How To Get Pregnant With Irregular Periods-Everything You Need To Know About Menses Health and Fertility with Dr. Lara Briden – #39

0:09 Charlene Lincoln: Welcome back to another episode of The Fertility Hour. I’m your host Charlene Lincoln. And today, we have a very special guest, Dr. Lara Briden. Lara Briden is a naturopathic doctor and the Period Revolutionary—leading the change to better periods. Informed by a strong science background and more than 20 years with patients, Lara is a passionate communicator about women’s health and alternatives to hormonal birth control. Her book ‘Period Repair Manual’ is a manifesto of natural treatment for better hormones and better periods and provides practical solutions using nutrition supplements and natural hormones. Now in its 2nd Edition the book has been an underground sensation and has worked to quietly change the lives of tens of thousands of women. Welcome, Dr. Lara.

Dr. Lara Briden: Hi. Thanks, Charlene for having me.

1:21 CL: I love that. I mean, I don’t know, I love talking about the menstrual cycle and periods. Like I was talking to another guest and she said it so beautifully, “the period is another vital sign,” right, of the body.

LB: Absolutely.

1:40 CL: And it tells us so much. But yet, it’s a mystery for so many of us, sadly.

LB: I call it the monthly report card’. It’s a little barometer check-in of our health, and I’ve said a few times I actually feel sorry for men that they don’t have it. They don’t have that window into their health. I certainly feel that with my patients. When I’m treating a man, I’m like, “oh well,” actually, suddenly there’s this whole gap of information that I don’t have about his general health. And the vital sign, that’s been sort of kicking around for a while, that idea. And about two years ago, ACOG (or The American College of Obstetricians and Gynecologists) issued a statement that called the menstrual cycle a vital sign. And they basically advised that doctors need to start speaking to their patients, especially young patients about menstruation because that then communicates the idea that it’s important for health, and by that, they do mean natural menstrual cycles, not pill bleeds, which we can get into a bit today perhaps.

2:49 CL: Two things come to mind. Has any man, when you said that, said “I wish I had my period too”? I mean, just I never feel that way.

LB: I know. I’ve said that in a few interviews and a few groups. I don’t know, I think maybe a few men thought, “Yeah, I guess that an interesting idea.” I mean, it’s totally off their radar or something that they would need. I mean, there’s some logic to it. It really is, as you say, it’s a vital sign, it’s a window into our health. It gives us clues about what we need to change, not just for our period but for our general health.

3:27 CL: Okay. Because I mean, I talk to a lot of women and like girlfriends, and they seem to kind of view it with a lot of disdain, you know, and this sort of burden. And only when I went to acupuncture school I was like, “Oh, my gosh. It gives you a wealth of information, and what is it telling me about my emotional state?” and a state of everything at this point. But I have to say I felt the same way prior to that.

And then the second thing I was thinking was when you were saying, you were talking that the doctor, they’re recommended to start talking to their patients when they were young. What would the doctors talk to them about because it seems like they have a disconnect about that as well.

LB: Totally a disconnect. I mean, that’s why that statement was such a radical thing, to be saying actually doctors need to, almost for the first time, start taking menstruation seriously. What it means by talking about that, they mean asking the patients like “Do you get a cycle? Is it coming regularly?” “Is it painful?” “Is there something about that?” You know, we should know and look into further. And that’s important information for the doctor but at the same time, the idea is that also communicates to the patient that this is an important sign to be watching. I mean, obviously I’m a cheerleader for periods. I think they’re great. You know, and I think that whole stigma around them and the way it’s been viewed as separate from health is changing. You know, more and more women are starting to embrace it. I call that the Period Revolution, which, you know, it’s just a funny little phrase but I think there’s a lot of something real in that as well.

5:09 CL: Okay. Our audience is women trying to conceive. Typically, our audience falls into the range of mid-30s to 45 years old and as we know, the birth control pill is used off-label for many, many, many things, so a lot of times a woman is on a birth control pill for sometimes years and years, right?

LB: Decades.

5:35 CL: A couple of decades, yeah. So you don’t really know what your menses is like and, you know, talk to us a little bit about that. Like what are some of the challenges that kind of come up with that?

LB: Actually, how I’d like to respond to that, first of all, the idea of being on the pill for decades, and one of the first reasons that’s problematic, is because our menstrual cycle is a communication between our brain and our ovaries. That’s called the HPO axis which is technical, but I’ll just say it’s the hypothalamic-pituitary-ovarian axis. It’s a very important part of not just fertility but general health, and it takes 12 years to mature. So, I got that piece of information from the endocrinologist professor, Jerilynn Prior, who helped me with my book. She had some data to suggest that.

So what that means is if we get our period at, say, 13, we’re not going to be ovulating straight away. The period, the cycle is still just getting its legs, right? Kind of calibrating. It takes 12 years not until we’re 25 that we have a proper, robust, fully ovulatory, making enough progesterone, grown up, mature cycle. So, that’s a lot and think about that for a second.

Then what happens if you put a young woman on the pill at 15 until, let’s say, 32, but not unusual. I see that a lot with my patients. Her cycle did not have a chance to grow up or mature. So then when she stops the pill at 30, because the pill shuts down all of that, right? It completely switches off ovarian function and that whole communication with the brain. So then it really should not come as a surprise that when she stops the pill finally at 32, that her ovulations don’t just bounce straight back into being regular. It’s a common problem after stopping the pill that nothing happens. Either nothing happens or you get maybe just, you know, 50-day cycles or it’s just not happening. And there’s different reasons, like other reasons that can occur but I think one of the problems is this suppression with the steroid drugs in hormonal birth control. I don’t use the word ‘hormone’ to describe what’s in the pills and injections and tablets. They’re drugs that suppress ovarian function.

And I just think, at the same time I don’t want to make it sound hopeless, I mean, certainly I’ve had women that come off the pill in their 30’s panic because they’re not getting periods. But then my message is, okay, some of this is normal, your body is trying to catch up, you know, try to calibrate for the first time, it can do that. It will do that. A lot of the time it will. It’s because the body is amazing and can try to make up for lost time and finally get there.

But what really makes me sad is if straight away a woman is shunted into fertility drugs and fertility treatment that she really doesn’t need because she can ovulate on her own if she would just get a chance to do so.

8:55 CL: Oh my gosh. I mean, for some reason that didn’t dawn on me, but it’s just like it would lead from one to the other. I mean, at the same instance I’m always amazed when there is a woman who has been on the birth control pill for a decade or more and gets off it, and then does get pregnant with the first few months. I’m like, “How did the body…? It’s a miracle.” I mean, it’s so miraculous how it’s able to do that. Talk about also the thing with the birth control pill. A lot of women are pretty much in the dark because they’re put on the pill to regulate their periods, painful periods. It’s very hard for a young woman to deal with that. They’re not given any alternatives or put on the pill. It seems to work well for that and they’re on it for quite a long time. But then there is like imbalances that occur, right, from being on that pill for so long. Mineral balances, nutrient imbalances.

LB: That’s secondary. We could talk about that. We could definitely talk about that. But I actually feel like that distracts from the main issue. So what you just said there, put on the pill to regulate cycles, it doesn’t do that. Right? It doesn’t regulate anything.

10:12 CL: Right. It appears that way though.

LB: It’s really an important point actually because— Pill bleeds are not periods. A pill bleed is a drug-induced… a drug withdrawal bleed. It’s timed monthly for totally no reason at all. Like, zero reason. There’s no reason to bleed monthly on those drugs. They do it because it was the original kind of cover story that they had for the pill. Like way back 60 years ago they couldn’t legally use it for birth control so they said at first when it was just becoming introduced, so they said, “Oh no. It’s not to prevent pregnancy; it’s to fix the period.” But you know, it’s funny because at that time the doctors would have known, “well, it doesn’t do that. You know, it just shuts everything down.”

But now, it’s about this strange situation where everyone including doctors seems to think it’s doing that and, yeah, it doesn’t regulate cycles. It certainly does mask symptoms because it shuts everything down. So I used the analogy just yesterday actually in another interview where it’s kind of like if you had a problem with your car and instead of fixing the problem or looking at what it is, you just shut it all down, like shut down the car and you just drag it with a horse, you know, it’s like okay, that use of that thing is gone and we’re just going to enforce this, you know, artificial cover-up basically.

So yeah, I mean, primarily that’s my main concern and also you know the way it’s used for every little thing, as you say. You know, for pain, for skin, when in actual fact especially for teenagers, there are things that work very well for those other conditions.

There was a study recently published in the Australian Journal of Obstetrics and Gynecology where they used zinc for period pain and they found it worked as well as the pill, and then the author said something like “Well, and it’s good because it’s cheaper than the pill” and also, you know, I would say also it’s good because it doesn’t shut down a woman’s hormones to address the fairly simply symptom of period pain.

So my experience with teenagers, because I treat a lot of teenagers as well, is they respond so well to like just coming off cow’s dairy, get on zinc, you know. They don’t need to be suffering all those pain and heavy periods and skin. Yeah, and then in terms of the nutrient deficiencies that you mentioned, I think a big part of the problem is that all types of hormonal birth control alter the microbiome which your listeners probably know about. So yeah, they’re going to have profound changes potentially in the digestion and then of course the microbiome affects other aspects of our physiology. All methods of hormonal birth control are potentially bad for mood. There was a big study that came out of Denmark a couple of years ago where they tracked 1.1 million women and concluded that all types of hormonal birth control are a risk for depression and anxiety potentially. Which isn’t that surprising actually because we also know that they change the structure of the brain. Or it’s not that surprising because hormones affect all organs including the nervous system and the brain, so those drug analogues are going to affect those systems as well and in a different way compared to our own hormones.

13:59 CL: Let’s just make an example. A woman who’s 20 years old, she’s not ready to start a family. She looks for birth control, birth control pills, something that’s offered to her. She’s on it for a couple of years and then she comes to see you. I mean, okay, I’m giving this example because when I was in acupuncture school we had a great gynecologist, Dr. Zhou, and she was telling us “If you’re on the birth control pill, you need to get off the pill and never use a tampon because those fibers, they get caught up in the tissue.” That’s why I stopped using tampon, got off the pill. I mean, this is a class of maybe 25 people. Two or three of them got pregnant because, I mean, obviously they didn’t do a back-up plan but, I mean, so that’s a major concern. It’s part of you educating them on like, what is it called, why am I blanking out, what is it called when you track your periods and your—

LB: Fertility awareness method?

15:02 CL: Yes, yes. Because I mean, obviously they need to have a solution.

LB: Obviously, women need access to effective birth control. We can just do a quick survey through them, if you will. I know this is a podcast on fertility but we’re also talking about people, you know, earlier in their life and… So fertility awareness method is based methods, it’s more than one method. It’s a number of different techniques using temperature and/or cervical fluid to check fertile days because women are fertile for only six days per cycle. Which, as you know, I’m sure because women know that when they’re trying to fall pregnant. You can use the same technique to avoid pregnancy.

There was actually just an article yesterday in the New Yorker about it. I’m actually going to share it on Instagram today because it’s a thing now. It’s definitely making a massive comeback. It’s in the broader conversation. Not just the old methods using pen and paper fertility awareness method but there’s a couple of products out there, devices that have a computer algorithm that potentially does that for you. I’ll mention them by name, if that’s okay. I mean, the one I like or the one I often recommend for my patients is called Daysy. It’s a little thermometer computer that does all the calculations. It gives a green, yellow or red kind of day, you know, a light on each day. The green means it’s safe to have unprotected sex, helps with avoiding pregnancy. And they claim a pretty high efficacy. I mean, they’re currently claiming I think 99.3 percent effective in terms of predicting fertile days.

Then the other one that’s called Natural Cycles which I think has a lower efficacy because of a different algorithm, but they recently had FDA approval as a contraceptive device basically, which is pretty massive. I mean, that’s just happened in a couple of months ago.

17:00 CL: Very cool, yeah.

LB: So that’s there, that’s out there and there are a lot of young women choosing those methods. So that’s one.

You know, we have barrier methods which somehow I don’t know why have kind of been forgotten about. They’re great. It’s a new diaphragm called Caya. There are, of course, condoms and there are new condoms. So with my patients I counsel them on if they want to use condoms, then it’s about choosing one that is going to have the safest, the least chance of being a problem and that means getting one that fits. I talk about a type of condom in my book, a brand called myONE condoms and it comes in 60 different sizes, which totally makes sense when you think about it. Why are we ever trying to use, you know, one size fits all condom? It really makes a difference in terms of slippage and breaking and things like that. So potentially, there’s a few other products on the market that would make condoms a more reliable method. A lot of people combine fertility awareness method and barrier.

And then, there is the copper IUD which is all a podcast on its own, which we will just touch on. I’ll just say, if it’s okay to mention, there’s a post on my blog called The Pros and Cons of the Copper IUDs. People can look there, look at all the ups and different sides of that. It doesn’t alter hormones, it doesn’t suppress ovulation. So you are naturally cycling when you have a copper IUD and it has one of the highest efficacy of any method, any type of birth control actually.

18:36 CL: If I could just interject real quick. You said that our fertility people aren’t going, “But why is she on birth control?” Well, we do really, really, really educate our audience about the preconception phase which is a minimum of four months before trying to conceive where you’re really preparing your body so that you could have the healthiest egg, your partner can have the healthiest sperm to conceive. So these can be used during that time. Obviously, you’re not going to use the birth control pill. So these could be a very viable option during that time.

LB: Absolutely. Also for between babies, right? So some of your listeners, hopefully do succeed with this pregnancy, they’re going to then after delivery be almost straight away faced with the problem again of “well, what do I do before the next one?” There’s that angle as well, and also for their daughters one day. You know, if you have a daughter, my plea would be please don’t let her take the pill at 14. There are already other options. There are other options coming.

Well, we conclude this section by I’ll just mention something called Vasalgel. They’re in your city, I think, so you’re in San Francisco, or you’re there in Berkeley. Non-profit organization trying to crowdfund some clinical trials for a male method called Vasalgel which is a non-hormonal, one-time gel injection at the vas deferens which can then be removed years later when a man is ready for it. So in my view, that is a gamechanger, like I am just holding out for that because then we can just finally have a conversation of how can we prevent pregnancy? Well, 50 percent of the population could do their side of things.

20:17 CL: Oh, I know. That would be nice. It seems less daunting than getting a vasectomy because my brother had one and he told me it was kind of traumatic.

LB: It’s certainly less daunting. It’s like a reversible vasectomy. It works on the same principle but it’s only a little gel that goes in there temporarily and then can come out again. Yeah.

20:37 CL: Okay, that’s very cool. Yeah, I’m anti-pill. I’ve seen so many problems with it. So let’s talk about though, you know, there are so many women with irregular periods, painful periods. They don’t even know what a healthy period really is.

LB: So what does a healthy period look like.

20:37 CL: Yeah, what does it look like.

LB: Yup, absolutely. So the monthly report card should look like, I mean, fortunately there is some variation of course because we’re individuals. So in general, for a grown woman, a teenager is a little bit different. They can have longer cycles and that’s okay. But let’s say a woman over 20, over 25, day one of the period should arrive anywhere between every 21 to 35 days, counting from day 1 to day 1. And it should be ovulatory which means ovulation should have occurred. Now, the interesting thing about that, of course it’s possible to have what’s called an anovulatory cycle. I’m sure your listeners know about that if they’re tracking their temperatures. There’s going to be a month where even if it looked fairly normal in terms of timing, there was just no ovulation. That actually we now know occurs in about 1 in 3 women just occasionally. I think it’s like 1 in 3 even just cycles even of healthy women are going to be anovulatory. It’s because of stress and other things. It’s a body’s kind of natural response to different things they’ve got in life to maybe say “Oh, that’s not a good month to ovulate.” So that’s the timing and the importance of ovulation.

And then the other aspects, the bleed itself could be anywhere between, say, 2 and 7 days would be a healthy normal bleed, losing no more than about 80 milliliters of menstrual fluid through all of those days. And arriving pretty much with no pain or PMS or much fanfare at all. You know, I actually believe from my 20 years’ work with patients and lots of conversations with readers on my blog, that is possible for most women. Barring, of course, endometriosis and adenomyosis are separate issues. I mean there’s other things obviously that can be going on. But for someone who does not have one of those diseases, that’s possible. That’s my experience, is that women can get there and with natural treatments and it’s not that hard to do.

23:18 CL: I know for someone who had PMS for many, many years, and then everyone talks unifying kind of like a tribe of women, you know, “I have terrible PMS” So it is very common but it’s not normal and as you said, it’s very profound when you go through sometimes if you forget when your cycle is coming and then you get it and then you go, “Oh, I didn’t even have any indication.” Because well even like in Chinese medicine, even the breast distention and tenderness, that’s a sign of imbalance as well.

LB: Exactly.

23:57 CL: You know, that’s just part of getting your period, getting very bloated, getting very emotional, the breast distention, the out-of-control cravings, the emotional cycling up and down. Actually, that’s treatable, right?

LB: Absolutely. Chinese medicine is a good place to look at the normal period. Yeah, because the expectation in Chinese medicine is just pretty much what I described, that the period comes without symptoms, that it comes regularly. They’ve known that for thousands of years. I had another Chinese medicine practitioner share with me something that her teacher said years ago which was basically yeah, isn’t it strange how American women think that periods should be painful or it’s normal for periods to be painful because in their thinking, periods should not be painful and that’s my thinking as well. If there’s pain, there’s something going on.

24:49 CL: Well, I think in this culture we have a Midol deficiency. I joke, but like, growing up I had friends who, you know, they would go to the doctor and get really high prescription Midol and that just seemed normal like “Oh,” you have to just take that whatever pink pill. Whatever is going on, you have to treat it. I don’t know if that seemed totally normal at the time.

LB: Well, you’re right that we were in that culture of this expectation of how periods are. I’m trying to change that expectation, raise the bar of expectation that yeah, periods are a natural healthy function and really shouldn’t be that many symptoms. I don’t want to have it sound like women should feel bad or that it’s their fault or something if they’re having symptoms because of course, a lot of women do have symptoms. But my message is actually there are some fairly simple changes you could make to, surprisingly, you know, you might be happily surprised to relieve a lot of those symptoms.

25:55 CL: Okay, do share what are some of those things that you found effective.

LB: Well, so a lot of this is in my book ‘Period Repair Manual’ and it’s going to depend somewhat on obviously what the symptoms are and who the person is. But let’s say just in very general terms I’m happy to give away the main points of treatment. I do feel like for many women, cow’s dairy is a major driver of inflammation and potentially certainly period pain, possibly PMS, often skin issues. I think there’s different aspects going on with dairy. I think it’s in large part to do with a sort of a histamine response in the body that many women get from cow’s dairy. And I say cow’s dairy because I find clinically that goat and sheep dairy is totally different, and butter is quite different because it doesn’t have an inflammatory protein called A1 casein that is in normal cow’s dairy.

So this is a big thing I do with my patients, even just myself personally when I stopped having dairy 25 years ago, I stopped having period pain completely. And to be fair, that is not going to be true for every single woman, so I don’t want to make it sound like every woman is sensitive to dairy or that’s the only solution that’s ever needed. Some women are fine with cow’s dairy. So this is where some of the nuances come into it, but it’s common.

Then the next, I speak a lot in my book about zinc probably because of that clinical trial I just mentioned where they used zinc for period pain and zinc works really well for skin. Teenagers, a teenager with acne if she would just stop even for six months cut on dairy, weigh back on sugar, take zinc, her skin should be fine. It takes a few months to clear but that’s a simple intervention that can work. Reducing dairy can help with periods as well. I also use the herbal medicine Turmeric quite a lot to lighten periods. It reduces prostaglandins.

Actually, interestingly about heavy periods and the histamine side of things, and I don’t know how much your listeners will know about histamine intolerance, but the uterine lining actually has a number of what are called mast cells who are involved in that histamine response and they also release something called heparin which is a blood thinner which makes periods heavier. So when I learned that earlier this year, I thought yeah, that makes sense. That’s possibly why cutting cow’s dairy can make periods quite a bit lighter.

28:39 CL: When you mentioned turmeric, how do you recommend that your clients take it? Is it in capsulated form or are you using the root?

LB: I used capsules. Take it with a fatty meal. There’s also different good brands of the high-dose capsules out there. It’s safe. I consider it safe when trying for pregnancy. Although the high-dose ones, I would ask patients to stop that one if they are pregnant. I’m quite conservative. Once there is pregnancy, I don’t like to have too many supplements in place. But, yeah.

29:11 CL: How do you view clotting? Because I know in Chinese medicine that was always like a diagnostic question “Do you have clotting? What size are the clots?” Like I have clots all the time. It was normal for me, let’s just say that.

LB: Well, it is directly related to the amount of flow. So the heavier and faster flow is going to, by definition, have more clots because the anti-clotting agents that the body naturally produces have not had a chance to fully work. So it does often just go hand in hand with heavy flow. But I mean, clots can also be a sign of other things like endometriosis. So it’s not particularly a heavy flow and there are clots, then I might be thinking more about inflammation or is there enough progesterone and things like that.

30:04 CL: Okay. I know in Chinese medicine also it’s called liver qi stagnation and sometimes emotional factors of like suppressions of anger and things like that, you know, come out in a very clotty period, dark period. What do you think about menstrual cups and I don’t know if it’s just me but I kind of like menstrual cups because I can look at the color of my blood and see what’s in them.

LB: I love them.

30:32 CL: Oh, do I have clotting or what’s the color of my blood and… I guess they’re kind of messy. There’s a little bit of a learning curve and women are kind of squeamish with pulling it out and it is filled with menstrual blood. But I think it’s a great alternative.

LB: I love them. Also I remember you said earlier about the gynecologist who was warning about the little microplastic fibers coming off tampons. The other reason the cup is good is because it doesn’t dry out the vaginal mucosa, so it’s healthier for the vagina. And yeah, the whole messy aspect I don’t see as a problem. Most of my patients, once they start using them, love them. And I personally use a menstrual cup for a long time.

31:15 CL: Do you have a brand that you have found an affinity to?

LB: There are lots of good brands out there. I personally use a Diva Cup, but that’s just what was easy for me to buy online.

31:30 CL: Yeah, yeah.

LB: But I do think it has to be a natural silicone, like a good quality material and I guess the right shape that women feel comfortable removing and working with, yup.

31:46 CL: If women aren’t comfortable using that, do you have any feedback on a lot of the commercial like the tampons and the pads that are out there, is there something that you can kind of say about having that close to your reproductive organs?

LB: Well, yeah. Well, for tampons I think it just a no-brainer. It’s really important to get one that’s organic cotton, not have the synthetic fibers in there because that is not good for the vagina; and preferably not with bleaches or dioxins or things that are going to… That’s real. So I guess I would say get a better quality, potentially organic tampon.

32:26 CL: Yeah. And the pads, a lot of them like I think they come with like perfumes and then they have gels that gets released. I don’t know if that’s… I’m going to say I’m acting coy but I don’t think it’s good at all.

LB: It’s not good.

32:38 CL: Against your vagina.

LB: Okay, here’s something and this is now for fertility. The vaginal microbiome is hugely important. I think we’re just starting to understand how important that is. So, would your listeners know what I mean by that? Like the good bacteria living in the vagina?

33:01 CL: They’re fairly well-versed in this but I mean, some will, some won’t.

LB: So the good bacteria that live in the vagina have a very important job of just lots of things. They maintain the normal pH. I mean, they’re going to affect the quality of the cervical fluid when that’s produced as well, which is very important for sperm transfer. There’s actually even some evidence that… because vaginal microbiome will also somewhat indirectly affect the uterine microbiome which is very important for fertility and implantation. So I think going forward we’re going to start to think more and more about what bacteria are living down there and what are all the different things that might influence those. So certainly that would be a reason to avoid, well, spermicides which is obviously not, you know, you wouldn’t be using if you’re trying to fall pregnant. But yeah, perfumes and things like that. Not good. And certainly not like any kind of wash or vaginal wash or douche or anything like that. It’s quite bad for the microbiome.

34:03 CL: Yeah, those seem to be quite popular. I remember in the ‘80s as a young kid, like your mom would have those and then hopefully they faded away.

LB: Well, I hope they’ve faded away. I know some people still do but they really are not good.

34:17 CL: I saw TV commercials about, I don’t know, some wash or something for the smell of the vagina. If you have a smell in your vagina, would it be vaginosis? I mean there’s an imbalance going on and it’s not a time to just put a perfumed wash.

LB: Absolutely not. Bacterial vaginosis is common. It’s an ecological issue in the vagina in terms of the microbiome. So it just means you need some more of those good bacteria, and there are some clinical trials using what are called vaginal probiotics which you take either orally or you can insert and they can improve bacterial vaginosis and yeah, create a better environment for both less small and also better fertility potentially, just a healthier situation.

35:14 CL: What about kind of… I don’t know, it’s coming for me as far as like period and PMS. Do you recommend like journaling or things like that? Because like a lot of emotional things come up during that time and some of it is through the filter of your hormones and it may be after you’re like, “Oh, I really do love my husband,” you know, but things get sensitive. So like, what kind of things do you kind of recommend to help transition you through that time emotionally?

LB: Right. Well, first of all, I would say again in terms of my raising the bar of expectation, I don’t think women should have to suffer much PMS. I do think again there’s some simple treatments. Magnesium, vitamin B6, potentially coming off cow’s dairy. I’ll say I’ll dip into Chinese medicine because I’ve studied a bit of that as well as part of my naturopathic degree. And we use the Xiao Yao or the Bupleurum and Peony to clear liver qi for PMS. I mean, that could be incredibly helpful as well. So there’s that.

But I will acknowledge that there are going to be some more subtle shifts in energy and mood of course because progesterone and then losing progesterone at the end of the cycle has effects. So I think certainly, I mean, journaling, if that’s what someone wants to do but also even just having some kind of tracking whether it’s a phone app that alerts you to “Oh, you’re in PMS right now” and then you can look at it and think, “Actually that’s probably why I’m feeling more sensitive than usual.” And yeah, that’s helpful. Just give it some context. And also to know that it’s going to end in a few days. You know, it’s not how you are now. It’s just that window of time where you are with your cycle. Yeah.

37:01 CL: Okay. So going back to fertility, women reach out to me and then they say like I’ve had really irregular periods, I have breakthrough spotting, amenorrhea, dysmenorrhea, just whatever all these different things going on and then I’m trying to get pregnant at the same time. I know it’s really hard because everyone feels like a certain, well, the biological clock, you know, and they feel kind of a rush to get things done. But it’s so important to have a healthy period and yet it’s kind of a daunting thing. I’ve always had irregular periods, so how in the heck am I going to make it regular in a reasonable timeline, you know. Right? I could start a family and all that. So what’s your feedback on that?

LB: Okay. Well, first, I’ll just respond to something we were talking about earlier especially if it’s coming off the pill and having no periods or regular periods for a while which is very understandable given what I described about what the pill does. Right? So I will say, yes, I mean, there’s some women whose ovulations bounce back straight away and they start ovulating and that’s great for them. But there are lots of women for whom that does not happen. And then the problem is if they’re pushed to the fertility treatment too soon. The reason I’m bringing that up again is because the messaging from the medical community to women is this idea of “you’re broken, you can’t ovulate.” They’re like, “I could see on this lab report that you didn’t ovulate. Or this ultrasound, you’re not ovulating. Therefore, you can’t ovulate.” That’s their kind of logic. That’s the part that I really take issue. It’s like, just because you have not been ovulating let’s say just six months off the pill, doesn’t mean you can’t. Absolutely does not mean you can’t. Like, in my experience most women absolutely 100 percent can. It takes time though. I need to explain the timeframe around this.

So even once everything is in place, let’s say, you know, certainly eating enough of something is a big issue, ruling out things like PCOS which actually polycystic ovarian syndrome is a complicated diagnosis which we could maybe catch on later, but you know, looking at nutrient deficiencies, making sure everything is good. Even then it could take six months to start to ovulate regularly because, well, 4 to 6 months. As you probably know, the ovarian follicles, the little pre-eggs, the little baby eggs growing, they take 100 days to grow and they need a healthy body and healthy signaling from the brain, everything working, everything happening, the hypothalamus deciding, the part of the brain that regulates periods deciding “yes, we’re going to do this, it’s time to do this.” Minimum, that takes 100 days after treatment, after natural treatment gets started. Minimum. And usually six months.

So when a patient comes to me and says “I’m going to give natural treatment two months and then I’m going to take fertility drugs,” I’m like, “Well, there’s no point.” Like there’s literally no point in doing this. Because it doesn’t have time to work, which I know doesn’t fit the timeline of a lot of women unfortunately that my experience with patients is it’s actually better to give yourself a little bit longer timeline. You might end up just becoming pregnant on your own before resorting to the drugs.

40:32 CL: I absolutely agree because I think it’s so sad because women feel like in that 4 to 6 months that their last egg is going to die.

LB: I know.

40:44 CL: Because that’s how we’re told. I mean, that’s what we’re, I don’t know, subliminally told that we probably have like one old egg rattling around in there and it’s going to go away.

LB: This messaging to women that they’re broke and they’re running out of eggs is very destructive, you know. I don’t even know how to begin to counteract the problems with the fertility industry. It’s really doing a lot of harm.

41:15 CL: But it’s going to be profitable, isn’t it? I mean, to have this message. Because you just put fear behind something and it’s a great motivator to go in one direction even if intuitively you feel like it might not be right for you or whatever.

LB: Can we bring in another aspect too which is the male factor. So there were a couple of articles that came out just together in the news. I shared that on Instagram a couple of weeks ago. But sperm is in trouble, like it really is in trouble. And there are a lot of men out there who their sperm is not that great even though the doctor might say it’s fine. This is the problem. Because they don’t really look at those reports very carefully. I mean, there’s this idea that one sperm is enough. That’s not true. There has to be quite a lot and they have to be of a certain quality.

So there is one article about the massive decline in sperm count recently. The second article was making the point that we’re in this situation with medicine right now where the only way to treat a male factor infertility is with IVF. So they said we’re treating women from male problems and one doctor said something like this is the only place in medicine where we treat another person for the problem of the main person. And I can’t tell you how many patients I sat down with and they’re women and they are trying everything, it’s like “I must have to eat something different. If only I could get the right supplement, it’s like everything… I’m just going to try all these different things with me,” and then I said it’s a male issue, like it’s a morphology issue with your partner, like until he does something, you’re not going to find that one right supplement or that one right herb. Which I know it’s hard to hear that. We have to, I don’t know, you know, men have to enter into that. I know a lot of men do, I know a lot of partners do come into it and do treatments as well.

43:25 CL: Yeah, that is coming out more and more and more because I’m hearing about sperm issues. It’s getting out there. It’s just that it’s weird because I guess like if a man, I don’t know, I guess it’s something to do with the manliness of the man if he has defective or low sperm, so you have to be like very fragile with the subject.

LB: I know.

43:47 CL: Or with the woman, it’s like, “yeah, well it’s been our fault all along. We’ve been kind of carrying this burden and it’s normal.” But yeah, with men, I know it’s weird when I’ve treated people and you go, “Oh my gosh, but your partner.” I mean, sometimes are like, “No, my partner is not going to come in.” Well, I don’t know what we’re doing here then because…

LB: Yeah. You can’t treat a woman for a male problem.

44:13 CL: Yeah. I mean, you can do things with the sperm but you can’t fix a batch of bad sperm. You can wash it and do all these manipulations but it only does so much and I think in a sense that’s why IVF treatments, they’re quite a low success rate, if you think about it. It’s like a lot of times it’s 70 percent failure rate in those because the human factor is not specific enough, yeah.

LB: The article I was just putting said that the main success with IVF is when it’s a male problem. So a lot of I would say a fair bit of IVF is being done and getting around a male problem. Which politically, it’s very concerning that these women are being subjected to drugs that they potentially didn’t need for themselves, but yeah.

45:07 CL: Absolutely. Because you touched upon PCOS and the IVF whatever, the topic of IVF, and that’s like a part 2 interview, right? We can talk about that.

LB: Yeah.

45:24 CL: I have mixed emotions. I want people to have a family; however, it can happen, but maintaining their own. Sometimes I just have concerns. I mean, it alerted me because there was a doctor and he was considered like the pioneer of IVF, Sami David. He co-wrote the book ‘Making Babies’ that came out now about 7 or 8 years ago and he was saying that the IVF industry is the most underregulated of all the medical industries. And think about all these IVF babies that are being born and the women that are subjected to all the drugs. It frightens me because what’s the long-term implications? We don’t quite know yet.

LB: Okay, from our perspective, from a natural health perspective, the way we think about it is a healthier woman will result in a healthier, you know, a pregnancy, a healthier baby. Like that’s the trajectory. It’s like, let’s improve the health of the woman and then out of that will come, hopefully, you know, a healthy pregnancy. With IVF, what concerns me most is a woman’s health is bottom of the list. Like as far as I can tell, everything, literally everything comes before a woman’s health. So it’s like they flipped it, right? So the mentality is get a baby and at what cost? Like especially there was a research study that came out that women with endometriosis are made a lot worse by IVF which is not that surprising when you consider what those drugs are like. I mean this sounds blunt and mean but my experience is, certainly in Australia where I work and the IVF industry is huge, those doctors don’t seem to care about women’s health at the end of the day.

I mean, I had one conversation with a patient with endometriosis and she was in a lot of pain after one of many cycles, stimulating cycles. And I said to her, “Well, who’s your doctor? Who’s your gynecologist who’s kind of looking after you?” And she said, “Oh, this fertility doctor who’s in charge of the IVF.” I’m like, “No, he doesn’t care about…” obviously from the behavior, “He doesn’t care about your health.” We need someone, another doctor who’s actually thinking about you.” I mean, I’m very woman-centered so when I’m working with my patients, yes, at the same time I want to honor that they want a baby, yes, but also my job is to look after their health. So, first and foremost that’s my duty of care.

So that’s why I’m so troubled by what I see. I mean, it’s hard to talk about it without being emotional. I mean, of course that’s why I get so upset when a woman’s been off the pill for four months, rightly so not ovulating yet because it’s perfectly a normal reaction to those coming off the steroid drugs, and is told “You can’t ovulate, therefore the only thing you can do is take these drugs,” and it’s crazy.

48:31 CL: I’m right there with you. I feel the exact same way. I watched this documentary. It’s worth a watch. It’s called Vegas Baby. It’s about an IVF clinic in Las Vegas and they ran this big nationwide contest and they chose couples and there was just one couple and really like your heart broke for them. The IVF failed and I think it failed again and then they went through the process where their health or the woman’s health was never discussed and they seemed to have like maybe not the greatest health, but they forced the drugs and at the end they were able to have the baby band maybe people were celebrating, “Oh, they got to be parents.” And it is beautiful but I was like, “Well, what is she going to feel like?” I say postpartum is a thyroid disorder, like I think about all those drugs being pumped into her system and what it is doing with the endocrine system. And you’re the caretaker for that baby, I mean, you have to think about yourself 5-10 years down the road. I have treated women who had undergone… there was one woman who had undergone four cycles of IVF and it was six years later and she was like, “I feel crazy.”  Like I never got my health back from this, but she had her baby. She had a daughter who actually had some health issue too, but I don’t know if that’s all interrelated. But you know, it gets complicated and yeah, I don’t like it either. I just think that women need to really protect themselves and the end goal is not just the baby; it’s having a healthy baby, a healthy pregnancy while maintaining your own health.

LB: Because women matter too. Women as individuals matter. Not just their potential to be a mother. And I know that’s very important to most of your listeners. I don’t want to take away from that. I know that’s important. But their health is important too as much.

50:23 CL: Absolutely. And if you think about it, I mean, if you’re listening to this and going, “Well, yeah, of course I matter. But I mean, also just as your role as the caretaker…” I mean, being a mom, it’s very challenging, I have found. And if I did not have my health and things like that, I don’t know, I just couldn’t imagine. It’s just challenging in and of itself.

LB: Also, just to open up another door, it is also possible. I’m sure you and I have both seen with our patients. To have both. It is possible to be healthy. You know, the pathway to a baby could be through health as well rather than, you know, through IVF potentially, I mean, bearing in mind all the factors. I mean, I guess if there’s a strong male factor, maybe that door is closed apart from IVF but then that’s another issue. I guess that’s thinking it through and just understanding that, you know, I guess doing it because of a male issue that at the moment, medicine has no other option. Medicine is failing women, basically. It’s not that women are failing or that men are failing. I think the current approach to women’s health and fertility is failing women, is setting them up for health problems that they just simply should not need to be subjected to.

51:46 CL: I interviewed Dr. William Davis. He wrote the book ‘Wheat Belly’ and then he followed up with a book called ‘Undoctored’. Just to kind of sum it up, but he was just saying like healthcare is failing us and that, you know, doctors kind of get mad at us going on the internet and searching out. I think we wouldn’t be doing that if we were getting answers the traditional route. But we’re banding together and finding information outside of that doctor’s office and talking, having conversations and he was like, “Yeah, the medicine of tomorrow is a lot…” I mean, we’re able to get these functional medicine lab tests ourselves because there’s a lot of directed consumer stuff and really search out people who aren’t practicing medicine in this old archaic way because I mean, let’s get real, ten years from now, all the ways that we’re treating any of these chronic diseases, it’s going to be hopefully radically different maybe 20 years from now. But it’s an archaic system of medicine, overinflated in cost and harming us more than helping us is my opinion. I’m trying to be diplomatic about it but I really do feel, you know, it’s shameful. And like putting young girls on the birth control pill, we should know better, you know.

LB: We should know better. We deserve better. It’s good to bring that in again and because I know we started out with talking about young girls and alternative birth control and, you know, questioning how does that fit into a conversation about fertility. It totally does. It’s in the big picture, right? It’s about how we treat women’s bodies. This whole mindset that… the other big part of my work actually is this idea that women don’t need cycles, don’t need ovulation, don’t need hormones until they’re ready for a baby. It’s like compartmentalizing all of women’s physiology for that one purpose which is crazy because we don’t do that for men. That would be like saying to men, literally saying to men “You don’t need testosterone until you’re ready for a baby.” So we’re just going to shut that down till you’re 35 and then go for it. Like, so that robs woman of the beneficial hormones and ovulatory cycles that they could have had all those years. And again, if you have a listener sitting there at 35 and this has been her experience, then please don’t feel bad. Your body can still recover and also this is good information for you to take forward and pass on to the next generation.

54:14 CL: I hope no one comes away from this being like “I get all the blame for this.” This is not, like you said, I mean, we honor women and we’re just trying to educate and we’ve all been duped to a certain degree. It’s our reeducation into our own bodies and it’s quite complex and a little bit confusing and overwhelming but we’re trying to disseminate the truth here.

LB: Although one of my messages too is that women’s health isn’t that complex. You know, it’s quite simple in some ways. I think that’s another thing that we’ve been duped, just thinking that, you know, women’s health, it’s so complex we just have to leave that in the hands of the gynecologist. It’s like no, it’s actually not that complex. Our cycle is a natural manifestation of our health. It responds incredibly well to some of the things we’ve spoken about. And just about that kind of collective women’s voice and passing that on. So yes, so even if someone individual has unfortunately been told to take the pill and from teen years to 35 and is now feeling bad about that, you can still take this information in your experience and you can pass it on to the young women in your life because I’m sure most people have younger sisters or cousins or nieces or someone who could benefit from a new understanding and a new way of doing things.

55:31 CL: Share this podcast with a young woman you care about absolutely, and you’re going to have daughters. And thank God our daughters won’t have to go through a lot of the stuff that we did and won’t be shrouded in mystery. I mean, there’s young women who died from birth control. There are major lawsuits in this country.

LB: That does happen.

55:56 CL: But they didn’t make national news. They were sort of like hidden stories of just terrible tragedies from birth control. So, yeah. Okay, I loved this interview. Very thought-provoking that’s why we didn’t hold back because…

LB: Yeah. It was good. It was a great conversation.

56:19 CL: Yeah. I would love to invite you back because I know you are just a wealth of knowledge and I just want to extract that from you. There’s more to say for sure.

LB: There is more to say. I want to say one more quick work about PCOS. Just a little quick word. Because this is another area where women are being done a disservice.

56:34 CL: And they would like to know more about like where can we find you. It will all be in the podcast notes, like you did vocalize that.

LB: I’ll share my details but also I’ll just say with regard to PCOS, I recently wrote a blog post called “Maybe You Don’t Have PCOS” where I talk about, I quote a recent paper from the British Medical Journal where the authors really questioned how it’s being diagnosed currently and questioned the way which I see too, the way a PCOS diagnosis is just slapped on women when they’re young, too young really to qualify for that diagnosis because it’s normal to have a lot of those features when you’re young, one of those hormonal features of PCOS.

And also, the other situation I see is post pill. So when you come off the pill, it’s normal to not ovulate straight away. It’s normal to even get some male hormone temporarily kind of happening. And then the doctor says, he looks at an ultrasound which is meaningless, and says, “Oh, you have PCOS therefor…” all the things that come after that. And therefore a woman might start doing a low-card diet or go on a diabetic drug that she doesn’t need or obviously IVF, all these things. I’m just really raising a question mark around that diagnosis for some women. Certainly some women do have polycystic ovarian syndrome for real but some women don’t, and I think some women actually have an undereating problem which is the opposite. So I really would like to get that message out there. That’s on my blog and that’s in my book as well called Period Repair Manual which is about how to ovulate again when you’re coming off the pill, you know how to deal with heavy, painful periods, how to think about whether you might have endometriosis, what some of the natural treatments are for that. I talk about conventional treatments as well in the book. I try to give kind of a full survey or what’s out there for different options.

58:22 CL: According to this article… okay, I’m very interested in that. But then, like what do they go on to say as far because I know the diagnostics are a little bit iffy, but how does one know if they really do or not?

LB: Yeah. Well, that’s a very good question. Okay, so one of the points they make in that article about the overdiagnosis of PCOS is that many woman, some women outgrow it. So for some women, it can just be a temporary state. I’ll go further and say can be a temporary state post pill that will just disappear basically with a year or two as a woman learns to ovulate again. But the true condition of polycystic ovary syndrome is anovulatory cycles, mostly anovulatory cycles plus high male hormones, either measurable on blood test or clear signs of facial hair which is not just a little bit of hair on the upper lip but like, you know, hair on the chin, the throat, the chest around the nipples. A clear picture. Then that is, yeah, that’s real and that’s often linked to an underlying condition called insulin resistance. That does require treatment because it’s difficult, well, impossible to fall pregnant if you’re only having anovulatory cycles, bearing in mind though even that real state of PCOS is reversible.

So what they also say in the British Medical Journal article is that most women with PCOS diagnosis go on to have pregnancies. That’s my experience too. And natural pregnancies. So most women with IVF can reverse out of that situation and start to ovulate. So again it’s the message of just because you haven’t been ovulating doesn’t mean you can’t.

60:21 CL: Yeah, absolutely. Okay, so how do we find out more about you?

LB: My blog is LaraBriden.com and my social media handle is @LaraBriden on Instagram, Twitter, and Facebook. My book is Period Repair Manual.

60:38 CL: I love that title.

LB: Oh, thank you.

60:43 CL: Yeah. I think that’s important to have on your bookshelf or in your Kindle or wherever you’re reading these days.

LB: Yeah.

60:49 CL: A really important one. Okay, thank you so much and I’m going to invite you for a part 2 and I’ll contact you in a couple of weeks when this is published.

LB: Thanks, Charlene.

60:57 CL: Okay. Thank you, Lara. Bye-bye!

LB: Bye.