Thanks for joining us for episode 110 of The Ancestral RDs podcast. If you want to keep up with our podcasts, subscribe in iTunes and never miss an episode! Remember, please send us your question if you’d like us to answer it on the show.
Dr. Jolene Brighten is a Functional Medicine Naturopathic Doctor, herbalist, bestselling author, speaker, and mother. Dr. Brighten earned her doctorate in Naturopathic Medicine from the National College of Natural Medicine. She received her Bachelor’s Degree in Nutrition Science and completed graduate coursework in molecular nutrition at Cal Poly, San Luis Obispo.
Dr. Brighten is renowned women’s hormone and autoimmune disease expert who takes a root cause approach to help women reverse disease and fall back in love with their life. She supports women struggling with hormonal imbalances including adrenal and thyroid, autoimmune conditions and digestive disorders.
In her patient centered practice, Dr. Brighten thrives on navigating the space between conventional and alternative medicine, all while working with patients to help them achieve optimum balance, health, and happiness.
The birth control pill is so commonplace in our society that not many of us think too much about it when prescribed. This game changing conversation with Dr. Jolene Brighten will educate and support you in making decisions that are right for your body.
Join us for an amazing discussion as Dr. Jolene Brighten dives deep into the surprising effects of the birth control pill on thyroid health and other body systems that are not widely known or talked about. A sample of what you’ll also hear is the symptoms of post birth control syndrome, nutrition to support coming off the pill, and alternative birth control methods.
Here are some of the questions we discussed with Dr. Brighten:
- How did you get into Naturopathic Medicine?
- What are some of the most common health conditions that you see in your clients that you’re working with?
- Why do we see hypothyroidism and specifically Hashimoto’s so much more often in women than in men?
- Can we talk a little bit about how the ovary/adrenal/thyroid axis fits together when it comes to thyroid disease?
- How does the birth control pill play into high estrogen preventing thyroid hormone from getting into the cells properly?
- What’s the process of coming off the birth control pill when having a chronic illness? How do you support your body before you come off of that?
- What are your favorite recommendations for alternative birth control methods that you educate your patients on?
- What are some symptoms of post birth control syndrome?
- This episode is sponsored by Paleo Rehab
- Find Dr. Brighten on Facebook
- Not getting your period? Join my “Get Your Period Back” program waitlist!
Kelsey: Hi everyone! Welcome to episode 110 of The Ancestral RDs podcast. I’m Kelsey Kinney and with me as always is my cohost Laura Schoenfeld.
Laura: Hi everybody!
Kelsey: We’re Registered Dietitians with a passion for ancestral health, real food nutrition, and sharing evidence-based guidance that combines science with common sense. You can find me at KelseyKinney.com, and Laura at LauraSchoenfeldRD.com.
We have a great guest on our show today who is going to talk to us about how oral birth control sabotages the thyroid and why you should ditch the pill if you’ve got a thyroid condition. We’re super happy that she’s joining us and we think you’ll really enjoy this episode.
Laura: If you’re enjoying the show, subscribe in iTunes so that you never miss an episode. While you’re in iTunes, leave us a positive review so that others can discover the show as well! And remember, we want to answer your questions on our show, so head over to TheAncestralRDs.com to submit a health-related question that we can answer or suggest a guest that you’d love for us to interview on an upcoming show.
Kelsey: Before we jump into our interview, here’s a quick word from our sponsor:
This episode is brought to you by Paleo Rehab, a five week online program designed to help you recover from HPA axis dysfunction, also known as adrenal fatigue. Is your perfect Paleo diet and lifestyle leaving you exhausted? Now is the time to start feeling the health and wellness you know you deserve. If you’re sick and tired of feeling sick and tired, and are ready to take back your health, then head over to MyPaleoRehab.com to get your free 28 page e-book on the 3 step plan for healing from adrenal fatigue. That’s www.MyPaleoRehab.com
Kelsey:Welcome back everybody! Today we are so excited to have Dr. Jolene Brighten with us! She is a Functional Medicine Naturopathic Doctor, herbalist, bestselling author, speaker, and mother. Dr. Brighten earned her doctorate in Naturopathic Medicine from the National College of Natural Medicine. She received her Bachelor’s Degree in Nutrition Science and completed graduate coursework in molecular nutrition at Cal Poly, San Luis Obispo. Dr. Brighten is renowned women’s hormone and autoimmune disease expert who takes a root cause approach to help women reverse disease and fall back in love with their life. She supports women struggling with hormonal imbalances including adrenal and thyroid, autoimmune conditions and digestive disorders. In her patient centered practice, Dr. Brighten thrives on navigating the space between conventional and alternative medicine, all while working with patients to help them achieve optimum balance, health, and happiness. Welcome, Jolene!
Dr. Jolene Brighten: Hi! It’s so great to be here. Thank you for having me.
Kelsey:Absolutely. It’s our pleasure for sure! I want to jump right into the good stuff here. Would you mind telling our audience a little bit about your background? How did you get into naturopathic medicine? What brought you there?
Dr. Jolene Brighten: It was quite the journey indeed. It actually started in childhood when I was obsessed with consuming medical text books. I was that weird seven year old with Gray’s Anatomy. I was really interested, my best friend’s mom was a pharmacist, and the pharmacology of plants and how to utilize those always really interest me.
What happened to me in my childhood is I actually got really sick and I had chronic gastritis which is really odd for a child to have. I struggled with digestive issues for many years until they finally discovered H.Pylori and my doctor tested me for it and that’s what I had. At that time I was 17 when they finally found it and it had really started when I was in grade school, and at that time they said well, you’re going to be on proton pump inhibitors for the rest of your life. We haven’t really tested these in people your age, but this is what we know is that you’ve got heartburn, you’ve got gastritis, this is what you have to do.
It was then that I started just making observations about how food affected my body. I actually found by making shifts and changes in my diet that I eliminated my heartburn and my digestive symptoms got better. That’s when I really decided I’ve got to study nutrition. Food is medicine. I saw the light at that moment. That’s where I took the next step to going into getting my undergrad in Nutrition Science. I actually studied Didactics simultaneously and I thought I might be an RD, but I really, really loved the science and I didn’t really love what the RDs told me what went down in hospitals.
Dr. Jolene Brighten: I was like I don’t see myself in the hospital situation. It was actually there that I went over the deep end into science as I say because I started working in recombinant DNA technology. I was studying nutritional biochemistry and how to actually manipulate genes to make animals produce different kinds of milk.
Long story short is that through all of that I saw that we were…so this is the stuff that we’re all against now, like how GMOs came about. It was in those moments that I really recognized that we weren’t asking enough questions and there was no respect about nature. There was no respect for nature. Yeah, we can manipulate these genes, we can do all these things, but I was the only one asking what does this do to the nutritional value? What does this do in someone’s body?
I laugh about this that in science we actually don’t know as much as we think we do. I recognized that and I stumbled one day upon the website of Naturopathic Medicine. I was in grad school and I was a yoga instructor so I had a private nutrition and yoga practice going. At the time I found Naturopathic Medicine, I was like this is everything that resonates with me. Albeit I’m a lot more of a science side of things, but I’ll say that that was what I’m looking for is someone to train me and to teach me how to respect the body, and work with the body, and ask the body why and go deeper with all of that. Once I found Functional Medicine I was like ah-ha! There’s that science part of me. That’s the jam right there.
That’s my story and journey and it really started I think like many of us feeling sick and then basically taking the bull by the horns and figuring it out and realizing that there is so much potential and there is so much we can do with our bodies to work with them.
Kelsey:Now you have your own Naturopathic Medicine practice, right?
Dr. Jolene Brighten: Yes. I have a clinic in Oakland, California and then we have a clinic in Portland, Oregon as well. We call them the sister clinics.
Kelsey: Very cool. What are some of the most common health conditions that you see in your clients that you’re working with at those clinics?
Dr. Jolene Brighten: We’re a women’s health practice. We call ourselves a root cause women’s health practice. We’re primarily working with women with autoimmune conditions and hormone imbalances. Where we really love work is on the inner section of how the hormones are actually influencing the autoimmune disease and how the autoimmune disease is affecting the hormones. We like to work on those two big categories there.
What we see a lot of of course is Hashimoto’s. It’s the most common type of autoimmune disease that predominantly affects women. We treat a lot of Hashimoto’s, a lot of thyroid conditions. We certainly see many women who are wanting to conceive. We’ve got an amazing pre-conception program and then we take them through pregnancy and then we set up post-partum plans. In their third trimester we have our game planned to prevent post-partum depression and post-partum thyroiditis which affects about 1 and 12 new moms who give birth.
These are the kinds of things that we’re seeing is a lot about women who are in their fertile years. Of course what comes with that is a lot of PMS, a lot of anxiety, depression, the emotional symptoms, the other things that happen when our hormones aren’t balanced. Also I work in all of that, I treat so much SIBO. This is something when I start talking about it, people are like, whoa, wait, you treat SIBO? I’m like pretty much every Hashimoto’s patient has SIBO. It’s something that I work a lot with some of these big supplement companies too on developing things for SIBO as well.
It comes as a surprise, but when estrogen is off or thyroid is off and all this kind of things, it’s going to affect your gut. And conversely, if your gut is not working right, all of your hormones are definitely going to be affected.
Kelsey:Exactly. I work with a lot of digestive health clients as my main clientele so I know exactly what you’re talking about here. But I could see why people might be a little bit confused. You’re talking about all these hormone things, these autoimmune things, and then all of a sudden gut health is coming out of here too. But you’re right, it’s all totally connected. When you start to focus on one or the other, you end up kind of having to loop everything in and treat everything at the same time.
Dr. Jolene Brighten: Yeah, and that’s the thing we need people to understand is that we treat the whole person. We’ve got to look at every system especially when you’re a thyroid patient. Every single cell in your body needs that hormone, so every single system is going to be affected and then vice versa. We have to be looking at that whole person, not to mention that next level of like what you think every day and what comes out of your mouth every day is affecting everything. You treat a lot of SIBO, then you know that the nervous system, and the negative self-talk, and some of these ways that people approach stress can have a lot to do with the dysfunction of their gut.
Kelsey:Absolutely. Today we’re going to talk a little bit about thyroid issues and how birth control, specifically things like the pill, can negatively impact a thyroid condition. Before we jump into some of the nitty gritty stuff about that, let’s maybe talk just a little bit about hypothyroidism in general, specifically Hashimoto’s, and why that is more common in women. Why do we see that happen so much more often in women than in men?
Dr. Jolene Brighten: Hypothyroidism is when there’s too little thyroid hormone. Your questions are great. We see Hashimoto’s is the most common cause of hypothyroidism. 90-97% of women, which I do have a lot of men in my practice with this as well, but predominantly women, it’s going to be due to an autoimmune condition.
Autoimmunity is when your body gets really confused and decides that your thyroid gland is worth attacking. It’s a confused immune system. There’s a lot we can dive into about autoimmune disease, but to cut to the chance, it’s because of the immune system attacking and destroying the thyroid that now you no longer have gland available to actually produce thyroid hormone.
This is mostly found in women and we know that you have 5 to 8 times higher risk once you get in your 30s of developing Hashimoto’s or hypothyroidism. Just to differentiate the two, you can have hypothyroidism and it can be due to other causes, but what I want to say is that with Hashimoto’s what we’re looking for are antibodies, anti TPO and anti thyroglobulin antibodies.
But what’s important to recognize is that, I kind of approach hypothyroidism like if I can’t find another root cause, then I’m going to assume this is Hashimoto’s. The reason for that is because the research has shown 10 even to as high as 50 % of people with Hashimoto’s will be serotype negative. That means you’re never going to show antibodies. What’s the best absolute best way we can tell if you have Hashimoto’s is that we can actually just go and biopsy your thyroid crazy, so just go in and take a little bits of your thyroid all over the place and look at them under a microscope. As you could imagine, that’s highly invasive, not really the ideal, and nothing I’ve ever sent out for.
It’s just an important distinction because I’ll hear all the time from women, no, I don’t have Hashimoto’s, I’m hypothyroid. Well nothing else is going on and honestly I’m basically like if you go on a gluten bender or you have a really high stressful point in your life, I’m going to test you again. Because to me, and I’ve seen this time and again with patients, it’s usually just a matter of time.
A lot of that can come through when we start strengthening their immune system, and balancing your hormones actually balances your immune system. This is why we think women are much more likely to develop autoimmune disease. There’s other theories, but a big one is that women have cycles and that estrogen spikes and dips throughout the cycles. If you see when women are at most risk of developing autoimmune disease is in her 30s. Well, what’s happening in our 30’s? Our DHEA and our progesterone have begun their decline which is protecting us against estrogen and cortisol.
Why that’s important is because what you’ll see in the research studies is that too much estrogen, and you’ve got immune system chaos. And too little estrogen, and you’ve got immune system chaos. It’s kind of like this Goldilocks effect. It’s like so many things in the body, the Goldilocks effect. The other time when you’re going to see it, peri-menopause is very high risk. And then I also see post-menopausal women start to have a lot of immune dysfunction.
What we know is that that estrogen really that gives us the robust immune system and helps it behave. I just want to be clear, estrogen is not bad. It’s an amazing, amazing hormone. But the name of the game with hormones is all about having the balance.
We compound all of that, and you guys are definitely on my tribe, but you compound that with we live in a society that’s a complete evolutionary mismatch to how we’ve actually developed. Women are more stressed out and exposed to more toxins than ever before. They’re bathing themselves in these exogenous estrogens basically so to speak that are grabbing onto receptors and causing all this hormone confusion.
But also I work with a lot of moms, motherhood is a complete evolutionary mismatch. Going through peri-menopause, going through these major life events, we as women need community. From research we know when we’ve got our tribe, when we’re hanging out with our ladies, our progesterone is up, our stress hormones are down. You can optimize your hormones just by getting together with your girlfriends once a week. I mean that’s awesome! But back in the day when we were going through some big stuff, we would have the medicine woman of the tribe or the other women’s wisdom. They would just encircle us, and envelop us, and teach us, and guide us, and help us not be alone in this journey.
What I see in my patients so much is everybody is on overdrive, cortisol just is pumping through the roof. Getting your hormones in balance, it takes a lot of finesse and you paying attention to really how are you living your life and is it incongruent with how your body needs to you live your life?
Kelsey:You mentioned cortisol, you mentioned thyroid hormone, and you mentioned estrogen. I’d love to talk a little bit about the ovary/adrenal/thyroid axis, which sounds a little complicated, but how that all fits together when it comes to thyroid disease.
Dr. Jolene Brighten: I would just say for your listeners if you feel like you have to listen to this again, no worries because you and I know it’s complicated. There’s a definite interplay. I love that you bring this up because I feel like this isn’t talked about enough and I think it’s something that it’s really easy in medicine to get myopic and to be just like you just have a thyroid issue, you just have an adrenal issue. The body just doesn’t work that way. In my experience, you can’t shift one hormone without them all feeling the effect.
Like what we were talking about, estrogen goes up, so estrogen dominance. I‘m sure you ladies see a lot of this especially if you’re treating the gut. With estrogen dominance we can have a relative estrogen dominance or just a frank estrogen dominance. But relative is the most common. This goes back to what I was saying, we’re stressed out. What happens when we’re stressed out? We push. The body is like hey, you’re stressed, not a good time to have a baby. How about we just focus on survival? It chooses cortisol over progesterone.
Let’s be clear, your body is not betraying you. Your body’s got your back, okay? Now it’s choosing cortisol over progesterone. Now your estrogen is higher than it should be. This is where we see the relative estrogen dominance. Why that matters is because it’s all about who gets to the receptors and who gets to stimulate the receptors most. It’s kind of like there’s two kids in the family and it’s like who gets mom’s attention? Whoever is the loudest. I’m a mom, so that’s why I can say that.
What happens is that estrogen starts grabbing on these receptors and estrogen is inherently inflammatory. Inflammation has a time and place, but in our modern age there just seems to be too much of it. Estrogen is causing inflammation. What happens is that the cells begin to get rigid. They won’t accept things like cortisol, and they won’t accept things like thyroid, and they won’t accept things like insulin. It’s just a little bit harder to communicate. And at the same time while the estrogen is going up, your body is like we can’t have all that estrogen, this is dangerous, so let’s make more sex hormone binding globulin. Also what goes with that is let’s make more thyroid binding globulin, let’s make more cortisol binding globulin.
Now that estrogen being high means you’re grabbing onto whatever hormones you can make, you’re grabbing onto them. And then in addition to that, you can’t communicate so much with the cell. The pituitary, the hypothalamus, how the brain is talking to all these glands is like we need more. Well now it starts screaming at the thyroid or screaming at the adrenals. This is where so much of what’s called adrenal fatigue, this is one of the ways adrenal dysfunction, which is how the brain and the adrenal glands are talking, can really get off.
I just want to say that this is really an important piece to recognize that it can actually all start with this estrogen dominance. Now like domino effect the adrenal glands are now getting imbalanced. As that starts to happen, the DHEA, all of those, so DHEA and your cortisol is coming from your adrenal glands. DHEA is a great anti-aging hormone, but it’s also a precursor to testosterone and estrogen.
I’m sure you guys have seen it where cortisol is declining and DHEA is through the roof, and that’s when ladies can start pushing too much estrogen. This is the one that’s a little bit confusing, but yeah, what’s going on with your adrenal glands can actually lead to a further hormone imbalance. It’s a little more well known is that if the adrenals are dysfunctioning, then you don’t have that cortisol to keep the immune system in check. You’ve got estrogen starting to drive immune system chaos. That’s really where an autoimmune disease can come from.
But at the same time, the way we like to look at this is that your adrenal glands, they’re kind of like the pilot light and the thyroid is the furnace. You never have a thyroid issue without an adrenal issue and vice versa. It always seems that pilot light will try to burn brighter basically when that furnace starts to dampen down because your body is like I still want to get up in the morning and seek out food, like I’ve got to figure out how to get it going, and it starts compensating. Then we start seeing issues with thyroid and adrenal function.
To bring it all back home to well what’s up with the progesterone, and the estrogen, and the thyroid is that you can have your pituitary is talking to your thyroid fine, so your TSH, your thyroid is responding correctly, your T4. But then you might not be converting which can be due to inflammation and gut stuff, and other things. But even if you are converting, you might not get that thyroid hormone at the cellular level because of those estrogen levels and the inflammation that’s going on. This is a whole lot of information!
Kelsey: It’s good though.
Dr. Jolene Brighten: But it’s to say like, ladies, every single thing is connected. If you’re working with a practitioner, they need to be looking at all systems and all hormones. It isn’t one snapshot in time. When we’re testing, we’re doing day 3 FSH, LH, estradiol. We’re looking at how is your brain communicating to your ovaries? How are your ovaries responding? That’s not where we’re looking for the estrogen dominance. We’re looking that you’re properly developing a follicle.
I want to just say as I start talking about this, we know now that less than 50% of women report that they want to be mothers. We know that less women want to be moms. I don’t know if you guys hear this a lot, but I hear this a lot from women that are like I don’t care about my fertility because I never want to be a mom, I don’t care about taking care of that. I’m like whoa, whoa, whoa, whoa, whoa. From an evolutionary perspective you are the most robust and healthiest of yourself when you are fertile. It’s actually a good marker for your health. Whether or not you want to have a baby, ladies, you always want to be cultivating yourself to be the most fertile because that’s when you get to bathe in this glorious hormonal harmony that your body can make. When our hormones are right, it’s not just about us feeling good and our mood being good, we actually are more productive, we serve our communities more. As women when our hormones are right, we are an unstoppable force.
Dr. Jolene Brighten: Always be cultivating your fertility. But I don’t want to dive too deep into the labs if that’s not the direction we want to be going here. But it’s all to say that you have to be checking those labs at the right times of the month. Especially with thyroid in the functional medicine space, people kind of start to freak out where they’re like your TSH is 2.5 to 3 and we need to start on medication. It’s like, maybe, but we should probably retest and just see is that true? Does that hold? With the only caveat being is if you’re pregnant.
My ladies that are like I want to get pregnant right now, if your TSH is 2.5 or higher, we have to start you on a medication because pregnancy is literally a stress test for the thyroid. If you’re not medicated, the risk of miscarriage is really high. In hypothyroid women, especially with antibodies they have two to three-fold increased risk of miscarriage.
My practice, my focus, and this is from me having personally experienced a miscarriage is to do whatever we can to prevent that. That’s my one caveat with starting thyroid hormone right away with a TSH of 2.5 is that…my motto in my clinic is that we don’t mess around, we don’t risk babies. We don’t mess around with that. We go by this is what the American Thyroid Association has said is the standard of care to protect as many mothers and babies as possible. That’s the caveat.
Kelsey:Got it. Okay. When it comes to thyroid disease and hormones, you’ve been talking a lot about estrogen and when estrogen is high there’s a lot of inflammation and you can’t get thyroid hormone into the actual cells. Did I understand that correctly first of all?
Dr. Jolene Brighten: That is correct, yes.
Kelsey:Okay, just as a recap. With that idea in mind that when estrogen is really high, it’s preventing thyroid hormone from getting into the cells properly, how does the birth control pill play into that?
Dr. Jolene Brighten: Great question! What is the birth control pill? It’s essentially a pill you pop every day to induce estrogen dominance on yourself. Sometimes there’s some progesterone in there. No, let’s be clear, it’s progestin, ladies, it’s nothing like the wonderful progesterone you make. But that’s essentially what the pill is, is it’s estrogen dominance.
This is what gets me fired up. Most women who have been prescribed the pill were never even told how the pill works, how the pill effects their body. They’re on it and they don’t even know. Let’s share that so that everyone knows. There’s several mechanisms where the pill will work. The predominant one, this is like this is how the pill really shuts it down is that we flood your system…well not we, I’m not giving you that, but you flood your system, you pop that pill, you flood your system with so much hormones that it tells your pituitary, shut it down, I don’t need you stimulating my ovaries to make anymore hormones. Shut it down means no follicle stimulating hormone, no luteinizing hormone, you never make an egg, you don’t ovulate. Therefore, your periods are not periods while you’re on the pill. They are just withdrawals from a drug.
I say that like, listen up! If you are listening to this and you’re like, wait a minute, is she bashing the pill? I just want to say if you cannot have a baby and that is the only way you can prevent not having a baby tired and true, I want to support you in that because I’ve been there. I was on the pill for 10 years. I could not have a baby. I also didn’t know all of this. But through my practice, I just want to say that I’m not anti-pill, but I am pro educating women about the pill because if you’re going to pop that pill, you should absolutely know what it’s doing in your body.
But that’s great, if you don’t want to have a baby, it shuts down your brain, it shuts down the whole fertility mechanism. But when all of that is happening, so that’s shutting down that mechanism. It’s kind of silly to me that doctors would ever even say like you can just get off the pill and everything will just be fine. It won’t happen like that. It’s like how can it not have an effect? That just is silly, it doesn’t make any sense. How can it not have an effect? You pumped yourself with so many hormones that it stopped your brain from working correctly. That’s really profound to me. That’s one thing to recognize.
The minor other mechanisms, I’ll just mention one, is that it will thicken your cervical mucus. Those progestins can do that and that’ll prevent sperm from swimming up. For our focus and what we’re talking about here and what women should really know is it shuts down your brain and it induces estrogen dominance.
If you’ve got hypothyroidism, this is something that I used to think…and this is me being a little bit hopeful I think, and we had to test it really…but I used to think in my practice women with hypothyroidism, maybe we can stay on the pill. Maybe I can support you enough to be able to make those changes. But I’ll say that time and again what I’ve observed especially in thyroid disease is that women will get a 60 to maybe 80% improvement and they’ll never move again. What being on the pill is like with thyroid disease, if you’ve got any kind of health condition and you’re on the pill is literally like walking up a downward moving escalator. You have got to hustle if you’re going ever make it to the top. It is everyday work.
When my patients come to that place of recognizing that this is a huge amount of work to maintain my health and really achieve the life I want, they get off the pill and they have such tremendous gains that part of me, I now, my perspective is now we actually have changed it in my clinic and I’m testing women’s hormones on the pill and then I’m testing them the first month off the pill. We’re starting to track data in this. I’m taking women off of it sooner and I’m actually seeing that they get better quicker. My perspective has shifted and I’m like okay, we’ve got to support you in the best way we can to transition this because as you guys know, post birth control syndrome is a very real thing.
Dr. Jolene Brighten: I wish I would have known about that and had prepared for that when I came off the pill, oh my gosh! That’s like the roller coaster that nobody tells you about or preps you about. I want to make sure that I’m supporting them first. Just people listening, you don’t just jump off the pill. You need a backup method to make sure you don’t get pregnant. That’s first thing. It’s so individualized. You’ve got to figure that out. You’ve got to read everything and you’re the only person that can answer that for yourself. Then you need to really start supporting your body and then come off the pill.
What I’ll say about that is we’re taking women off of it sooner, of course I say it like that, it’s with their consent. They’re a player in this. We’re never going to force anyone to do anything. But we’re seeing that they get better way quicker and healing their gut is so much easier.
Dr. Jolene Brighten: I mean so much easier, which is definitely something we can talk about in terms of how the pill is affecting the gut and the thyroid hormone if you’d like to get into that.
Dr. Jolene Brighten: I will tell you a story. I’m a really big nerd. I get journal articles delivered to my inbox and every Saturday morning I love reading them. I’ll never forget when this study came through and my jaw just dropped and I still get blown away. Out of Harvard University, they found that the use of oral contraceptives, so birth control pill, was linked to a 300% increased risk of Crohn’s disease.
Dr. Jolene Brighten: You take that pill for 5 years and you’re going to throw yourself into an autoimmune bowel disease. Which as you ladies know, Crohn’s disease, when it gets going it’s a fierce one.
Dr. Jolene Brighten: And it’s difficult because what do we have to do to heal autoimmune disease? We have to heal the gut and we have to get nutrients in. What they said in that study though was we recommend that before a doctor prescribes the pill that they actually do a family history or a genetic test on women because this is really significant. You ask any women who’s on the pill, did your doctor mention this to you? Did your doctor mention that you can develop an inflammatory bowel disease if you have a family history? Did your doctor take your family history first? No.
Dr. Jolene Brighten: Is that because their doctors are bad? No, it’s not that their doctors are bad. It’s that their education is limited. They only have so much bandwidth and so much to learn, but nobody is teaching them about this. Your doctor doesn’t know what they don’t know. I just want to make that clear. Let’s not hate on MDs. If you’re in a car accident, I want them. That’s who I want. Not me, you don’t want to see me.
There’s that one piece. What does that tell us about the pill? We know about the birth control pill is it absolutely skews the microbiome and it creates intestinal inflammation. If you’re creating intestinal inflammation, that’s leaky gut. We know the pill is associated with leaky gut. What is one of the, I call it the three ingredients of developing autoimmune disease? It is leaky gut. There you go. The pill is already putting you at risk for autoimmune disease.
But where do you convert your T4 to T3? Let me back up and say your thyroid will produce T4, which is inactive thyroid hormone and a little bit of T3, which is active. That’s your metabolism, your energy, all the good stuff is your T3. You only make a little bit. Most of it has to be converted in the periphery. We’re talking like kidneys, liver, and gut. If your gut isn’t working correctly, then you’re not going to convert as much T4 to T3. Now mood’s tanking, hair is falling out, just everything is going downhill. You’ve got those hypothyroid symptoms.
And then what happens? Well now you don’t have enough T3 so now you don’t make enough stomach acid. If you don’t make enough stomach acid, you don’t secrete pancreatic enzymes, gallbladder doesn’t work correctly. Now we’re at risk for pathogens coming in, we’re slowing our motility, we’re not absorbing our nutrients as well. Now we’re getting nutrient depletions. You also don’t have T3 to stimulate your motility. Why do I say all my Hashimoto’s, all my hypothyroid patients have SIBO? Because at the crux of SIBO is a motility issue and anyone who hasn’t had enough T3, they get constipated. So ladies, that’s why we get constipated if we don’t have enough T3. I also have Hashimoto’s so I can speak to this. Now you don’t have motility. So what do you get? Now pathogens.
We could take two people, and same is true if you’ve ever had SIBO or are hypothyroid. If you’re one of those people, I can expose you to the same amount of Salmonella that I would expose someone with a normal working gut to. The normal working gut will likely handle it and pas it though. We all get these low dose exposures to these pathogens. But if you’ve got comprised motility, now you’ve got an infection. There was time for it to flourish and now we’ve got an infection. Now what happens? Now cortisol issues.
You can see how it’s not simple. There are no simple answers especially when it comes to what birth control can do to the body and the aftermath of that. I really like to drive that home that there’s a lot of ways that it’s touching your system. But it’s my opinion if you have ever been on the birth control pill and you have not committed to healing your gut, you need to do that. If you have not worked hard on getting on a whole foods diet, maximizing nutrient absorption, getting your nutrients up…I have seen this in patients who they took the pill, they’ve been off of it for like a decade, and they are like yeah when I came off the pill I had x,y,z, it never stopped. They’ve seen all these other practitioners that have been tracked over the years. They’re nutrient depletions never came back until we really fix the gut and loaded them up.
That’s when we’re running these organic acid tests and things like that because the pill, even though it’s broad sweeping and it does all of these things in the system, that’s the tricky thing about post birth control syndrome. You can have all of the symptoms or one of the symptoms. You’re an individual. This is where it’s really important as patients, we need you to be tracking this data and telling us what’s not normal because you’re the only person living in your body so you’re the only one who has that data set. I can run the labs, but I’ve got to look at it in conjunction with your story.
To bring it full circle, why is that important? Why do I want to say that? Because your symptoms are not in your head. They are absolutely not in your head. If you feel like whatever is going is on is not normal and your doctor is not listening, you need a second opinion. Because what you feel in your body, if you feel it’s off, as a doctor I think that is super important data. That is highly valuable and I need to listen and I need to ask why.
Kelsey:Yeah, that’s such a refreshing perspective I have to say. I’m really happy that you brought up how birth control actually works because I was put on birth control as a young teenager for acne. No education, nothing. I knew absolutely no idea how it worked. My doctor basically said nothing to me about it whatsoever. It was just like this will help your acne, get on this. I think I was on that probably for at least 7 years of my life which is crazy especially as a young kid.
It’s just unbelievable to think that there are so many women out there who have been on the pill for really long periods of time without getting any education as to how it affects other body systems. Especially bringing it back to thyroid disease too, it’s like well if you either have genetic history of that, family history of that, or you already have some sort of thyroid disease and then you’re getting prescribed the pill, man, some education would have been real nice right about then.
Dr. Jolene Brighten: Right? Can I speak to your getting prescribed the pill for acne? I’m going to just be straight up. I don’t think anything pisses me off more than that because what doctors do is they say here’s a symptom, let me suppress it. Why is post birth control syndrome so hard? Because 60% of women are on the pill for symptom control instead of preventing pregnancy. Now that is a huge disservice in women’s health.
You tell a young girl your body is talking to you, something’s off, let me just shut it up. And then 10-15 years later she comes off the pill, well what would you do if for 10 years you had something really big important to say? You’d start screaming the second you had a voice. That’s what your body is doing because your body wants you to survive. Your body is very investing in you surviving.
You got prescribed it for acne. I took the pill to prevent pregnancy. But this is what’s really scary to me is that, so I lecture about this to other practitioners, they don’t recognize that 60% of women are on the pill for symptoms. What is the most common? It’s irregular periods. So, oh, I can make your period regular! No, no, you can make my drug withdrawal regular. Let’s be real, let’s call it what it is, not shaming. When we treat symptoms, we acknowledge we’re treating symptoms. When we’re treating root cause, we acknowledge that. It’s important we fully disclose to the patient what we’re doing and why.
With PCOS, it’s the number one, that’s usually the number one thing that gets masked with the pill. But if you’re a woman who has irregular periods and you’re put on the pill, almost as high as 40% of them will never ever have their period come back. They will never ever be fertile again and motherhood was just stolen from them. To me, that is something as a doctor you should be disclosing and it’s actually within our Hippocratic Oath to be disclosing this stuff before we prescribe the pill.
But what’s the problem? Is it that your doctor is withholding information? No, your doctor doesn’t know. If I die in this mission, I will make sure that as many people know about this as possible because there are a lot of women popping this pill without anybody talking to them about what could happen to their body.
Kelsey:Absolutely. It’s depressing hearing it come out of your mouth. I’m like, man, this is terrible. But you’re so fired up about it. It’s great!
Laura: Jolene, something I see in a lot of my patients because I work with a lot of hypothalamic amenorrhea type clients, it amazes me how many of them their doctor’s would be really kind of pushing the pill really hard. It’s one thing to offer it as an option, but I’ve had some clients before who kept emailing being like I don’t know, my doctor really wants me to do it. I’m like just give it a couple months because we’re working on basically like nutritional recovery of hypothalamic amenorrhea caused by under eating, over training kind of situation.
It’s just crazy because it can take several months if not years to see that recover because they’re malnourished for a long time. But it always just drives me nuts when I get these emails from clients that are like my doctor is really pushing me hard and I’m kind of running out of…I don’t know what the word is. Just they don’t feel confident enough to keep saying no. I’m like, no! Just wait, please wait! We haven’t even been doing it that long. You’ll be fine! Then it’s just funny to see a couple months later they’re like, well I got my period. I’m like yeah, see I told you! It’s just crazy.
Dr. Jolene Brighten: Yeah. I’m so happy that you’re doing that work because it’s so true. As we know, our toolkit is vast. I don’t get worried when people are like I’ve tried everything. I’m like, I doubt it because there’s a lot out there. But just to speak to that pressure that comes from doctors…. So what’s going on? What are we getting worried about in hypothalamic amenorrhea? Let me just say, hypothalamic amenorrhea is when your brain isn’t communicating to your ovaries. There’s this mismatch that happened in there.
What’s the worst thing you could do? Shut it down again? That’s what the pill is going to do, it’s going to shut it down again. Basically if you’ve done any work, it doesn’t even matter…because it puts you back to step one.
But where does this come from when patients start to get where they’re like maybe I should just do what my doctor says. This is my perspective. One is if your doctor educated you well enough you would know what the best decision is for you. The doctor is worried because if you don’t have enough estrogen, so after a period of time your bone, your heart, your brain, they’re all going to start degrading. Definitely seen that.
I think patients relinquish their power a little too quickly to doctors. Our clinic, my entire clinic’s motto is we don’t heal our patients, we teach them how to heal themselves because this idea that you should do what your doctor says without question, I’ve been a rebel from day one. I wouldn’t do that. My doctor was like you’re on a PPI for life and I was like, no, I’m going to figure this out, I’m going to do something different. That’s what I want my patients to do as well. If you’re a patient listening to this, this is your body, okay? If you don’t like what your doctor is saying, maybe it is the right answer for you, but I think it’s important that they emailed you and said okay I want you to chime in on this as well.
Something I want to say though and speak to the fact that what if your period is not coming back and you do need hormones? It’s not the pill. If you need hormones, look at bio identical hormones that you can use topically, maybe an oral progesterone. But you have that option. To me whenever we’re going to give something, we want risk to benefit analysis taking place with that. With me sometimes it depends on how long the patient hasn’t had their period for and then I run an N-telopeptide on my patients which is something that looks at bone turnover so I can understand are we losing bone. This is something I run in my peri-menopausal woman too if I’m starting them on thyroid because every endocrinologist and everyone out there freaks out about T3 because they’re just like your doctor is just going to make you lose bone. I’m like we’ll just measure it and we’ll see what happens.
That’s just for ladies who are like well maybe I do need hormones. You can always go with topical bio identical and that’s going to bypass your liver which makes your liver really happy. You want your liver always happy. But you can use a really, really low dose with that. Honestly, in my opinion there’s a million things that come between you….Actually I don’t even think women really need to choose the pill. It doesn’t work. It’s not root cause medicine. It’s going to cause you more trouble in the long run. Just not worth it.
Just super grateful for you ladies doing that work. There’s not enough of us. I think right now there’s not enough of us and we need more of us doing this work so women have a place to go.
Kelsey: Yeah, absolutely. Just a quick recap here. The pill is terrible for pretty much every body system. In case you haven’t gotten that from what Dr. Jolene has been telling us. It really does not serve your body well.
What I’d like to cover now is let’s say a woman is on the pill, she’s got thyroid disease or she’s got some other illness or chronic condition that obviously the pill is not great for. What’s the process to maybe consider coming off of that? How do you support your body before you come off of that? What are the other options out there? What’s your favorite couple recommendations that you educate your patients on as for alternative birth control methods?
Dr. Jolene Brighten: Sure. If you’re listening to this and you’re on the pill right now and you’re freaking out, the first thing to do is get on a prenatal or a multivitamin. Get on some good nutrition or good nutraceutical basically. You’ve got to start taking something like that. But what’s the issue? Your gut might not be absorbing it.
What I’m going to say right now is not sexy, it’s not glamorous, but it’s the tried and true of what works. First thing is you’ve got to dial in your nutrition. You have no option but to be eating a nutrient rich diet. What I’m saying right now, you’ve got to be doing while you’re on the pill and you got to do at least for a month before coming off the pill. You’re going to eat a really nutrient dense diet.
Depending on what’s going on in your gut, you may start your probiotics, you may start fermented foods. I love utilizing all of those things, but if you’ve got SIBO, you’ve going to feel way worse. It can also be a test. If you eat fermented food and you bloat and you feel awful, then you need to test. That’s always what we need to be doing. Even though I’m going to be talking generally, I’m a very big proponent of always testing. We want to know what’s going on. You’re an individual and I like targeted therapies because I like my patients to get better like yesterday instead of 10 years from now. I want you better fast!
Look at eating the fermented, the prebiotics. If you’re someone who’s got constipation, if that’s your issue, the way you’re going to detox the pill, your liver is going to ready it up, it’s going to take all that estrogen, ready it up for excretion, and put it in the gut. If you don’t poop every day, you don’t move your estrogen out. If that’s the case for you, you can utilize things like triphala or magnesium, but I want you to understand that that’s chasing a symptom and that’s treating a symptom. You’ve got to poop though, so you got to poop, but you need to work that up further. If you start taking magnesium, you shouldn’t require magnesium every day to have a bowel movement. If that’s the case, we have a problem there.
I get frustrated because I have too many patients to come to me where practitioners who are like well if you poop everyday with magnesium, just keep taking that. I’m like you shouldn’t be dependent on anything for your body just to work. With caveats being if you don’t have organs anymore, then you’re going to be dependent on things to replace the function. No all or nothing statements there.
The other thing that I like to do is before a woman comes off the pill is I do like to get the nutrient testing. I’m running an organic acid, I’m running inflammatory markers. I’ll actually say that before I would ever put someone on the pill, I would run fibrinogen, I run factors for looking at clotting. I would run your genes, I run your genes to look at your clotting factors. I would run things on inflammatory bowel disease. That’s me, I will be checking everything on that. I actually like to check those things crazy.
I mean the fibrinogen levels, oh let me explain that. Fibrinogen is a marker for clotting. What is the biggest, scariest thing the pill could do? We didn’t even talk about this. Everyone has heard this. Throw a clot, a clot in your brain, a clot in your heart, clot in your legs, a clot in your lungs. It’s not good as you can imagine. What’s something that we can track and measure with that? Well, fibrinogen. I run advanced inflammatory panels. Everybody’s inflamed on the pill. That’s why I’m running these while they’re still on the pill to see this.
They come off and we’re doing things, so we’ve got to work on the inflammation, the gut. We’re doing things like fish oils coming in. We have people making sure, so if you’ve got a thyroid issue, we’re usually aiming for two servings of seafood a week. We’re getting our selenium and our iodine. It’s always the big no-no to just jump on iodine because you have a thyroid condition. That’s one sure way to flood you. I like using the seafood twice a week or even eating kelp with that so we’re really nourishing the thyroid. And then we’re using organ meats as well. Whether that’s if I can get patients doing like bone marrow, beef heart, things like that, again, really nutrient dense foods. Of course I love the bone broth, and the collagen, and all of that for healing the gut.
I’m cautious that if you’re listening to this, I don’t want to tell you like take L-glutamine, take marshmallow, do these things to heal your gut because I really do believe that if you think you need to start going to those higher level supplements that you actually need a provider to work with on that. It’s something because it’s just enough times that patients coming in with grocery bags full of supplements because they listen to someone speak online who said all of these things would be good and they’re like well I didn’t get better. It’s like well you only needed 3 out of 30 of these things and then we need to do it in a very nuanced way.
I just want to be cautious about that because I also don’t want to make it sound like it’s super, super easy either. But what I will say, one thing that we definitely do with all of the ladies is we get them going with turmeric because it’s great definitely for the liver detoxing, great for the gut, great for their brains because our brains definitely go through a loop with all that estrogen. And then we’re feeding them healthy fats. I do an upgraded turmeric latte kind of action where I’m putting MCT oil in there, and grass fed butter, and I use collagen as well. We’re just doing this kind of upgraded beverage that they’re drinking everyday because we need those healthy fats for our brain but also so that you start making your hormones. Your brain shut you down from making your own hormones.
I mean the pill makes a lot of us gain weight and so a lot of ladies are still on the fat free bandwagon. But please, please, please, if you’re thinking about coming off the pill and you want to make your own hormones, get those healthy fats in. That’s another really big focus. But of course, you’ve got to be absorbing them. So much comes down to the gut.
Once you come off the pill, once you’re coming off of that, depending on where a woman’s at, we might do things like tinctures, or seed cycling, and all those kinds of things. But we’re definitely supporting liver detox because we want all of those fake hormones out of your body as soon as possible. I want to speak to this point. I’m speaking a lot about nutrition. I told you it wasn’t going to be the big sexy stuff because it’s really the foundational stuff. For a lot of women they’re going to need to go beyond that. But I want to be really clear that if you are not doing the foundations, it doesn’t matter how many supplements you take. It doesn’t matter if you take a medication. No medication or supplement can undo an unhealthy diet and lifestyle.
Dr. Laura Brighten: You absolutely have to start there. As women come off the pill, that’s where we’re going to support the liver and we’re going to support phase one and phase two liver detox. I just want to say I can see benefits of juice cleanses. There’s a time and a place for these. I’m really not a huge fan because you can become a metabolic obscenity. That’s what I call those things where I’m like you literally just cussed out your body with what you did. A lot of people with thyroid issues, adrenal issues, hormone issues, they need to keep their blood sugar controlled tightly.
But what I want to say is that if you’re not eating high quality protein that you’re absorbing every day, you’re not running phase two liver detox. Let me explain why this is important. Your liver has two phases of detox. Phase one packages up, get it ready to go. Those are actually more toxic intermediates. The toxins have now been made more toxic basically and then you have to push it into phase two.
This is where people get sick on “liver detoxes,” I’m doing little air quotes right now, is because they do things that push off phase one. It’s like “I love Lucy” in the chocolate factory. The answer isn’t to speed up phase one. The answer is to take care of the bowels in phase two otherwise you’re stuffing the chocolates everywhere. It’s not a good scene.
Dr. Jolene Brighten: What does phase two really rely on? A lot of amino acids. This is something where you absolutely, it’s non-negotiable, you have to be eating high quality proteins. I would say, I was a vegetarian for 10 years. I am not anti-vegan or vegetarianism. They absolutely have a harder time though detoxing and coming off the pill. We’ve been tracking this and I can say it that I’ve seen it enough times.
We definitely respect people where they’re at. But at the minimum if you’re a vegan or vegetarian, I really encourage you to try at least getting collagen in to get those amino acids. And let me say this, that if you don’t eat animals because you don’t want to support the husbandry practices or you want to look out for the planet, let me say this, when you consume the end product, so collagen being from the hide of a grass fed animal, that life was sacrificed as it was. You actually help close the loop in fully honoring and utilizing that animal and showing it a lot of respect. You put your dollar vote to vote towards the farmers who love their animals, who take care of their animals, and who take care of the planet and are looking out for that.
I just want to say that because there can be a lot of guilt around giving your body actually what it needs. But please understand that if you actually, you’re buying bone broth, you are really honoring the process of a really high quality animal and the respect of nature. That dollar vote helps our planet tremendously. I just want to make that really clear.
Kelsey: I love that perspective!
Dr. Jolene Brighten: Good! I’m glad that you do. I mean I don’t want to be disrespectful. Again I was a vegetarian for 10 years and so I definitely understand that it’s an identity in a lot of ways. A lot of people come to that with a lot of morals and conviction. I want to honor and respect that and help them see that actually we can all work together.
What would Native American’s do? How did they live? When they took an animal’s life, they honored that animal’s life and they used the entire animal. I belong to the Cherokee Nation in Oklahoma.
Dr. Jolene Brighten: Actually, I’m part Native American and so I think a lot about these things. That’s something I really feel like it’s one way to give yourself permission to heal yourself. It doesn’t mean you’ll need it forever, but you give permission and at the same time you honor your mission and you actually help all of us change the way things are being done to our planet right now.
Kelsey: Love it, love it! I mean I think that’s a really needed sentiment for a lot of people out there who think about meat that way and just feel guilt surrounding that. I love what you have to say about that.
Dr. Jolene Brighten: Thank you!
Kelsey: We talked about this process of preparing your body for coming off the pill which is to support your different body systems through a nutritious diet, maybe some supplementation. I would add here and I’m sure you would agree, focus a lot on stress management as well. And then of course like you mentioned, diving deeper into the gut if there might be any issues there. Then you come off the pill and we’ve kind of touched on the topic of post birth control syndrome. I just want to talk about maybe you could enlighten our listeners who aren’t super familiar with that just some of the symptoms that they might experience after coming off the pill and when they can expect to maybe feel better from those symptoms that are not a lot of fun.
Dr. Jolene Brighten: Post birth control syndrome, I kind of giggled about this the other day that I was like post birth control syndrome is like the new leaky gut, the new adrenal fatigue. I’ve been in this arena long enough to remember when anyone who said leaky gut was called a quack. It always makes me giggle because I’m like you know you guys were still discovering anatomical structures in the human body that we’ve been dissecting forever. So many we should just honor and respect that we don’t know everything and that’s okay.
Dr. Jolene Brighten: This is one that not a lot of people have heard of, but it’s very real. I appreciate you actually asking this because it’s going to validate a lot of women who are like oh my gosh, I thought this was in my head! We see post birth control syndrome, the symptoms that I’m going to go into, they usually arise within the first four to six months of coming off the pill. They can be immediate. I just had a patient just last week that it was like she came off the pill and then immediately it was not a good scene for her. I will say the caveat is that she should be post-menopausal but her doctors were keeping her strung out on the pill for a long time. Women listening to this, if you’re still having your period and you’re 56 and you’re on the pill, it’s really time, you got to get off.
Let me go back. Four to six months, these are the symptoms that usually pop up. We already talked about amenorrhea, so women may not have their periods come back. Conventionally speaking, the rule is that if your cycles were regular before the pill, then after three months of no cycles, we should test. If your cycle was irregular, then it’s like okay well that could be four to six months later then we would test. I disagree. I think by month two if it’s not coming back, let’s start the testing process. As you know but your listeners might not know, is that tests can take about two to four weeks to turn around the results. For me I’m like we don’t waste any time.
There’s the amenorrhea, or a loss of menstruation. Or on the flipside, your periods might come back with a vengeance. You might have really heavy, painful periods. Or you might have what is a luteal phase defect which is your cycles are really short so your period is coming every two to three weeks. You don’t have enough progesterone going on. Of course infertility is another symptom of that. Hypothyroidism, there can be a transient hypothyroidism that I see in women being on the pill and coming off of it. It’s something that I’ve actually seen resolve with coming off the pill. Acne for sure.
Dr. Jolene Brighten: Acne and then fluctuations in weight. The body composition can change. Breasts can be bigger, breasts can get smaller. Your butt might get bigger, your butt might get smaller. It just all depends on the hormones which is again why you need a hormone expert in this business. Because when patients start telling me symptoms, I’m like I know exactly what hormones we’re talking about and then I’m going to them them and make sure. Migraine headaches, any kind of pain syndrome starting to come on, depression, anxiety, mood swings, irritability, anger, and changes in the bowels as well. Because if the pill’s been disrupting your microbiome and offending your gut basically and you come off of it, your gut is going to start trying to restore itself. I’m telling you you’re going to need a lot more support.
And then any kind of inflammatory or immune changes and immune imbalances. Usually the trend with the pill is you come off the pill and the inflammation starts to come down. But I have seen women with autoimmune disease as they’re coming off of it, this is something I learned many years ago and we protect against this now, is that the autoimmune disease there can be like a transient flare moment. I’ll tell you the canary in the coal mine, what tells me and most of my patients it’s coming is they start getting flu-like symptoms. They think they’re getting a cold after coming off the pill.
If that is you, you need to get some fish oil, probably probiotics, get your vitamin D checked and look at that. Those are three players we know that can start balancing your immune system right away. But if you can’t get your vitamin D checked in time, let me tell you, what is a vitamin D deficiency? It’s a nature deficiency. Why all of a sudden do we see humans having all these vitamin D deficiencies? Because we never go outside.
Dr. Jolene Brighten: The root cause solution is get your butt outdoors! Start moving your body. Go out there and spend some time in the sun because as you said, that stress reduction piece is really important. So two for one there. You can go outside in the sun, walk, move around, and you’ll be amazed if you can do 10 minutes of that how much happier and even keel you’re going to be throughout the day.
Does that make sense? Those are some of the symptoms that we see. Like I said, you can have all or none…or excuse me, all or one, not none, that makes no sense…one of these symptoms. It’s important, there’s not a whole lot of us practitioners out there. I’ve been reaching out to who else is doing this work. I’m getting a lot of people reaching out to me. We’re not at a place where a lot of people are super savvy in the knowledge about this. I’ve been developing protocols around this for the last five years.
Let me just say ironically when I went into practice I was like I don’t ever want to deal with birth control, I don’t want to be prescribing that and dealing with it. And it’s hilarious now because what is one of the most common denominators of all of our patients? I’m sure it’s true for you. They’ve touched that pill in some point in their lives. We see all of these fallouts that I’m like there’s no way it didn’t play a role. There is no way it didn’t play a role.
Kelsey: It’s so interesting too because in the scheme of things sort of this new thing, like there hasn’t really been a generation of women that have been on the pill for 10 or 15 years and we’re just now starting to deal with those women who have had that happen to them.
Dr. Jolene Brighten: Yeah, I mean that was me. I was on the pill for 10 years and then I came off it. Once upon a time, you never did the pill. The research is like more than 10 years you have risk. You know what else I want to say? If you’re a woman listing to this and you’re over the 35, you’re at a much higher risk of having a stroke or an adverse event from that birth control pill. If you’re a woman over 35 and you’re smoking, oh my goodness! That is super dangerous behavior to be engaging in. If you’re a woman has migraines with auras, you are at a really high risk for stroke as well. What is the pill usually prescribed for? Oh you’re having hormonal headaches? Let’s just go ahead and give you the pill.
This has been well documented in the research forever I feel like for like since the first time I ever started reading research papers, which is dating myself a little bit. But it’s been in there, it’s been in the research for a long time. But you know what? Doctors in a seven minute visit can’t give you the time to talk to you about that. That’s why you, and me, and Laura, we’ve got to go out there and talk about this.
Dr. Jolene Brighten: When we see change in medicine, for everyone listening, practitioners, we can say all that we want. We don’t make the changes. It’s the patients demanding their doctors to do better that makes the changes. If you’re listening to this and you’ve felt disempowered in any way around the birth control pill, know that you are the catalyst for change. We’re out here, this podcast is fantastic. We’re out here educating your listeners, but it’s going to be your listeners who mobilize. It’s going to be these women who are like I deserve better than this. You know what ladies? We do deserve better than this in women’s medicine. It’s going to be them demanding better of their doctors that we’re going to change this. I tell you in my lifetime, we’re going to change this. It’s not going to be me who changes it, it’s going to be the women I educated and empowered for them to have a voice to speak for themselves.
Kelsey: Absolutely. Amen! I love that!
Dr. Jolene Brighten: I didn’t answer your question about what are the alternative forms of birth control.
Kelsey: Oh yeah! We got so fired up about all these topics.
Dr. Jolene Brighten: As you can tell, I’m all about the sisterhood and that’s looking out for each other because I think the moment women wake up and see that if we all work together, oh my goodness! The world will change, it will change.
Dr. Jolene Brighten: Here’s the deal, alternatives to the pill. Now again I’m going to say it, you’re the only person living in your body. You’re the only person that can make this decision. I don’t make medical decisions for my patient. It’s my job to educate them. You lay it all out basically like here’s the menu and let’s go through what you might want to select. We’ve got food sensitivities, you’re going to go and you’re going to ask your waiter or waitress a million questions about the menu. That’s what I do. I present it in that way. I’m like let’s go, ask me all the questions.
I’ll say that predominately within my practice that women go with is actually the fertility awareness method. And then they’re using technology they’re leveraging technology which is super rad that we can do this. I don’t know about you, but I love Taking Charge Of Your Fertility. I think it’s a great book.
Kelsey: So good!
Dr. Jolene Brighten: But I will never chart, I will never chart.
Kelsey: I’m too lazy.
Dr. Jolene Brighten: And then there’s systems where you could put that in. I wouldn’t do that. Oh my gosh, ladies, I was the worst about tracking a period until we had apps. But, your period, it’s the fifth vital sign says ACOG. All the big heads of gynecology said that your period is so important that we should evaluate it along your temperature, along your blood pressure, all of that. Keep that in mind. Why are we giving women the pill? When we give them the pill, we miss out on data that’s crucial.
Why do my patients choose the fertility awareness method? Daysy is the predominant one that my patients select because you pop it into your tongue and within seconds you’re done. And then there’s a light and you’re like okay, I can have sex unprotected or not. Why they choose the fertility awareness method is because I teach my women in their practice how to be their own hormone detective. I give them the data point. My patients are awesome like this. We joke that we have our own little lab and they’re tracking all of their data.
There’s certain points in their cycle I want them tracking. I come from a big research background so I’m not like I want you to look out for x,y,z because I don’t ever just want to just basically assert the outcome I want to see. I just want you to tell me day 10, around 10, how are you feeling? Around day 14, how are you feeling? What’s going on? My patients will use fertility awareness method because it helps them get really dialed into their own body.
Once they’re dialed into that, my patients have started to notice…I have a lot of Cross Fitters in my practice. And you know that’s an intense exercise and for some women especially I’ll say if you’ve ever been on the pill, I have seen that hypothalamic/pituitary/ovarian axis is much more sensitive to stressors. It’s more fragile is what I call it. I’ve had women that actually will compete at Cross Fit, like some women are like day 7 to 10, like early in their cycle and they’re ovulation is delayed. They see what that stress has actually done to change their body. It doesn’t mean you should never do Cross Fit or ever do that, but isn’t that really interesting to know about how your exercise is affecting their body?
Dr. Jolene Brighten: I’ll say it feels like women at first are like, I don’t know, it feels really labor intensive, or does it work? That’s always the question. I actually have an entire article written on this because I just was so sick of MDs telling my patients that they were either too stupid, too lazy to do this, and it didn’t work. I’m like, no.
What we know about the fertility awareness method is that there was actually a study that showed that when the fertility awareness method was used the way that it should be…so this is important, we can’t talk about all this, you need a fertility awareness coach or someone like me or yourselves that can teach you how to do this. If women are taught, this is the difference, if the doctor teaches the woman, she’s very, very successful in this….Everybody thinks that birth control has these really high efficacy rates, like it really, really works. But actually with the level of education doctors are doing and how much women understand it, and because it makes most women feel so sick, it’s actually not as effective. Actually fertility awareness method, really it rivals it.
There was study that showed that for pregnancy there was 0.6 pregnancies per 100 women per 13 cycles. What does that mean? Over a year they tracked them and less than one women out of 100 got pregnant using unprotected sex the entire time. They were using unprotected sex outside the fertile window and then during the fertile window they said they either abstained or there was no unprotected.
I don’t believe in abstinence because evolutionary speaking, your body won’t allow it. Your body will drive you to breed. The reason why I say I don’t believe in abstinence, let me explain this what happens in the physiology. On about day 10 you spike your testosterone. We all know like testosterone does a lot, but we all know the first place our minds go, we’re like woo-hoo! Libido! Libido spikes around day 10 so that you really want to have intercourse. Then what you do is you capture the sperm. Yes, you capture the sperm and it lives in your body for about 5 to 6 days. Guess what comes 5 to 6 days later? An egg!
On the day you’re most inclined to want to have sex, that drive can overcome even your best of willpower I will tell you especially if you’re in a monogamous relationship because they’re right there next to you. That’s why I say I don’t believe in doing the abstinence part. That’s when I’m like use a condom, use a condom. Nobody likes condoms, I know that. But if you don’t want a baby, I think it’s a small sacrifice. From someone who has a baby I’m going tell you if you don’t want a baby, you just use that condom because that’s way less work.
The other thing some of my patients, most of my patients don’t want to use any hormones because they’re having a lot of issues with their hormones. I say that because Mirena IUD is always the reflex. If you don’t want to do the pill, the doctor is like do the Mirena IUD. Here’s what I’m going to say is that all of this birth control stuff, all of these birth control methods, we get dismissed left and right as women. If you go online, and this is what I think, if there enough women are telling me they place the Mirena IUD and then they were manic or they had anxiety, I see those are the two predominant things, and then they have it removed and they’re fine. I’ve seen this so many times. There are support groups out there everywhere of like hundreds of thousands of women saying this. But everybody in medicine, everyone in science is saying it’s not possible. I am saying it’s not possible that this many women say this and something’s not going on.
Dr. Jolene Brighten: To me I don’t know enough about that. What I’ll also say is that they just released a new one, Skyla, it’s a new IUD that’s hormonal. I got really upset about this because, you can tell I get upset around a lot of things on this subject. I got upset about this because they just pulled the male birth control study. The men have lower incidence of reporting depression than women do, but women, we get dismissed anytime…we had a million women in this study and they still dismissed us that we were having depression. But in a male study, less than 5% of men are depressed and they pull the study. In the same quarter they released Skyla which is throwing 20 something percent depression rates in women.
Dr. Jolene Brighten: And they’re not dismissing that. I got really upset about that because I have a whole article about medical gender bias because that’s exactly what it is. The burden of not getting pregnant will always fall on us, ladies. It will always fall on us. The pharmaceutical companies are not very motivated to improve upon this because no matter what, they’ve got us as a customer. They’re got us. I get it.
Let’s just acknowledge too that since the introduction of the pill, we made more money, we’ve graduated college at higher rates, it has absolutely helped us propel ourselves as women. But it came at a cost. There’s a price there. This is not just shame, don’t feel guilty if you ever took the pill. I took the pill and I’m not staying up all night over it. You learn better, you do better. That’s what we do. Nobody has ever healed their body by hanging out in their past and trying to heal that. You don’t go and harp on that. We’re right now in present time. We have the past data, that’s good to know. What can you do right now in present time? And that’s where we focus.
Kelsey: This has been an awesome episode I have to say! I’m fired up now. I want to go dig into all this research too. I think everything that you said throughout this episode is so important for women to hear. And especially of course if you’ve got any other type of chronic illness going on, you really need to take a look at your hormones, especially so if you are on the pill or you have been on the pill and you never really necessarily recovered fully from being on the pill because you didn’t know it maybe had such a damaging effect. There are alternatives as you’ve discussed and there’s a way to come off the pill in a way that’s going to support your body as much as possible and get you on that road to healing as fast as possible, which is really important to everybody.
Dr. Jolene Brighten: Yes!
Kelsey: We’re going to have to have you back on again sometime I think because seriously I could talk to you forever about this stuff. I think we’ve given women listening a place to start and that’s really important. We’ve educated them on what the pill does, how it affects your body, and why you might want to consider alternatives.
What I appreciate about your perspective is that you support the women themselves. It’s not like you’ve decided that the pill is bad and so you’re telling your patients don’t go on the pill. You’re supporting their education around their own body and their own health and then like you said, laying out the menu for them and then talking though every question that they have so they can make the right decision for themselves.
Dr. Jolene Brighten: Yeah. At the end of the day, it’s really the patient who should be in charge of their health. The way I see it is that I’m just more of the trail guide. It’s not me who takes the steps. That’s why in my practice I’m like we really have to honor the work the patient is doing because when we get to the end of healing journey, did I take all of those steps? No. I just showed them the way. They did it. We need to honor them in all of that.
I feel really sensitive about talking about this subject that I don’t ever want a women to feel like she’s being judged in this. If you’re making what you feel is the best decision for your body, then I just want to support you in that because I can’t possibly know what’s best for you. I don’t live in your body. That’s why I’m also cautious of I don’t say what my favorite birth control is because I don’t want you to be like, oh I just did this because Dr. Brighten’s favorite. Who cares what I think? All that matters is what you think.
In my clinic, we’re all about strengthening and empowering women. Our name is Rubus Health, and for those of you that don’t know, Rubus idaeus is red raspberry leaf which is the herb that we use to strengthen and support the womb space. That’s how we see ourselves is that we’re here to strengthen and support women overall because truly for every women’s life that we effect and we help her elevate, she creates a ripple effect and she goes out and she changes her community and it’s a beautiful thing to see.
Kelsey: Amazing! If people want to learn more about you, your practice, everything you’ve got going on, where can they find you?
Dr. Jolene Brighten: You can find me at DrBrighten.com. The names a little tricky but DrBrighten, so brighten like the sun. You can find me there. I definitely have way more information on this topic. If you’re wanting to do a deep dive I’ve also got lots of information there for you to go check out. And then of course you can always hit me up on my Facebook page. That’s where I tend to answer the most questions in the comment sections of things that I post there. You can always hit me up there and I’m happy to answer any questions that you might have regarding this episode because I know there’s a whole lot we couldn’t even cover in this time. I’m grateful for the time that we did get together and what we’ve been able to do in this time to set women up for success with this.
Kelsey: Absolutely. We’ll link to that in the show notes. I just want to thank you for taking the time out of your day to do this interview. Like I said, I think it’s going to help so many women to just be educated on this whole topic. I got some education too, which is always fun on a podcast.
Dr. Jolene Brighten: Awesome! You all asked great, great questions. Most people I get on with, they have no idea what I’m talking about and so they’re like wait, wait. And it’s great because we give the really basic stuff. Your questions, I just want to say that I loved this interview because you let me go on that deeper level which is where I really like to go. I just really appreciate how you really got in there and got deep and you brought out things that I think are really going to help so many women. Thank you for just being an amazing interviewer!
Kelsey: Thank you!
Dr. Jolene Brighten: And inviting me to be on here because I just love you guys! You guys are doing amazing work in this world.
Kelsey: Thank you so much, and you are as well. Thanks so much Dr. Brighten and we will hopefully have you on another time! Take care.
Dr. Jolene Brighten: Take care.