260. Dr. Jennifer Berman: Peptides, Hormones, and the Anti-Aging Protocol Most Women Start Too Late

Welcome to Biohacking Beauty podcast. We have a special episode for you today. I am of course Amita Eshel. This is. We are the co hosts of this podcast and the co founders of Young Goose Skincare, the skin optimization company. Today we have a really cool guest. Her name is Dr. Jennifer Berman. She's an internationally renowned urologist. Some of you might know her from her award winning series Birmingham and Berman and as the recurring co host on Emmy award winning the Doctors. Aside from that, she's a real wealth of knowledge about anything around vaginal health and health and optimization around hormones, peptides. And that's what we invited here her to talk about today. Today, the link between hormonal optimization and peptide therapy and skin health should be a very interesting conversation and we're very excited.

0:04

Yeah, I'm super excited for this conversation for all of you guys to hear it. Not every day we bring you guest that just vaginal expert, Vaginal health expert, peptides expert, menopause expert. Yeah, very cool.

1:04

But before and yeah, before we start,

1:20

yeah, we, we need to read a review.

1:22

That's right. So every, every episode aside, if we don't forget, we read the review.

1:25

We never forget. What are you talking.

1:32

No, we did forget like once or twice.

1:33

Yeah.

1:35

But anyway, like the reason we do it is, is twofold. First of all, to acknowledge the fact that you take your time and you leave a review and you share the love with us and it's important to us. But really we need this podcast to reach as many ears as possible. Because what we're doing here is this is a free platform. We don't charge anything. We don't, we don't monetize this platform. The idea is to bring you what works around optimizing your health to optimize your skin's health. And we, we feel like this is our mission. We want to reach as many years as possible. And you know, when you share this podcast, which we hear a lot of people say that they've heard about it because they have a friend who shared about it or social media or something like that, or when you post a review, all of those things help the growth of the podcast. So we want to give back. So anyone who we read their review, you can reach out to us through serviceungoose.com or DM us on Instagram young gooseskincare and tell us we read your review and you're gonna get a free product.

1:35

Yeah.

2:43

And without further ado, today's review.

2:43

Okay, the review goes. This is the best podcast for cutting edge information about longevity, science and aging. This is not it, though. The friendly and humorous banter between the two hosts reveals how much love and respect they have for each other. And I really value that. I look forward to every episode. Thank you so much. Thank you. Amazing.

2:46

And now, without further ado, please welcome Dr. Jennifer Berman. Jennifer, welcome to the Biohacking Beauty podcast.

3:06

Thank you. Thank you for having me.

3:31

We're so excited that you're here. And as a top podcast and beauty category with kind of intersection and alternative health, we are going to dive into the first question that is also kind of like the number one asked question right now for us in our DMs and our emails. And it's, you know, peptides are very trendy right now. It's the hottest topic I think there is. And with that people really want to know.

3:33

And that's my personal, my personal vindication over anesthesia. Because Anastasia was freaking out about me injecting peptides into my body. Yeah, now everyone else is doing it.

3:58

It was over 10 years ago and he was trying because I was freaking out. He was doing it at night when I was like already asleep. And then I would find in the kitchen with like barely any light injecting his belly fat. And it looked weird. It looked like he's doing something wrong. And I just like caught him doing it. It was, yeah, it was not a good look.

4:11

He clearly was and is an early adopter. Probably not just the peptides of everything.

4:35

Of everything.

4:42

And it's his mindset. I actually am not an early adopter. I've recognized that of myself. But in terms of peptides and for me, things have to be grounded, grounded in science, you know, that there has to be other people trying it first. I'm not the one to go out there. But in peptides, what he has done, and based in his own mind and experience, he reconciled that there is sufficient evidence that these are naturally occurring proteins in our bodies. Ten years ago and now we have peptides. Peptides are basically proteins that our bodies make with aging. And in women, menopause and perimenopause. And in men, men, they call it. Andropause in men, aging with age, menopause in women, andropause in men, the quantity of the peptides that our bodies make and the quality of them declines. So in mid age, he was ahead of his time and he was probably using them to optimize wellness for physical fitness purposes, to build lean muscle mass, to decrease visceral fat, to improve glycemic control. He knew the benefits of that and understood the benefits of that way before it became mainstream. And so he's probably gonna live longer, he's gonna be healthier and it's to his benefit. Today, when the rest of us are catching up, you, me and everyone else, we will also get the benefits because we're technically starting early. We're not in, you know, assisted living in nursing homes right now. We're living vital lives, we're living productive lives. We still have our cognitive function, we still have our health, our fitness, our beauty, our sexuality. So peptides play, I'm not gonna say they play a critical role. They have a great deal of health benefits, especially in perimenopause. So you're mid to late, 30 people and up in terms of optimizing wellness and health, increasing the performance and prevention of disease.

4:44

Yeah. And with that, so the people, what people really want to know is which peptides are the most evidence backed for repairing skin muscle tone. And I know it's not going to be the same one, but this is what they want to know. Boosting metabolism and supporting overall anti. Aging. Aging. So if you had to be clear,

6:55

I want to be super crystal clear that peptides are not drugs at all and they are not regulated by the FDA at all. And they're not approved by the FDA at all. That doesn't mean they're bad, that doesn't mean they're necessarily unsafe. But what that means is that we as a doctor, in terms of my recommending them, and I've learned this, I'm learning this myself real time, literally in the weeks and months going on because there's a lot of movement and a lot of things and a lot of federal regulations, a lot of differences state to state. So now as far as my practice concerns me as a doctor here in California, I can only recommend peptides from medical grade peptides. The peptides that you're seeing online, even with, I can't think of some of the sites but you can buy, but you guys could be having a peptide line. So there's no regulations. Anybody could be selling peptides and you'll see they're for research purposes only. So the selling of peptides, I'm not gonna say those peptides are bad. That's not for me because I can't say that. I don't know and I'm not. And I've used those peptides myself personally and with my family. I'm not gonna say those peptides are unsafe. I, I have no data to support that and I've used Those peptides and used those in my family. The only thing that I can say now today as a doctor, I cannot recommend to other human beings peptides that are for research purposes only. I can only recommend medical grade from certain 503B pharmacies. So if anybody is, you know, for your viewers and listeners, I would recommend now for getting peptides that they go to a health care provider that has access to medical grade peptides. Not, not for research purposes only. Those pharmacies, the compounding pharmacies that are compounding peptides that aren't five or three pharmacies are going, they're going to be eliminated. So I do want to just say that and say that as a caveat. But going back to your question about which peptides, okay for beauty, I like the one called ghkcu. GHKCU is a copper peptide. You probably see on Instagram and TikTok the Glow and CLO, it's a bundle or blend. They're combining GHKCU with other peptides. BBC157TB500 and there's another one called CLO versus Glow. So what that does is it improves the collagen elastin of your skin in your face and body. Helps with skin texture, tone, improves the pores, decreases fine lines. The TB 500 and the BPC 157 decrease inflammation. Anything that decreases inflammation is anti aging and also increases the microcirculation to your skin which declines with aging. So there is a blend Glow, CLO or just plain old GHKCU which is a copper peptide. It's blue, it looks blue which makes it seems very recognizable. And that one is great for anti aging and beauty. You mentioned one. What was the other one for? Inflammation or for building muscle?

7:16

Muscle tone?

10:35

Building muscle. We call these, I like to call them HGH human growth hormones secretagogues so they increase your body's own production of growth hormone. My favorite one, there's a bunch of them, but my favorite one and the one that I see the most benefits with personally and with my patients is the CJC ipamorelin And what that blend does, that CJC combined with ipamorelin it decreases visceral fat in your belly, increases lean muscle mass and it also just as a side because growth hormone in your circadian rhythm helps with sleep. So my menopausal women and perimenopausal love that one. They love combining that one if they need to lose weight with the GLP1s with you know, ozempic or ride or yeah. What was the first one? Manjaro.

10:37

Yeah.

11:33

So that's lean muscle mass, beauty.

11:34

And then for metabolism and like overall anti aging would you say? Just those all encompass. So you have anything else and then.

11:37

And then there we have. I like the BPC157. I have a lot of athletes, women athletes, tennis players. That really helps with recovery after exercise. Women with joint pain, aging and menopause people have flares of their rheumatoid arthritis of their, you know, achy joints or people that have had injuries and hip replacements and back pain. And I also had older women and men. My husband is a lacrosse player and he plays like in this old man lacrosse like 70 year old men. He's not 70, but really old guys that are still running around, still playing in Vail at altitude. He's loading up on BBC157 now in preparation for that and did it last year and noticed a great shout out

11:47

to Jackson, our producer that talked to me for an hour about lacrosse until he understood. I understand nothing about it really.

12:31

It is, I mean it's a fast game, it's a rough. Like they beat each other up and they're constantly falling and using a lot of almost like acrobatics.

12:40

Wow.

12:51

But there's also peptides that have. These are the ones I'm talking about. Like there's. Oh my last. Like for my menopause. We talk about beauty, weight loss, building lean muscle mass, pain, inflammation and then sex. There's one for sex. And then there's also the brain cognitive. So which is very important especially to me with aging, menopause, foggy thinking, memory focused concentration, being able to multitask and perform cognitively the way you learn your 20s and 30s. That gets worse with aging and menopause and women that are in high level jobs that are having to multitask, manage multiple things, manage people, manage their lives. I see, you know, many of them complain about difficulty with that noticing that in the workplace and it impacts their confidence and their performance. So there are peptides and I'm a huge fan of these peptides that help to enhance cognitive function, to prevent age related cognitive decline and inflammation in the brain and to enhance neuroplasticity. And my favorite ones are C Link and C Max. So those two. There's another one called cerebralysin that a lot of people in like just mainstream regenerative medicine may not have heard of yet because it is that one is used in traditional medical practices, in neurology practices for brain injury, traumatic brain injury, concussion and Stroke. So they're using that, they're using cerebralysis and IV and regenerative. For my purposes. Nobody is injured or stroked out yet or had had a concussion. But from the standpoint of enhancement and prevention, cerebralysin can be given. Now this is, this is one caveat with cerebralysin compared to all the other ones. All the other ones, like you said, can be given subq in your belly fat. Cerebralysin needs to be delivered IV in the acute trauma setting or, or for prevention purposes. And this is based on limited clinical research, but from what's available I intramuscular. So it can't be just given in your fat. So it is a little bit of a longer needle and it does require you have to put it in your gluteal region. So it's a little bit trickier and harder to do. And there is a specific protocol for cerebralysin. You don't have to use that every day or five days a week. That's just like a 10 day interval. But I'm a huge fan of it from the standpoint of enhancement of neuroplasticity, cognitive function and cognitive protection, especially women that struggle with those symptoms or are at risk, have a family history of Alzheimer's or things like that.

12:51

And with cerebral lysine, could women, let's say in their late 30s already start using that, that experience like brain fog maybe from, you know, either recovering from pregnancy or postpartum 100%.

15:40

And that would be. So the mid to late 30s is technically perimenopausal just by virtue of your age. Regardless of what's going on with your period, that age is perimenopausal. And that's the age by the way, when you need to start thinking about and doing these things. Because by the time you wait until you're menopausal, by then you don't get the preventative benefits, you'll get symptomatic, you'll feel better, but you're not going to get the prevention of disease. Very important. I didn't say that. So it's good you brought that up. Very important. It's not that there's nothing wrong with starting now. You need to start now in your mid to 30s to get. This is when you start with peptides and then hormones too if you need.

15:56

Yes, I have what you're saying. I'm just gonna go ahead. Say one thing. Cerebralysis, very tricky. Also from like, from like evidence based point of view, it was very difficult to like look at like a healthy, you know, I Hate that term like a healthy population because the end of the day, if we're not optimized, are we healthy? That's the question. But looking at you know, non chronic population and then trying to improve their, their results with cerebralysis, very difficult since like protocols are more challenging. As you mentioned with CMAX and Silic, it's almost like the opposite. Right. You know, and I would love for you to talk about the experiences around them. Like why would you choose for example one over the other? And then why would one combine them? And why, what would they, what would be a telling sign where they need to, you know, choose one over the other. Obviously I'm talking about anxiety, et cetera.

16:39

Well, I combine them together. I don't even do one or the other anymore because I feel like they go hand in hand. One is more mood oriented than neuroplasticity, but they both go hand in hand. And there's a third one called that I didn't mention because that one not a lot of companies carry it. And that one is more purely mood called PE 2228. That one definitely anxiety, mood elevating. But the C like C max together from the neuroprotect. So moodiness, the moodiness and irritability. Either women will say they feel irritable and short fused or we'd be depressed. A lot of that can be hormonally related and we can regulate that with hormones. But about 40 to 60% of women that are optimized on hormone replacement therapy will still complain of feeling foggy, thinking and these mood things. So the foggy and mood in my mind and I have no evidence basically to go together which is why I combine those hormones. Feeling foggy and flat. I feel flat. I feel unmotivated. It's there. There's either an anxiety element to it or I'm not even going to say just depressed because now and this is despite mood stabilizers, this has been studied actually. So with aging, menopause and deficiency of estrogen, our brains are shrinking, we get moody. Da da da. What I so how I got into all this was I read and learned about that part of the problem. Why are they still depressed? Why is it so despite mood stabilizers? And this is where certain women, this 40, 60% of women have a deficiency in glutamate production and brain derived neurotrophic factor. So this 30 by the way, I think I might be one of them. That despite hormone replacement therapy our brains are still not generating brain derived neurotrophic and neurotrophic Factor BDNF and glutamate. That's been proven. So there are clinical studies that have shown that in this population of women, they're using different Medicaid, different things like cerebralysin, ketamine. Ketamine is now been linked to, and there's studies that are ongoing at Stanford and Harvard. Perimenopausal, menopausal women on hormone replacement therapy, off form of replacement therapy and ketamine sub anesthetic doses have been shown to increase neuroplasticity, enhance cognitive function. And there's protocols for this. So after reading all of that and learning about that, that's how I, you know, I was like, oh, so that makes sense. We're just like in the very beginning neonatal phase of figuring out, figuring this out, especially as it pertains to cognitive function and neuroplasticity. What I find most concerning, but also enlightening is that it was the neuroscientists, not menopause doctors, not internists, not, you know, and they weren't even United States people. The neuroscientists were the ones that broke the news and broke out with the information about hormones and the brain in women, hormones and longevity in women, hormones and the ability to function in the world in women. And neuroscientists are, you know, they're ph. They're a different kind of doctor. They're not, they're not treating human beings. It's a whole different field. And the fact, the fact that they were the ones that kind of broke, broke the news and still was also really troubling to me is that the medical community were still lagging behind the fda, the healthcare, the American College of Deception guidelines. That's not what's progressing, what's creating progress. It's your podcast and human beings, social media. If social media did not exist, we probably would even be having this conversation. So because of social media and women were talking to women and they were like, wait, you know, lady in Europe and the lady in New York and they're seeing like, oh, there's hormones. Wait, these symptoms are, I can't sleep, I'm moody, I don't want to have sex. I got, Wait, there's something, there's a reason for that. They just told me like, this is what happens. And there's a movement that's been created by women, by the way, it's also happening. So menopause is one movement, hormones, the other one that's happening, I'm seeing right now. I don't know if you know, About PCOS Polycyst rebranded as pmos, as I'm

17:39

sure, you know, premenstrual. It's no longer pcos, it's pmos.

22:33

Right. So I just saw that on. There was somebody posted on LinkedIn, by the way. Not Americans, no major voice. All of those studies are taking place in other countries. There's not a United States presence, They're not a United States thought leader, which is also really weird and doesn't make enough money.

22:38

I think that's the, the pcos.

22:58

The PCOS and menopause were the same. You know, PCOS is typically younger, but those women really suffer going into menopause and then so. But it's hormones, women and hormones and the imbalances associated with them being neglected by our, the healthcare community. And peptides, regenerative medicine, peptides, alternative medicine doctors. All these people that have been out in the, you know, they've been out boots on the ground trying to help people and be. And we, and we in the medical community, in the ivory tower in academia, we were calling it pseudoscience. We were calling it, you know, pushing it aside, we were ignoring it, research purposes only. That would still be going on were it not for the fact with social media people saying, wait a minute, you know, whatever. And so now the medical community, myself included, is being forced, you know, to address it and understand it.

23:02

I do have one question before we move on from, you know, sealant CMax. There is a concern, I think it's especially with men, but there is a concern of hair loss when using sealant. C Max is something that you have encountered. Is it something that you've had people complain about or.

24:01

No, no, but I'm glad you brought that up. I have had complaints with the GLP1s. Yeah, hair loss and definitely hair loss with tests in women with hair growth where you don't want it and hair loss where you want it, with testosterone. I have not seen or heard that related to C Link or C Max and I. But that's not to say that it hasn't happened because I do have people complaining of hair loss, but I personally have not made the link to that peptide. But is there data about. I haven't seen that?

24:20

Yeah, there is some data. Obviously their data around them is not, you know, that great to begin with, but yeah, there's some data, there's some concern with hair loss.

24:54

Before we move to the next topic,

25:04

you have to be sure. Let me just say one thing. With the sea like cmax, what I would do, it could be that I haven't noticed it. It could be causing my people's hair loss. But I'm blaming it on their hormones and the way so those people that in those studies or those reports we have to look at what hormones are they on are because hormone balance can optimize hair growth. And if clan cmax people weren't optimized, maybe that's why if they were so there's lots of confounding variables that could be impacted.

25:07

So. So the question that I had a lot of peptides that you mentioned at the beginning, something like GHKCU, it's a very popular peptides, BPC157. Yes. And others, they're kind of like as you said, you know, you can see them on Instagram and they're sort of widely available.

25:37

But I deem peptagram.

25:57

Peptagram and there are some others that you mentioned especially for the brain health that as you mentioned, it's more of like a medical and it's a complex protocol. So for some of our listeners that don't have a healthcare provider that they can turn to like a functional medicine doctor that would even know all of this information, where do they start of finding out if this is the right route for them and working with someone if they don't know, how would they find a healthcare provider?

25:58

Well, the interesting thing is now and again I'm another generation, there is a new generation of physicians that are evolving right now that in telehealth and what they and by the way, I didn't grow up with that. It's very new to me. I've resisted it. Part of me feels that it's not even real medicine if you're talking to somebody like this and then especially telemedicine where you're not talking to any doctor, you're talking to an AI and the AI is go into a quiz. So but I'm going to say but I have had to in my old age adopt and you know, you either adopt and grow. So in this adoption I have understood that these telemedicine platforms, the good thing about them is that they have found the pharmacies in order for them to stay in business and scale, they can't be screwing around with it. So they have found the 503 BE pharmacies. They have formed a coalition around them. They are prescribing hormones and peptides. So it's very easy in your city, wherever you are, I am, I'm in the process as a dinosaur doctor of converting my practice. You look so young and yours Vital.

26:34

And it's so funny when you keep referring to yourself as an older or even a dinosaur.

28:09

Listen, a dinosaur doctor is Ross from Friends. Okay, you're not a dinosaur.

28:13

Anyway, I mean I feel like compared to that, I mean I'm so much. These people are in their 20s, they're babies and they're multi millionaires there and they're using technology to create change. And I feel like there's two different worlds. There's my world, maybe you're that I live in that I'm walking around in and talking to people. There's a whole other world going on over there where they are these 20 year old, they're Gen Z and younger 18 even geniuses that are using technology in all fields, every field. I'm only noticing healthcare and what they figured out how to do is to scale to the masses. So the small business little doctor like me in private practice that can only see. I can see 8 to 10 patients a day on a good day. And again, you know, we can only see so, so many people, they have figured out how to see hundreds of thousands. And I'm not going to say that that's quality care but from the standpoint of what we're talking about people having access to peptides and hormone, I'm not going to say to use this for your, you know, annual exams or if you have health issues or are sick, but for access to these preventative measures that there, there are telehealth platforms that are associated with and I, the one, the one that I'm. You caught me a little early because the one that I'm using, the doctor, the 20. He went to UCLA when he was 13 years old. He graduated UCLA when he was 17. Then he went to Duke Medical school and he graduated Duke when he was 24. He's now 28. And he has created a company called MyOrbitHealth. MyOrbitHealth.com, which is a coalition of telehealth providers. So he. For doctors from all over myself and many others to be able to scale their practices in multi state. So it's a multi state mega PC telehealth platform because I'm not licensed and I'm licensed in California. I'm not licensed in 52 states. There's apparently 100 doctors right now and there's probably more 100 of them that are licensed in 52 states and they're all together, they're like a little mob and they are these. So they're licensed in 52 states and they're offering telemedicine. So there's apparently, you know, hims and hers and all these other telehealth platforms. But those telehealth platforms have funneled through like there's five dom like gas and electric utility. Like there's five major hubs that service all these telehealth platforms. These hundred doctors are controlling the. You know, offering the care to all the. And they have doctors. It's almost like multi level marketing, like herbalife. That's how I know.

28:19

Like a pyramid. And I'm like, oh my gosh.

31:32

Multilevel doctors happening. That's healthcare. So the main. The main professional courts. Then under each doctor, that doctor has doctors and nurses that are seeing patients and seeing. And they're doing thousands of patients a day. They're writing thousands of prescriptions. And they. All the hundred of them or on all five different platforms. So these are multimillionaire doctors. And I wouldn't even call them doctors. Like I was like, is that really a doctor? Like it's. They're doctors. Many of them have practiced medicine. Many of them have never literally touched a patient. You know, they went from medical school. Right. My guy went right from medical school into, you know, into tech. So it's a new way of handling patient care. But that's different, but necessary. And the other. I've gone totally off topic here. I'm going rogue. But the other weird thing.

31:34

No, but I think it's very interesting. People don't know that.

32:33

Okay. Is going to be. We worry about the receptionist being replaced by AI. The social media manager being replaced by AI doctors. The regular run of the mill doctor stands a chance of being replaced by AI with robotics. Because now with the, you know, the telehealth and you can funnel people to different centers and that can scan just routine labs and blood pressure and heart rate. So you have triage. Maybe it's not going to replace doctors, but replace nurses in triaging people then to whatever.

32:40

Yeah.

33:15

The future. And I feel like this is happening in my lifetime, you know. And also the other thing that's happening definitely in your lifetime, Mine too probably is the ability to extend our age. That research with Peter Santis and the other one, I forget his name. They're on the. It's already done. They're on the cusp of releasing it. Who gets it first, how it's played out. I don't though. But. So we're going to be living longer, we're going to be living healthier. It's scale. It's not just going to be access to wealthy people. It's going to be scaled across nationally. And once these hundred doctors, the gig is going to be up on them soon. And it's going to be, you know, every doctor is going to be, you know, able to.

33:15

You're referring to David Sinclair and David Sinclair.

34:07

Yes.

34:12

Yeah, basically. And their new FDA approval to look at age reversal in humans in eyes. Yeah. Starting with people with glaucoma. Yeah. You know, as we grow older, the information architect is called the information theory of aging. Basically, your cells lose their ability to understand what they need to do and the entire idea of Yamanaka factors. A guy named whatever his first name, Yamanaka, found that there are, like, four proteins that can indeed reverse. You know, if you get them to the right place in the DNA, they kind of can kind of attach themselves to the original state of information and rewind cells back their usual state. The re. The reason there's so much. There's so much caution around that is because if you get it wrong, you basically are becoming of one big ball of cancer. And funny thing is that actually there are, like, studies in animals showing that only two. So they've isolated one of the four Yamanaka factors to be the one that drives cancer the most. They kind of kick it out. And they're looking at three factors now, but in skin, it's interesting that they found that only two of the Yamanaka factors are really needed to reverse skin aging. Who gets it first? That's interesting. Interesting. I think not to go completely off topic, but, you know, when you look at, like, nuclear arms race, it's not only about the nuclear bomb. You need to have, like, the missiles to get it wherever you're going. Right. God forbid. So here also, it's the. How do you get it there? Right? Like, is it CRISPR? Cas9? Like, how do you get it to the place that they need to go? So I think there's multiple layers until, like, we'll be able to. Young goose will be able to create a cream where.

34:12

How do you get it to the part of the body that you want it to like? But. Well, yeah, that's. They're saying, like, with stem cells, they just know where to go. Like, you don't have. They're not legal here in the United States, obviously, but in Dubai, in Panama, there's three centers that I know Americans are going to. There's one in Mexico, one in Panama, one in Dubai, and they're using mesenchymal stem cells, Morton's Jelly stem cells, and Stem cells from fats that whatever which way they're getting stem cells. But. And my question was, how do you know, you know, especially if you have an injury, how to. Aside from injecting it into a joint, if you're taking. If they're being delivered IV in other countries, not here in the United States, but apparently they know where to go and they're.

36:01

They do.

36:53

And there are also different ways of like a little bit priming tissue where you want it to go.

36:55

You're correct. However, that would not be. That would be adjacent, like Yamanaka adjacent. That wouldn't be necessarily like with the Yamanaka factors per se.

37:00

But you don't think they have receptors or that are.

37:13

No, no, it could be that, but it is. You know, there is a few issues with like, with stem cells specifically, especially if they're not yours. Like, the problem with yours is.

37:16

I was just thinking how stem cells know where to go. These factors will. Will do the same. I'm not sure.

37:28

But no, these factors are definitely. Don't know where to go. Like, you inject them locally, so they are there. Right, but how do they go? Like, where do they go specifically? Like in the DNA, they need to be vectored, basically. And that you could do with different ways. The issue is like, how do we get them, you know, to an application that is, let's say the skin, right? Like, you cannot, you know, you could kind of inject the skin, but it would be, you know, are you going to microneedling it and microneedle them? And there's still like, you know, issues that need to be solved on a delivery level, you know, technically. And I'm not going to go to missiles again. But let's say Uber, you know, Uber existed like way before in air quotes, like Uber existed. It was like you go to Craigslist and you see who's driving to Miami from Fort Lauderdale and you'll hit your ride. Uber is the platform that made it extremely accessible. So the platform's still missing, like the delivery platform still missing. Yeah, very interesting. It's going to take probably a while.

37:34

Okay, so let's say we're thinking aging has to be a. Apply directly to the skin, but the skin is a reflection. What's outside is actually what's going on in the inside. So if they can reverse the aging or add a, you know, it's not going to say that we're going to look 10 years younger, but when we're 10 years older, maybe we'll stay looking like this. I would like to look, but that's probably what it's going to be is that the anti aging is from the inside and because of all the factors and cytokines and not neurotrophic factors and whatever the anti inflammatory and pro inflammatory that is going on systemically is going obviously to impact the skin of my face, the skin in the mucosa of my gut, my vagina, my lungs, my respiratory tract and then it will preserve what I've got probably.

38:38

Oh yeah.

39:31

Me look younger.

39:32

Oh yeah.

39:33

And then they'll have topical ones that we can put on with microneedling and everything.

39:34

And even, even your, even your you know, your run of the mill laser or whatever. Right. Your average in I want to say like inflammatory response but basically like your average stimulation is just going to work so much better because you are on the inside a four year old. Right. So you react to everything much better.

39:39

Okay, so I think this is a great segue to the next topic which the, the question that we have prepared is you know, to hear your opinion if there is a point in life where skincare alone cannot fix your skin if your hormones are not optimized. And to be honest, we kind of know the answer. Yes, there is a point where, you know, skincare alone will not move the needle. So it's a little bit of a longer way to ask the question but I personally have a friend, she is 50, she's going to be 51 this year. She is very much a biohacker. She was early adopter of a lot of things but all of a more of a natural things within biohacking and longevity field. So you know, red light therapy. She's there really like very conscious of her diet and exercise, lifting weights, like doing all the things. Right.

40:00

Yeah. Crystals. I'm kidding.

40:54

But she didn't pull the plug on the HRT and she's already 50. So she's just had a year where like this year between 49 and 50 was when she like was like oh my God, I have hot flashes so much like so often and they're really to her they're, they, they really ruined the quality of her life. You know she's a public person, she speaks a lot in public and sometimes she can focus because she just feels like, you know, sweat is dripping on her face and she's like okay. Also talks about beauty and stuff and of course it affected the quality of her skin too. Like you can actually see that. Yeah, like wrinkles are much more noticeable and all of the things she was doing do not work the Same way. But she still is like wary of hrt. She's like, she sort of like almost there, but she didn't do it yet.

40:56

There's no difference. Peptides are naturally occurring proteins in your body. Hormones are naturally occurring proteins in your body also. They're, you know, 70 beta estradiol. Your ovaries are making testosterone. So if you're scared of hormones, you're scared of yourself. So I can't, I can't even wrap my head around that. But I can wrap my head around people that, that believe in. And I'm learning this and accepting it myself that we were really. Our bodies were designed, designed and are designed to heal. And all of the illnesses and things that we're experiencing are in many ways created by us due to our diet, due to our lifestyle, due to the stress that is creating inflammation in our body, especially the foods that we're, that we're consuming. And you know, so there's a little bit of that and people that can remain in a headset space of natural and that which she did, this lady did. It's easy to do that. And you know, when you can rely on skincare over the counter and or prescription skin care products alone, that's in your 20s and early 30s. Anyone who thinks that you might like have a better and completely staying out of the sun, whoever can do that. So people in their 20s and 30s can rely on going to getting hydrafacials using all sorts of skincare, keep maintaining their glow and they can have, they can move into aging ahead of the game. Like so they're in the top percent, they're in the front.

41:50

But they are going slow aging.

43:28

They can slow it and do it a little better. And because they're conscious of it, and it may not even be the creams, it may be because they're consciously thinking, I want to be healthy, I'm taking care of myself, I'm eating well, I'm doing this. That their brain, because your brain, the diseases that we create are 90% diseases that thinking about. So they're thinking, well, that's the problem with nutrition studies. Why they can't do placebo control. Because as soon as you know you're eating something healthy, your body changes. As soon as you think you're drinking a good drink, every cell in your body. That's why they can't do so same thing with her and her cream. She's thinking, oh my God, I'm doing all this stuff. And the. Which impacts every cell in her body. Every cell in her body. Is going to act as if it's beautiful and it's doing well. That's proven. I'm not saying anything new. Hopefully you already know that. So now she's aging and now she's starting to experience other things. Maybe now there's stress and other stuff in her life that she can't just rely on. You know, okay, I'm. Well that there's other things that are coming in and she's starting to experience these symptoms. As soon as she experiences these symptoms, she's like, oh shit, maybe I'm not. Maybe I don't have control over this. Maybe. And so now she's a regular person. She's just not like you and me with everything and she. And she's experiencing symptoms. So she can continue with natural remedies. There are natural remedies, supplements, topical things, even peptides. But from the standpoint of hormones, she would. If her hormones are out of balance, being out of balance, which is going to happen to all of us. Those that. That don't suffer. There is a. I call them unicorns. There's a couple of unicorns that go through menopause seamlessly. I'm okay. Yeah, I had hot flash or two, but it really wasn't that bad. And I'm sleeping and I'm very. I never heard of very few women. Very few women. I can count them on one and a half hands in the decades that I've been practicing medicine, experiencing that way. And those women are not only unicorns, but they think they. They function and live in that world of positiv. I'm in the, you know, not allowing themselves. And then. So that's. Those are the unicorns. There's another group that are like the Soviet bloc warriors that. This is nothing like that'll come in and have like a specific thing. My vagina hurts. And their hot flashes, whatever. Night sweats, whatever. Yeah, I had those. My joints.

43:31

I lived on a potato for three years.

46:11

This is not strong. They push through pushing their potato car like they're. They're workhorses and they have to be really broken and really run down and to complain. And then when those women make it in there. I have one lady that's a. She's a convict.

46:14

And that's my friend, by the way. She's the Soviet one.

46:33

So is she. So she's so.

46:36

So that explains why she didn't pull the plug in. She's like, I can get through it.

46:38

Well, that's it. They say I can get through this and woman thing. Like, no Big. And until something, I guess she's sweating and has to be on tv and she doesn't like that or whatever. So that's like getting her to talk about it. And we can easily fix it. It's easily that problem. The hot flashes or night sweats or the sweating during the day, the hot is like, like a little puff. That's the easiest.

46:42

But, Jennifer. But you're saying something. You know, you started saying something in the beginning, which is so dramatically, you know, meta shifting, like zeitgeist shifting, which is like, if you're suboptimal, that's already wrong. You talked about, like, you know, hormonal changes affecting anything from like, obviously, like brain size to, you know, you're. You're aging faster just by having hormones that. Hormones that are out of balance. Like, I want people to hear it from you. Where suboptimal is suboptimal. Right?

47:07

Oh, God. And if the main thing that I've picked up in women, especially perimenopausal women, is that these symptoms creep up slowly, it's not like you're just all of a sudden hit over the head and life is happening. And it's very easy to attribute these symptoms to other things like, oh, my husband just lost his job, my son didn't get into University of Virginia. I have so much work to do. A wedding, like, all these extra. Well, maybe you going through a divorce. And that's what all of these, like a global pandemic. Any outside thing that causes stress, stress causes hormone imbalance, and stress causes all these feelings for you not to sleep, blah, blah. True, but so does perimenopause and menopause. So if you have hormonal imbalance and are compounding it with these outside factors, it's even worse. So that's what I really want to stress to women is if you're experiencing those symptoms, don't minimize them. Don't attribute them just to stress or life or work or that, yes, all of those things are contributing to it. But if you're in your mid to late 30s and up, you are also at a point in time where your hormones are fluctuating, if not declining. And if you want to optimize your wellness, your wellbeing, your longevity, your health, and prevent disease, you need to address that. And up until recently, all of these symptoms that I'm talking about were disregarded by the medical community. They were not considered medically relevant or deserving of medical attention. This is the course of my career. I'm now 60, so I went into perimenopause when I was 37. I'm now 61. So for the course of my entire lifespan, this is what I've been experiencing with my peers out there. I've built a career based on their neglect. Now everybody's woke to menopause and hormones and peptides. Not because of the medical community, but because of you guys, because of your podcast, because of social media, because of the women out there that are talking to each other and saying, wait a minute, what the f. Like what this is. Like there's a solution to this and nobody's telling me. And so you're saying, where do they go? I'm saying I don't know because there is. And if I'm having to refer people to telehealth platforms, you know, it's pretty bad. And so they can all call me, but I'm only one lady and I only have eight hours in the day, which is why I'm scaling also. So the goal is to find a healthcare provider, a medical doctor, nurse practitioner, regenerative medicine doctor, whoever it is, that understands, you know, hormone imbalance and that is familiar with peptides. You say HRT and peptides when I go and Google in Florida. And if you look at West Palm beach hormone expert, one thing is that they can do. There's a company called Biote B I O T E which is they're a. They, they were the ones that created the biotee pellets for hormone replacement therapy in men and women. They've now expanded into regenerative medicine, anti aging peptides and, and they're treating armies of doctors, mostly obgyns, some plastic surgeons, but they're training doctors in hormone replacement therapy and regenerative medicine. So if you in Palm beach were to look for biot provider near me, they, you know, those are doctors that speak this talk and walk this walk this walk.

47:44

But it's very actionable for our listeners. Yeah, thank you so much.

51:19

Yeah. And I agree, you know, it's coming full circle to what you said before about working with a provider. Here are a few things that we didn't say but are important. First of all, protocols change. 99% of people in the field up to like a year ago didn't know about the glow and close tax, for example, which is basically like, you know, as you said that before, CLO is just KPV plus what you said before, even times of day or times a week, protocols of using those peptides changed. I was talking to the person who actually owns the patent for a peptide called Moths C. Shout out to Pinchas Cohen, Dr. Pinchas Cohen. And he's like, to be honest with you, all of our studies were done when people were injecting it twice a day. And now I see online people saying, you know, injected three times a week. I don't know where they got this protocol from as an example. Another one is times on and times off. The reason I think medical supervision is supervision, advisory, whatever you want to call this is non negotiable is that most peptides work on eliciting a response in the body through interacting with receptors. And these are, these are getting occupied and kind of attenuated. Like the response is changing over time and you can get to a place where buildup tolerance. You mean it's called like receptor occupancy or attenuation of response. We're basically like, like it's more than the. The sensitivity of the receptor is getting diminished.

51:26

And so. Well, that's why they say to cycle them, you know, to go use them five days, like here. Yes, A week, weekends off and cycle do like a, you know, a month or two.

53:18

But it's super. But it changes. It doesn't only change between peptide to peptide. I think, I think it like, you know, people go on GHKCU for a month and they say, hey, I didn't see anything. GHKCU is the slowest peptide to even show an effect. It takes six months for you to even know what's going on. People are abusing. You mentioned the sex peptide before. I'm assuming you meant like P141. P141 is a derivative of.

53:30

Is it melanotonin?

54:01

Melanothan, Melanotan. People can abuse like crazy and it can make, you know, it's the kind of the Barbie peptide. It's called the Hollywood peptide because it makes you darker. But it can cause pigmentation. It could, you know, have some other issues. So I think having someone who, like yourself, for example, someone who is deep in the conversation, it's an ongoing conversation who is with like a conduit to what's going on now in the world and not necessarily trusting, you know, in the peptagram, some influencer that is very driven by their agenda for that matter, is very important in my opinion.

54:03

And I will add to that that as you know. But I want our listeners to hear that again that the peptide stock that works for your girlfriend, even your sister sometimes might not work for you. So it's so important that you start low and slow and you ideally in Our eyes, you know, paramount, non negotiable, that you have a medical provider to guide you through it that also has ideal years of experience like yourself and not a 20 year old. Maybe the genius one that went to UCLA at 13. I'll take my bet on that guy.

54:42

But other overall, everybody else respond differently. We've shown with peptides and hormones, there's not a one size fits all cookie cutter. And that's the problem with telemedicine too, everybody. So the one size cookie cutter does not work especially for women as it pertains to menopause. And peptides, men are a little bit easier, but them too, you know, there's genetics.

55:17

Okay, so it was such an interesting conversation and now we usually wrap up our episodes with rapid fire questions. So those you feel free to answer in a rapid manner. It's more like they make really good for like, you know, social media clips and stuff. Okay, first one. What's the biggest mistake women make when it comes to aging and their hormones

55:42

minimizing the symptoms and blaming them on other things.

56:05

I like this one.

56:08

You can ask it.

56:10

All right, thank you. I appreciate your approval. Is there a menopause biotype that determines the best anti aging approach for each woman?

56:11

That's my menopause biotype. Did you specifically ask that for me? There is a menopause biotype. It is available on my website, sexualhealth.com that does help women navigate menopause, understand their symptoms, understand how they're going to metabolize hormones and understand and know their risk factors associated with hormone imbalance, which will be good for them and helpful to their providers. Thank you.

56:20

Okay, next one.

56:44

I like it. It's like, you know, when we, when we used to, in my old days when we used to hire people, we used to get them through like, we used to basically like have a, have a type of like how they handle pressure, how they do that and they get like archetypes. So it's kind of that for hormones.

56:45

Okay, what's the biggest misconception about vaginal health and aging? That you want to clear up the

57:06

misconception about vaginal health. Women don't understand two things. What's good for your face is good for your vagina. The vagina ages in a similar way that they need to use it or lose it. Same thing that applies to men, that they, the more sexually active they are, the more engaging in sexual activity, the better the health of the tissue. And that you know, that vaginal dryness and urinary tract infections are associated with hormone imbalance, women, like young women might be starting to develop urinary tract infections and not even realize that it's due to hormonal imbalance and birth control pills. This should have been my rapid fire birth control pill person. If you're mid to late 30s, experiencing UTIs and are on hormonal contraceptives, that's, that could be one of the reasons why.

57:11

Okay, we have a audience question, which is how do you change the vaginal microbiome in the most effective way? And then subcategory was if the person is pregnant, would that, would the approach change?

57:57

Well, the thing about the microbiome, your vagina is a self cleaning oven, so it keeps itself balanced on its own. Things that interfere with that are birth control pills and aging and menopause and putting perfumed douching things along those lines. Some women also have an allergy or irritation to sperm. That's a whole nother certain sperm. That's a whole nother conversation.

58:12

Yes, douching is when you hang up with douches, right? That's douching.

58:38

Douchey guys will give you bad vagina problems for sure. And also urinary drink and that. So the douching, the putting it up there, that perfumes, soaps and other things changes the microbiome aging of menopause. What happens with age, menopause and if you're taking birth control pills, the ph, the acidity of the vagina changes. It becomes more alkaline, less acidic, which then predisposes you to getting yeast infections, vaginal infections, urinary tract infections and other things. So we want to keep the vagina more acidic. It does that on its own. Taking probiotics, eating a healthy diet and not douching, not doing things that and hormonal contraceptives will alter the vaginal flora also.

58:42

And last question, red light therapy in the vagina. Game changer or.

59:26

Well, red light therapy. I'm a huge fan of red light therapy for all the reasons that everybody already knows in the vagina we're using, at least from my, in my perspective, my practice, the FDA approved devices that we have are radio frequency heat therapy, which is a game changer, in fact, a game changer for me as a urologist because before, especially not just for vaginal health and lubrication, arousal and elasticity, you know, making it tighter, making it prettier, but from the standpoint of function, urinary function and stress, incontinence and leakage after babies, these therapies are helping to treat that whereas before we would immediately have to take these people to surgery to do slings and lifting, now these therapies are the. Now these minimally invasive red light radio frequency heat therapies are the first line of therapy. Minimally invasive, no downtime, no pain and are extremely effective and FDA approved.

59:33

Do you think they're better as far as like, again like, as far as like leakage, et cetera. Are they better than tcl? What's the TCL machine called? The one that does it with electrical magnetical pulses,

1:00:31

high intensity focal electric magnet. That's a fine treatment for the pelvic floor. So the pelvic floor is hammock and your core, that company BTL makes M Sculpt. Yeah, BTL muscle and emcella for your. So cordo flora there. Which is, which is great, but that's not like vagina specific. That's. That's pelvic floor, which is also important. So women with stress urinary incontinence, that helps the pelvic lift and support your pelvic organs. These other ones are in the. Literally Kegel, right at the Kegel muscles. Tightening those. The Emcella does too. But BTL has another one called mfem. So mfem. So with the emsella plus the mfem which targets right into the vagina, the Kegel muscles and the anterior, the urethra, the anterior pelvic wall and pelvic floor. So we can get a macro approach with the emsella and more of a micro approach with some of these other technologies. And it's the whole.

1:00:45

Okay, you see I asked you to ask three and then asked 11 questions.

1:01:51

No, no, we're great. I think those were interesting rapid fire questions. And I did want to talk about vaginal health and your conversation took us elsewhere. Maybe we will bring you back to dive more into that. We would love to have you again, but I'm glad that we actually ended up talking about both and give some advice there.

1:01:55

I just want to say I think the Emsella, their slogan should be we raise the ceiling.

1:02:14

That's right. Raise the ceiling to the floor. Lift the ceiling.

1:02:21

Yeah, exactly.

1:02:25

That's good. A good slogan.

1:02:27

Jennifer, thank you very much. Where can people learn more? Maybe reach out? Like how do people.

1:02:30

Yeah, yeah. So my website is bermansexualhealth.com it's in the process of being updated and renovated by the 28 year old team. And then my Instagram is enberman md. You can also reach me at my office at any time. We're Pretty much covered all the time. At 310-772-0072, they can email me directly at officerjenberman.com D R J E N N 2 N S behrman.com we respond to all emails. We can send you more information. We can direct you to healthcare providers in your area. We can set up a consultation, help you get your blood drawn. We now have a home blood drawing kit. You don't have to go to lab for a request anymore. You can do it at your home with these little pinpricks. It's not even have to draw it out of your vein, which is huge for many people.

1:02:36

With a little leech.

1:03:29

Say it again.

1:03:30

Like a little leech.

1:03:31

Like it's a little. Well, there's like a pin prick, but there. Yeah, there's like. There are five of them. Just goes prick. Doesn't really hurt. You take them off, put it in the back, send it. And the cool thing is, from my standpoint, better than lab poor requests, which takes seven to 10 business days to get all the results back. You get the results back from that within three to four days. So it's really made, you know, improved the speed at which we get the test back and the amount of things that. Yeah, people don't have to get five blood, you know, tubes of blood or leave their home.

1:03:33

Yeah, wonderful. Okay, well, thank you so much for such a live, lovely chat that. It was lively and it was lovely, and we just love how much passion you have for every life. Everything you speak about, you. You live through it, you. You educate. So thank you so much for your time.

1:04:04

Are you a couple of you? I'm sensing.

1:04:22

Yeah.

1:04:25

That's so nice. You could work together and age together beautifully. All right, well, congratulations.

1:04:26

We're not. Okay, thank you very much.

1:04:31

Thank you.

1:04:35

Thank you. We hope to talk to you again.

1:04:36

Yeah, Bye.

1:04:38

Bye.

1:04:39

Bye.

1:04:39

Sam.

1:04:48