ketogenic

Dr. Cates: Welcome to The Spa Dr. Podcast. I’m Dr Trevor Cates. On today’s podcast we’re discussing healthy hormone balance, so many women have symptoms they don’t even realize are related to their hormones. Shifts in hormones start occurring in our thirties that lead to changes in our skin, cycle, mood and sleep, and so much more often women are misdiagnosed or prescribed unnecessary medications. So I asked my guest today to come on the podcast to talk about an important conversation around hormones. My guest is Dr Anna Cabeca. She’s an internationally acclaimed menopause and sexual health expert, global speaker and pioneering promoter of women’s health. She is triple board certified in gynecology and obstetrics, integrative medicine and anti aging and regenerative medicine and she’s author of The Hormone Fix a diet and holistic lifestyle program for menopausal women. Her areas of expertise include bioidentical hormone treatments and natural hormone balancing strategies and she has received extensive notoriety for her virtual transformation programs. On today’s podcast, Dr Anna explains how women’s hormones start changing and our thirties and through menopause and how these changes create symptoms and she shares how to reclaim optimal health and have a healthy transition through menopause and beyond. We discuss bioidentical hormones, diet and other lifestyle practices, all that play a role. So please enjoy this interview

Dr. Cates: Anna, it’s so great to have you on my podcast. Welcome.

Dr. Cabeca: Thank you for having me Trevor. Always great to chat with you.

Dr. Cates: Yeah, absolutely. And so today we’re talking about hormones, which is always a hot topic on The Spa Dr. Podcast and literally can cause hot flashes, so literally a hot topic. I know that a lot of times with women think about perimenopause, menopause, the main thing they think about is, is hot flashes, night sweats. But there’s so many other symptoms that women have around this transition. And so a lot of people are given any depressants or sleep meds are different things when they’re not actually realizing that hormones are a big part of these symptoms. So, but can you give us the full list of what are all the symptoms?

Dr. Cabeca: Yeah, yeah. And it’s a, it’s a surprising my long list and it really, some of the things that are associated with hormones, you know, the imbalances or the regularities in the perimenopause and menopause, I mean even early on are surprising. So something like hot, you know, we know hot flashes, but heart palpitations, heart palpitations, that’s your, you know, that drives fear until woman takes us to the Er, to the emergency room, we end up on a Beta blocker, which increases insulin resistance and hyperglycemia. And it really, we just needed maybe some progesterone. We needed to detox, we needed to really optimize our nutrition and lifestyle component. So heart palpitations, a surprising one. But it’s very often we see this in this perimenopause time period. So that’s one. And another one that we don’t think about associated with our hormones is restless leg syndrome. You know, we know insomnia, right? We’re like, Oh man, I can’t sleep. It’s stress. It’s this that and The other thing, it’s also deficient progesterone. There are progesterone receptors in our fashion and when are our facia starts to become, as we age, we lose the elasticity in our fashion. We worry about that as we get lines around our hopefully laugh lines and smile lines and we have these wrinkles show up. But we also know that we get the sagging of the muscles under the arm. We get the relaxation of the pelvic floor leading to incontinence and other symptom, um, hormonally. Also partly hormonal and then the restless leg syndrome, just that irritation and the rest in the leg. So hormonal and nutrient issues are associated with that. And many women start to experience that in the perimenopause and postmenopause. But early on in our mid thirties, as we start to, as our hormones start to decline, progesterone declines first. And associated with that, we get progesterone deficiency symptoms, sometimes also called estrogen dominant symptoms. And what that feels like is irritability, pms, mood swings, um, you know, irritation. It can feel like we can also experience things like, uh, irregular bleeding, discomfort with our menstrual cycle, more pain, ovarian cyst. breakthrough bleeding with our periods are heavier beer, heavier and more painful bleeding with our periods and that typically takes us to the gynecologist. So I would see a client at that time at this stage of the life in their early thirties already showing signs of hormonal insufficiency. But what happens, they get put on a prescription of a selective Serotonin reuptake inhibitor called an Ssri for short or when of the new generation ones, but you know, good old friend Prozac. Zolaf, Selectsa any of those. And then birth control pills because that won’t cover off all the symptoms. One thing just I would like to say is we’re getting really technical but to bring reality back into it when you’re feeling these symptoms, I always tell clients, if you only hate your husband two weeks out of the month, it’s your hormones and not necessarily your husband. We’ve got to get the hormone. So hating your hormone or being really angry and irritable, kind of like that discontent. That is physiology. We have to understand there’s a lot of that that is physiology as pet, especially, particularly if it’s only two weeks out of the month. Right.

Dr. Cates: Absolutely. And I’m so glad there are a couple of things I want to highlight that you’re talking about. What is the age? Because what you’re talking about is, um, symptoms starting in your thirties because when we say menopause or even perimenopause, a lot of times women think, oh, I don’t have to worry about that until I’m 50 or maybe my late forties but really symptoms can start as early as thirties is, is that beginning of change? It doesn’t mean you’re going through menopause, it’s just that’s what our hormones start to shift. And for some way it, you know, there’s a genetic factor. Sometimes it’s different lifestyle factors as to when, how early those symptoms start for some women they don’t have that. But it does happen a lot. And, and like you said, one of the first things that I, at least I see in my practice is, is relationship issues sometimes with kids and husbands. And I don’t know why. I’m just so irritable and, and I snap so easily and I’m not sleeping at night. And, and uh, and, and that could be the first thing. And, and they’ve been to other doctors, like you said, that puts them on antidepressants, but the monthly meds and then we realize it’s hormones and doing some simple things can help restore a healthy household.

Dr. Cabeca: Absolutely. Absolutely. And I think just these early signs, early signs of hormone imbalance, if we had trouble with our periods as a kid even, it’s going to say, okay, well you’re at risk for having more difficult time with the menopausal symptoms. But all it just says, okay, we need to empower our body with the right, you know, the right ingredients. So we have to do the right next steps to create the seamless transition. And I’ve seen it created in, you know, like these generational issues, right? Hereditary issues with, with menstrual periods, et cetera. And, and one thing I’ll tell you a story about a client that came to me and her name was Zoe and she was 37 years old and she came to my office. She was a busy mom. She had four children. She was doing Carpool, doing the bookkeeping for her husband’s business and volunteering and so many ways. And she came to my office and she said, Doctor Anna, I am just so irritable. I just make it through the day. I feel like I don’t, I don’t want to play with my kids anymore. I don’t. I’m aggravated at my husband. I’m resentful. I just don’t feel good. I don’t have the energy and I’m exhausted, but I can’t sleep. And, and so I said, okay, well there’s a few things that we can do. I’m going to check your lab work while I’m waiting for those results to come back and let me put you through, you know, essentially what’s now called my keto green program. Let me put you through like a nutritional detoxification program and just 21 days, just 21 days. And so I put her on a modified elimination diet. And then you talk about this a lot, especially functional medicine. So the modified elimination diet, high alkalinizing diet and low carbohydrate, no artificial, no sugar, and no white, what do I call it? No White, no wheat, no sweet and very little red meat diet. Right. So, so she did that and she came back and some nutrients. I put her on magnesium and then some bioidentical progesterone and just because I could right. And so she came back and for her follow up in six weeks to go over her labs and she said, I am a new woman. Oh my gosh, I feel better. I have my willpower back, have my energy. And she says, Dr Anna, my daughter came up to me, my six year old came up to me yesterday and just gave me the biggest hug. And she goes, mommy, you’re smiling again. It brings tears to my eyes when I think about it at him. Yeah.

Dr. Cates: Yeah. Impacts the whole like, yeah, I just get your, yeah. Cause I, I’ve heard it so much in my practice and I, and I, and it’s so great to see that, to see that impact that you can have. So I love this idea of the Diet too, that there actually are foods that you should eat, things that you could do with your lifestyle to balance hormones. And I think a lot of times people, they think, oh, I’ve got to go on birth control pills, or I’ve got to go on hormone therapy, which nobody, identical hormones are a powerful tool. Uh, birth control pills, not so much for this. Um, so, uh, if anybody wants more information on that, check out the podcast. My podcast guests, Dr Jolene brighten. I was talks about birth control, post birth control syndrome. Um, but we’re going to talk about alternatives to that. And that is the power of foods. So explain what you’ve discovered with when people’s diets is. This was one example. What have you done?

Dr. Cabeca: Well, first of all, that it takes more than hormones to fix your hormones, right? We know that if that was the case, everyone on if it, if it was the case that just hormones would fix it, then everyone on thyroid meds would be thin and energetic. Well, we know that’s not the case, right? So it takes more than hormones to fix our hormones. And that’s one thing that I recognize. But what does it take for you as the individual? And this is where diets and sometimes we focus on the food so much, but we recognize that diets fail. And I would say it’s a four letter word with the word die in it. How can that ever be a good thing? And, uh, and but that’s really shocking. Shocking numbers. 99% of diets fail. We’d never tried just one diet. I mean, I’ve, I know that I’ve tried at least 10 or so, so it wasn’t to uncovering the food that works for us is the food we should did eat. So how do we know? So we know that we stay, wait, you know, from food sensitivities and certain symptoms that arise from food sensitivities, all the inflammatory symptoms, allergy symptoms, diseases and weight gain or weight loss resistance from food sensitivity. So one thing that I do with my clients and now I’ve worked with thousands of women, menopausal and beyond and as well as in the early menopause, I think 30’s on and um, have them, I have them test their urine, Trevor. Now this is so controversial because I have my client’s check, their urine Ph. But let me tell you, when you do it and you figure out what’s working for you versus what doesn’t work for you, that makes the difference. So for example, we know and we talk about this in functional medicine, we want to see an alkaline urinary Ph, totally different than blood Ph, blood ph. We’re talking about arterial blood gases that we do in emergen situations. Our body is, is, is just programmed to keep that number so exact and it will rob Peter to pay Paul in order to do that because we are slightly alkaline at 7.4. So where do we get that from? Minerals with? We’re not, if we’re very acidic, we’re going to be robbing the nutrients from our bones. So that’s why we see women in their thirties with osteoporosis, highly acidic diet, highly acidic lifestyle. Those things affect us. But our, again, our blood ph isn’t changing, but on a daily basis we can check our urinary Ph to see what foods are working for us. Are they alkalinizing us? Are they creating inflammation? We need both. We need acidic foods and alkaline foods, but we need predominantly to regulate our body with food and lifestyle that empowers an alkaline urinary Ph. So by that, by saying that it empowers our optimal health and empowers hormone balance and empowers a body low in blood sugar and low in inflammation. And that’s really key because when we’re, um, so that’s what I, when I look at food choices and I talk about my Keto Green, this is low carbohydrate but highly alkalinizing nutrition plan. And in my book, The Hormone Fix I put in a 10 day quick start, Keto Green detox as well as a 21 day menu plan because it’s part of it, right? It’s a part of it that we can tangibly look at and say, okay, well what are some guidelines for this nourishment? So it’s very simple. It’s fat, healthy fats like avocado, like olive oil, like salmon and oysters, you know, it’s healthy fats. It’s a healthy protein and not a lot too much protein will kick us out of Ketosis. So, and we don’t need so much as women, especially as we’re aging, we need healthy protein, but not, not, we’re not men size proteins, right? We don’t need that. Um, and so we also need healthy fat, healthy protein. We need fresh greens, we need low carbohydrate, fresh alkalizing Greens. So if we think right there just those three things on our plate on a daily basis. And so the Greens being a selection of low carb vegetables, I love the cruciferous specials, the leafy Greens. I’m in the south, so we’ve got tons of collards and chard and you know, kale and just name it. It’s really, so adding those very low carb beet Greens. My absolutely favorite alkalinizing vegetable or the Greens from the beet leaf, the beat. Maybe just a sliver you can you because they’re high in sugar and they’re so good for you, but don’t eat a lot of, I’m a little bit goes a long way, but definitely eat the beet greens and that’s like magic. And then the fourth just add in there is extra fiber because we are going to get some from our greens, but we really need to make sure that we’re having regular bowel movements, especially for clear skin and especially for estrogen detoxification. We cannot afford to let estrogens reabsorb into our system. We have to have healthy elimination for healthy estrogen detoxification. And that’s pretty cool. So fiber and the, for me it’s like making a great great Keto Green smoothie in the morning, adding in some Chia seeds and flax seeds, some nuts and seeds. And that combination can be very, very beneficial. So if we think of this as four components, we’re really creating a healthy lifestyle and hormone balancing menu plan. But unless I’m checking, I really don’t know if it’s working for me. So I’m really big on test don’t guess. And that has helped so many of my clients fine tune the personalization of their lifestyle and nutrition plan so that they can be better armed when things go awry.

Dr. Cates: And so how did you come to the awareness that this was so important for your patients?

Dr. Cabeca: Well, I tell you, I mean, you know, I went through menopause when I was 38 and I was diagnosed with premature ovarian failure, early menopause, and told I was completely and irreversibly infertile, which was devastating news to me and my husband at the time. And so we were just devastated. So that took me on my healing journey around the world. So from that I really dug into functional medicine and healing. I guess I would say I don’t discriminate on healing modalities if they work. So I really learned that. And, and Lo and behold, I reversed my infertility. I reversed my menopause and I had my daughter Ava Marie when I was 41 so now I’m 52 with a 10 year old, which, you know, you just have to have good cognition. So when I went through menopause again at 48, I, um, I really was experiencing what so many women have experienced before that they’ve told me they would, I have patients come to my practice as they hit their 50s or hit this menopausal time period and they’d say, talked her Anna, I’m gaining weight and I’m not doing anything different. I’m like, Oh, you’re 20 pounds higher. Surely you’re doing something different, you’re eating more, you’re not exercising more. What are you doing? Like I swear Doctor Anna I’m not doing anything different. And then Lo and behold, 48 I was gaining five, 10, 20 pounds and I was not doing anything different. So, you know, having to eat my own words and, and, and Lo and behold, I was, wait, I need to maybe give, revisit Keto, cause I’ve been aware of the literature and Ketogenic diets for my Parkinson’s patients, epileptic patients and the, and just for weight loss and the list goes on. But every time I, or put a client on a perimenopausal client on a carbohydrate restricted diet, they would have irritability, mood swings, agitation, just didn’t feel good would hit a wall essentially. And for me, I called it keto crazy. So I’m like, I can’t go key to crazy. This cannot be good for the menopausal woman or the perimenopausal woman. And so, but hence I had gained that 20 pounds. I try to figure it out. So I started checking my urine and every time I restricted carbs, I would be very acidic with my urinary testing. So urine Ph less than seven. And in fact it was five persistently. I’m like, no wonder I’m irritated. No wonder, right? Like my body is really struggling to maintain, uh, you know, a healthy, probably just a healthy internal physiology. We talk about cell membrane exchange when we get into the biochemistry of it. So I was like, okay, well let me really focus on the alkaline foods. So I added more of my Greens, my mighty alkaline Greens. I added Beet Greens, just looked at all the low carb alkalinizing options. And started tailoring that and I got alkaline with my alkaline, your in your Ph then push my body into ketosis. So I call that getting Keto alkaline or keto Green and you have this combination and not only does the weight started coming off but you feel clearer. Brain fog lifts my memory clarified it. And as a mom and that this point single mom of four children, I was, you know like you cannot have a foggy brain. You cannot be exhausted because the kids will take advantage of you. I don’t know about you or anyone listening how your kids are, but mine were like, Oh yeah this is the time to ask mom for what we want.

Dr. Cates: So, okay, so with the testing, what, so where, what exactly should people be testing? What numbers should they be looking for at it? How do they know?

Dr. Cabeca: Yeah, so one thing is is to test urinary Ph. So you can just get from the pharmacy or health food store, just Ph test strips and there’s all different kinds. They have different scales. Do you want to just always measure on the scale on the bottle? And I created Keto Ph strips. So it measures Ph and also urinary ketone. Now there’s benefits to urinary ketones, the blood ketone testing, is certainly the gold standard. But for daily basis, especially when you’re checking all throughout the day, it’s very economical, really cost pennies to measure urinary key terms. So keytone and urinary Ph testing. So first check your, your new Ph. You want it to be above seven when you wake up in the morning. And ideally when you go to bed at night, it will naturally turn acidic. Uh, after a workout. High exercise, we’re pouring lactic acid into our, so there’s times where naturally acidic, that’s great. We want that metabolic versatility. But overall we want to get some alkalinity in. And what I’ve now have run thousands of women through my online programs. And what we found is that so many women are at the beginning about 90% acidic and these are women. oftentimes that have been taking care of himself that have been juicing, eating healthy, you know, and, and so we want to look at that. I mean, so basic, but it gives us so much. It’s like the number on your scale. It tells you to get, am I doing good? Am I not doing good? Am I going the right direction? Am I not going in the right direction? That’s how I look at it. It’s not by, you know, it’s not like, you know, the ultimate there are certainly better ways we can test. But this is easy and inexpensive and you can see what’s happening to your body. Then you recognize, okay wait, I’ve been alkaline and now I ate, um, some yogurt or Kefir and all of a sudden I’m acidic. Well, you probably have a dairy sensitivity. Something does not agree with you, right? Because that’s an alert. And then the other thing is, oh my gosh, I w I went off my key to green plan, but I was out with friends and we were having a blast and it was so much fun. And Lo and behold, they’re alkaline the next morning because again, the oxytocin, the powerful alkalinizing hormone number, body, oxytocin is just so ever present. So how cool is that? So it’s not just diet, it’s a lifestyle too. So that’s where we have to kind of blend it, incorporate. But if we’re not testing, we’re just guessing what’s working for us or with our, we’re condemning ourselves for that great meal when it actually served your body. You know, we’re going to condemning ourselves for going off program, having a couple glasses of wine or whatever, and it actually, you know, it actually suited you. You know what I mean? Not to do it every night. That’s not going to suit you. But that, that balance and I think that’s the eye opening piece. So Urinary Ph seven or better, seven or higher and to get then into, to push to ketones. And I don’t care trace ketones one plus ketones in your urine, unless you have seizures. We don’t have to necessarily reach those higher numbers.

Dr. Cates: Okay. Okay, great. Um, and, and I love what you talked about. It’s like you said, it’s not just food too, it’s, it’s the other aspects of our lifestyle of an oxytocin is such a powerful hormone. I think a lot of people don’t know about it. And so can you explain what, what exactly oxytocin is and when we get a boost in the US?

Dr. Cabeca: Yeah, yeah. It’s absolutely my favorite hormone. I think it’s the most powerful hormone. I know it’s the most powerful hormone in our body. And in my book too, I dedicate a chapter talks to Towson. Um, what we know is that oxytocin is the love and bonding hormone go hormone of connection and intimacy. It’s a trust hormone that enables you and me to interact and have fun. It’s a hormone that’s released when we’re laughing and it’s also, we know very much like sometimes the only, um, women have firsthand experience with artificial or injectable oxytocin when they’re in labor. That’s pitocin. So many women are familiar with that term. Pitocin, pitocin is oxytocin. We inject that into pregnant women to help their uterus contract more regularly and to speed up labor and, but that’s where our body is naturally producing that. Hence when you have, and have had, if you’ve had the experience of holding this brand new baby and your arm that oxytocin has now imprinted this baby on you, there’s an attachment and a bond. Well to a lesser degree, we have that with intercourse and orgasm. So the power of, of sexual intimacy is that hormone oxytocin is released. We’re bonded, we’re connected, we can restore relationship stripes that way, but we can also, you know, again, it’s a powerful hormone and to understand that it can also lead us to make the wrong decisions if we’re increasing that oxytocin hormone with the wrong person. So, you know, something to think because naturally we’re physiologically connected to that individual at least til our next, our next menses.

Dr. Cates: So yeah, it’s, it is a powerful thing. And, um, I think it’s important for women to know that and that we have more of that than men. So that’s some the reasons why we get kind of attached to people more than men do. Right?

Dr. Cabeca: Absolutely. Yup. And it also responds differently in women to men. So for men, and I teach this in one of my online programs too, like the reactions of what oxytocin does to you. For women, it creates a sense of intimacy connection. So if, say for example, after intercourse I always tell man, you just have to give her two minutes, you know, two minutes of that intimacy. It doesn’t matter how good the sex was, that two minutes will really make a difference. Connect, talk, you know, what feels good, what does she like, blah, blah, blah. You know? And for guys, they just want to roll over and go to sleep, you know, they’re like, oh relax, good night. I’m like, wait two minutes, wait two minutes. Take advantage of the hormone. Oxytocin.

Dr. Cates: Yeah. And um, and so that, that does kind of have him kind of going backwards now that the, a lot of times with changes, women’s hormones, there is a decrease in sex drive. So to even get to the point of having the ability to have that great oxytocin surge during orgasm or that connection, um, we get a lot of women can’t even get to that point. Right. Because there are sex drive is so low. Anything that you can say about, um, about that for, for women?

Dr. Cabeca: Yeah, I think there’s a few things. Number one is that a secondary sexual desire is, um, normal. So what I mean by that, because I asked a question, I ask my patients questions about this. So I started in sexual health area in 1999 and I started asking my questions, these questions, cause no one talks about the libido. And so about 70% of my clients were having issues and what they would tell me, what I heard over and over again was Dr Anna, I have no problem once we get started, but I just, you know, I just never want to initiate sex. I haven’t initiated sex in years. And so that’s normal. That’s called the secondary response cycle. And that’s actually been scientifically diagram versus like men. Okay, let me think it and then I’m there. So when we kind of have to plan it, be receptive for it and allow the foreplay, allow the intimacy, you know, get in the mindset and then, um, and then you’ll, once you start with petting foreplay or whatever, you will get turned on and then you’ll be, okay, I’m in it now. And they can take a while. And it does take longer as we get older too, because the hormone of receptivity is testosterone. Now when we are stressed, we are going to empty Dha but predominantly testosterone. So when we are stressed, testosterone is in the, you know, is very, that can be very suppressed because we don’t need our reproductive hormones in times of stress. It’s just not the time to put a baby in your body. Right? So it makes evolutionary sense for that to happen. And, and that’s really critical. Stress can play havoc with our hormones. And I dedicated a chapter also to stress in my book, especially post traumatic stress, but everyday stress is just as troublesome to our hormones. And that’s one reason. So we have a natural secondary desire. And so just almost scheduling, being prepared, what makes you happy, what gets you in the mood and communicate that and then just be open to and let him know, look, I just need some foreplay. I need you what? Bring me coffee in the morning and that’ll start the good day. That’s my philosophy. And then secondary secondly is that if we have, as we’re getting older and we lose some hormones, we lose the elasticity to our a vagina and we lose the natural secretions. Orgasm is less pleasures us. And what’s worse, we have maybe some pain or discomfort when we have intercourse, urinary leaking or after intercourse were experiencing discharge, odor, urinary track infection and those like if you experience these things, why would you want to have sex? First you have to understand even you love your husband, you love sex, you’ve loved it all your life. You’re, you won’t even, it will be natural not to have desire for sex because the payback is too uncomfortable. And that’s sometimes not, I mean it’s often, I would say most of the time, not even conscious. And so you start and he’s recognizing you’re not comfortable and all of a sudden you’re, you know, you’re sleeping apart, you’re both voiding it. You’re not talking about an intimacy. There’s a rift and intimacy. So you know, that was one of the reasons why I created a natural part because there’s no natural solutions that are available to women anywhere. And so that’s why I created Jova, my anti aging cream for the Vulva that really does help with this. And I mean just, I tell clients, just read the testimonials because the stories are, are, are just, you know, profound in the difference that making this little adjustment to your body can make a difference. Because we all know hot flashes, hot flashes eventually go away. But seriously, with my Keto green way and the things I recommend, you won’t experience hot flashes, but vaginal dryness just gets worse as we get older. Incontinence is, you know, one of the number one complaints with women over 60 and so we each really understand that we have to start taking action no matter what age, you are, pelvic floor exercises, some jova and being open to intimacy and scheduling that in because that oxytocin hormone improves not only your longevity, we know it increases longevity, the quality of life as well, but it also increases the longevity of your relationship. And that’s really important.

Dr. Cates: Absolutely. And jova is, where is that available? Because it is. So it is all natural. Right? So this is, I’m a big fan of course, cause it’s, you know, we’re talking kind of like skin care, it’s a little down,

Dr. Cabeca: Yes it’s vulva anti aging skincare. uly

Dr. Cates: It’s so, yeah. And it’s so important because it’s clean and effective. So it’s, it’s not just a lube It’s also just going to be protective and beneficial.

Dr. Cabeca: Right. So yeah, we think of, you know, like anti aging, you know, anti aging for a face. We think about that for our lips and it’s really important. But also anti aging for a pelvic floor is really, really important. And so that’s where jova comes in. upper lips lower lips, think of both.

Dr. Cates: All right. So where is that available and it’s available online. so@dranna.com will give you a link to, we can offer your audience a free trial of Jova so they can have a seven night free trial.

Dr. Cabeca: Yeah. And for what age group is that best?

Dr. Cabeca: For women, really. It’s if you’re having problems, should you have any difficulty with the accidental urinary leak when you cough or sneeze or decrease in orgasm, Decrease in pleasure. So at any age, but especially in our forties fifties we really want to work on prevention as well. But I have clients in their seventies using it and I have a 29 year old who was on a marina Iud that has loss of orgasm. So that has helped her.

Dr. Cates: Okay. All right. So you just mentioned the IUD and now that just opened up a, I’m sure questions for people. So Marina IUD is the Iud that has progestin, has progesterone, but it’s actually progestins and it’s a synthetic form of progesterone. Why is that not, why is that creating issues?

Dr. Cabeca: Well, if for this client and for others that I’ve read about, it also affects the flora in the vagina. So you have decreased lubrication and um, and so there’s that plus Progestin in and of itself decreasing your natural, your body’s natural production of progesterone and affecting that whole hormonal cascade that goes from there.

Dr. Cates: Right. And there’s an Iud that does not have any hormones. So that, that, that’s the alternative to that. Okay. So I have a question for you. What is, what is healthy menopause? So if someone were to to go through it, because menopause is a natural thing. It is. Where are our periods are supposed to stop at some point, but what is, what it would be healthy starting your thirties forties beyond what would be healthy ?

Dr. Cabeca: Really. I think it’s really going into that state where you’re physically, physically healthy, your physiology is balanced, you’ve got clear cognition, you know, blood sugars balanced and that you don’t struggle with the symptoms that are, you know, that can really plague you. So the, you know, we commonly talk about hot flashes, hot flashes, weight gain, memory loss, fatigue. Those are some really key issues that can plague us in the perimenopause when our hormones are out of balance, we’re going through a natural transition. So we’re going to have some, right? We’re going to have some fluctuation fluctuation, but it should not be the predominant experience of this time period. Our periods will eventually stop and, and then we move into postmenopause and continue to maintain health and vitality. It’s really critical. So that would, I would consider that healthy menopause, I mean essentially symptom-free transition, but you know, even like just understanding you’re having these normal fluctuations, that’s okay. Just like when we started our periods, for some of us it was like, okay, Gosh, look at this. It’s uh, you know, I’m having bleeding and others, you know, for maybe even years we’re having pms before they actually had their period. And so look at what’s interfering with this hormonal balance because we should just be able to transition through without any significant symptoms.

Dr. Cates: Okay. So some symptoms are healthy or normal and that we can use it as an indicator. Okay. When it’s time to do something different. Right? So using symptoms to monitor progress, right. And that we’re on the right track or not. Kind of like why talk about skin giving us information. You could pay attention to it or you can ignore it. But paying attention to symptoms actually is a great tool that our body’s giving us a, something’s not right. Like, let’s get back on track, let’s use some additional tools to help support our body. Right? Like you’re talking about the Keto Green Diet, did you use that to support the body and also biodentical hormones would be another thing to help support people that uh, that can help during those times of transitions when, when symptoms are a problem. Right.

Dr. Cabeca: I agree. And I love what you said. you know the symptoms are giving you information so that those are red flags and then just work to correct that and always think, okay, we need to correct that. And certainly nutrition and lifestyle first and then adding bioidentical hormones. I think it’s, it’s, you know, essentially of course I was a big part of my practice, so bioidentical progesterone, if we need biodentical Dha, testosterone, estrogen and just a little bit goes a long way. We don’t need to reenact our periods each month and bio identical, um, you know, healthy, optimum levels to keep that optimized. Trevor, I often get the question, you probably do too. Well, how long do I need to stay on hormones? And the other question that I often get is when am I too to start hormones? And so the, for the first one, how long do I stay on hormones? And again, if we lived in the Amazon, if we lived down in nature, if we picked our food the day we ate it, we probably wouldn’t need additional hormonal support, but we don’t. And so I go in and when we’re trying to optimize our health and live with quality of life and longevity as strong and capable and mentally acute as we can be, then I think hormones have a place in our life for the rest of our lives. And I typically, it’s transdermal versus oral because we don’t want to give our liver anymore to work with Nor our digestive system. So vaginal or transdermal hormones through the skin are great ways to do that. And just a little bit goes a long way. I typically start with progesterone, progesterone topically and or pregnetalone and/or dhea as well. And so, you know, jova has Dhea. So that’s part of the anti aging ingredients for the vulva that help with that formulation among other ingredients. But so those are, that’s a good way to start. And then just thinking through, well then when do I, you know, so when do I stop? I’m going to take again, continue. And how old are you to start if you haven’t started already? We know that it’s oral hormones. We do not recommend starting significantly postmenopause but transdermal hormones, um, you know, can go a long, can be very beneficial and safe because we know even transdermal estrogen, transdermal progesterone do not increase inflammatory markers or coagulation markers such as the HFC, RP c reactive protein. So transdermals are a great option. It doesn’t matter how old you are, as long as you’re healthy and you’re doing the right things.

Dr. Cates: Yeah, and I completely agree with that. And I, it is something I hear over and over again from my patients is that they go to see another doctor and the doctor says, oh my God, you can’t be on hormones. You can’t be there. They’re not safe. It’s really dangerous. And I’m always surprised at the level of concern that a lot of doctors have around bio identical hormones and so, but I think there are a lot of different ways to prescribe hormones and that’s part of the issue is that there definitely are ways that that there are sometimes prescribed that aren’t safe, but yeah, well that are well educated and bio identical hormones center supporting the natural physiology. If a woman’s aging process, I think that it’s, it’s extremely beneficial for the women and not just symptom management but also prevention of osteoporosis and and different health issues. Right. Would you agree?

Dr. Cabeca: 100% I completely agree. Just like there’s the right in the wrong way to do Kido. There’s the right and wrong way to do hormones. And if we’re at risk, if we have cardiovascular risk factors, if we’re unhealthy, and I would tell my patients as a bio identical hormone prescriber and like if you’re not going to follow these principles you’re driving through for dinner, you know you’re driving through your meals three times a day. I’m sorry I’m not writing you any prescriptions. I cannot do that until you’re doing a, B, and c and that’s, you know, those are free changes that you can make better gonna improve the quality of your life.

Dr. Cates: Absolutely. Absolutely. So important to build that foundation, that solid foundation. Okay, well it’s been so great getting this information for you. Just a wealth of knowledge and tell everybody where they can find your book, it’s just just coming out. So it’s exciting to have you on, right as this is coming out.

Dr. Cabeca: I know it’s just released. I’m super excited about that. And it is published by Ballantine penguin random house and it’s called The Hormone Fix and you can just come to Dranna.com and sign up for the book through there. So DrAnna.com.

Dr. Cates: Excellent. All right. Thanks again for coming on.

Dr. Cabeca: I appreciate it. Thank you so much for having me.

Dr. Cates: I hope you enjoyed this interview today with Dr Anna Cabeca and got some great hormone balancing chips and I love hearing from you. So please post your comments below the interview on Youtube or on the spot Dr Com below. Dr Anna’s podcast interview. Tell us how, how you think about this interview, other things that you would like us to do with the spa doctor podcast, other guests that you would like me to have, other topics you’d like us to cover. I love hearing from you and join us on social media and you can go to The Spa Doctor pages on Facebook, Twitter, Instagram, Pinterest, Youtube, and join the conversation there. Love hearing from you, and if you haven’t taken the skin quiz, I encourage you to do that to get great information about what your skin’s trying to tell you about your health and what you can do about it. Just go to theskinquiz.com it’s a free online quiz, theskinquiz.com and I’ll see you next time on The Spa Dr. Podcast.