruciferous vegetables, fiber-rich foods, and probiotics for better estrogen detoxification.
• Engage in regular strength training and post-meal walks to aid insulin sensitivity and metabolic health.
• Evaluate the products you use daily and consider replacing those with harmful endocrine disruptors with cleaner options.

For further insight, revisit Episode 2 of Season 2 on anxiety and stress management to complement the knowledge gained in this episode.

Listeners can also take a free hormone symptom quiz available on Dr. Michelle Weeks' Instagram (@weekswellness) bio to gain more clarity on potential hormonal imbalances.

Connect with Dr. Michelle Weeks

• Website → WeeksWellness.com
• Instagram - @WeeksWellness

Timestamped Overview

00:00 Progesterone-Estrogen Ratio & Stress
10:08 Understanding Hormonal Balance in Women
15:21 Using DUTCH Test for Hormone Analysis
20:15 Hormonal Cycle and Ovulation Process
24:14 Signs of Estrogen Dominance
27:54 Menstrual Product Capacity Comparison
37:20 Signs of Estrogen Imbalance
41:51 Progesterone and Cortisol Pathways Explained
44:35 Stress, Cortisol, and Fertility Connection
51:32 Insulin Resistance and Metabolic Dysfunction
58:44 Stress's Impact on Progesterone Levels
01:01:14 Progesterone Cream and Estrogen Detox
01:05:25 Pair Carbs, Walk After Meals
01:14:32 Authenticity and Inner Healing Journey
01:18:01 "Discover Dr. Mary's Integrative Practice"

If you have any other questions or topics you want to talk about, send me a message on Instagram. And if you loved this episode, please leave me a rating and a comment with your feedback. Please share this with your friends and loved ones, too!

I’ll see you in a week!

Transcript

0:01

Hello, everyone. I wanted to do a prelude to or prelude, I don't know if I'm saying that right, to this episode of estrogen dominance. And, basically, I wanna do this because there's a lot of talk about hormones and how things break down, and I do the best that I can to summarize things in order for it to be more digestible. But I thought explaining it a little bit more here would help prepare you for the episode so you can start to understand and take away things a little bit easier. So, basically, we're going to explain why painful periods are not normal, tender breasts, mood swings, PMS symptoms, you name it, how we've normalized them in society. And we're gonna go through the the menstrual cycle and the different phases and how hormones are affected during that time. We have four main hormones during that psych our cycle. And the two that I want you to focus on is gonna be progesterone and estrogen. So just we'll be talking about LH and FSH, but just for now, during this episode, to break things down to be more digestible, just focus on the progesterone to estrogen ratio. So there's going to be the ratio is important because when we have low progesterone, that's when we get a cascade of all of these symptoms that you'll, you'll soon find out. And the biggest takeaway from this episode, you're gonna get a lot of information on where to start and what to do. And I summarize this in the end of where to start, but one of the most common reasons we have low progesterone is due to chronic stress. And we live in a society that really capitalizes on us being stressed, living in fear, and constantly running around their head cut off. So I didn't say this at the in the episode, so I wanted to say it now is that I think it's important for you to listen after you listen to this episode, if you haven't listened to episode two of season two, I would highly recommend it. I talk about anxiety and stress and how it shows up and different ways we can look at it and and how it shows up in our body and different ways to approach it that may be non conventional, but also conventional as well. Another thing that we'll talk about in the episode as well is something called insulin resistance, and we dive more into that about how that's a big reason why we have chronic weight gain maybe around the midsection, ongoing high blood sugar, how that can set off a whole cascade of other symptoms as well. What I don't mention in this episode, which I wanted to, but I just didn't cross my mind and because we were trying to get it done in an hour because she had to, had a a prior engagement, is something called a continuous glucose monitor. So this is something that's been incredibly helpful for me to understand, my insulin resistance and how that affects a variety of symptoms such as endometriosis and all these things. So that's something that I would love to add in there is that you can work with nutritionist that understands the blood glucose monitors. They're continuous ones, the ones that you put in your arm, and it's really incredible how much information you can get out of that because you may be surprised on what things spike your blood sugar. Like, for me, my inhaler was spiking my blood sugar, and if I had more than one cup of coffee at a time, it was spiking it through the roof. So this was also worsening my period symptoms as well. If this doesn't make sense, bear with me. Listen to the episode, and you'll see how they all tie together. But, basically, when your insulin isn't working, it's the we have more glucose in our bloodstream. And when that happens, we can develop more fat. And then when we produce more fat, that produces more estrogen, thus adding to the estrogen dominance issue. And at the beginning of the episode, Michelle talks about how it's the ratio of things. We want more of that progesterone in that end phase of our cycle, which is called the luteal phase. So you may need to listen to it a couple times. This is a very important episode because it can be really impactful. And then finally, at the end, she suggests different ways to help lower the estrogen, And the common denominator of all that is going to be managing chronic stress, and then you can kinda add on a lot of these other factors. I wanna do this really because I know it can be incredibly overwhelming. I've been on the other side of this. I have tried to do everything perfect immediately and then went to a shame spiral because I couldn't do it. And so I just want you to start being aware of these things. Just don't even need to change anything right now. Just start bringing it to your conscious level to understand. And then after this episode, if you haven't listened, listen to episode two of season two on anxiety, and I think you'll get a ton of great information about this. I know that it's been really impactful on my life and gaining control over my cycle and my pelvic pain. Now further ado, we will jump into the episode. Ready to tackle the topics that you've been curious about but never felt comfortable asking? With a straightforward, no nonsense perspective on life, blended with candid stories and a healthy dose of humor, Doctor. Mary Grimberg cuts through the fluff and addresses the conversations we all need to have on TMI Talk, where no subject is too taboo. Our bodies, our minds, and everything in between. Now here's your host, doctor Mary. Hello, everyone, and welcome back to TMI talk with doctor Mary. Today in this episode, we're gonna dive deep in with doctor Michelle Weeks on painful periods, fibroids, mood swings, endometriosis, infertility, irregular periods, and weight gain, especially around the midsection. Oftentimes, this is due to something called estrogen dominance, and so that's what we're gonna dive into today. And as doctor Michelle talks, we will break down a lot of these really complicated terminologies and hormones to make it more digestible for you to understand. So before we move further, I would love to introduce doctor Michelle Weeks. She's the founder of Weeks Wellness. She has gone through the cap pelvic program through the American Physical Therapy Association, a board certified health a board certified women's health clinical specialist, one about 500 in the country. Doctor Ricks has also received her certification in dry needling. She's also received a functional fertility certification through a four m and training in next level functional nutrition. She has also obtained advanced training in the areas of visceral and neural manipulation through the Barrow Institute. She also has a Mercier therapy certification for fertility and myofascial release. Whoo. You are just pretty awesome. And if for those of you that don't know Michelle, she's also a friend, a colleague, and, a a mentor for me. So I am really excited to have you on here, and you're so humble. I am so excited to be here because I love talking with you and, yeah, just sharing all this information with everybody. Such a wealth of knowledge that I'm like, the world needs to hear what you have to say. And how many clinics do you have now? I have four now. That's awesome. Yeah. So just opened our fourth in Littleton, Colorado. Awesome. Where can you tell everybody where your other location is? Absolutely. So I have, my main clinic in Tallahassee, Florida, and then we have one in Cambridge, Massachusetts, 1 in Arlington, Massachusetts, and now one in Littleton, Colorado. I I don't know how you do it all. For you all listening, she does everything. I swear. We, we met way back, like, a couple years ago at the the PESR training and hit it off. That was so great. Like, yeah, meeting you was, like, the greatest, like, part of that that training, honestly. Same. Yeah. We just immediately hit it off. So I'm excited to share this with everybody. So, you know, hormones are incredibly just, I believe, misunderstood, not talked about, and I'm somebody that has struggled with estrogen dominance, and you help me with this. And and once I've learned this, my mind has just been blown. And and so can you break down what estrogen dominance is so people can understand, from just kind of a basic level? Yeah. Absolutely. And I'll probably take a a little bit of a step back from that too and just tell people so hormones are actually the way our body sends messages to itself. And so it's this very delicate kind of dance imbalance. And so if we have too many messengers, it should trigger our body to stop producing some things. Or if we don't have enough messengers giving the message, it should tell our body, okay, we need to kind of build this back up and produce a little bit more, to make sure that we just have this really nice balance in our system. And then I think a lot of people think balance means even. Right? Mhmm. But that's not always the case especially with hormones. Some things we want to be we we want a higher ratio of one to another and that's actual proper balance. So it's not always they should equal each other and I think that sometimes brings a little bit of of confusion for people too when they think about like, oh I have to balance my hormones. What does that truly kind of mean to them? So essentially estrogen dominance. Now there are times if you're a cycling female that you actually want to have more estrogen in your system than progesterone. So that's what we're gonna kind of talk a little bit too about ratios between. So really the first half of your cycle, so the day that you start bleeding, is cycle day one. Up until the day that you ovulate that's something called your follicular phase. And it's within that phase that you actually do want more estrogen circulating in your system. And then after you ovulate, so after ovulation but before you start bleeding again, that's your luteal phase. And in that phase, you want your estrogen levels to drop and you really want your progesterone to be at a higher level. And so depending on what phase you are in your cycle, that's gonna mean something a little bit different for your estrogen. So when we talk about estrogen dominance too, what that means is we have too much estrogen when we shouldn't have it and likely and or not enough progesterone, and that's the ratio that is off. And that can lead to so many different symptoms. Yeah. And so when you say the ratio is off, can you explain to them when that ratio is off and how how would somebody know? Because I know I mean, it's the wild wild west out here, at least in Austin, where people are just being tested for hormones. They're like, oh, you're great. Everything looks good. Can you explain, like, if somebody's you know, maybe let's be real. People are gonna have to ask their primary cares specifically for day, you know, three or day 21. So can we kind of yeah. How what are some guidelines you'll give people? Yeah. Absolutely. So because I just explained to certain periods, we would expect more estrogen to be in our system And other periods or points during our cycle, we would expect our estrogen to be lower and our progesterone to be elevated. So if we are testing our hormones on the wrong day in our cycle, then we will potentially not get any usable information. And I see this so so much. All the time. All the time. All the time. Yeah. All the time. Pretty much all of the time. So really, we want to test our estrogen levels, something called our LH, which is luteinizing hormone, and FSH, which is follicle stimulating hormone. And we're probably not gonna get into those things too much today. But those, we want to have tested on cycle day three, potentially cycle day four because that's really when we're expecting and when research has backed up showing what our estrogen, our FSH, and our LH levels should be at that phase in our cycle. This is not when we want to test progesterone because if we did, it's gonna be low, but it should be low. So that's not an abnormal finding. We wanna test progesterone when we expect it to be high and that's gonna be in the middle of that luteal phase, which they're estimating is around day twenty one. So, generally, I tell people that it's really six to nine days post ovulation. I mean, they are just assuming that everybody has a twenty eight day cycle, which is also not necessarily the norm. But if you're not somebody that's tracking your ovulation and your fertility, then day 21 can be a pretty fair assumption. Or you could kind of do some math if you are have a fairly regular cycle and let's say it's always twenty six days, then you should know you could kind of bump that timeline up. So then you're probably gonna wanna test your progesterone on, like, let's say, day 18. And then once we have those numbers, so estrogen on day three, progesterone around day twenty one, now we wanna compare what those ratios are and it should be about a a two to one ratio of estrogen to progesterone. So what what if somebody that oh, like, so many people have irregular periods. And so where how would they, like, how would they go about this, number one? And number two, what about people on birth control? Yes. Two big questions. That's a great question. So then sometimes serum blood tests are not the way to go. I like to also utilize something called the DUTCH test. So it's dried urine assessment. So really what it's looking at is our hormone level, but also how our body is metabolizing our hormones, and then also looking at some of the the precursors and really kind of the larger picture. So oftentimes, that's my preference, and I will I will correlate them too with, like, the blood levels that we're seeing, for more traditional labs just to make sure that everything is is kind of making sense. So when we're doing the dried urine test and if you have irregular cycles and or you're on birth control, we have a little bit more leeway, when we're doing that in our cycle. Generally, we wanna aim for around that day twenty one or post ovulation, which we know you're not ovulating, generally speaking, if you're on birth control, but in that in that time frame. So roughly around day twenty one or so. Okay. No. That makes sense. I mean, what what you would I've also seen it too, and you and I have talked about how you said, you know, you had just said it's the estrogen to progesterone ratio is a two to one. You had also mentioned before, like, a a hundred to one ratio or a 200 to one ratio. Yes. So you can also depending on when when you're testing, you can look at that too. So there are a couple. So you could, you know, test your estrogen with your progesterone on day 21, and we can look at that that ratio a little bit as well because we would expect to see estrogen to be kind of on that lower end. It's not gonna be as helpful as doing a cycle day three and a cycle day 21, but we could definitely kinda look at different things. And then we're also, again, gonna look at, you know, FSH and LH. So really, I guess we will get into this a little bit. I mean, I guess it's hard not to. Yeah. Hard not to. So luteinizing hormone is, and some people that are listening, especially if they've been tracking their fertility or kind of have been been in that space. Oftentimes, when we're looking at, like, ovulation testing and ovulation strips, that is actually looking to see if your LH has surged, and that happens just prior to ovulation and and is what helps to trigger it. But in order to get LH to surge, estrogen also is surging at the same time, so they kind of correlate closely together. So that's another kind of way we can can help look at that. So we wanna see, you know, does our estrogen level kinda make sense with what our LH level is on those those serum blood tests too, just to kind of give us a more well rounded picture with that. So So, like, if somebody is looking at like, if you pull up and and you guys, if you're listening, you can kind of pull up a hormone level chart based on, like, your cycle. Right? So when you're looking at it, you see, like, a little bump around day three of for estrogen. So why is it that it's day three for that and then, like, another you said day eighteen for the progesterone? Mhmm. So what about those days? I I just think it's important, like, when people understand the why because then it just kinda clicks more. At least for me, that's when my brain works. Right? Yeah. Yeah. Absolutely. So estrogen is helping to build our lining of of our uterus up. And so that's why if we've shed our lining and we're menstruating, then we're gonna see that estrogen kind of start to come up in order to prepare for our next cycle. And so during that follicular phase so the the reason it's called the follicular phase is because our ovaries are, developing follicles to determine which egg potentially we're going to ovulate. And so, during that phase, we have FSH, so follicle stimulating hormone, is being produced because we have all these, like, little, like, baby can I call them baby eggs? I don't know if that makes sense. Little baby eggs, and we wanna see which one is gonna mature into the biggest, potentially best egg, and that's what our body is going to choose to ovulate. Okay? And so we want estrogen to come in, and it's gonna help to prepare our uterine lining during that phase as well. And so we've got these follicles that are growing. We eventually end up with one winner bag follicle, and then our LH and our estrogen surge, boom, we ovulate if everything is functioning correctly. And then what happens is that that follicle that we ovulated, that starts to produce progesterone. And so now we see estrogen is coming down and this ovulated egg is producing this progesterone because that is potentially what's going to allow it to survive and turn into a baby if a sperm comes in and fertilizes it and we go forth. And so that's why really in that second half in that luteal phase, we do wanna see progesterone coming up. That's a really good indicator that you actually ovulated that cycle. And so sometimes what happens is we're not if we're not ovulating then we're not gonna see that spike in progesterone. Or potentially if that end quality is not great, our progesterone might spike a little bit, but not really to the level that we would want it to if we're thinking about it from like a fertility aspect. So there's just some different numbers, that we look at and definitely more of an optimal range of numbers as well. So where, you know, maybe your physician looked at your lab work and you're within range, well, we know It's yeah. That's a wide range and that's not actually truly what's most optimal. It's like the you you took statistics. Right? I don't know. You could help me bring it up. I was like, two like, two standard deviations. So essentially, it's like 95. 5% of the population fits in with the reference range. Like, would you say 95% of our population is healthy? No. No. But they're but they're part of our reference range of what's normal. It's normal. Saying okay. So, like, most women wear size, what, five and a half shoe to ten and a half shoe? So that would be, like, what is considered normal. So if you were a size ten and a half and someone said, oh, here's a five and a half shoe, it should fit you because it's with you're within this normal range. Is that gonna be, like, comfortable? Now I understand. Wear it? Now I understand statistics. That makes much more that's not I don't know what standard need be I I mean, I have tried so hard to understand that. I hated statistics. But I loved that example. I think people really like it. So let's go into what those symptoms look like. So at the beginning of the episode, we talked about, you know, a variety of different symptoms. And so can you explain I mean, estrogen dominance. Oh my gosh. It can be so many symptoms. So let's go through what those common symptoms are and and then the why. Actually, before we do that, try not to be overwhelmed with all the hormone information. All I want you to focus on right now during this podcast episode is the lute would you say the luteal phase, like, the last half? Yeah. The last half of our cycle is really where if you have estrogen dominant, that's when we don't want estrogen to be dominant. Yep. Exactly. So that's kind of where a lot of issues kind of stem. Perfect. Okay. So typically after day fourteen. So if you tend to have more of these symptoms around day fourteen, let's just start paying attention to that. Your estrogen's gonna be higher than your or sorry. Your progesterone's gonna be higher than your estrogen around that time. So that's the only thing you need to remember for this right now. So k. Go ahead. Yep. So some clastic symptoms that you have excess estrogen, so we're gonna call that estrogen dominance, weight gain, okay, especially around the middle, and we'll kind of get into the why behind some of that in a second as well. Fluid retention, but really more specifically around your cycle. So I would even narrow this window down a little bit more and say probably about starting a week prior to when your cycle should start, that's when that fluid retention is something that you're gonna notice. And then at the same time too, if you notice breast pain or tenderness, which I know is so common. Personally, that's what I had for a while too. Like, always, like, the week before my cycle, like, I'd be like, oh, yeah. Oh, that's that's sore. I don't wanna, you know, go and do a lot of running or any contact sports or anything like that. No jumping. Jumping on the titties or flapping in the face. Mine aren't big enough to flap in my face, but you don't want them flapping around. Not comfortable. And then any heavy bleeding during your cycle. And I'm gonna pause on this for a second because I feel like so many people have no idea what a normal amount of blood loss is for their cycle. And I know every time I explain this to a patient, like, I feel like their mind, like, blows because they just never would have thought that that they actually had heavy blood loss when they did. It's been normalized we've normalized all of these things in the media, on TV, on just the way we talk about stuff, and just the mood swings too. When I see them on TV, I'm like, shut up. Like, they're like, oh, I'm on my period. Let me eat a bunch of chocolate and, like, be a, you know, like, in a bad mood to everybody. And that's just me. And it's like, if you calculate like, if you actually calculate if if we just accepted this as fact, which we tend to have as society. Okay? So if they're, say, the typical person menstruates, we'll say, five days, and maybe they start menstruating around, we'll say, I don't know, twelve, and then maybe they go into menopause fifty five, like, 50 we'll just say 55 just to kinda make this more dramatic. How many cycles of that, Mary? You doing math? I am doing math. So forty three years times 12 times five. K. That's 20 almost twenty six hundred days. So what does that equal for years? Seven fucking years. So seven years of your life Is that right? There's no way. Are nor these are like yeah. That's crazy. Sit with that. I mean, my calculations don't think they're perfect, but, I mean, come on. Like, this is insane. Like, that's why okay. Anyways, keep going. Yeah. I digress. No. You're you're in good company for that. Okay. So heavy bleeding, what you really need to know is normal blood loss, 60 to 80 milliliters for your entire cycle. Can you, like so I'm gonna break it down here. I'm like, come on. I don't have I don't put, like, my blood in, like, a milliliter. I'm like, hold on. Let me measure this. Okay. So the average regular tampon heavy tampon holds 10 milliliters of blood saturated. The same with a regular pad. A menstrual cup or a menstrual disc will hold anywhere from 30 to 50 milliliters of blood. So if you're somebody and you're using a menstrual cup and you're filling it up twice for your whole cycle, like, you're there, which I okay. And I get so the main thing too is, like, obviously, if your tampon or your pad is not fully saturated, like, you're still gonna change them every couple of hours, like, that that's fine. So sometimes I have to tell people, like, just if you had to, it takes a little bit of imagination if you're using those, because, obviously, we don't want you to keep your tampon in for, like, ten hours if it's not saturated because that's not great either. So you you will have to get a little bit, you know, creative with trying to determine, like, is that about half saturated, a quarter, kind of what does that blood loss look like. But most people are are actually saturating a tampon or a pad every hour to two. I mean Totally. Well well, what size hand bone are you talking about? Right? Because there are, like, a few your regular. Okay. So a regular so they should be going through about up to nine. No. Up to eight. Eight will be your top level. Six to eight. Because you don't wanna fully soaked. That's not like fully soaked. Pee you know, because when you pee and you would tampon it, it gets all wet and soggy and, you know Yeah. So you might take it out and change it. Yeah. This is why I switched to cups, by the way. If anybody is not Love menstrual cups. It's like a life changer. Like, I want everyone to know about menstrual cups. Like, I you have one, and they boil it at the end of your cycle. You dump it out when you're in the shower. I mean and you just you dump it out every twelve hours. It's, like, it's incredible. Yeah. I I have an episode on this earlier. I need to look at which episode it is. But if you wanna listen to how to find the right period product, I have an episode earlier in this, and I can tag that in here. But That's awesome. That's awesome. But it makes it easier too for then determining how much blood loss because you really can see, like, oh, is that menstrual cup all the way full? Then and I know this thing is holding 50 milliliters, and maybe that was on your first day. And then on your second day, it's almost full again. You're at a hundred. You're already now at into the heavy bleeding category. Mhmm. But that's what everybody thinks is normal. Right? Yeah. And I've talked to people too. They're like, oh, yeah. I can't I have to change my menstrual cup more than twelve hours. Like, I have to do it, like, midday because that because I've gotten that question too. They're like, what what do you do, like, in the middle of the day if you have to do it from, like, a rinsing and sanitary? Like, I was like, but I don't. Morning and you know, morning and evening, because I don't thankfully fit into the heavy bleeding category for that. But, I mean, that definitely is an eye eye opener for some people. Oh, yeah. I mean, like, even just in our pelvic floor training, like, they don't talk a lot about these details either. You know? And so it's it's crazy how much we are just just the lack of information about it. I mean, estrogen dominance is something that I have suffered with for a very, very long time, and I'm in the process of normalizing that. And thanks to you, you're the one that brought it to my attention, and I was like, oh, you know, because I kept getting, like, acne, severe painful periods. I mean, crushing mood swings. Like, just, like, a couple days before my cycle, I'd be like, why do I just I'd get some dark ass thoughts. And I was like, something is off. I don't feel like myself, but I don't know what's happening, and this isn't normal. And, you know, I I'm a pelvic floor physical therapist, so I know, like, it's it's something to do with my cycle. And then when I got my cycle, they were, like, blood work. They were like, oh, that's fine. You're normal. I'm like, how the fuck is this normal? Like, it's not. Yeah. So, anyways so, yeah, if you wanna kinda so okay. So the irregular or the heavy bleeding. So heavy bleeding, clots with your cycle, And, you know, a few, like, really, like, tiny, tiny clots are fine, but if it's anything a quarter or larger, that's what I'm talking about, with that tissue. Endometriosis is a estrogen dominant because, again, like we talked about back in the follicular phase, the role of estrogen is to build up our endometrial lining and our endometrial tissue. And so it doesn't matter where in your body that endometrial tissue is, but if we throw some estrogen in the mix, it's gonna make it grow. And so that's going to, continue to feed that endometriosis. Food Living with anybings? Oh, sorry. Is I I don't think enough people actually know what endometriosis is. And so briefly, which is, like, I know it's hard to say, because we have an hour. Can you describe it a little bit just so people can be like, is that me? Is it not? Yeah. So endometriosis is, by, like, true definition, is the internal lining of our uterus. So that tissue, imagine that it got out of our uterus and it can be anywhere in our body. It's got anywhere. Yeah. It can be anywhere. And so really it's just the presence of that endometrial tissue outside of where it should be in the uterus. And so oftentimes, like your hallmark signs, which there can definitely be some atypical signs as well, and I've definitely seen it, and I'm sure you have in patients too. But you're gonna have cyclical pain, intense cramps. So these are the folks that, you know, you're on you know, the first day of your cycle, you know, you can't go to work, you're doubled over in bed, you can't function. Pain with sex is another huge kind of hallmark of endometriosis. You can have lots of bowel issues, again, that tend to be more cyclical as well. And so once we really start to see kind of this pain and inflammation that has truly a more cyclical pattern to it. And if, you know, periods are not great and sex isn't great, like, to me, those folks I'm sending, like, you need to get assessed for endometriosis. Well, the thing that sucks, though, about endometriosis is the gold standard is still the, laparoscopy. Yeah. I have lots of lots of thoughts on that. And, really, if we're gonna think about doing any type of surgery, it needs to always be done by an excision specialist, which they're not everywhere. And, you know, we shouldn't just be going in and doing, you know, a local laparoscopic surgery trying to get your endo out of your uterus or full around your fallopian tubes, around your over just like in your pelvic cavity. Like, that to me is such a disservice and can promote its growth and spread throughout the rest of your body. Well, it just doesn't It doesn't address why. Like, okay. You remove it, but it's still there. Like, for instance, like, I have endometriosis, and it's something I manage through understanding what we're gonna be talking about. And when I don't have it managed, which, like, this last month, I've been under a lot of stress. My cortisol spiked, and then naturally, it's the holidays, so I didn't eat as healthy. I haven't been meditating as much or exercising. So I just, like, went off the rails. So, like, my period is not ideal right now, but I know how to get back kinda onto it. And so that's the empowering part, but it's still insane to me that that is something we just jumped to because, first of all, then it promotes more scar tissue on top of it, and and the the tissue is actually scarring onto other organs too that can also attach the rectum. That's why you can have bowel issues during your cycle. But, we won't have to dive so deep into that, but just so people can be a bit more aware. So go ahead. Keep going with the other symptoms. Okay. Food cravings. Yes. Hello. Yep. You mentioned that one. Hormonal and premenstrual headaches. I definitely see this one a lot too, those, like, cyclical headaches. Fibrocystic breasts. So not even just tender, but if you feel like kind of lumpy for lack of a better term or cystic breasts, that definitely is a sign of excess estrogen fibroids because, again, that's that tissue growth and so estrogen loves to help tissue grow. And so that estrogen is just kind of feeding that fibroid. Irregular bleeding, short cycles. So not you know, we really do want a four to five day cycle. Like, a two day cycle is not something to be like, woo hoo. I have a short cycle or, you know, not not something to be super excited about. It's telling us that something's not quite right with our body, and depression. Beautiful. Had that. Oh my gosh. Yeah. If you're, like, a few days before your period and you're like, man, having some dark thoughts or just super anxious and you just not you don't feel like yourself, you're not crazy. Just know please know that. I just you can feel sometimes it's physiological. Like, it's just you can feel outside of yourself. And the amount of times I've been gaslit about this has been insane. That's why I'm so obsessed with just talking about this stuff because if if you don't know this, it's it can be really disempowering and really scary. Yeah. It can be. And I'm gonna say too, like, with depression because I've been doing more research in the perimenopausal population because that is and we'll kinda get into this maybe a little bit later. But perimenopause is one of those times that we start to see estrogen dominance, and we see that there can be a sharp increase in depression. Oh, yeah. No coincidence. Yeah. Totally. Well, it's it's interesting though because I think when you think of perimenopause, right, people think their estrogen's lowering. We think so much about estrogen, estrogen, estrogen. And I've seen so many people put on estrogen right away when it almost makes their symptoms worse. Mhmm. Because it all goes back to what I was first saying. It's about the ratios. So while, yes, estrogen may be dropping, but your progesterone is dropping even faster. And so that ratio is now way out of whack. And that's what we need to to really address. And so, honestly, progesterone supplementation is gonna be really helpful. You know, I was listening to so I'm in that global pelvic health group, that Tracy Sher runs. Mhmm. And one of the ladies on there, she's a she's a surgeon, that specializes in endometriosis. And one of, you know, one of the things she was saying was just talking about how, like or at least I I'm pretty sure it was on this. She was saying, like, the first line of defense in every other country is to go on progesterone, but for some reason in The United States, people are put on estrogen. I know. I had a patient asking me that the other day about how she had endometriosis, and they put in a IUD that was estrogen driven, and she was questioning it. And I was like good for her. What? Yeah. Yeah. I don't know. And I was like, yeah. Not like shaming that we don't know. Because the estrogen is what's feeding that endometrial tissue. So really, you know, you would want to ask some questions around maybe a progesterone if you wanna be on a if you wanna be on a hormonal birth control. You know, progesterone only might be the best route for you and not a IUD that is estrogen driven. Yeah. So if you're listening to this and all these symptoms sound like you, look at your birth control. What are you on? Is it mainly estrogen? Are you on progesterone? People are on progesterone, but I can almost guarantee you most people, from what I've seen, they're on some form of estrogen, and then they're just stuck. They're just on it until whenever, indefinitely. And And this should ask the symptoms. Yeah. And they don't know why. I think, you know, we'll dive here in in a second into, like, yes. We can do the progesterone supplementation, but, like, just for people to know, like, you know, and have an idea. Can you explain? I I was so freaking fascinated when we talked about the breaking down and producing of progesterone. So why this happens and explaining a little bit about why does the estrogen or the progesterone lower, what causes that. Because I'm all about, like, what can people take away from this, like, right now that is, you know, and that they can take away right now. And so one of the things we talked about was, like, how cortisol goes down that same pathway. So Yep. Can you blow people's minds right now on this, please? I I could try. Okay. So you might have to pull me out of the weeds a little bit here. Just maybe don't go through all the cascade. Just kinda, like, start You already, like, didn't see. Yeah. You're, like, reading my mind. I see. But, like I will you see where I'm going. Okay. So I'm gonna start with cortisol or not cortisol. Cholesterol Cholesterol is the start of everything because I also think that that's important because I've had a lot of of patients, also probably more in the menopause than some on the the male end of things that their physicians want to be really, really aggressive at getting their cholesterol, like, super, super low. But we need to know that we need cholesterol to make our hormones. And so if we are on a low fat diet or we're scared that our cholesterol is gonna be too high, that can definitely be impacting your body's ability to actually create hormones. This Don't be afraid of fat is my number one kind of starting point. This fact, I just I feel like we need a moment of silence here for the women in the nineties that had to go into the no fat diets. Diets. The worst thing we could have done for our hormonal health Oh, and add cardio on top of it, all that Yep. Oh my god. These are the women. High intensity. Like, yeah. We're we're we're screwed. Which those things aren't necessarily bad. HIIT is not necessarily bad. It's just that the amount of At a certain point. Yes. The amount of Or it's with the low fat and the other stress in life. Okay. So anyways, we need cholesterol to make hormones. It starts with cholesterol. Starts with cholesterol. Okay. And then it goes down it kinda goes down this pathway. And then really, our body has to decide if it's going to make progesterone or if it's going to make cortisol. So cortisol is our stress hormone. So when we're like really, like, fight or flight or in the thick of it, and there's so many symptoms that we could talk about related to cortisol, elevated cortisol levels. But our body then chooses in times of stress to make more cortisol and stop making progesterone. And our bodies are super smart. Right? So the reason that this also occurs is that our most of our bodies were created with fertility in mind. So regardless of if you want to have children or you don't want to have children, this is why our actual fertility status is a good indicator of our overall health. So if our body is wanting to be fertile and be able to get pregnant, then that's why we make progesterone. But if our stress level is so so high, that's not conducive to creating a life and maintaining a healthy protective factor, our body just shuts down that progesterone pathway. So now we've got increased cortisol because of the stress in our life. Progesterone is dwindling, and so we see this also too in something called hypothalamic amenorrhea. And so we see cycling women that are losing their periods or having anovulatory cycles, and it can be due to it's a triad. It can be due to any one of the three things or a combination thereof. High levels of stress, which we talked about, so our body shuts off that progesterone pathway, undereating, and overexercising. Everything we've been freaking taught to do. And we're losing our cycles, and you'll go to your physician, and they wanna just put you on birth control, which is not a solution Nostrogen. To any of our problems. It's just like, hey. Here here's a really bad Band Aid on the situation instead of trying to dig deeper, or these folks will get labeled with PCOS. They don't have PCOS. They have people got like a menorrhea. Their system is shut down because it's under such stress that it's not gonna ovulate. So that yeah. So they're losing their appearance. But so what's insane to me and this is something that, like I know there are people that truly struggle with infertility. I have done IVF in in the past. I do not have children, but I did because I am a carrier for a a genetic illness. So in that case, it doesn't matter my hormones. Like, it's just whatever. Right? But we have such an insane amount of women unable to get pregnant, and we are not talking about this. Nope. It is insane. So now let's think about our generation. Right? So we're like, I'm in my I'm 38. How are you? Yeah. About that. About that. Same gen yeah. We're the same. Same generation. So our generation was just, like, put on birth control. I never was able to tolerate it. In retrospect, it's because it was estrogen dominant, and I could just I went psycho on it. Not like psycho. Just cranky, whatever. So, so let's play this out. Right? So our generation, okay, we grow up. We are the generation of Britney Spears being called fat when she gained maybe five pounds. Yep. Okay. We are the pretty skinny. Yep. We are the low fat, high cardio. Okay? Estrogen birth control. We are also the first main generate first or well, I guess gen xers would be but, like, our population of women are more in the workforce. Yep. They're taking home they're honest they're taking on the household duties as well. Yep. K? Now taking on bias against women in the workplace. Okay? That's not even adding on any other stressors. And we're we're even considering if they have a family if they have kids. Oh. Because then they're also the primary caregiver if kids are sick who's staying home, mom or dad Exactly. In our generation Yeah. Mainly. Yeah. In heterosexual relationships. But yes. Exactly. And so it's like and then we're gaslighting them on top of it. And then we're telling them they're fat, and they need to lose weight and just it's anxiety. Just go on an SSRI. So now we're going on an SSRI when it's not even an s it's it's a hormonal issue. Well, an SSRIs will impact your hormones. Oh, yeah. It I gained I was on Lexapro, and I gained 35 pounds. It changes your body's creation of the ketone and estrogen. And so if you come off of them, then there's yeah. We you know? Your body had that conversation because I was like, me getting off my SSRIs has been worse than chemotherapy. Let me say that again. It has been insanely difficult. And that's why I'm so thankful you and I talked because I was like, I don't know what's going on. Like, this is insane, but I was getting gaslit again by being like, just half your Alexa Pro and get off over time. Like, I've been on this shit for twenty years. Okay? My whole body has gotten used to this. Yeah. And so it's this cascade it's oh my gosh. And when I see it in the clinic, I see it all day, every day, you know, all day, every day. And it's just the only thing we can do is just keep talking about keep getting the word out. Keep getting Exactly. Educating. And so now let's talk about so people may not know what insulin resistance is, but this is one of the main reasons if you have, like if you feel like you can't lose weight. Not saying if you wanna lose weight. It's more of I think of weight gain as a symptom. I don't think it as, like, somebody needs to look a certain way. I think it's our body giving us a message. Yeah. And so, with insulin resistance so, basically, how does this estrogen dominance affect insulin resistance? Actually, before you answer that question, can you explain what insulin resistance is? Brief, or do you want me to do it? No. We we can. You can you can chime in or or yeah. Because this is super important to it all. Like Yes. Incredibly important. So when we eat, our body as it's digesting our food, it will turn some of it into glucose or sugar, if that to be very, like, simplistic about it. And so we've got sugar that's in our bloodstream, and it needs to get inside of our cell. And so in order to do that, it attaches onto insulin, and insulin helps to bring it into the cell and for our cells to use that as energy. And so what happens over time is that our, cells become resistant to that insulin, and we can't get that sugar or that glucose into the cell where we need to utilize it, so now it's just circulating in our bloodstream. And so that's why if you go and get a blood a blood test and they test your glucose level, that's what it's really showing you is how much glucose or how much of that is circulating in your bloodstream right now. And there's definitely certain levels of that that we want. And so when we see insulin resistance, that is kind of the beginning of a metabolic dysfunction, which is kind of our overarching title. Like your med yeah. It, like, slows your metabolism. Very yeah. It's a very vicious cycle. Like, metabolic dysfunction is responsible for so much not great stuff happening in our bodies, including weight gain. And then really what happens is when we gain weight in fat, our fat actually helps to create estrogen. So now that's kind of how they're starting to correlate together. So now we have some increased fat, and we're increasing our estrogen rate, which then doesn't help our metabolic dominance. Our our insulin resistance and then increases our estrogen dominance. And now we're just in this, like, loop cycling in the wrong direction. So if, you know, people are listening and you're feeling overwhelmed, we're gonna summarize it in a little bit of breaking this down of, like, what to do. You can listen to this episode a few times if you need to. It is incredibly important to maybe listen to this episode a few times just for you to understand your body. Because once I figure found this out, it changed my life. It changed my relationship to anxiety. It changed my relationship to depression. It it it just it everything started to make sense because my physical symptoms were correlated to something that I had never been told about. And so what's interesting though about insulin resistance, though, is that most physicians are unaware of this. So you can even get your a one c, which is a one c will measure, like, your blood sugar over the last three months, and it can look still somewhat normal, maybe even prediabetic. So that doesn't even necessarily show if you have insulin resistance. So sometimes if you can see I've seen it where they'll do like, you can just even see, like oh, gosh. What would you say the best way to maybe look at maybe your fasting glucose. So your fasting blood sugar, so your glucose, looking at that. Oh, but did a thumbs up when I did that. Hey. Nice. Yeah. I always recommend people do a well, all labs, I like fasting because it just kinda evens the playing field, because different like, if we're eating something different or drinking something different, it can definitely impact what's going on in our system from even an inflammation perspective, and it can change what our our lab values are showing. So number one, I always tell people to fast. That's usually for at least eight eight hours. So glucose, a hemoglobin a one c, and then a fasting insulin. So those are the three things that I'm really looking at when I'm, assessing anybody's labs. And really for for a one c, the traditional medical cutoff is five like, 5.7. They'll start to say you're prediabetic. And so, like, you can get, you know, 5.6 and be like, Mary, you know, Mary, you're doing great. Well, you're like I still don't know. Away from prediabetic. Like, you're going down the wrong direction. I personally like the your a one c to be five or under. And so if I'm noticing that someone's a one c is, like, 5.3, I'm starting to have the conversation on what do we need to do to get everything back on track because we don't want you even to get close to a 5.7. Like, we wanna stop this metabolic disease from progressing, and we wanna come back to where you're gonna feel more optimal. And so there's a lot of things that we can do from a diet and lifestyle perspective in order to help to get that back under control. So I'm gonna well, I wanna we're gonna jump into all of that because that's the the biggest takeaway for people to take action. So in summary, we're gonna try to digest this all. And if you need to correct me, please do this. Okay. So first, if you are experiencing any of the symptoms that we talked about, abnormal periods, painful periods, tender breasts, lumpy breasts, pretty much any freaking symptom that we've taught is normal around your cycle. It's not. It's not. Okay? This is a sign that your estrogen is likely more dominant in relation to your progesterone. So those are the just the two hormones you just have to remember. Okay? And so when that happens, that offsets this whole cascade of symptoms, which you can have those symptoms. And so that's a big sign that you may have it, but you can get your labs done day three for estrogen and day eighteen for progesterone. And what did you say what did you say for LH and FSH? Was that That's day three. Day three too. Okay. So, basically, all of them on day three. And then day progesterone. Except for progesterone, which is day eighteen. Would you say eighteen to twenty one? Yeah. Okay. Depending on if you're if you're tracking your cycle, then you kinda know. Otherwise, day 21 is pretty standard. Okay. And then if you are on birth control or you are have irregular periods so it's hard for you to know, she's recommending the DUTCH test, which is a urine test. Where can they get that? So Dutch has the website, or they can work with a provider go directly to the website and do it? I think they can go to the website and find a provider that's close to them. Okay. Perfect. So that's a great takeaway for them to see. And so one of the major reasons why progesterone is low is because of a high cortisol, and high cortisol is when so when we get really, really stressed, our body releases cortisol, which basically releases a bunch of blood sugar into our bloodstream to help us run from a bear. It doesn't know that we're stressed out about all the bullshit happening in life. It just knows we're running from a bear. So if you stay in that, and it's not just going into fight or flight. It's the fact that we don't come out of it, and we don't know how to come out of it because our society does not value the things that bring us out of fight or flight. Right? We're in The US just for people that are listening. Yeah. And so that can be a major factor. And then so then when you're when that happens, your estrogen's higher, your estrogen. Then and then when you develop the insulin resistance, you have more fat on your body, which then increases your estrogen. So they're not directly related per se, but they affect each other. Correct? Yep. Correct. Okay. So if you're insulin resistant, that's gonna you're gonna likely have more fat, and when you have more fat, that's gonna produce more estrogen. So now add on if you're estrogen dominant and we're in this high stress state, your body is producing that stress hormone instead of progesterone. You see. So now you're even more estrogen dominant than you were to start with. Yes. And so then with that, you want to if you wanna know if you're insulin resistance, you would look at your a one c, your fasting glucose, and your fasting insulin. I will fully admit my, a one c is not that, although, like, it's been kind of wild since chemo, so I've been working on regulating it. But I think in the last few months working on my estrogen dominance, I'm gonna see it significantly change. You'll also see too with insulin resistance, high blood pressure, high cholesterol, because that all happened to me too. And I I was like, what is happening? This is Yeah. This is insane. So what are some why does that thumb keep popping up? I don't know. Yeah. Alright. What are some lifestyle changes people can implement, like, right now? So they can ask their doctor and talk to them about progesterone supplementation. Yep. Or you could do a topical progesterone cream, as an option. And I tell people if you're cycling that you want to use that appropriately in your cycle, so in that luteal phase, so post ovulation, prior to starting your cycle again because that's when we want that progesterone to be elevated. We didn't touch on it a ton, but we also want to look at so really there's, three phases of estrogen detoxification. So this could be another reason why we have elevated estrogen levels because one of the three phases of detox is not going appropriately. So the first two phases take place in your liver, and the third phase is actually your gut health and so your ability to have regular bowel movements. So if we're constipated, that gives our body more time to reabsorb some of the estrogen we're trying to excrete. Okay. If we have poor what's called phase two detoxification of our estrogen, that, again, can cause issues. So that's kind of when we talk about, like, methylation. So people have heard of, like, the MTHFR that kind of comes into here. And then there's also phase one of, detoxification in our liver. So what we would want to do from a diet and lifestyle is it is to help to optimize those detoxification pathways. So cruciferous vegetables are fantastic to support, especially phase one and phase three. It's gonna help keep everything moving. So cauliflower, broccoli, asparagus. I was just gonna say what she's try what she's saying is basically, well, we have excess estrogen. So estrogen dominance can we wanna help reduce get the body to process and excrete the extra extra estrogen, and that's what she's describing here. Thank you. Yeah. So to do that and we would just wanna support all of those phases. So definitely broccoli, asparagus, cauliflower, things that are Tutti vegetables. Yes. Tutti fuse. People really aim for I think we were taught you can tell me if you were taught differently, but more in, like, the pelvic health world, like, twenty five grams of fiber a day. Actually, it needs to be, like, closer to forty to forty five grams of fiber a day. But I will tell people, don't jump into eating, like, a crap ton of broccoli because you won't be gassy and bloated. You gotta ease your body into it because if you have a partner, they're gonna be so annoyed at you farting around the house. Let's just be honest. Yeah. And not all fiber is created equal, so this is why I personally love chia seeds. And I, like, tell people to, chia seeds are so fantastic because it just really helps to, like, soften your stool. They're, like, anywhere from 10 to 15 grams of fiber per serving. And I tell people just make a smoothie, like, because berries have good phytonutrients. They're a good source of fiber. And so load up some berries, put some chia seeds in there. Like, you have, like, a fiber packed smoothie. You're supporting your liver. You're helping to excrete your estrogen. So like doing the chia pudding where basically I'm gonna say it's, like, half chia seeds or maybe a little less, and then the rest is some form of milk. And then I put a little honey in it, and it's like pudding the next day. Yeah. I've heard people too, like, add, like, some cocoa powder to it, and it's like a chocolate You can add berries to that. Yep. Yeah. So so many ways, but really, like, number one takeaway, get more fiber into your diet. Like, that will automatically help to degrade that estrogen in your system. The other kind of surrounding the insulin resistance piece too is never eat a carb by itself. Naked carbs. Always pair of potatoes. No naked carbs. So if you're gonna eat an apple, have a little piece of cheese or a little bit of almond butter or something like that with it. Like, don't just have your carb by itself. And then the other piece is you want to try to walk for fifteen minutes after each meal because that will automatically help your blood sugar, that glucose, get into the cell without using as much insulin. And I've had people ask, like, does it matter what time of day I I walk? If I walk for thirty minutes, like, in the morning, is that fine? I said, no. It has to be very time specific. And it doesn't necessarily have to be walking, but, like, some type of movement for fifteen minutes after you eat is going to help if you have insulin resistance to help to kind of bypass that system. But it can still, like I mean, because if people are listening, they're like, I can't walk at fifteen minutes after every meal. Like, still walking. Yes. Like, some god. Still good. Optimally after a meal, but if not, walking daily Yes. Would make a big difference too. Yes. Or or even if you can't commit to fifteen minutes after a meal, like, whatever few minutes you can, like, something is gonna be better than than nothing, from from a timing perspective too. Or, potentially, like, make sure you're walking maybe after your most carb heavy meal is gonna help as opposed to if you had a meal that was mainly like protein and fat. You know, we're not getting as much blood sugar spike from that. So, you know, we you definitely play around with it, but the overall kind of sentiment to that is if you can move after you eat, that's gonna be helpful. Perfect. So Well and then, you know, to kinda add on to that too is, like, this is why so many people are talking about, like, strength training. So when you're strength training and you're building up that muscle, your muscle absorbs that glucose for you. Yep. So that's why, a lot of times when you're in perimenopause and you're gaining weight and you're not sure why, typically, it's because you're probably doing a lot more cardio. You're probably not eating enough. And so those two things, if you're doing intense cardio, your cortisol is spiking, and then you're not recovering because you're not eating enough, and then maybe you're not sleeping. And so it's kind of wild how almost slowing down and walking and strength training can be really incredible. But if you still like to run and stuff, that's great, but it just depends on how you feel. Right? If you don't feel good like, when I would do intense hits, I was like, I didn't I was like, why did I do this? This doesn't feel good. And Well, the other piece to that too is so we talked about, like, how your cortisol is elevated. Mhmm. Over time, our system can only have an elevated level of cortisol for so long, and then what we end up seeing is the reverse. Then we end up in this low cortisol because we are so stinking fatigued and we've burnt our like that's we burnt out our system when our cortisol bottoms out. And when people are at that phase, I really I want them moving for stress relief, but I don't really want their heart rate much above 90 because your system is so It's taxed. It's so fast. Attacks. And so we need movement and gentle movement, but that is definitely not the time and place to be pushing it by any stretch of the imagination. We need to help our body recover and heal. So, you know, that's why too if you're listening and, you know, you've like Mary said, like, you feel like crap after a HIIT workout and so depleted. Like, that might just not be the right thing at this point in time for you. Or it just don't push forever. Well, I mean, I like HIIT workouts. I just don't do them intensely. I just chill out a little bit. Like, I just, like, don't go all out, and it feels good. So, technically, it's just more of a strength training thing. Yeah. So I know you have to go soon. So Yeah. I wanted my last, like, big piece too for what is increasing estrogen, especially in our, like, this day and age in our society is endocrine disruptors, which we didn't really even talk about, but this is my other We're gonna have to do a whole another episode together because there's so much to talk about. But essentially, an endocrine disruptor is something a substance not produced in our body that comes in and will attach onto our cells and will mimic estrogen. So things that can be endocrine disruptors are they can be in our clothing, they they can be in our personal care products, our shampoos, our laundry detergents. There's kind of this whole long list, but essentially, many things that are around us this day and age are an endocrine disruptor, and that also can increase the, estrogen dominance in our system. And so that's another place to kind of start to look for people and and something that they can do from a lifestyle perspective is just start to make a little bit better of a choice in the products Products. That they're using or the clothing. And I tell people too, like, you can get, like, way out of control with this. And I've I I went down I'm I went down a crazy path with this, and it, like, stressed me out more. So Exactly. There's a there's a I think there has to be a balance because I've seen I saw some guy the other day on Instagram saying don't touch receipts. I was like, I'm sorry. If I'm stressing about touching receipts, just I'm done. Like, I can't I have so much more to stress out about that there's a balance here, but I think it's super important to be aware of like, there's so many dyes, like, in our detergent. And Like, that's an easy thing. And I tell people, like, switch it out, like, when you're done with what you have. Like, don't throw like, don't necessarily, like, throw away everything in your house, but, like, hey, when my deodorant's gone, like, I'm gonna replace it with this instead. And just, like, slowly making smarter choices for your health is is better. Because again, like, if you make a small change, like, you've seen this in the PT world, like, you can't ask patients to completely upend their like, it's going to be more stressful. They're going to fail at it. Like, pick one small change and do one small thing at a time, be successful with it. Like, that's gonna be so much better for your health for so many reasons, honestly. Well, yeah, I went down a path where I just threw everything out, and it was, like, like, I just went all out. And so I would just say, like, when you're just being aware of it, there's a balance between obsessing about it and a balance of actually, like, all of my stuff is, like, clear. I try to be aware of, like, my facial products that I put on. Like, if you go to, like, old tools before, a lot of them are saying clean beauty products now. I'm looking up. It's like EWG, skin deep cosmetics database. There's a lot of places and apps that you can scan and look like because they're all gonna have some form of a little bit of toxicity, but just knowing how much you're putting on your body and being aware of that, is is gonna be super important. I will be fully transparent. I have not switched from an anti, perspirant. Wait. Which is the one with I can't I've tried no aluminum, and, man, I I will have no friends. I tried. I had given up on this search because I had tried, like, every single one. And some of them were like, they make you smell worse. Right? Like, it's not like It's not and so I have a friend. She's like, Michelle, I swear this one is good. And I was like, it took me a while. It took me, like, months before I finally ordered it because I was like Which one do you like? So Primally Pure is the only deodorant that I have found that actually works and doesn't make you smell like, it doesn't make you smell bad. Like, that is literally the only one that I have ever tried after years and years and years, and I had given up, like, many times. And I'm like, I'm just gonna use the stinking aluminum and you know? I've literally resorted to okay. Am I gonna hate the way I smell all day? Is that gonna stress me out more? You know, you gotta weigh out. You do. You do. And so I'm in the I go through phases, but if you know? But it's just being being aware of all of it. So the other thing was there another one you wanted to add? Nope. That's the only deodorant I will add. No. Sorry. No. No. Of any other because the the other lifestyle thing that I find and is really the main reason I started this podcast is to be authentic and real in all these things is thinking and working through a lot of inner shit. Like, ultimately, you can do so many things, but if you are constantly if your inner narrative is negative and you're processing a lot of an if you're dealing with a lot of unprocessed trauma, right, and if you're in environments that keep you small and are toxic, you can I say this because I literally did so many things right, and that's when I got cancer not saying people are gonna get cancer, but I just I talk about it because it's like, I I was like the epitome of, like, in good health from, like Yep? Western standards. And if there's one thing to change and all of this seems really overwhelming, just start noticing your inner thoughts and noticing those stress levels, noticing that things that are not bringing you joy or happiness, like, what bullshit are you dealing with in your life? Right? I'd say even just start there. And then as you start kind of going with that, then you can start looking at products, and then you can start looking at these other things. You wanna do it that feels good for you, and it's not stressful. Yes. Because then it's almost counterbalancing it. It a % is counterbalancing it. Yeah. And so I almost think, like, for what's working for me is almost like the progesterone supplementation and stress management and then exercise And then Yeah. Just kind of every morning daily meditation, even if it's just five or ten minutes. I find that when I'm just running out the door, the rest of the day is just shot. And so kinda getting into something that calms and helps support your nervous system, and then start looking at your diet, and then start looking at all these different things because, yeah, like we're saying, just don't stress yourself out doing it. Just start noticing. There's there's power in the patterns. That's what I say. % agree. So well, thank you so much. I will put your information below. Do you have an Instagram or anything you want people to follow you at? Yeah. So I'm at weeks wellness is my Instagram handle. And, actually, in our bio, we have a link to a hormone symptom quiz. Oh. So you can go on there. It's a free quiz. You can take it. It looks at more than just estrogen. But if you have any questions on if some of the symptoms that you're having are related to hormones and you're not quite sure if you need further testing or not, that's gonna be really helpful to you. So Perfect. And are people able to work with you guys virtually? Yes. They are. Oh, sweet. Okay. So good. If you guys you know, that would be helpful for them to, you know, get some information on understanding their hormone balancing and work with your staff. And I know you're probably super busy. So maybe you directly or me too. Yeah. Yeah. No. This is like my this is like my love for pelvic health, this kinda like hormone niches. Oh my gosh. You have been such I love it. A wealth of knowledge. So alright. Thank you, and we will put all your information podcasts. To learn more about Doctor. Mary, head on over to doctormarygrimberg.com, and make sure to follow Doctor. Mary at doctormarypt on all social channels. To learn more about Doctor. Mary's integrative practice for pain relief in Austin, Texas, head on over to resilientrx.com. Thanks for listening.