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Dec. 16, 2024

Progesterone: Navigating Motherhood's Hormonal Maze with Dr. Shweta Patel

Progesterone: Navigating Motherhood's Hormonal Maze with Dr. Shweta Patel
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Season 3

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Discover the underestimated power of progesterone with Dr. Shweta Patel, an OBGYN and women's health expert, who shines a light on its critical role in pregnancy and beyond. Gain insights into how this often-overlooked hormone supports everything from the menstrual cycle to postpartum health. Dr. Patel demystifies the scientific intricacies of progesterone, tracing its journey from conception to its protective functions during early pregnancy and its importance in postpartum birth control choices.

Navigate the cognitive whirlwind that new mothers face, as we unpack the hormonal rollercoaster that can leave many feeling foggy and overwhelmed. Through heartfelt anecdotes and expert advice, Dr. Patel illuminates the need for societal empathy and celebrates the resilience of mothers adapting to their transformative roles. Addressing the impact of hormonal shifts on mental clarity, we discuss the pressures of motherhood and the importance of support systems to ease this challenging transition.

Laugh along with us as we tackle the quirkier side of hormone research, dive into the complexities of hormone testing, and tease the rich content of Dr. Patel's upcoming book on women's health. From postpartum depression treatments to the importance of empowering women with knowledge, this episode covers a spectrum of hormonal health topics with a touch of humor. Whether you're intrigued by hormone dynamics or seeking advice on maternal health, this conversation promises to enlighten and entertain.

Grab The Book of Hormones here: https://amzn.to/4fjj6L1

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Medical Disclaimer:
This podcast is intended as a safe space for women to share their birth experiences. It is not intended to provide medical advice. Each woman’s medical course of action is individual and may not appropriately transfer to another similar situation. Please speak to your medical provider before making any medical decisions. Additionally, it is important to keep in mind that evidence based practice evolves as our knowledge of science improves. To the best of my ability I will attempt to present the most current ACOG and AWHONN recommendations at the time the podcast is recorded, but that may not necessarily reflect the best practices at the time the podcast is heard. Additionally, guests sharing their stories have the right to autonomy in their medical decisions, and may share their choice to go against current practice recommendations. I intend to hold space for people to share their decisions. I will attempt to share the current recommendations so that my audience is informed, but it is up to each individual to choose what is best for them.

Chapters

00:00 - Understanding Women's Hormones With Dr. Patel

11:50 - Progesterone in Women's Health

27:30 - Motherhood and Cognitive Functioning Challenges

35:05 - Importance of Progesterone in Mood

48:12 - Hormone Conversations With Dr. Patel

57:35 - Hormones and Pregnancy Book Announcement

Transcript
WEBVTT

00:00:00.179 --> 00:00:06.362
This episode of the Birth Journeys podcast is sponsored by the Book of Hormones by Dr Shweta Patel.

00:00:06.362 --> 00:00:11.393
It's available for purchase now on Amazoncom See the link in the show notes.

00:00:11.393 --> 00:00:15.387
Hello, today I have with me Dr Shweta Patel.

00:00:15.387 --> 00:00:19.333
Dr Patel is an OBGYN and a women's health expert.

00:00:19.333 --> 00:00:24.004
She created GaiaWellnesscom, where women can meet with their women's health physician online.

00:00:24.004 --> 00:00:26.006
To GaiaWellnesscom, where women can meet with their women's health physician online.

00:00:26.006 --> 00:00:42.701
Dr Patel provides comprehensive women's health care online to women in Florida, north Carolina, virginia, indiana, tennessee and expanding to South Carolina, new York and Georgia, with plans to expand nationwide.

00:00:42.701 --> 00:00:48.292
And she also offers the Gaia Wellness Forum on Facebook, which is open to anyone who has ever identified as a woman and who is interested in contributing to women's health concerns.

00:00:48.292 --> 00:00:56.302
Today we're going to be discussing her new book, the Book of Hormones, which covers women's hormones from puberty to menopause and beyond.

00:00:56.302 --> 00:01:00.015
Dr Patel, welcome back and thank you for joining me.

00:01:00.015 --> 00:01:04.704
I forgot to mention we're going to be focusing on progesterone.

00:01:04.704 --> 00:01:07.649
Deep dive into progesterone.

00:01:07.649 --> 00:01:09.152
I love it.

00:01:09.152 --> 00:01:10.433
Estrogen gets all the credit.

00:01:10.513 --> 00:01:13.581
It's so not it yeah.

00:01:13.701 --> 00:01:15.323
Let's make progesterone happen.

00:01:15.343 --> 00:01:28.022
Yeah, if we were to rank them like in the Olympics, it would be progesterone would be gold, estrogen would be silver and what's the other one?

00:01:28.042 --> 00:01:29.484
Bronze would be gold, estrogen would be silver.

00:01:29.484 --> 00:01:30.087
And what's the other one?

00:01:30.087 --> 00:01:30.888
Bronze would be testosterone.

00:01:30.929 --> 00:01:45.536
Okay, I was gonna say, I don't know, oxytocin or oh, okay you had to go there, okay I'm sorry yes, sure is like important in pregnancy, pregnancy, but it's like they're in certain times, whereas progesterone is like they all the time.

00:01:45.536 --> 00:01:47.001
It's like a helicopter mom or something.

00:01:47.001 --> 00:01:49.888
It's like fully loaded and need.

00:01:49.888 --> 00:01:53.462
It has to be there, even the smallest changes, and we're going to notice.

00:01:53.462 --> 00:01:58.316
Estrogen is there as well, more like part-time.

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And then testosterone and oxytocin is like the vacation hormone, like it comes in for a really brief period of time but does a really big job.

00:02:06.483 --> 00:02:12.747
And then testosterone is probably like the zoom calls it's not really there but it's not not there.

00:02:12.747 --> 00:02:13.852
It's like virtual.

00:02:13.852 --> 00:02:14.655
It's the virtual hormone.

00:02:14.655 --> 00:02:15.659
It's a virtual hormone.

00:02:15.659 --> 00:02:22.687
Says so much about our libido, huh right oh, my goodness, it's completely there.

00:02:22.907 --> 00:02:24.968
My sex friend it's virtually there.

00:02:24.968 --> 00:02:27.891
Yeah, yeah, totally Okay.

00:02:27.891 --> 00:02:41.745
So I'm thinking, just because my listeners mostly either preparing for pregnancy, pregnant currently or postpartum and trying to just kind of manage all of that, how does progesterone play into that whole?

00:02:41.764 --> 00:02:41.905
process.

00:02:41.905 --> 00:02:44.128
It actually plays into every phase of that.

00:02:44.128 --> 00:02:49.064
Without the effects of progesterone, we wouldn't be able to get pregnant.

00:02:49.064 --> 00:02:58.699
We wouldn't be able to go from the first date, as I call it in my book, which is where, like the egg and the sperm meet and they have their little-.

00:02:58.740 --> 00:03:01.968
Hopefully it's not the first date when that happens, but okay, yeah, sure, with that happens.

00:03:01.968 --> 00:03:02.949
But okay, yeah, sure.

00:03:02.989 --> 00:03:04.449
Wedgie was the bear.

00:03:04.449 --> 00:03:13.877
I was speaking anatomically, chronologically, definitely not socially Okay, but if that's how it happens, that's roll with it.

00:03:13.877 --> 00:03:15.802
That is exactly how it happens.

00:03:15.802 --> 00:03:19.050
I think they even made a movie about it and Katherine Hagel was in it, they did yeah.

00:03:20.599 --> 00:04:02.625
So, outside of fertilization, when the fertilized egg actually comes into the world of the womb, there would be no world of the womb without progesterone, which is why that period of time between fertilization and implantation is where most women A don't know they're pregnant because nothing is seemingly different from the outside, and B the follicle, or what I like to call, like the nest from which this egg hatched, is very rapidly taking on the production of progesterone to sustain this fertilized egg until a placenta can develop.

00:04:02.625 --> 00:04:11.531
So it's almost like passing the baton, and if that small window of time where the baton is dropped, the whole game's over.

00:04:11.531 --> 00:04:16.206
And so the structure that I'm talking about is called the corpus luteum.

00:04:16.206 --> 00:04:22.970
It's literally the bruised up, dinged up cyst that we have that released the egg.

00:04:22.970 --> 00:04:36.230
It's like it went through labor itself, right, and now the egg's like trying to make its way down and everything's fine and it's loving its new home because it's been made nice and plush by this corpus luteum because of progesterone.

00:04:36.230 --> 00:04:44.209
So without progesterone there would be no nice little down comforter in the womb for this egg to snuggle into.

00:04:44.209 --> 00:04:58.586
And then as soon as maybe about week five to eight kicks in, that's when the placenta is actually like in existence, but still like a weakling, it's not really doing its full potential.

00:04:58.586 --> 00:05:01.432
But that's also all progesterone Like.

00:05:01.432 --> 00:05:07.302
The whole point of the placenta is, amongst other things, but it's progesterone production.

00:05:08.124 --> 00:05:23.130
So when there's not enough progesterone, because either the corpus luteum was straggling along or because the placenta was like I can't even, those are the times where you see those early pregnancy losses.

00:05:23.130 --> 00:05:30.110
Sometimes they're so early that a woman doesn't even realize she was pregnant, or it's what they call like a chemical pregnancy.

00:05:30.110 --> 00:05:35.170
It doesn't change the fact that if you were pregnant and if you knew about it and if you're trying, it sucks.

00:05:35.170 --> 00:05:39.048
But it's that one hormone amongst other potential causes.

00:05:39.048 --> 00:05:40.911
But that one hormone is so critical.

00:05:40.911 --> 00:05:44.985
That is how quickly it can go the other direction if it's not there in sufficient amount is so critical.

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That is how quickly it can go the other direction if it's not there in sufficient amount.

00:05:46.911 --> 00:05:50.579
And then, once the placenta is established, it fully takes over production of progesterone.

00:05:50.579 --> 00:05:52.985
Estrogen's there, the ovaries are producing estrogen.

00:05:52.985 --> 00:05:57.305
So we obviously are still a woman, we still have estrogen circulating in our blood.

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We don't become anharmonic.

00:06:02.721 --> 00:06:05.406
Okay, anharmonic I like it.

00:06:05.545 --> 00:06:07.831
I'm not anharmonic in harmonic are you?

00:06:07.831 --> 00:06:09.014
Is that what they call it?

00:06:09.014 --> 00:06:13.350
I have no idea, I just came up with it I love it.

00:06:13.370 --> 00:06:18.800
I think I should coin it, should people are going to go to their doctors and start saying am I in harmonic?

00:06:21.244 --> 00:06:21.906
what I don't know.

00:06:21.906 --> 00:06:22.846
Can you sing me a song?

00:06:22.846 --> 00:06:32.605
I'll tell you um um sounds like, but cuter, yeah, yeah that's another that's another term I really liked.

00:06:32.605 --> 00:06:39.192
I like using now is cuterous like I can't stop that yes, right, it's just so stupid, but it's cute.

00:06:39.192 --> 00:06:42.862
My cuterous is hurting we have stickers.

00:06:42.923 --> 00:06:44.985
I actually have a a cuterus down here somewhere.

00:06:44.985 --> 00:06:49.492
I bet you do I'm not going to dig for it right now.

00:06:50.293 --> 00:06:51.175
I know it's a plushie.

00:06:54.300 --> 00:06:56.408
Oh because you were looking down and you were like where do you?

00:06:57.452 --> 00:06:58.396
keep your uterus.

00:06:58.396 --> 00:07:01.747
Oh my god, look at those beady black eyes.

00:07:01.747 --> 00:07:04.088
I know For those of you that are listening.

00:07:04.259 --> 00:07:07.170
This is a actually it may not be an actual cuterus.

00:07:07.170 --> 00:07:08.062
That is a brand.

00:07:08.062 --> 00:07:11.766
I believe this is a uterus from giant microbes.

00:07:11.766 --> 00:07:13.250
That's very cute.

00:07:13.250 --> 00:07:16.644
And the ovaries, and help me, I guess these are the eggs that detach.

00:07:16.644 --> 00:07:21.663
But I'm trying to make an anatomical sense of this because, like, why do they detach, are they not the ovaries?

00:07:21.944 --> 00:07:22.524
No, they're not the ovaries.

00:07:22.545 --> 00:07:23.846
They are, but why do they?

00:07:23.865 --> 00:07:27.571
detach Because the ovaries aren't attached to the fallopian tubes.

00:07:27.571 --> 00:07:36.083
Oh, they're attached to, almost like I knew that, but like why I don't know why do they?

00:07:36.083 --> 00:07:36.283
Dangle?

00:07:36.283 --> 00:07:37.026
I don't know either.

00:07:37.105 --> 00:07:42.221
That's where I was like what, Maybe that dangly ovaries here?

00:07:42.242 --> 00:07:43.324
Maybe these are the ligaments?

00:07:43.524 --> 00:07:44.005
I don't know.

00:07:44.487 --> 00:07:46.291
No, because the ligaments come from the uterus.

00:07:46.291 --> 00:07:52.267
So it's anatomically Incorrect, but still cute.

00:07:52.267 --> 00:07:53.149
Still a cuter, super cute.

00:07:53.149 --> 00:07:55.934
Yeah, I don't like it.

00:07:56.399 --> 00:07:57.923
It looks like one of those mittens you wear.

00:07:57.923 --> 00:08:01.632
Yes, yeah, that's why it's cute.

00:08:01.632 --> 00:08:04.086
We were talking about the cuter.

00:08:04.086 --> 00:08:05.028
Thank you.

00:08:07.076 --> 00:08:07.336
Thank you.

00:08:07.336 --> 00:08:42.529
So if the placenta doesn't start making enough of progesterone after you're well into your second, like after you're done with your first trimester, and like the placenta is really supposed to be doing all of it on its own at this point, that's when you start becoming at risk for preterm labor, and it's part of the reason why we prescribe women progesterone in pregnancy, if they're at risk, either because they've had a preterm delivery in the past or if they are showing signs that they might be at risk for it.

00:08:42.529 --> 00:08:56.129
In this pregnancy, which is usually like, their cervix starts to become very thin and it's shown with like enough statistical data to back it up that it's worth trying to prolong pregnancy.

00:08:56.129 --> 00:08:57.692
That's at risk for preterm labor.

00:08:57.960 --> 00:09:02.578
Okay, so it's the progesterone that keeps the cervix from thinning.

00:09:02.599 --> 00:09:02.860
Melting.

00:09:03.360 --> 00:09:12.432
And then the progesterone comes from the placenta and then so if you have a healthy placenta, that's so, is it okay, which I'm trying to.

00:09:12.432 --> 00:09:14.292
I'm thinking chicken or egg, that's a great question.

00:09:14.292 --> 00:09:16.461
So where does the progesterone initiate from?

00:09:16.461 --> 00:09:19.563
Or does your body signal like how does that work?

00:09:19.904 --> 00:09:30.535
We have our own progesterone that is produced from our ovaries, but specifically the part of our ovary that hatches the egg.

00:09:30.975 --> 00:09:31.277
Okay.

00:09:32.341 --> 00:09:50.323
Now, when we are not pregnant, ie that egg waits and gets ghosted or gets stood up and nothing happens, our ovaries' progesterone production drops because the part that's hatched, the egg, doesn't get the memo like hey, they really hit it off.

00:09:50.323 --> 00:09:53.351
You're such a great matchmaker, oh my God, totes, great job.

00:09:53.351 --> 00:09:59.025
So the corpus luteum cyst starts to shrivel up and die, and this happens every month.

00:09:59.025 --> 00:10:00.169
Don't worry, nobody gets sad.

00:10:00.169 --> 00:10:04.374
We have millions of those potential infections corpus lutei.

00:10:05.879 --> 00:10:11.360
But I believe that is the plural.

00:10:11.360 --> 00:10:14.000
So yeah, I just, yeah, you just.

00:10:14.000 --> 00:10:17.097
It just sounds funny, I think we established that grammar was not an issue.

00:10:17.530 --> 00:10:18.173
No, we're not.

00:10:18.173 --> 00:10:19.337
We're not the grammar police here.

00:10:19.337 --> 00:10:22.538
No, we're not the anatomically correct police.

00:10:22.558 --> 00:10:23.140
We are not.

00:10:23.890 --> 00:10:28.380
The part where if we don't get the egg fertilized then we have a period.

00:10:28.380 --> 00:10:29.523
It's because of progesterone.

00:10:29.523 --> 00:10:30.091
Crazy.

00:10:30.091 --> 00:10:32.556
How does progesterone do so many things?

00:10:32.556 --> 00:10:40.442
I know it's just one of those really modest unsung heroes for real because everyone's always talking about testosterone.

00:10:40.442 --> 00:10:49.099
Estrogen is always oh my God, venus, oh your boobs and like your hair and there's a glow around you Also causes blood clots and stroke, but nobody talks about that.

00:10:49.099 --> 00:10:52.807
And what's the name of that geyser that just goes off?

00:10:52.807 --> 00:10:53.609
Old faithful?

00:10:53.950 --> 00:10:54.370
Old faithful.

00:10:54.711 --> 00:10:55.774
Yeah, like it's there.

00:10:55.774 --> 00:10:56.535
It's always there.

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It does a great job reliably.

00:10:59.160 --> 00:11:00.931
That's what progesterone is.

00:11:00.931 --> 00:11:03.575
It helps us get to pregnancy.

00:11:03.575 --> 00:11:09.465
If we don't get to pregnancy, our period happens as a result of the lack of progesterone.

00:11:09.465 --> 00:11:28.636
If we get pregnant, then it helps keep the pregnancy going, as in we have our own progesterone production from our ovary that sustains the egg until the placenta is grown enough to make its own progesterone, and that's when you start throwing up.

00:11:29.250 --> 00:11:31.817
Rude, it's the mom hormone.

00:11:31.817 --> 00:11:34.042
The mom's, like the, you know, manages the whole.

00:11:34.042 --> 00:11:35.898
All right, this person needs to go here.

00:11:35.898 --> 00:11:37.245
This person needs to go here.

00:11:37.245 --> 00:11:40.817
We're going to soccer in this car and then we're going to this birthday party.

00:11:40.817 --> 00:11:41.799
That's progesterone.

00:11:41.820 --> 00:11:47.018
It's the mom hormone, hcg is the part also that makes you.

00:11:47.018 --> 00:12:01.984
That's like actually what causes you to throw up, but it's like the placenta when it takes over and just goes through and everything starts going on auto drive, that combination of sudden exponential increase in our hormones is when you're hugging the toilet.

00:12:02.591 --> 00:12:04.590
That's so fun, so amazing.

00:12:04.590 --> 00:12:07.779
Speaking of which I failed to mention that I also have a placenta here.

00:12:09.169 --> 00:12:10.273
Stop it Now.

00:12:10.273 --> 00:12:14.642
That actually just looks like lips smoking a bent up cigarette.

00:12:14.642 --> 00:12:15.864
It really does.

00:12:17.250 --> 00:12:22.886
Okay, so keeps you pregnant, makes you throw up, which also keeps you pregnant.

00:12:22.886 --> 00:12:25.293
What about after pregnancy?

00:12:25.293 --> 00:12:35.940
Because I know I remember learning that we get the progesterone only pill or a low estrogen pill when you're breastfeeding.

00:12:35.940 --> 00:12:37.243
What's going on there?

00:12:37.750 --> 00:12:51.052
When you are in the immediate postpartum period, your body is still, though it should have, most of its mammary production situated, its mammary situation situated.

00:12:51.052 --> 00:13:00.769
I'm sure that there are women who are listening who've experienced that delay, where they're struggling and they're not producing milk yet and it almost feels like it's not going to happen.

00:13:00.769 --> 00:13:29.945
And so there is that window where the impact of your hormones can actually be negative if you are taking estrogen in particular, because too high estrogen levels can actually give the opposite message to your breast tissue and, without getting too technical, it would dampen the production of breast tissue and milk production.

00:13:29.945 --> 00:13:41.142
So, for the first few weeks, a woman shouldn't really be taking any kind of estrogen-based birth control or should only take progesterone-only birth control.

00:13:41.142 --> 00:13:48.082
Now, really, a woman in the first few weeks after pregnancy shouldn't be needing any birth control Leave her alone.

00:13:48.809 --> 00:13:50.734
Right, let her heal.

00:13:50.734 --> 00:13:55.263
Literally, let her heal, let the woman heal, let both of them heal.

00:13:55.263 --> 00:14:00.097
But of course, that's also not always a guarantee.

00:14:00.097 --> 00:14:07.119
We do, especially if there's someone who's at risk for unplanned pregnancy or because there are risks associated with that too.

00:14:07.119 --> 00:14:21.062
Having a pregnancy too soon after being pregnant health risks to mom and to baby, and so there is a benefit of ensuring that no pregnancy occurs in that time period, but ideally we can ensure that without any hormones.

00:14:21.062 --> 00:14:42.215
However, if we're going to start a mom on something, then either the low dose estrogen combination pills, like low estrogen, usually around four weeks onwards, or if it's something like you need to be started on something immediately, then a progesterone only option, because that will not interfere with breast milk production.

00:14:42.655 --> 00:14:43.457
That clears it up.

00:14:43.457 --> 00:15:02.940
The thing that I was thinking, though, my brain was going to when you talked about that delay of breast milk production, and I hear my patients ask me a lot, especially the ones that had a C-section, especially if it was like a planned C-section.

00:15:02.940 --> 00:15:06.354
They're worried that their breast milk isn't going to come in.

00:15:06.354 --> 00:15:09.682
Is that related to progesterone or is?

00:15:11.472 --> 00:15:12.634
that just a myth.

00:15:12.634 --> 00:15:23.539
I think that when there isn't that natural progression of oxytocin that results in labor, no hormone is an island.

00:15:23.539 --> 00:15:29.761
Literally, you can't say, oh, there's no impact on that, no, I'm pretty sure there is, we just don't care about it because it's not significant.

00:15:29.761 --> 00:15:44.604
So we typically say that the fact is, some women will start lactating even while they are pregnant, and so you don't need to have the labor experience in order to stimulate lactation.

00:15:44.604 --> 00:15:50.051
Stimulate lactation.

00:15:50.071 --> 00:15:54.779
So I don't think that C-sections, or especially like the scheduled C-section, where there's no exposure to labor, has a significant impact.

00:15:54.779 --> 00:15:57.171
But I don't think that it has none.

00:15:57.171 --> 00:16:21.794
And I think that ultimately, the biggest thing that impacts oxytocin levels outside of labor is bonding, which is why a woman continues to produce oxytocin and continues to also then generate prolactin, which is like symbiotically oh oxytocin, oh prolactin, prolactin, oh my God.

00:16:21.794 --> 00:16:27.331
That synergistic reaction makes sense because it's like okay, you see, baby, you start lactating.

00:16:27.331 --> 00:16:30.898
Okay, you start lactating, baby sees you, and so that makes sense.

00:16:30.898 --> 00:16:35.394
But I don't think it's dependent on it or is the only way to get to that equation.

00:16:35.394 --> 00:16:35.995
I guess yeah.

00:16:36.836 --> 00:16:39.322
I would agree, and it's all about risk benefits.

00:16:39.322 --> 00:16:44.942
There's always going to be some sort of impact on something when you make a choice to do anything.

00:16:44.942 --> 00:16:46.392
Absolutely.

00:16:46.712 --> 00:16:47.716
Even we're not on an island.

00:16:47.716 --> 00:16:51.576
No one's on an island, except for the people that are on an island.

00:16:51.576 --> 00:16:54.475
They're together on an island.

00:16:54.475 --> 00:16:56.696
They're enjoying their life right now.

00:16:56.696 --> 00:16:58.019
Let's go to an island.

00:16:58.710 --> 00:17:01.735
Yeah, sounds amazing, my oxytocin levels will go up.

00:17:01.990 --> 00:17:03.537
Yes, which is the other thing.

00:17:03.537 --> 00:17:11.316
It's like oxytocin levels go up all the time, even like when we are interacting with our children that are walking around no longer breastfeeding.

00:17:11.316 --> 00:17:20.780
So the impact of oxytocin on breast tissue is also very time dependent, so it's not going back to the.

00:17:20.780 --> 00:17:23.875
Does that have an impact on breast milk production?

00:17:23.875 --> 00:17:29.155
If you have a C-section because you're not exposed to as much pitocin or oxytocin, I don't think it's a critical one.

00:17:29.155 --> 00:17:30.900
Yeah, there's lots of impact.

00:17:30.940 --> 00:17:34.415
The stress hormone probably does something too.

00:17:35.498 --> 00:17:38.625
Yeah, you're not being sliced open or anything.

00:17:39.230 --> 00:17:42.219
Right, or you didn't just have a really long labor and opt for a C-section.

00:17:42.219 --> 00:17:43.021
You're not stressed out.

00:17:43.021 --> 00:17:44.813
No, there's a lot more to it.

00:17:44.813 --> 00:17:53.662
Okay, so we were talking about birth control options and how progesterone plays into that and the options with different doses of progesterone.

00:17:53.662 --> 00:17:56.013
Can you weigh in on that and explain that a little bit?

00:17:56.034 --> 00:17:56.996
Yeah.

00:17:56.996 --> 00:18:15.101
So the different options are there's a pill, there is the injectable called Stepo Provera, there is the implant, which is Nexplanon, and then there's the IUD, which is like the Mirena, the Skyla, the Kylena, et cetera.

00:18:15.101 --> 00:18:18.536
All these cool names Sounds like Kardashian sisters, but it's not so.

00:18:18.536 --> 00:18:33.413
The cool thing about the pill is that while it's a pill, you don't have to get a shot or have an implant put into you, and it's progesterone only also cool in the setting of not wanting to take something with estrogen in it.

00:18:33.413 --> 00:18:58.679
The caveat with the progesterone only pill is it's low dose of progesterone, and the reason why that's important is because on its own, not the most reliable contraceptive in conjunction with breastfeeding is less likely to fail when done in conjunction with breastfeeding, and that's because the dose is low enough.

00:18:58.769 --> 00:19:06.636
It's not like when you get the shot, where you're getting a three-month supply up front hanging around in the fatty tissue of your arm or thigh.

00:19:06.636 --> 00:19:18.353
This is a daily dose that needs to be taken, and even a slight variation in the timing of when you take it can impact its bioavailability, meaning like it wears off.

00:19:18.573 --> 00:19:26.136
So if you don't replenish it right when it's wearing off, you're creating windows of opportunity for failure.

00:19:26.136 --> 00:19:29.183
This is great, right, so fun.

00:19:29.183 --> 00:19:36.634
Yeah, why would a woman who's sleep deprived with a child and leaking out of her boobs accidentally forget to take her pill on time?

00:19:36.634 --> 00:19:37.856
Can't imagine.

00:19:37.856 --> 00:19:39.300
That's so silly.

00:19:39.862 --> 00:19:40.702
Nothing else going on.

00:19:41.450 --> 00:20:00.294
No, For all the other more perfectly ideal scenarios, it's a great option as long as you don't have changes in your weight, changes in your body temperature, changes in what else you're taking with it, like other medications, that could impact its absorption into the bloodstream first pass effect as well as the time.

00:20:00.294 --> 00:20:02.419
So just changes in when you take it.

00:20:02.419 --> 00:20:06.296
Yeah, it works great All those variables.

00:20:07.310 --> 00:20:23.000
Oh and changes in your breast milk, like in your stimulation, because the other part of the reason why and this is again a hit or miss in my opinion, but a lot of women think that breastfeeding is an actual contraceptive method.

00:20:23.000 --> 00:20:24.523
They're not wrong.

00:20:24.523 --> 00:20:36.964
It does have a suppressive effect on ovulation, but there's no formula for exactly how long somebody has to be on the boob and for how often.

00:20:36.964 --> 00:20:39.070
What's considered effective?

00:20:39.070 --> 00:20:39.873
So good luck with that.

00:20:39.873 --> 00:20:53.098
That's why, on its own, it's not technically considered a satisfactory contraceptive method, but when you combine the two they're perfectly imperfect together and so it's considered to be a better option.

00:20:53.098 --> 00:21:12.361
Now, if you'd like something a little bit more reliable, then yeah, the options of Depo-Provera shot, which is notorious for weight gain but does work in preventing pregnancy, also notorious for causing erratic and annoying bleeding, which is great because you're already having that, so why not some more?

00:21:12.361 --> 00:21:25.378
And you can't take it for more than two years executively, because it does have the effect of making your body kind of estrogen poor, which then affects your bones.

00:21:25.378 --> 00:21:39.575
And I do know women who take like depo shots every three months for years and years because they were never counseled about the impact it can have on your bone density, and so it's definitely be cautious.

00:21:39.575 --> 00:21:46.535
It's a great solution for unlimited window of time, but you don't want to be using that as like your long-term method of contraception.

00:21:46.535 --> 00:21:48.357
You don't want to be using that as like your long-term method of contraception.

00:21:48.377 --> 00:21:51.041
Yeah, or the IUD, which, in my opinion, is ZOG.

00:21:51.041 --> 00:21:53.085
Right, you can get it placed.

00:21:53.085 --> 00:21:56.952
Some places still offer to place it right after delivery.

00:21:56.952 --> 00:22:06.217
The failure or the propulsion rate was high enough where we stopped doing it back at the military, but you can get it as early as whenever and it's good for anywhere from three to seven years.

00:22:06.217 --> 00:22:12.019
Makes your bleeding lighter, doesn't make you gain weight, doesn't make you go crazy.

00:22:12.019 --> 00:22:14.614
If those things are happening, they're happening on their own.

00:22:14.614 --> 00:22:15.778
That's why I love it.

00:22:15.778 --> 00:22:17.692
Got one too.

00:22:17.692 --> 00:22:20.921
Huh, no more babies for me.

00:22:20.921 --> 00:22:25.359
You know what the best part is you get an entire election cycle.

00:22:25.359 --> 00:22:28.153
Yes, yes.

00:22:29.654 --> 00:22:31.998
FYI Run, don't walk.

00:22:31.998 --> 00:22:34.742
Yes, don't get your IUD placed right now.

00:22:37.069 --> 00:22:39.394
Yes, yeah, I said that in my book.

00:22:39.394 --> 00:22:43.400
I'm like I have the Mirena and it almost gets me through two election cycles.

00:22:43.400 --> 00:22:45.762
It's amazing, if I wanted a stretch, I could get to two.

00:22:46.344 --> 00:22:48.086
Yeah, now it's making me.

00:22:48.086 --> 00:22:51.492
Oh, no, I Okay, I'm good, I'm good.

00:22:51.492 --> 00:23:03.661
Yeah, you have some exciting options for postpartum hormonal regulation and mood regulation, which is fascinating to me.

00:23:03.661 --> 00:23:04.643
Tell us more about that.

00:23:05.009 --> 00:23:08.119
I think going back to, like, what's up with progesterone?

00:23:08.119 --> 00:23:08.862
Is it important?

00:23:08.862 --> 00:23:19.500
The placenta shearing and coming out, it is like a nosedive in our progesterone levels and the sad part is all we're doing is coming back to pre-pregnancy levels.

00:23:19.500 --> 00:23:27.784
But that is like going from being on the first class flight and then traveling on Greyhound.

00:23:29.192 --> 00:23:32.489
I was going to say in the luggage compartment, but Greyhound sounds better.

00:23:32.750 --> 00:23:33.773
We're not even by air anymore.

00:23:33.794 --> 00:23:38.845
We're not in the air anymore, so we're in the luggage compartment of the.

00:23:38.784 --> 00:23:39.502
Greyhounds sounds better.

00:23:39.502 --> 00:23:39.856
No, we're not even by air anymore.

00:23:39.856 --> 00:23:40.905
We're not in the air anymore, so we're in the luggage compartment of a greyhound.

00:23:40.905 --> 00:23:42.140
Essentially, we're like the worst of the worst.

00:23:42.140 --> 00:23:43.992
That's harsh, but yeah sure, and it's like we were fine with it before, right.

00:23:43.992 --> 00:23:46.557
So it's not that we're deficient in the hormone.

00:23:46.557 --> 00:23:56.844
It's that drastic change that causes us to act all sorts of the ways right, including, to some level, sometimes even postpartum psychosis.

00:23:56.844 --> 00:23:59.557
It's because of that drastic drop.

00:23:59.557 --> 00:24:13.544
If we were to take the drop that we experienced immediately after delivery and spread it out over a month, everybody would be fine, but since we spread it out over like an hour, it creates some real shit and we really depend on oxytocin at that point.

00:24:14.432 --> 00:24:20.897
It's amazing though how it like really functions, like it's like well, are we gooey with your baby?

00:24:20.978 --> 00:24:23.913
and completely like I don't care, that I don't know put back together.

00:24:23.913 --> 00:24:32.919
However, you delivered, my brain don't work my brain broke literally, but it's true, it is my brain.

00:24:32.919 --> 00:24:40.002
It's like why would mother nature think it's a good idea to break our brain right after birthing a child?

00:24:40.805 --> 00:24:45.718
it's like because all you have to do is cuddle that child, or run and cuddle that child, depending on right.

00:24:45.778 --> 00:25:20.636
No, because mother nature was banking on some solid alpha males that are like protecting and providing, and was not currently thinking about 2025 right I'm just saying, but I think the logic is, no, your job now is to just keep warmth and be a food source and everything else will be brought to you right, like food and protection, except we have to like get back to the other children or go work and or just figure out how to put the circuit breaker back on or something Like life goes on and we have to still use our brain while it's broken.

00:25:21.097 --> 00:25:33.215
And I say that in jest, but what I mean when I say our brain breaks is progesterone, though it usually only gets like the street cred for being like hey, what's going on?

00:25:33.215 --> 00:25:38.396
Guys, I'm here to reboot your uterus and then help the pregnancies feel nice and cuddly.

00:25:38.396 --> 00:25:39.580
You like my progesterone voice?

00:25:39.580 --> 00:25:41.433
Thank you.

00:25:41.433 --> 00:25:44.781
It's like such a basic, like unremarkable voice, right?

00:25:44.781 --> 00:25:49.759
Yeah, so, but progesterone actually is a precursor to a neurotransmitter in our brain.

00:25:49.759 --> 00:25:58.568
Wow, yeah, oh, no big, just kind of like a big deal with the GABA receptors and everything.

00:25:58.588 --> 00:25:58.710
Right.

00:25:59.871 --> 00:26:03.457
The ones that, like dopamine, like you, tickle those kinds of receptors.

00:26:03.457 --> 00:26:12.442
Yeah, so Super important, a little bit, yeah, and we can't make that neurotransmitter from any other way.

00:26:12.442 --> 00:26:15.532
It's progesterone or it's nothing, and so what happens is it's nothing.

00:26:15.532 --> 00:26:19.219
We're stuck with maybe.

00:26:19.219 --> 00:26:20.401
What is it?

00:26:20.401 --> 00:26:28.651
Serotonin, norepinephrine, epinephrine, dopamine, and then that fifth one, and so we're just dealing with four out of the five that we normally have.

00:26:28.651 --> 00:26:33.196
So just a 20% drop in cognitive functioning, nothing.

00:26:33.436 --> 00:26:53.499
Nothing, no big deal, yeah, okay, so we talked about that huge hormonal letdown After delivery, and then it stays at your pre-pregnancy level, but then everything else in your system has to, like, figure out how to live life again at that pre-pregnancy level.

00:26:53.499 --> 00:27:06.521
And so then it's since it's a precursor to neurotransmitters that are important for mood and like all of the things, mood and thinking, we'll just generalize it it's a precursor to brain function.

00:27:06.521 --> 00:27:08.092
Precursor to brain function.

00:27:08.092 --> 00:27:09.074
What about that?

00:27:09.074 --> 00:27:17.576
So are we shocked, now that moms have a lot of challenge, I'm shocked that they function.

00:27:17.576 --> 00:27:25.958
Let's flip that mindset around and be like hey mom, congratulations to you if you're still breathing after all this happened, yeah.

00:27:27.694 --> 00:27:29.364
You remember that it's front to back?

00:27:29.364 --> 00:27:30.490
Yeah, you do.

00:27:30.490 --> 00:27:33.518
You are an ace.

00:27:33.518 --> 00:27:35.334
Yes, because I would have not.

00:27:35.334 --> 00:27:37.152
I would have not with what you're working with.

00:27:37.152 --> 00:27:37.913
I would have thought.

00:27:37.913 --> 00:27:38.936
I would have been like what do I?

00:27:38.957 --> 00:27:39.458
do with this?

00:27:39.458 --> 00:27:40.401
Exactly, yes.

00:27:40.401 --> 00:27:47.864
And then we add on this entirely new experience of you're basically becoming a whole new person.

00:27:47.864 --> 00:28:00.835
You have to figure out who you are with all of this new body and the new everything, and then the new baby, and then all the things are working differently and nothing looks the same, nothing feels the same and I can't brain the same.

00:28:00.835 --> 00:28:01.698
But carry on.

00:28:01.698 --> 00:28:02.400
Everything's fine.

00:28:02.400 --> 00:28:04.276
Yeah, you should be so happy.

00:28:04.276 --> 00:28:06.015
When are you ready to go back to work?

00:28:06.015 --> 00:28:07.619
Six weeks, exactly.

00:28:07.619 --> 00:28:15.661
It's no wonder that moms are feeling a little overwhelmed and they can't always do it.

00:28:15.661 --> 00:28:21.674
I don't know how else to put that, but let's manage expectations.

00:28:21.674 --> 00:28:25.643
What is going on with society where moms just have to do it alone?

00:28:26.170 --> 00:28:26.329
Yeah.

00:28:26.329 --> 00:28:30.017
Or how about when a woman is back to work?

00:28:30.017 --> 00:28:36.458
And struggling and it's like gosh, all she's thinking about nowadays is being a mom.

00:28:36.458 --> 00:28:41.279
Yeah, yeah, no, fucking shit Sherlock.

00:28:44.471 --> 00:28:45.715
What else is there to think about?

00:28:46.076 --> 00:28:47.039
There's no brain work.

00:28:48.270 --> 00:28:49.797
Yeah, exactly yes.

00:28:50.049 --> 00:28:52.356
And that's not to say for women who want to go back to work.

00:28:52.356 --> 00:28:54.281
Great Again.

00:28:54.281 --> 00:28:56.416
If you're feeling it, go for it.

00:28:56.416 --> 00:28:58.397
I'd be stuck at front to back.

00:28:58.397 --> 00:29:00.315
That's where I would be stuck at.

00:29:00.315 --> 00:29:03.457
So, if you're, I would just breathe in and breathe out.

00:29:03.758 --> 00:29:20.119
Yeah, like I would seriously be just giving myself UTIs all day long, because, I'd be like Right, I tried making myself coffee the other day after I had a really busy shift and I drove home and I think I put the bottle of creamer in the microwave.

00:29:20.119 --> 00:29:24.740
Oh, I couldn't get to the point of making my coffee because the creamer was gone.

00:29:25.230 --> 00:29:26.817
That sounds really fun and confusing.

00:29:26.970 --> 00:29:28.535
Yeah, it's like a chicken and the egg about my coffee.

00:29:28.575 --> 00:29:30.200
Yeah, exactly what do I do?

00:29:30.200 --> 00:29:31.853
How do I coffee this morning?

00:29:31.853 --> 00:29:46.554
Right, I remember coming home and from a shift, while I was, like I don't know, like eight months pregnant, I had my lunch bag.

00:29:46.554 --> 00:29:49.638
I had my purse it was winter, so coat and my keys, oh, and my phone somewhere.

00:29:49.638 --> 00:30:00.555
So there was a pocket in the side of my lunch bag and so I just dropped my keys and my phone in there and I walked inside and my daughter came up and gave me a hug and my in-laws were in town.

00:30:00.555 --> 00:30:15.681
There was just a lot going on Because I had not finished eating my lunch because I'm a nurse and rarely does that happen I put my lunch bag in the fridge because I didn't want anything that was left over to spoil, because then I was going to take out the bad stuff and over to spoil, because then I was going to take out the bad stuff and the good stuff was going to stay for the next day.

00:30:16.340 --> 00:30:18.103
And I couldn't find my phone or my keys.

00:30:18.103 --> 00:30:19.344
I was so confused.

00:30:19.344 --> 00:30:23.227
I had the whole family looking for them and of course I found them in the fridge.

00:30:23.227 --> 00:30:29.261
And can I tell you the flack that I got from my husband when he's like why are you phoning your keys in the fridge?

00:30:29.261 --> 00:30:33.920
I was like it makes perfect sense, yeah that makes 100% perfect sense.

00:30:35.363 --> 00:30:44.943
If you know the backstory, my hands were full, that's why your battery was running low, so you pulled your phone to use up less power.

00:30:45.569 --> 00:30:52.932
I used my brain what little brain I had left to put my phone and keys in a safe place so that I could get inside the door.

00:30:52.932 --> 00:30:56.142
And then I was done.

00:30:56.990 --> 00:30:58.855
Why don't we talk about how you guys failed me?

00:30:58.855 --> 00:30:59.617
How about that?

00:30:59.617 --> 00:31:00.480
Right, let's talk about that.

00:31:00.520 --> 00:31:08.163
Yes, why didn't you guys know, logically, that I put my keys and my phone in my bag and put it in the fridge?

00:31:08.163 --> 00:31:11.518
Duh, but I found it later when I went to go make my lunch.

00:31:11.518 --> 00:31:12.770
But you know, this is a cold phone.

00:31:12.770 --> 00:31:14.694
It I found it later when I went to go make my lunch, which, but you, that was a cold phone.

00:31:14.694 --> 00:31:15.777
It was somewhat chilly.

00:31:15.777 --> 00:31:19.563
It was somewhat chilly, but it wasn't much long after, so it was fine, yeah.

00:31:21.471 --> 00:31:21.853
Cold calls.

00:31:21.853 --> 00:31:22.576
Ha ha, ha, ha, ha ha ha.

00:31:22.576 --> 00:31:35.763
So the whole point of the brain break is to demonstrate the value of progesterone, not just on its own, like that.

00:31:35.763 --> 00:31:58.196
Oh yeah, that's why things are as challenging as we don't let them seem they are, but also because one of the treatments that are currently out there and granted it's a very expensive treatment, so it's reserved for severe refractory cases of postpartum depression and or psychosis, which I think it's just unfortunate.

00:31:58.196 --> 00:31:59.715
I don't think it's always going to be the case.

00:31:59.715 --> 00:32:09.221
I think somebody is going to come up with a compounded version one day and hopefully we'll all just get to live a better life, but until then you have to really wait to lose your shit before you can have it.

00:32:09.221 --> 00:32:19.585
But all it is is a synthetic version of the neurotransmitter that we create from progesterone allopregnanolone.

00:32:20.411 --> 00:32:23.857
Ah, there it is, I think I remember.

00:32:23.857 --> 00:32:24.551
Okay, so is.

00:32:24.551 --> 00:32:25.757
It is ziranolone.

00:32:25.757 --> 00:32:31.363
Also Because there is a new medication that came out for severe postpartum depression.

00:32:31.769 --> 00:32:32.972
Are we talking about the same one?

00:32:32.972 --> 00:32:36.101
Maybe Still resto, maybe.

00:32:36.260 --> 00:32:36.843
Zirananolone.

00:32:36.843 --> 00:32:44.871
What is it?

00:32:44.871 --> 00:32:46.133
Yes, Zoranolone is a synthetic form of allopregnanolone.

00:32:46.133 --> 00:32:46.614
It's the only oral.

00:32:46.614 --> 00:32:49.259
Ah yeah, that came out a year or two ago and it's a 14 day treatment.

00:32:49.259 --> 00:32:51.743
So we've got the really expensive.

00:32:51.743 --> 00:32:55.861
I'm sure they're all expensive right now, but like the really expensive IV version.

00:32:55.861 --> 00:33:01.261
And then it appears that now there's an oral treatment and we have no idea how much it costs.

00:33:01.261 --> 00:33:06.923
But the point is, this is for really severe postpartum depression.

00:33:07.910 --> 00:33:31.061
Which is one of those things where I'm like, okay, it's severe if you have postpartum depression, but a qualifier like that in my world is like a slippery slope, because you're already dealing with a woman who's prone to guilt, complex and prone to I'm failing in motherhood, and so when you try to quantify whether their symptoms are severe or not, I feel like there's more women that will fall through the cracks.

00:33:31.061 --> 00:33:31.911
That's true.

00:33:31.931 --> 00:33:36.940
Yeah, I guess a better way to say it is the intractable, like we've tried other medication.

00:33:36.940 --> 00:33:41.875
I mean, at any point are we hoping that this becomes the new medication, like the first?

00:33:42.276 --> 00:33:44.622
I think it has so much to do with everything else.

00:33:44.622 --> 00:34:00.397
I think it has to do with your insurance and your doctor addressing it, and then your willingness to be on a treatment that is effective, because we tend to like to beat around the bush when it comes to doing things that work right Everyone's like.

00:34:00.397 --> 00:34:01.661
Isn't there something else I can try.

00:34:01.661 --> 00:34:18.652
First Again, because it comes with that taboo of oh, you're failing at what you should be doing, naturally, which is obviously already hair done, makeup on, wearing high heels and baking dinner for everybody while the baby is still out hanging off of one boob.

00:34:18.893 --> 00:34:20.315
Yeah, good luck.

00:34:20.315 --> 00:34:30.001
So if it's the precursor for the neurotransmitters that balance your mood, I guess it just depends on what end you want to attack the problem at.

00:34:30.001 --> 00:34:32.152
Do you want to start at the source, or do you want to?

00:34:32.992 --> 00:34:40.121
Yes, the way antidepressants work is that they slow down recycling.

00:34:40.121 --> 00:34:43.846
Yes, our recycling of our neurotransmitters.

00:34:43.846 --> 00:34:49.101
And that sounds like oh, why would you want to not recycle your neurotransmitters?

00:34:49.101 --> 00:34:50.094
Don't you want to keep using it?

00:34:50.094 --> 00:34:58.344
No, but the quicker we clear it out of our system, in our brain system, that's more opportunity to go without it.

00:34:58.344 --> 00:35:03.856
So it's like there's blood in the water and you're clearing it out, right, like we know, we want it to linger.

00:35:03.856 --> 00:35:05.014
We want the fishies to come.

00:35:05.014 --> 00:35:18.413
So antidepressants like Paxil or Welbutrin and Zoloft, these are your garden variety, costco grade antidepressants that everyone's familiar with.

00:35:18.413 --> 00:35:27.759
The way they work is they're not giving you the actual neurotransmitter that you are either deficient in or going through too quickly.

00:35:27.759 --> 00:35:34.112
They are blocking the hungry hippoing of that neurotransmitter.

00:35:36.775 --> 00:35:39.159
The hungry hippoing of neurotransmitters.

00:35:39.219 --> 00:35:49.413
You heard it here, folks yeah and only here, along with anharmonic yes, I think there's another one in there somewhere too.

00:35:49.413 --> 00:35:49.994
There's so many.

00:35:49.994 --> 00:35:57.773
We want those white little balls to stick around in the playing field for the hippos, right, we want those white little balls to stick around in the playing field for the hippos.

00:35:57.773 --> 00:36:23.518
And so, whereas treatments like Silresso or the synthetic version of allopregnanolone is that they actually give you the neurotransmitter that you are deficient in, so that it then allows for more balls to be there, not because the hippos have stopped moving, but because there are more balls and the hippos are like whoa, we're full, but this is great, except they're not full in a postpartum woman.

00:36:23.538 --> 00:36:36.237
Yeah, so, essentially, if you take the reuptake inhibitors, the traditional medications that block the neurotransmitters from being recycled, and that's not working, maybe it's because there's not enough neurotransmitters from being recycled and that's not working.

00:36:36.237 --> 00:36:39.677
Maybe it's because there's not enough neurotransmitters to recycle to begin with.

00:36:39.677 --> 00:36:45.634
That's where the problem could be the sudden decrease in progesterone.

00:36:45.634 --> 00:37:09.143
So then we maybe put back the progesterone, which is the precursor to those neurotransmitters we liked, and then now we can actually have functional reuptake inhibition or functional recycling of the neurotransmitters like to the speed and level that we would be able to maintain a mood that feels doable.

00:37:11.010 --> 00:37:12.152
Right, right.

00:37:12.152 --> 00:37:23.846
I guess the best way to put it would be like in terms of motherhood If your kids are hungry and there isn't enough food in the house, you don't tell them to become less hungry.

00:37:24.429 --> 00:37:26.717
Yeah, you just give them enough food to eat.

00:37:26.717 --> 00:37:28.481
If there's not enough food, they're going to be hungry.

00:37:28.769 --> 00:37:34.782
Hungry Correct, but the treatment it wouldn't be like just give them Benadryl so they go to bed hungry.

00:37:40.070 --> 00:37:41.713
That would be treating a woman with an antidepressant.

00:37:41.713 --> 00:37:44.360
Again, it works for the short term If there's enough neurotransmitters to make it work.

00:37:44.380 --> 00:37:48.782
Right, but that is why, and that's why not everybody is being treated with this drug.

00:37:48.782 --> 00:37:50.186
Who's not postpartum?

00:37:50.186 --> 00:37:51.951
Because that's a great idea.

00:37:51.951 --> 00:37:54.454
Why doesn't everybody get more neurotransmitter?

00:37:54.454 --> 00:37:55.416
And that's not the point.

00:37:55.416 --> 00:38:05.822
The point is, there's a very specific cause for this depletion, and so we're actually addressing the cause there, or dare I say, for once.

00:38:06.730 --> 00:38:18.190
Yes, and this kind of ties into this common argument that people will liken it to If you were lacking insulin in your body, would you replace it in order to stay alive?

00:38:18.190 --> 00:38:21.077
Insulin is also technically a hormone.

00:38:21.257 --> 00:38:26.130
Yes, oh it's like you read my book Right.

00:38:26.371 --> 00:38:49.717
So if we're just balancing the progesterone because there's a sudden deficiency in the balances off after a natural process leading to signs and symptoms of depression, which is just basically a neurotransmitter imbalance, then why so much stigma around postpartum?

00:38:49.737 --> 00:38:50.398
depression.

00:38:50.398 --> 00:38:52.362
Oh my God, why not?

00:38:52.362 --> 00:38:53.911
Because we can Right Exactly.

00:38:53.911 --> 00:38:57.376
Give us an opportunity to feel bad about ourselves and girl, you know we're going.

00:38:57.376 --> 00:38:58.378
We're going to.

00:38:58.378 --> 00:38:59.911
Yes, I'm bringing my laundry, yeah.

00:39:00.632 --> 00:39:01.634
Yeah, exactly.

00:39:01.634 --> 00:39:08.235
So maybe we can reframe this whole postpartum depression thing and just help people balance their hormones.

00:39:08.235 --> 00:39:09.018
That'd be great yeah.

00:39:09.679 --> 00:39:14.380
I would love it if we saw this as like the way we see taking our prenatal vitamins afterwards.

00:39:14.380 --> 00:39:18.349
You know how we judge women when they don't take their prenatal vitamins after they deliver a baby.

00:39:18.349 --> 00:39:22.278
We're like, wow, it's like you don't even care about yourself anymore.

00:39:22.278 --> 00:39:28.476
How are you going to get your iron back?

00:39:28.476 --> 00:39:29.778
You're still producing for two.

00:39:29.778 --> 00:39:34.186
Okay, right, so that was my judgy cis voice.

00:39:34.186 --> 00:39:39.817
So, just like that, you're going to take prenatal vitamins because you know that you've lost a lot of stuff.

00:39:39.817 --> 00:39:50.978
God knows all the stuff that you've lost, but you've lost a lot of stuff and you need to take your prenatal vitamins to help you while your body becomes to the point of being balanced again.

00:39:50.978 --> 00:39:57.251
Thank you, we are back to where you were, where nobody was trying to grow out of you or something.

00:39:58.193 --> 00:40:02.101
Yeah, you're not in a parasitic relationship anymore.

00:40:02.121 --> 00:40:04.313
Yes, and then you're off on your own Training.

00:40:04.313 --> 00:40:04.873
Those are off.

00:40:04.873 --> 00:40:05.335
Go ahead, girl.

00:40:05.335 --> 00:40:13.978
Exactly, yes, yeah, same thing, just like that Blood, I don't know, neurotransmitter, same Iron, all the important things.

00:40:13.978 --> 00:40:16.943
You don't have to wait for it to be such a big deal before.

00:40:16.963 --> 00:40:21.340
Yeah, you would give somebody blood if they had a postpartum hemorrhage.

00:40:21.340 --> 00:40:25.221
Why wouldn't you give them progesterone if they had a postpartum progesterone hemorrhage?

00:40:25.221 --> 00:40:30.695
Oh, that's the problem, or maybe you did with the blood leaving your body.

00:40:30.735 --> 00:40:39.639
I think one day, maybe in the far away, we will start giving everybody these kinds of treatments preemptively, just like right now.

00:40:39.639 --> 00:40:43.114
Some people think oh my God, why are you giving me Pitocin?

00:40:43.114 --> 00:40:44.577
Do I need it?

00:40:44.577 --> 00:40:45.559
Oh, I love that question.

00:40:45.559 --> 00:40:47.864
No, you don't need it yet.

00:40:47.864 --> 00:40:50.815
Your body used to do this on its own when we lived in the jungle.

00:40:50.815 --> 00:41:08.960
But since we don't live in the jungle and don't forage for our own food and do have things like obesity and high blood pressure and all these other medications that we take, and our body has become used to not doing what it's supposed to do, we have to help you out a little by making sure you don't bleed, because we don't want you to need a transfusion.

00:41:11.193 --> 00:41:14.998
Same goes for a feel-good hormone called progesterone, apparently, yeah.

00:41:15.179 --> 00:41:18.623
That'd be really lovely if we had all of those options just available.

00:41:18.623 --> 00:41:30.920
Yeah, wouldn't it be wonderful to be able to, like, when you do the postpartum CBC, could you do like a postpartum progesterone level and just like see where we're at in baseline?

00:41:30.920 --> 00:41:38.010
Or maybe like what I don't know, postpartum oxytocin level, and just figure out like how to maybe we yeah, too hard Right.

00:41:38.731 --> 00:41:48.498
I think that how much of it would be the validity of those things and the utility of those things versus the need for them.

00:41:48.498 --> 00:41:55.003
Are all three different ballgames, right?

00:41:55.003 --> 00:42:10.110
Unlimited resources, and we can just sit there, you and I, and be like these mad scientists that just tested everything and we're looking at a woman's levels of iron and estrogen and progesterone and oxytocin heck, even testosterone, just to be like okay, see, that's why she doesn't want to have sex.

00:42:10.110 --> 00:42:11.534
Guys, leave her alone.

00:42:12.436 --> 00:42:15.911
They'd be fixing the testosterone so fast if we did that Right.

00:42:15.911 --> 00:42:17.376
Oh my God, maybe that'll be the first one.

00:42:23.190 --> 00:42:28.083
Can you imagine let's come up with a finger stick testosterone test so that women can be like sorry, honey.

00:42:31.949 --> 00:42:33.494
It's physiologically not possible right now.

00:42:33.534 --> 00:42:37.023
Guys would be running out and buying testosterone for their wives.

00:42:37.043 --> 00:42:38.708
Yeah, They'd be like a little for you, a little for me.

00:42:38.728 --> 00:42:46.195
A little for you, a little for me, yeah, but I think that we don't have enough information to tell whether that would be effective or not.

00:42:46.195 --> 00:42:52.619
And I don't think that the reason we don't have enough information is because it's not necessary.

00:42:52.619 --> 00:42:53.139
I don't think it's.

00:42:53.139 --> 00:42:57.081
And I don't think that the reason we don't have enough information is because it's helpful.

00:42:57.081 --> 00:43:12.652
I think the reason we don't have enough information is because the costs don't necessarily justify the means, and when you don't have data because it's too expensive to generate, then you don't have data to prove it on a level where it can become cost effective.

00:43:12.652 --> 00:43:13.454
So then the whole.

00:43:13.454 --> 00:43:15.400
So there's just no money.

00:43:16.971 --> 00:43:19.014
There's a self-fulfilling prophecy.

00:43:19.255 --> 00:43:20.639
Gosh, I love those.

00:43:21.101 --> 00:43:23.952
Tell us what we're going to learn in your book.

00:43:23.952 --> 00:43:27.119
This was just one conversation about one hormone.

00:43:28.722 --> 00:43:29.503
I know, right, crazy.

00:43:29.503 --> 00:43:33.476
I'm a little less verbose on each topic, I promise.

00:43:33.476 --> 00:43:49.000
So you will not spend like an hour and a half understanding each hormone, but the tone and the informality is pretty much the same.

00:43:49.000 --> 00:43:50.764
That's why you're here.

00:43:50.764 --> 00:43:57.556
I should have probably consulted with legal before I published this book, because I don't even know if I'm allowed to say things the way I did.

00:43:57.556 --> 00:44:12.960
But I know I did and honestly, as my first born Mimi, my husky child mix, she passed away just about a little over a month ago and after that I had even less fucks to give about what I said so.

00:44:13.722 --> 00:44:16.775
I'm sorry You're going to have a lot of bleeps on your podcast, but that's all right?

00:44:16.994 --> 00:44:20.063
No, it's not, I don't bleep, I just put explicit and then we're done.

00:44:20.063 --> 00:44:23.175
Good yeah, I don't like censoring.

00:44:23.175 --> 00:44:24.659
Oh shit, here I was holding back?

00:44:24.880 --> 00:44:26.650
My goodness, I do.

00:44:26.650 --> 00:44:28.755
You should have told me that before.

00:44:28.755 --> 00:44:31.583
So yeah, outside of that, and then a lot more explicit.

00:44:31.583 --> 00:44:33.132
Just kidding, they're not that many.

00:44:33.132 --> 00:44:34.293
In fact, they're actually not.

00:44:34.293 --> 00:44:37.599
I think of myself as like the Ted Lasso of OBGYNs.

00:44:37.880 --> 00:44:42.793
Okay, I like that, yeah, making everybody play together as a team.

00:44:43.313 --> 00:44:47.989
I was thinking more like just cheesy, but yeah, okay, awesome, yeah, amazing, yeah.

00:44:47.989 --> 00:44:49.574
There may be a dad joke in there too.

00:44:50.317 --> 00:44:52.001
Oh, that's okay, I like dad jokes.

00:44:52.001 --> 00:44:54.635
And then your next work in progress after you take a nap.

00:44:54.635 --> 00:44:58.682
After this book, yes, Because my brain broke.

00:44:58.682 --> 00:45:04.692
No this book.

00:45:04.692 --> 00:45:05.898
Yes, because my brain broke.

00:45:05.898 --> 00:45:07.547
No, I'm going to get some Zorresso.

00:45:07.568 --> 00:45:16.817
Oh my God, we did Google how to say these things before, but one of the tests to see if you need it is to see if you can say it, and so obviously just kidding.

00:45:16.817 --> 00:45:22.300
Also, we're not getting any kind of kickbacks from any of these companies that we can't say names correctly.

00:45:22.420 --> 00:45:22.860
None of them.

00:45:23.300 --> 00:45:24.101
Especially after that.

00:45:24.101 --> 00:45:30.806
So what you can expect from the book is that it's not going to be the PowerPoint of books on the topic at hand.

00:45:30.806 --> 00:45:51.929
It's more like going to be a transcription of a conversation you probably would have had with your girlfriend, who happens to be a doctor, and that may or may not be a good thing, because the conversation is very natural and so it goes all over the place and somehow magically comes back to the point, kind of like this episode.

00:45:51.929 --> 00:45:56.896
Yes, like I said, it's kind of just the tempo.

00:45:56.896 --> 00:46:20.063
And in the first book, the book of hormones, obviously there's so many other hormones in addition to progesterone, including ones you don't think of as hormones, like vitamin D Booyah, and I don't mean the dick, the actual vitamin D like sunshine, and so I try to keep it organized by how it affects women.

00:46:20.063 --> 00:46:22.996
So we do talk about menopause, we talk about puberty.

00:46:22.996 --> 00:46:40.780
So if you have a teen or a tween and don't want to have to reinvent the wheel on that conversation, there's that, as well as birth control, trying to get pregnant, becoming pregnant, as we talked about in this podcast episode.

00:46:40.780 --> 00:47:03.501
But then crazy thing is, this topic of pregnancy is just so ginormous that it felt like a fire hydrant to the face when I was trying to incorporate it into something of an organized chapter that didn't go on forever like me right now and so I realized I'm like this is ridiculous, I'm not going to, I'm just I'm going to need to write a separate book.

00:47:03.501 --> 00:47:10.719
And so the chapter on pregnancy is as comprehensive as one can get without having written a separate book yet.

00:47:11.362 --> 00:47:26.943
And then, of course, there is other topics, such as things that we don't necessarily associate with being just a woman, but it still affects us harder than it does men, like diabetes and your thyroid and guess what your adrenals and cortisol.

00:47:26.943 --> 00:47:56.192
And then there's an entire dedicated section to just straight up treatment protocols, so that, in other words, you can feel confident that you know the options and you are not just relying on a very busy, frazzled new graduate doctor, who may be like running on short on time because they're busy seeing a bajillion patients and, though their heart's in the right place, they don't have the capacity to always cover everything.

00:47:56.192 --> 00:48:04.724
You can walk in there feeling empowered that you already have all the options you need to know about and have a more targeted discussion with your doctor.

00:48:04.724 --> 00:48:10.480
The goal is to make this a tool so that the doctor-patient relationship actually is improved.

00:48:10.480 --> 00:48:14.695
This is not like giving you what we don't want you to know.

00:48:14.695 --> 00:48:15.637
There's no such thing.

00:48:15.637 --> 00:48:17.543
We tell you everything.

00:48:17.543 --> 00:48:19.876
If we had more time, look at me, give me an hour on a podcast.

00:48:19.896 --> 00:48:23.594
I just want to tell you in a way that makes sense, so that you get the actual information Right.

00:48:23.994 --> 00:48:36.490
Exactly and so yeah, that's, and it literally does have dad jokes in it, like some of them are authentically produced, like their original Shwetha Patel dad jokes.

00:48:36.952 --> 00:48:37.532
Oh, I love it.

00:48:38.474 --> 00:48:40.119
Yeah, you want to hear one.

00:48:40.119 --> 00:48:48.664
Yes, okay, since you're insisting, why did the ovary stop ovulating?

00:48:51.670 --> 00:48:57.695
Just because Wait, what Just PCOS.

00:48:58.474 --> 00:49:01.177
PCOS, pcos.

00:49:01.277 --> 00:49:04.518
Oh my God, I was thinking like P.

00:49:04.518 --> 00:49:09.101
Oh my gosh, there you are, hi.

00:49:10.143 --> 00:49:10.722
It's me.

00:49:10.722 --> 00:49:16.106
I'm a middle-aged dad stuck inside a middle-aged woman's body.

00:49:16.106 --> 00:49:17.427
Oh, my goodness.

00:49:20.936 --> 00:49:21.420
That sounds gross.

00:49:21.420 --> 00:49:22.061
Not in that way.

00:49:22.061 --> 00:49:26.851
That should be a movie.

00:49:26.851 --> 00:49:27.592
They have the mom and the kid.

00:49:27.592 --> 00:49:28.596
Oh, the parent swaps, yeah, or the, what is it called?

00:49:28.596 --> 00:49:32.644
13 to 30 or something like that 17, again with Zac Efron.

00:49:34.731 --> 00:49:35.653
I guess, there's a lot of them.

00:49:35.653 --> 00:49:37.918
Matthew Perry oh, rest in peace.

00:49:37.918 --> 00:49:41.226
And then the next book will be there's a lot of them.

00:49:41.226 --> 00:49:42.208
Yeah, matthew perry, oh, rest in peace.

00:49:42.208 --> 00:50:03.876
And then the next book will be everything on pregnancy, including some things I think that will be a little bit different from other books, but also combining different books together, which is like how to level up your experience in labor and delivery, down to including what to say and ask how to say it to nurses and doctors so that you get what you want.

00:50:03.876 --> 00:50:07.927
Birth plans yeah, love that.

00:50:08.027 --> 00:50:11.760
All the things like are we gonna keep calling them birth plans, because they're not really a plan.

00:50:11.760 --> 00:50:21.103
Birth goals, I call them perfect preferences or, yeah, vision, yeah so like, like goals, hashtag, birth goals.

00:50:23.210 --> 00:50:28.422
I don't know my head bobbing so much when I say it, but Love it.

00:50:28.630 --> 00:50:29.554
My Indians coming out.

00:50:29.554 --> 00:50:33.016
You're going to go Bollywood on me right now.

00:50:39.570 --> 00:50:40.112
Yeah, you did.

00:50:41.474 --> 00:50:46.172
Built in bobble, doll arrived is there anything we didn't cover that you want to talk about?

00:50:47.195 --> 00:50:48.822
so much, but not for this episode.

00:50:48.882 --> 00:50:54.038
Not for this episode we'll do it later, okay, yeah, dr patel, as always, it has been quite a pleasure.

00:50:54.038 --> 00:51:02.541
Thank you likewise, and if your book is now out, the book of hormones by dr shweta Patel is now available.

00:51:02.909 --> 00:51:04.034
Yeah, you can Google it.

00:51:04.034 --> 00:51:06.878
Preferably you go on Amazon because that's where it's published from.

00:51:06.878 --> 00:51:16.574
So if you do, if you're one of those folks that has Kindle Unlimited where you have like that it's included in your Prime membership or something you can actually read the book for free.

00:51:17.257 --> 00:51:17.619
Amazing.

00:51:18.150 --> 00:51:20.114
The other way that it is available is paperback.

00:51:20.114 --> 00:51:30.885
Again, you just go on Amazon and put in the book of hormones I don't think you can get a more straightforward name and it's hard to miss the cover.

00:51:30.885 --> 00:51:33.992
It looks nothing like a medical book on hormones.

00:51:33.992 --> 00:51:35.715
It's a woman jumping for joy.

00:51:35.715 --> 00:51:36.538
There you go.

00:51:36.538 --> 00:51:44.900
Or you can also, if you want to scope it out before you buy it, you can also just go on the page on Amazon and look at the sample.

00:51:44.900 --> 00:51:46.672
It gives you the first four chapters for free.

00:51:46.813 --> 00:51:50.224
Oh, wow, I know I was kind of like WT.

00:51:50.664 --> 00:51:52.110
I didn't know if I was happy or upset.

00:51:52.110 --> 00:51:53.393
I'm like good thing it ended on.

00:51:53.393 --> 00:51:55.159
A cliffhanger Was it the.

00:51:55.159 --> 00:51:56.061
Pcos joke.

00:51:56.061 --> 00:51:59.677
No, I gave that one ahead of time.

00:51:59.677 --> 00:52:00.903
That was a spoiler alert, all right.

00:52:02.389 --> 00:52:08.523
When you want to hear the joke about PCOS or why the ovaries start working or stop working.

00:52:08.523 --> 00:52:10.213
I'm messing it up.

00:52:10.213 --> 00:52:11.456
I'm not even Delivery.

00:52:11.456 --> 00:52:12.418
It is.

00:52:12.418 --> 00:52:12.960
It is.

00:52:12.960 --> 00:52:13.501
It really is.

00:52:13.501 --> 00:52:26.297
Okay, If you want to go read Dr Patel's book, go to Amazon and get the book of hormones and start learning about your hormones and stay tuned for the book of pregnancy or whatever that title is going to be.

00:52:26.318 --> 00:52:28.050
That's literally what it's called the book of pregnancy.

00:52:28.050 --> 00:52:28.972
Book of pregnancy.

00:52:28.992 --> 00:52:34.213
I like to keep it pretty straight and narrow, yeah, yeah, nobody's going to be confused about what it's about.

00:52:34.213 --> 00:52:35.715
Thank you, as always.

00:52:36.891 --> 00:52:37.938
Thank you for having me.