ADHD, Menopause, and Fertility – What Doctors WON’T Tell You About Women’s Health

A lot of women now are waking up and realizing that things like perimenopause can start as early as 32 years old. Why do you think that's happening? Why are we going to perimenopause sooner and sooner? So, yeah, I think we should define some things. So everybody's on the same page. So what is perimenopause? Perimenopause is basically the time where we're running out of eggs. We've had this robust savings account, but we weren't spending on a spending spring, right? Through our 20s and then into our 30s. So we're running out of eggs. Perimenopause starts with the decline of progesterone. So when we ovulate, what's left behind is the corpus luteum and that produces progesterone. Then over time, we ovulate less and less. Progesterone goes more and more. And then estrogen finally drops off. You go 12 months of no period. Hello, happy anniversary. You're in menopause. And the next day you're post-menopause. So we're all on the same page with that. We are seeing more women report. We're waiting for the research to catch up to tell us how significant is this. This is very much of what we saw when more moms were reporting, hey, my eight-year-olds going into puberty. And we were seeing more women report precocious puberty. So that's early puberty. Research took some time. And finally, lo and behold, here we are. And we know that there are correlations between girls who are getting their hair dyed and wearing more makeup. The younger they start that, the sooner that we're seeing, they have menarche. So that's the first period that you have. And so the hypothesis is, if you start your period earlier, in theory, we're born with all the eggs we're ever going to have. Right? I say in theory because there is some interesting research being done with stem cells and so things we might change this idea in the future. So if we're born with all the eggs we have, and I tell you, there's a finite period of time you can ovulate, and then you're going to go into perimenopause. And instead of starting your period at 14, you're starting at eight. You know, even if you're starting at 10, we just cut four years off. Right? Yeah. So that is one hypothesis. The other thing that we have to sit back and ask the question is, why now more than ever are we seeing so many women struggle with infertility? So that's another big question that we have. You know, once upon a time, you know, it was just, you know, this very rare thing that you would hear about somebody doing IVF. Now it's something that even ACOG is like, everybody, as soon as you have a fertility problem, go straight to IVF, which I disagree with. We should disagree with completely. We can totally talk about that. That is, um, that is a money driven position for sure. So that's the other question we have is that we're seeing fertility issues. So by way of that, there's often ovulatory issues, egg issues, mitochondrial dysfunction at the root of that. So that's another question we have. And as I bring up mitochondria, that's another big piece of this is that, you know, before you ovulate, there's about 600,000 mitochondria rallying for that egg. We are inundated in an environment that is toxic for the mitochondria. So we have to ask the question of what happens when you compromise the mitochondria to the quality of our egg, but also to the function of the ovaries overall. So one of the things that I found really interesting when I was researching holistic fertility was that we have more mitochondrial density in our oocytes and our egg than anywhere else in our entire body. I think it's like a hundred thousand over there. So when your mitochondria health is declining, then what are your eggs being fed? Yeah. And this is what I loved. You also brought up stem cells. So Reese was ahead of the curve with this research. They started doing PRP and stem cells and we're able to pull women out of menopause and slow down perimenopause. Do you think this will become common as time goes on and will more people seek this out versus doing things like IVF if the cost benefit is there? Okay. So we've got two different questions here. One is like menopause and the other is fertility. When we talk about fertility, yes, I think we're going to see more stem cell treatment be leveraged. So I had endometriosis excision surgery and when I underwent the surgery, I had to have. So there's little cysts that will grow in your ovaries sometimes and I needed to have these removed. I asked them at that time, hey, I'm under anyways, please inject my ovaries with PRP. My surgeon was like 100%. Let's do this. So. For people listening, there's a lot of supplements that you take that end up in your plasma that you, if you're taking those in a higher dose, when they do the PRP that those nutrients should in theory be there and get injected to the ovaries as well. So yeah. What are those supplements? So CoQ10, vitamin C, vitamin E are antioxidants. The key thing to know about mitochondrial dysfunction is that oxidative stress, which is high reactive oxygen species, basically I call them the bad mofos that are just like decimating cells. They're combated with antioxidants. When your mitochondrial are dysfunctional, the mitochondria will actually produce reactive oxygen species. So we get in this like vicious cycle, this loop. So those three antioxidants are really potent. Omega three fatty acids are something as well. And we know those are anti-inflammatory. They're very important for our cellular integrity. So those are some of the things that you can be taking that can help. And of course, like, you know, we need a lot more research on this to understand, like, how can we make PRP even better? So from the fertility standpoint, I think, yes, absolutely. I think at this point, the best endocrinologist that I know of the reproductive endocrinologists, they are doing this therapy. And when you, when you talk about cost, right? Cause that's part of this equation. The cost of IVF cycles in the U.S. looking at like 20, 30 K a pop, right? People's like, I mean, that's, you know, when you look at like how someone goes through three cycles and that's some people's annual salary, that's wild. That a PRP treatment, depending on the place, you know, that might be more around like $1,000, 1500. It just depends on where you're going, where you're at in the U.S. So when you start looking at it from that perspective, it's very cost effective. Now, for the question of menopause, there's a lot of things that are starting to be looked at in the research of how we can delay menopause. I think that the generation right now who is making that transition in menopause, right? So they're like, they're about 10 years older than me. I think they're more hesitant around that. They still adopted the narrative of periods make you weaker. They're just horrible. You can't, we can't wait to be done with them. And that's not because like, oh, they're just dumb women and they don't know better. It's because they had a generation still in nations. Yeah. Who were gaslighting them and doing them a disservice. So for them, I think they would be more hesitant. For someone like me, I'm like, sign me up. Right? We're seeing rapamycin as a potential therapy. That's something that I'm like, I should probably consider that in a couple of years. Yeah, I took a rapamycin. Yeah. It's something where, you know, we have to stand back and say, okay, there's no clinical trial as of yet. It's coming. Yeah. Right? They're in the works, but we have to look at like, why only have so much time, right? Like, am I going to wait five years? Like the five years, I will be closer to 50. Like the interventions might not be as effective. So I think yes, PRP, rapamycin, I think we'll be looking at stem cell therapy. I think it's interesting to look at red light therapy being put over the ovaries and how that can stimulate things. And so for people listening, if you're like, why the hell would I want to keep my period longer than I need it? The longer you bathe in your natural hormones, the better your brain health, your bone health, your heart health, your sleep, your sleep. The minute you lose that estrogen, your cardiovascular health, your brain health and your bone health start to decline. Now that's why there's this critical window, right? Of where we want to start estrogen replacement therapy. But that's another tangent. Knowing all that you do about the space, I wanted to ask you something because I think about this myself. Women today live under so much stress. We have to show up to work. We have to perform here. We have to look a certain way. We are having all of these expectations put on us. How important is your emotional body? Because I believe that your, your outcome does not lie at the bottom of supplement, a peptide or just like a PRP session. I think it has to do so much with regulating your nervous system and your emotions. So when you look at people and you look at the data and research, what can women start observing about themselves about self-regulation? I think some of the best research we can look at is the ACE scores. So adverse childhood events. We know that has such a tremendous impact on our overall health, but certainly our hormonal health. We also understand that if you have HPA access dysregulation, so what is that? That is our stress system, how our brain talks to our adrenal glands. You have that and you're going into puberty. You are more likely to develop depression. And we're not talking about like, I'm sad, I'm a teenager. I cry, right? Cause I think we've all been there, but we're talking about major depressive disorder. We understand that people who have blunted cortisol responses. So, so when you get stressed, you should spike cortisol. They're no longer able to do that. More mental health disorders, more chronic disease develops from that. We see more hormonal issues and we certainly see problems with our cognitive function as well. So more executive dysfunction, which is a term that gets applied to ADHD is a lot. And yes, that is someone who that's like the hallmark of ADHD is executive dysfunction, but any of us can develop executive dysfunction for a variety of reasons. So I saw this really interesting. Um, it was actually a podcast podcast clip that Gabor Maté was saying that ADHD, while it is a diagnosis, it is a result of trauma, childhood trauma of how a child dysfunctions and copes in the house. It's a tune up mechanism, right? So it goes back to the ACE score and saying that if you have the self awareness, again, it's not about medicating it, but having that awareness and moving through releasing some of that trauma in your body so that it doesn't show up and dysregulate your health. Yeah. Well, you have to, you know, I would challenge Gabor on this because we do know there's a very high genetic component with ADHD. So it's like 70 to 80%. I have ADHD. My son has ADHD. We just went through a whole new round of psychoeducational eval for him going into school and he is someone that because of the kind of childhood I have, I made sure I set up his childhood in a way where it was like, if you need support, you're getting the support. We've always named emotions, worked on emotions. And so we see that despite him having a very different childhood than I had, the ADHD is still there and pronounced because we've got this genetic component. And I think, you know, I was very naive when I was pregnant. You know, I had my own garden. I grew my own food. I ate, you know, ate dirt. Like I did all of these things. I did all of this prep and I thought like, Oh, you know, what my health is, that's going to determine my baby's health. And like I can help prevent this. And in reality, there is this genetic component, the degree of dysfunction that we see, I think we very much do. We do contribute to in a way. I don't like this whole like, you know, blame moms for any neurodivergence where people are like, it's mom's fault because of this. And that's what the research has mostly done. Like through generations, but we do see this component. So for women who are listening, who are thinking about getting pregnant, mom's metabolic health matters. Absolutely. So whether you are obese or overweight, if you have diabetes and how significant your diabetes is, so insulin resistance to gestational diabetes. And if you need medication, that is more strongly associated with the development of ADHD. However, I also challenge this research in the perspective of like, there is no that happens in utero. There's inflammation and there's hypoxia. Right. There's, there's all these things that happen that we know when we are metabolically inflexible in pregnancy. But how did you get there? Right. Right. It was lifestyle. And what does your child then get exposed to in the home? It's lifestyle. So it's a question of like, was mom's pregnancy what made babies ADHD worse? Or was it mom's lifestyle that led to these factors that would have, you know, been higher risk factors and then therefore the child was exposed to those same lifestyle components. What about the whole role of like generational trauma that carries down and can be experienced in your, in your cells, in your DNA and expresses yours, you know, expresses as you go on. So no matter what the mom did in terms of lifestyle, if you haven't dealt with certain things, certain emotions and stuff, those will carry through. Yeah. We, you know, we have less research on kind of like that, that soft concept of trauma, right? Of like, Oh, I had a bad childhood. I didn't work through that. And then I had a pregnancy. Well, the strong traumas, right? So Holocaust survivors, those who have been through famines. So we know that if mom went through a famine, that will change baby's metabolic health because, because your body's brilliant. And it's like, whoa, whoa, whoa, whoa. We didn't have enough food. So when I am born, I need to store food. Like I need to store food and I need to be safe. And so I think it's completely plausible that if we have an emotional dysregulation due to trauma, that this is going to play out in our hormones. And that could have an effect on our child. When it comes to things that are complicated, like ADHD and autism, you know, people are always looking for one gene. We know there's like 80 genes. So, um, and we know that there's clusters of genes, which is why in certain neurotypes we see higher incidences of endometriosis. We see higher incidences of autoimmune disease. There are higher incidences of other co-occurring conditions. It's, uh, you know, also something that with roughly 30% of autistic children, there is co-occurring intellectual disability. And that is something where we have to piece out because we need to actually study what is contributing to intellectual disability. We know metabolic dysfunction in the mom, maybe what is contributing to that. If we have hypoxia and not getting enough oxygen in you, that could contribute to the intellectual disability, which is separate from the autism. However, the autistic genes were predisposing, right? You know, to the, to the epigenetic input that then flip the switch for your child to go and develop intellectual disability. With all of that said, if you're a mom listening to this, none of this is your fault, right? Because we have complex issues. Like this, to say it's your fault is to assume that everyone has access to health care. Some people live in rural areas. They don't have access to that. Awareness. Yeah. Or education. I mean, as we know, like not everybody has access to, uh, you know, being able to eat a whole foods or have the means to do that. So we've definitely, I want people to understand that like it's very easy to be like, if mom just ate better, however, we have systemic issues that also have to be addressed that we can enable someone to, to eat better. If you're spending hundreds on skincare by ignoring one of the most powerful anti-aging tools out there, you are missing out my biohackers. I'm talking about red light therapy and bond charges, red light face mask. It has completely changed the game for me. Red light therapy isn't just another hype. It penetrates deep into the skin, boosting collagen, reducing inflammation and easing signs of aging. 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So for women listening to this, you know, if they're in their 30s and 40s and they're like, Jolene, tell me, I'm listening to all of this. I want to look into my health. I want to take a deep dive. What tests should they first and foremost get done? And then looking at that, getting the research back on that, getting their kind of range back, what would be next steps for that? Okay. So 30s and 40s, here's the thing. There's a lot of tests we should be running that I think too often we're waiting until there is Frank symptoms, which by the time your body has sent up the flare, like we've already had changes that are sometimes irreversible. So in this whole perimenopause conversation, everybody's very focused on estrogen, progesterone, testosterone is now getting pulled in. Very important. Thyroid though, we're not talking enough about thyroid. Once we get into 35 plus, we are much higher risk of developing hypothyroidism, which in the United States is primarily caused by autoimmune disease and is primarily affecting women. So for that, TSH, what the brain says to the thyroid, T4, how the thyroid responds, T3, how the body converts it, reverse T3. Are you so stressed out or not eating enough or something? Going on that you're inactivating your thyroid hormone, essentially. And then TPO and thyroid globulin antibodies. We also need to be checking vitamin D. You got low vitamin D. You're probably going to develop an autoimmune disease, cancer, something big bad that you don't want if you've got the genes for it. So we know this is a key player in disease development. So we want to be getting a vitamin D. We also, so I said we want to look at these hormones, right? So FSH estradiol is done on day two, three or four of your period, ideally day three. But you know, life's not perfect and labs are not always open. So that's when we want to get that done. Progesterone, if you are ovulating all kinds of wonky, you're like, I don't know, period is sometimes coming every 45 days, sometimes 60 days. Don't bother with a progesterone because you're going to have a really hard time catching it to get an accurate progesterone needs to be five to seven days post ovulation. And if you're like, well, that's hard. How do I catch ovulation? We can do LH test strips. But if you don't want to do that, if you are like, I consistently have a period every 28 days, back it up day 19 to 21 of your cycle. That's when we're going to, we're going to test for things. So we can, we can look at that ideal progesterone. We want that at least in the double digits happening there. Now we also need to be looking at, I think earlier is better fasting insulin, hemoglobin A1C, a fasting glucose. Honestly, I don't even care that much about it, but it comes with a comp metabolic panel, so we're going to get it anyways. Um, and why they don't care that much about it is because you can be fasting on your way to the lab and somebody cut you off in trial. Yeah. You could be scared of needles. Now your glucose looks like it. It's up because your stress response begs glucose to come out to play to fuel your muscles. So, uh, we, that's why we want to look at fasting insulin because fasting insulin is the first problem we see. Hemoglobin A1C is the average of the last three months. What is your blood sugar looked like on average? We can tell, do we have metabolic issues? The other thing I think is really important is getting a cortisol curve done. So you can do this saliva testing, there's a Dutch test, Dutch test, doing urine testing, coupling that with your cortisol awakening response. Um, this is something that is really common to see if you have trauma, if you are very, uh, very stressed and it's been long term, if you are neurodivergent, we will actually see the cortisol awakening response is blunted. It's lower than it should be. And here's something everyone will tell you to get morning sunlight. And that is the best thing to do. If you do not get six hours of sleep, it is doing the exact opposite. It is ruining your circadian rhythm. So you need to get at least six hours of sleep. Otherwise I tell people, if you haven't gotten six hours of sleep, right? Because you had a horrible travel day and all of that, you're going to wear your sunglasses in the morning and then we're going to take them off later in the morning. Because that, that less than six hours of sleep, we haven't had enough time going through the sleep cycle to then spike cortisol appropriately. And it actually can work against you and keep you up later at night. If you do that. When it comes to sleep on average, how much should women be sleeping in their thirties and forties? Oh my gosh. Everyone hates me when I say like, you should be getting eight to 10 hours. And they're like, no, we're at a time to sleep eight to 10 hours. I definitely sleep eight. What time do you go to bed then? I go to sleep usually around like nine. Amazing. Okay. Till seven AM usually. Incredible. And you sleep through the night. Yes. Yeah. And this like, I will say, um, we were, my husband and I had a cocktail last night and he was like, Oh, it affects your sleep. He was like, I was up all night and at like four o'clock and finally was like, Oh, like I can't get to sleep. And I was like, welcome to your forties. I take glutathione. If I have a drink at night, I take glutathione and then I'll end up staying asleep at night because it'll just help clean it out of your system. Yeah. Yeah. Um, that's my little bio hack for that. Um, but you know, okay. So I want to, I want to back this up. You are going to be able to get less sleep in your follicular phase and still thrive. So when your period starts, the first day, you might be like, well, I'm kind of tired, but after that you're going to find you could get six, seven hours of sleep and you're going to be fine. You flip into ovulation. Progesterone is there to get converted to alopregnant alone to stimulate GABA in the brain and to put you to sleep. Women are like, Oh, I'm like not able to get so much done and I'm feeling like I'm dragging. I'm feeling more tired. How much are you sleeping at night? Because biologically your brain has just shifted to be primed to be getting at least eight hours, if not nine hours of sleep during the luteal phase. So while you're cycling, there is wiggle room that happens there. If you're someone who's in burnout, for example, you're going to need to hit more like that 10 hours. And so it really depends on the individual. And when I say the average, it doesn't mean you have to sleep 10 hours every single night and we know we don't make up sleep. Right. So I look at my 20 year old self, I was sleeping like six hours. I'm like, you ain't ever getting that back. But we can, you know, if it's something where it's like, okay, like I got, you know, eight and a half hours of sleep and then the next day you get nine hours of sleep, but we know the female body needs more sleep. It's doing way more than the male body. Absolutely. Right. Like we do not, there's actually a great book coming out. Dr. Sarah Hill, I'd recommend everyone check her out. I had her on the podcast. We had a long conversation about how we just disrespect what women's brains are going through every month. We build all this estrogen. We build all of these neuronal pathways in that follicular phase. And then we switch over to the luteal phase and we build all these gavoreceptors. We start to shrink the pathways. We change things like our brain is doing so much, which is why we require more sleep. And the entire premise of seven to eight hours was based on men and forced on us to get us to be more productive in society. You know, you said something about burnout right now. So I've recently been experiencing that and that has thrown off all my hormones. My vitamin D is in the garbage. I have developed a little bit of hyperthyroidism. Iron deficiencies have come up. So it's so crazy that how stress impacts women so differently and can cause havoc on our hormones versus men. Yeah. And that's why I always talk about a lot of these bio hacks that people go through and they're like, Oh, I'm just going to do really long fast. I'm going to do cold plunging all the time. That doesn't work for our body because we don't perceive good stress and bad stress is just stress for us. So if you're already stressed out and you're inflamed, that's, that's it. Basically. Yeah. No, you're absolutely right about that. It's like, is fasting great? Yeah. But done at the right time and in the right way. And if you can take it, yeah. Uh, is cold plunging great? Absolutely. You know, I went to Iceland and I posted photos of me like doing the sign. And I think this is just like the way they live and jumping into, but they're tuned for that, right? Yeah. And people were like, well, where are you at on your cycle? I'm like, I'm in Iceland when I'm in Iceland. Okay. Like I'm just like, living your life. Yeah. Like seriously, I put my body through enough things that I know that like there's a resiliency like play one time in Iceland. I'm going to be fine. But when we are day in and day out in and dated with stress, and then we expose ourselves to more stress, right? So like, if you're someone who is incredibly stressed out, you have an autoimmune disease, let's say it's Hashimoto's, your hypothyroid, your, your hormones haven't been worked out, your medication isn't dialed in and you're doing high intensity interval training. You're going to be like, what's wrong with me? Because three days after that, I'm still wrecked. I can't get out of bed. I'm so sore. And it's because it is this kind of training bad. No, it's amazing in the research. But your body can't support it. But at this time in your life, it's not the best thing for you. And can you get back to that? Absolutely. But first you need to work on what is going on. This kind of brings me to the next topic. I really want to talk about it is a link between stress and your libido. So obviously we know when we start hitting perimenopause, menopause, our hormones shift so much, so libido can shift as well. So how would you tell women to keep their life still spicy? And how do they create more awareness about the stress in their life and how that's affecting the libido? Yes. Okay. This is what you have to understand about perimenopause. And I'm glad that I gave you the progesterone spiel at the top of this because progesterone acts as a buffer against stress. So GABA is like, stop, chill. I always think it's like, chill, baby girl, be cool. Like you're going to be fine. Like easing you, you know, like a mom rocking you. Like it's going to be okay. And when you lose that progesterone, you lose that stop, that break. And now it's all gas pedal of cortisol, norepinephrine, stress hormones happening in the brain. So you are going to feel like the stressors you handled in your 30s, they're way more impactful. That's real. That's not in your head. It's happening in your head, but it's not, you're not making it up. So with that, we have to step back and understand how do women's libidos work? So society tells us like women just don't want sex and men, you know, they always want sex. What we, there was actually a new study that came out and said that myth alone, if you believe it, the worst your libido is just you by believing that thought. Men, worst their libido are, if they think the expectation is they're supposed to always want it, women thinking I'm just a gatekeeper. I am not supposed to be sexual. They also will manifest that in their body as a reality. So firstly, let the myth die. It's not true. Now, secondly, we have to understand that the brain is the primary sexual organ. And I go through all of this. My book is this normal talking to you about how what happens to your nervous system affects your ability to receive the sexual signals and the input. The sexual stimuli of maybe like, you know, your partner kisses your neck and that usually does it for you. That travels to the brain. The brain's like, this is good. Yes. Get everybody all together on this. Like, you know, get send a rousal out, get everything going. If you are stressed, that signal can't move. I call it's like a train track and we've just got blockades on that train track. So when your partner tries this and the signal, it actually can't move. So when we talk about women's libido, we have to parse out that one, not everybody has spontaneous desire, which is what we see in the media. You just always want it. You're just like, they just look at each other and that's it. Yeah. Right. No, there's like half of us that, you know, need to actually get things going before we're like, Oh yeah, no way. Yeah, I like this. I'm into this and that's normal. It also changes with our cycle. You're more in the mood for what they call the sexual phase of your cycle. Six days around ovulation. You're less in the mood post ovulation. Why? Because the egg has been dropped. There's no chance of getting pregnant. Your biology is shifted to I might be pregnant. Let me, let me get my community. Let me keep myself safe. So you have to understand that some things are just biologically natural and that we have been told a story that's not true. But if you are experiencing stress, you need to, I like to do this little thing with patients where I'm like, just brain dump and write everything that's stressing you out. Because what we often find is that when we look at that, there's things that are fabricated stress. There's things that we're taking on and we're making into a thing that don't have to be, I think, cross those out and let those go. And then we want to look and take inventory again and say, like, what is something I can change? Start to circle those. One of the biggest stressors women face that get them, keep them from getting in the mood and put them out of the mood is body image issues. So I want every woman listening to know that if anyone is lucky enough to have sex with you, they are not looking at like, what does your body look like in this position? Is there a role? Do you see a cellulite dip? Oh, are my breasts looking like, you know, more saggy as I lean in that they are not thinking about that research tells us men are just, they're amygdala's are overridden and they are not thinking about that. Okay. And for women, we think about that and we look at ourselves. And so that's the number one stressor that you can address and you can start to do something about because in Barry Menopause and menopause, our body shifts and changes. We've got, we've got to grapple with what society has told us. Now, the very big silver lining is, is the other big thing that gets us out of the mood and can block your libido is a threat of an unintended pregnancy. When that is no longer the case, women become very sexual creatures. So with this whole myth that like in menopause, you're going to lose your libido wrong. And there's no cyclical progesterone coming in to block you, 10 to 14 days out of the month. People aren't talking about this enough, but I truly want to optimize your health. 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Can you sing out loud and stimulate your vagus nerve? If we can stimulate the vagus nerve, that is going to help with our stress levels, but here's something really cool, that vagus nerve that everyone's like, it innervates your brain and your heart. It also innervates your cervix. So it's actually involved in your reproductive organs as well. So stimulating the vagus nerve is one way we can start to modulate our stress hormones in a positive way so that our sexual hormones can come out to play and do what they were designed to do. Could you on that based on that implement vagus nerve, like regulation or stimulation, if people are going through fertility, you'll want to get pregnant or going through IVF or something else like that or trying to conceive naturally. I think IVF, I think trying to get pregnant and IVF, these are some of the most stressful times of women's lives. We are told this myth our entire life. You can get pregnant any day out of the month. Like you're just going to get pregnant whenever, you know, anytime in your cycle, when you actually try to get pregnant, it is not what you've been taught. And everybody who's been lying to you did a major disservice to your mental health. So I definitely think vagus nerve stimulation, whether you're massaging, you're gargling, you're singing, that has a big role to play in terms of our health overall. If your body perceives that you are in a stressful state, it will always choose cortisol over, progesterone, over ovulation. Why is that? Cause it will always choose protecting you, keeping you safe and keeping you alive over potentially life threatening condition, which pregnancy in a stressful environment is life threatening. Absolutely. You talk a lot about, I want to go into supplementation for a second. You talk a lot about the science of the connection between creatine and ADHD. Yeah. And I really want to educate people on that. You know, there's been such fascinating research being done with like creatine for like Alzheimer's prevention, dementia. So helping with memory. Also, there was a study where it was so funny because Rhonda Patrick was talking about this and my husband's like, you're only taking five grams of creatine. Like, you know, you should be taking 20 for this study. I'm like, I sleep. People in the study don't sleep. Yes. And I'm like, also when I did 10 grams, I was bloated and puffy and my rings didn't fit. I was like, it didn't work for you. Can we talk about the study quickly? Cause people, I know about it, but people might want to hear a little bit more about it. So they had severely sleep deprived people. And so when you're severely sleep deprived, other studies have compared it to like binge drinking, drinking drunk. Like that's how poor your brain works. Like you, you wouldn't get behind the wheel, right? If you've been drinking, you shouldn't. You shouldn't be. Yeah, exactly. Who would run the car with someone who was drunk. But yeah, there's all these people who are sleep deprived, going through life, putting themselves in danger and putting others in danger. So in the study, they had incredibly sleep deprived people. We know cognitive function. You can measure those tests. It's very poor cognitive function. Your memory, your working memory, your word recall, and every concern is to go, they gave them a high dose of creatine. And what they found is that they were able to mitigate the facts of the severe, severe state of lack of sleep, which is detrimental to the brain. So it was looking at these extremes to see like, what is creating to do for you? Creatine here. So when we look at ADHD, here's the thing to understand about ADHD is that metabolically, the way your mitochondria is set up, the way your brain is set up to produce energy is, it's a little poorer than other people. So you're going to use more energy quicker. You're going to have a hard time recruiting that energy. And that energy is ATP. Now, what we come to understand from creatine is that it may actually be donating to ADP, which is the precursor to help us get to ATP. So basically you have this period where like you build up energy, you then use the energy and then you got to rebuild the energy. Creatine may shorten that time. Creatine may make the brain be a little more efficient in getting that energy production. So this is important to understand for people with ADHD, because if you are, I call it like running hot, you're burning like rocket fuel, right? But like it's just a, it's a Honda, right? It's like not supposed to go on rocket fuel. But that's like the rate you're burning energy in this and how like how high value that energy is, right? Rocket fuel is not cheap. And so the other caveat to that is that you've got neuro inflammation going on a lot of the times. Again, this is the gene clusters that happen. People who are neurodivergent have a tendency to throw inflammation a little more quickly, their immune system. You know, the underlying theme I like to say is dysregulation, dysregulated nervous system, dysregulated immune system. And it's not necessarily that you're, you're broken. It is that it's dysregulated because modern society, modern environment, isn't set up to support this operating system. And that's essentially what is a different operating system. So creatine may help with your brain health in terms of giving you more energy because that inflammatory piece also disrupts your ability to make energy as well. And so what people report when they're taking creatine is that their executive functions are better. So sometimes it's emotional regulation can be affected, but it's often more focused and more sustained focus. So what can often happen, especially in the alludial phase for women or women in perimenopause menopause is that they have a hard time starting a task. Then they finally start a task. They don't have the gumption to get through. Right. I burn out. I'm getting exhausted. Yeah. Yeah. And that is because the brain fuel, like they just burned through it. Right. It took so much energy just to get started. And then they had very little left to keep going. I also want to talk about a little bit talking about the brain, creatine, all this stuff. How much blood sugar regulation adds to this whole dilemma as well. So why it's so important to not have insulin spikes. Yeah. Well, people don't realize that insulin, there's this weird thing that we do as humans. We're like estrogen progesterone. Those are women hormones for making babies, forgetting that there's receptors all over the brain. Insulin's kind of the same thing where it's like, oh, it's just about glucose, except insulin's also interacting with the brain as well. And insulin's playing a role in our executive functions as well. But we also know from the research of like dementia, when we have blood sugar dysregulation, we can have adverse changes happening in the brain that are going to affect our memory and our brain health long term. So the other thing I think to understand about blood sugar is that if you're spiking and dropping and you're having all these wild swings, understand that your hormones are getting these signals. So cortisol epinephrine, norepinephrine's having to come in. Enough of that going on. Now we're seeing progesterone issues starting to come up. So it's, you know, it's rarely just one thing, but it's interesting as you bring up insulin, I think about women with PCOS and we think about their brain function. We see a very high correlation between PCOS and ADHD, which people are always like, Oh, it's the testosterone. And while testosterone, high testosterone is what contributes to like the male like archetype of ADHD, and we can see that in PCOS, their blood sugar dysregulation and inflammatory profile that we see, I mean, 70% of those with PCOS have insulin resistance, have blood sugar dysregulation. That is tremendously impacting their brain. Again, they may have ADHD, right? But they also have this metabolic issue that makes energy utilization even more of a struggle. Do you know what's so crazy is when I was looking to all this fertility stuff, I realized PCOS and dermatitis is directly correlated to things like insulin resistance and inflammation in the body. But when you go to your traditional gyno or, you know, a general doctor, they don't address that at all. That's not a concern for them. And they're just trying to put you in one form of some sort of medication versus being like, let's do these things to lower your inflammation markers, balance out your blood sugar. But it's something that's not even spoken about. So women again, are being treated for things incorrectly and getting their basically is gaslighting them. The thing you have to understand about modern gynoecology is that they're expected to do so much, so much. In fact, I think too much in the fact that you have a gynoecologist who is like there delivering babies, seeing someone through pregnancy, but then they're also expected to be a hormone replacement or menopause specialist. And they're also expected to, you know, understand, like diabetes and, you know, understand blood sugar management. And they're supposed to understand endometriosis, which by the way, every endometriosis surgical specialist has said on my podcast, every single time, without fail, if you're a gynoecologist delivers babies, they should not be do your excision surgery because you need at least 50 under your belt every single year, if not more. And if somebody is delivering a baby, they're a generalist, they're not a specialist. And so I think that's the real big problem we have to stand back. What we need to look at is that there needs to be subspecialties in gynoecology. There's the people who do obstetrics. I mean, when you consider that, I mean, I was blown away hearing that gynoecologists are not trained in hormone replacement therapy, but it made sense to me because I am, I've been prescribing for over a dozen years and I had so many gynoecologists who would be like sending me messages being like, don't you know, you're going to give this person cancer or you're going to kill this person. And I'm like, respectfully, I'm actually trained in this. Yeah. This is my background. And you do, you are not. And all you're doing is parodying what some professor attending said to you at some point, and only now we're seeing gynoecologists who are now stepping into that and owning that. Like we got no training. We have to change this entire paradigm. And there are gynoecologists. Dr. Tara Scott was one I had on my podcast and she was talking about how she's a gynoecologist and for 25 years she's been specializing in hormone replacement therapy. And how many of her colleagues were like, you are crazy. You should not be doing this. Get back to the livering babies. And she's like, no, like I can't do both and do it well. And I think that I really admire practitioners who look at that and say, like, no, no, no, I can't do everything and do it well. This jack of all trades is not working. I need to focus in. And so I think that's really important for women to understand is that gynoecologists are just, they're expected to do way too much. And you're right. They're not looking at blood sugar. They're not. I mean, I remember during my pregnancy, I was 40, my last pregnancy, my doctor didn't tell me that there was that she'd put in a thyroid order. I'm taking my prenatal. What does my prenatal have in it? It has biotin in it. I go get my blood drawn. My TSA, it's just like 0.01. No, it's like super low. It's abnormally low. She's like, you're hyperthyroid. Your medication that you're on, I need to cut it in half. I'm like, no, you don't. My T4 and T3 are fine. We're not doing that. She comes out with a prescription and she's cut my thyroid prescription by 75%. That would put me at risk of miscarriage. That would put me at risk of preeclampsia. That would put me at risk of dying. And I know what I know and I'm like, absolutely not. I go to my maternal fetal metal specialist, okay? Gynecologist, but specialist training. And I talked to her about this situation. She's like, you can't do that. Like you could die. I'm like, okay, same page. And I was like, I was taking biotin. She's like, oh yeah, you can never take biotin and test your thyroid. I'm like, there you go. Specialist understands this, that we have abnormal lab results because of what I was taking. But my gynecologist who's managing the pregnancy, she doesn't know all of that. And I, being a doctor, was like, I wouldn't expect you to know all of that. Like I will see the specialist and have that conversation. But, you know, I think women have to really understand that we have also been told they're a one-stop shop and they're not. And they're not. But you were a doctor and you caught that. But imagine the average person would not know that. Then God forbid they would have a miscarriage and then they would be like, well, it is what it is and not know that because the thyroid medication was cut. That's why it led to the miscarriage. As someone who's testing and I was retesting for what works for my gut, immune system and hormonal health, I definitely do not mess around with any probiotics that die before they even reach my gut. So this little guy, Just Thrive, is completely different. It is clinically proven to arrive 100% alive, survives antibiotics, and even helps to heal leaky gut in just 30 days. It beats bloat, helps with nutrition absorption and turns your gut into an antioxidant factory. And it's the only probiotic I trust and recommend to my biohacket community. Check it out at JustThriveHealth.com and use code biohacket for a discount and enjoy. Yeah. It's not something I think reproductive endocrinologists, they understand this. Thyroid meets infertility, meets miscarriage, crossroads that we find ourselves in. I have fortunately managed enough. I mean, I have OB-GYNs who are like, I have a pregnant patient. She's not hypothyroid. She's taken armor. Like, I don't know, even know what armor is. Like, can you manage this? And we'll co-manage it. And I love that because a gynecologist who's like, this, I don't understand. Let me please get them some help with someone else. That's exactly what integrative care should be looking like. You also talked about, you know, you have such an extensive background with hormone replacement therapy. How upset were you when that research came out that women have basically been lied to all of this time about how our HRT can actually lead to cancer? And it was synthetic HRT versus, you know, bioidentical. Yeah. No, I actually wasn't surprised at all. And we, so here's what people need to understand. When somebody who knows what they're doing is prescribing your hormone replacement therapy, they're giving you topical estrogen and they're giving you oral micronized progesterone, which is bioidentical. That is the standard starting place for most people. Many people are saying progestin is progesterone and they are telling women this, what's crazy to me. Your whole life birth control is totally safe. It's totally safe. Don't question it. It's safe. You get to your 40s and suddenly HRT will kill you, but I'll give you the pill. I'm like, are you from you? Are you? I mean, you're going to give them something that does raise clotting factors at a time when they're high risk. Absolutely. Of having stroke, heart attack, all of that. But also you're giving them progestin. They're having anxiety. They are having sleeplessness. They are having issues in their relationship. Why? Because progesterone gets metabolized to alopregnant alone and that hits GABA. So that's what they need. It's not there, but you gave them progestin. But if we looked at the research on birth control and birth control pills, having a slight increased risk of breast cancer, so increasing that risk, it does lower the risk of ovarian cancer. Right. So it's a little about weighing risk versus benefit. That's progestin. So when you look at the women's health initiative, I mean, you're giving me a horse you're in and progestins. These are not something that humans should be taking or, or even like the body has seen. And so none of that was a surprise. And even now we see people saying progesterone will cause breast cancer. I'm like, back it up. That's progestin. When you look at these molecules, they are different. And the way that progestin interacts in the body is different. Progestin doesn't go through the same metabolism pathway. It has a higher affinity for receptors, depending on the progestin. It may even act more like an androgen. Then you're like, why am I losing my hair and have acne? Like, thanks progestin. So, you know, that's something that it was, I, there was not a surprise to like any of us who have been in the arena because we're like, that's pretty much what we thought. We thought the whole time, but there we are muzzled and not allowed to talk about birth control in a negative way. And I learned that when I put out my book, I was like, I'm getting out this book. It's going to help women who are on birth control. Holy stuff. And people were like, you, how dare you talk about that? And I was actually just having the thought as I was getting ready this morning. I'm like, man, I went first. I definitely walked through fire, but now here we are. And I'm seeing gynecologists who once hated on me, who made their whole platform to try to take me down. Biting their tongue. No, no, reading how to be on the pill. They'll never give me credit, but they're literally going on podcasts. And I'm like, that is literally in beyond the pill. The book you said was a dumpster fire. Yeah, you're saying that. And now like we're seeing that conversation, which I'm like, this is so amazing. But like, here we are now finally starting to be able to be free to talk about these things. So for women listening, they're like, we've heard this. Okay, we don't want to go to our gynecologists. Who should they approach or what should they look up, no matter where they're based to figure out if they need hormone replacement therapy and who can guide them through it? Okay. So you can figure out if you need hormone therapy based on your symptoms. So if you are somebody who is over age 35, but not yet 45, right? You're in that 10 year window and you're having symptoms. There's a lot of things you can still do naturally. So it doesn't mean you have to go right to HRT. 45 is the acceptable age for menopause. If you are in menopause before then, first we got to figure out, is it really menopause or is it something else? And we can actually, you know, we can start these hormones if necessary. So you can figure it out based on your symptoms. And I think a lot of women into it, like something is wrong. I need more. I would recommend looking at the menopause society's directory. These are people who are, they tend to be much more critical thinking and they look at the research, they look at the guidelines. The guidelines are very different than what you're seeing, you know, perhaps coming out of ACOG, the American College of Obstetricians and Gynecologists in terms of how women should be managed. And they, they change faster. They do a lot of continuing education for their providers as well. So these are people who will be certified menopause specialists and they're going to understand HRT. Now they still may be offering you, you know, synthetic progestin. So that is something that you have to ask for. Yeah, you will run into. And I want people to understand that sometimes HRT can be cost prohibitive. It really shouldn't be. I mean, like prometrium, which is the bioidentical progesterone, depending on your insurance, might be $5 for a month's supply. Right. Estrogen can be really economical, but sometimes the pill is completely free. And people are like, I need symptom relief. I can't afford these other things. And I'm 42 and I can't get pregnant. And listen, you could get pregnant at 42. There's no rules. There's no rules here about this that says that you can't. So sometimes the pill might be the best thing for you. But when it's just primarily for menopause hormone therapy. So when we, when we narrow in the language to this demographic, that's where we want to be using our bioidenticals. And also for women listening, right? Because they're taking in all of this information. They're like, Jolyne, I'm just getting so overwhelmed with where is my starting point? Yeah. What is the first thing that I should start? Besides paying attention to my body, how I'm sleeping, do I have brain fog and stuff? What else is an indicator that I should look into things? Okay. So I think that so often we dismiss symptoms in our own body, right? We say, like, Oh, it's just stress. Oh, it's just this, Oh, I just need to do that. Oh, I'm not enough. I need to do more. If you are noticing symptoms like hair loss, dry skin, changing skin, your brain functions changing, you're like, I'm losing words mid sentence. If once a month you want to divorce your partner girl, something is going on with your hormones. Right. It's really about tuning into your own body and knowing that nothing is just a result of just getting older. Right. Until you're like 70 plus, then we'll start using that language. But I feel like we all knew the golden girls growing up. And so the golden girls, I mean, I am older than like, yes, the golden girls where I look and I'm like, I mean, I'm like, how is this? Yeah. The golden girls on it. And I'm like, Lord, like this is our idea. Yes. Like 40 is old, 35 is old. Like, and it's absolutely not. Yeah. If you're feeling overwhelmed and you're like, I don't know where to start. Usually my experience, most women are already doing everything right. Right. They're trying to get sleep. They're trying to exercise. They're trying to, you know, take their supplements, do all of these things. I think it is a good idea to get lab testing and to get your baseline of where you're at right now. Because while I say you can tell if you are, you know, in peri-benefiles, you need estrogen, you need progesterone. You can't tell with testosterone. We didn't talk about that lab. Women need to have total testosterone and free testosterone and sex hormone binding globulin because you're free testosterone is low, but your sex hormone binding globulins high and total testosterone is normal. You don't have a manufacturing issue. You have a gobbling up the product issue and we've got to free it and liberate it. And one of the biggest reasons for low testosterone with high sex hormone binding globulin, or you have low testosterone symptoms overall. So you are somebody who is losing muscle mass. You do not set boundaries. You feel like you're a pushover. You're a people pleaser. You're trying to protect yourself because testosterone low says I'm weak and I need to do something to keep me safe. I can't rally against the tiger. You need to lift weights and you need to eat protein because you have two things going on, not enough testosterone and metabolic mayhem. And you can address those lift weight, eat protein at every single meal. You'll start to shift your testosterone and you'll improve your metabolic health. If you know me, you know, I avoid C-dwells like the plague. They're everywhere, even in snacks labeled as clean, organic or healthy. But the truth is they wreak havoc on your metabolism, your hormones, and make you super inflamed. That's why I'm obsessed with Prima, one of the few products I completely trust. Prima was created to push back against process artificial foods and bring us back to real nutritional and ancestral ingredients that actually nourish your body. 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So you're fueling your body with real clean nutrition because you're part of the biohacket community. You get 20% off. Just use code iman20 at eatprima.com. Ditch the seed oil, fuel your body right. You will feel the difference, I promise. So it's so funny you're saying that I recently got tested. I did all my functional labs and my testosterone came back extremely low. I'm lifting weights. I prioritize protein, but it just wasn't enough. And I think it's because of chronic burnout. So do you want to talk about that? Yeah, I want to go there. Okay, so we've got two places we manufacture testosterone. Okay, ovaries and adrenal glands. Right. When the ovaries go, we lean back on those adrenal glands. They produce DHEA. We can measure this via DHEA sulfate. We can do that in the blood. They also, this is like why like a Dutch test? Because a Dutch test, this is what I look at. Insurance, sometimes if I'm going to order all of these hormones on insurance, we're going to look at like $500 or I can order on a Dutch test and it's like $300. So sometimes we have to weigh it. People are like Dutch is expensive. I'm like, yes, and co-pays suck too. So we have to figure it out. Yeah. But with DHEA, that is coming from the adrenal glands. That gets converted into testosterone and estrogen. This is why even, this is why some women, they're going through perimenopause, menopause, they're like, I'm not having the same problems you guys are. Okay. Cause you handled your trauma, you took care of your adrenal glands, you're sleeping. You listened to Dr. Brighton, you're doing all the things. No, you're not doing that six to seven hours being like, I don't have time, right? You are doing good blood sugar management. And so your adrenal glands are healthy and robots and they're able to support you. The problem that we're seeing is this sound caregiving. This is what happens when women, this is so lame. You're in your perimenopause and menopause and then you got to take care of kids and take care of aging parents and in the society that's not supporting you with either of these things. And now your adrenal glands are basically like, you know, they're on a life raft being like, please. Hope us out. Yeah. And so you can be lifting weights and eating protein and doing all that right. But again, if you're not handling your stress, I have, um, in my book is this hormone, I did this hormone pyramid and the foundation, if you guys can see me, the very bottom is insulin and cortisol. That's metabolic health and stress in the sandwich right above that. That's going to be thyroid and at the tippy tops, the sex hormones, the sex hormones are the ones we feel so, so much and we want to chase them down. We want to fix them. The bottom. But it is the foundation that is not solid. And I think so many women living in, especially in the U S right, where we supposed to work or certain way, and we're trying to fit in the workouts and be socialized and a lot of them are moms and they also have to look presentable. There is just so much chronic fatigue going on. That's basically spiraling everything out, but we are just programmed to live that way because that's what's expected of us. And I, on the flight over, I lost my luggage and I thought to myself, the stress I'm going through to fucking figure out my luggage, compare it to a man and how he would respond to it is completely different. And that just spirals us out even more. And it took me, Jelena, took me two days. Like today I actually slept and felt better, but yesterday I was still, cause I dysregulated my nervous system so much. I felt like shit yesterday. I should have called you because why I sent you the, um, so I have had this happened to me enough times that I just embrace it of like, it is what it is. You have to go shopping. Yeah. The universe says you have to go shopping. And so that's why I was like, uh, okay, in Mexico city, we actually have like, we have like all the Parisian designers. Like we have like the biggest mall in Latin America is in Mexico city. Like there are options. Like, yeah, but the contacts thing is like, what do you, what do you do? What do you do there? Yeah. Yeah. That's, that's the tricky one. And you know, as we're, we're saying all of this and you were talking about, like women have all of these pressures that constrain our relationship dynamics with our partners and that can lend itself to having libido issues as well. Because women have to feel supported in a partnership. And you know, there's one way that men sometimes get trained of like women, just handle everything and I just depend on them. And that's not, that's not okay. That's not because you're living in fight or flight the whole time. Basically trying to keep it all together, trying to hold, you know, holding up the table and one leg is broken. You're like surviving totally. And that's my message to men is that if you want her to be in the mood more, you want to crave you step up more and do the unsexy things of like household chores, putting the kids to bed, like checking in on her more because Hallmark is like, Oh, she wants roses and chocolate. And then, okay, okay, I'll do that. But like no one taught men that actually know her nervous system. Like, so men are always out there saying like, we are here to protect you and we defend you. And I'm like, you're right, but the tigers, the bears, the lions, the gone, what you now have to defend and protect us for is the stress of life. That is what we need you to step in and defend against is us taking on too much of too much being put on our plate of, you know, a mother-in-law who's like, yeah, but you can do much on like that's where you become the defender of her nervous system regulation and she will crave you. Oh, thank you so much, Jolene. I've loved sitting down and having this conversation with you. And thank you for opening up and inviting me down here and coming on to Biohacket. I think my community has so much to learn from you. Your books are such a source of like encouragement and research and inspiration for so many women. Well, thank you so much for having me. Thank you for tuning in to Biohacket. If you've enjoyed today's episode, please don't forget to subscribe, rate, and leave a short review. It really helps us reach more listeners just like you. Follow us on Instagram at biohack dash it for exclusive content and the latest updates. Remember, your health is in your hand and curiosity heals.