3 Health Changes to Make Before Trying to Conceive [Podcast with Dr. Felice Gersh] - PCOS Diva
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3 Health Changes to Make Before Trying to Conceive [Podcast with Dr. Felice Gersh]

PCOS Podcast 144 - 3 Changes before TTC

“People take control of their health by understanding the process that’s going on in their body and how to repair it and get back to a state of metabolic homeostasis where things are aligned with the way nature intended.” – Dr. Felice Gersh

Dr. Felice Gersh is a double board certified, ground-breaking thought leader in the field of PCOS. She returns to the PCOS Diva podcast to discuss taking control of your lifestyle before trying to get pregnant for the sake of the mother’s pre and postnatal health, ease of conception, and future health of the child. As Dr. Gersh explains, “If an unhealthy woman somehow achieves pregnancy through luck or through different techniques and gets through that pregnancy, that child is more likely to have a whole slew of issues; whether it’s ADHD or even increased risk of autism, or things like metabolic syndromes, diabetes and weight gain at younger ages, cardiometabolic issues, and mood problems.” Listen in (or read the transcript) as we discuss:

  • The food you should include in your diet every day
  • The critical factor of circadian rhythm
  • How timed eating may help
  • The brain/gut/inflammation connection and how to make it work better
  • Benefits of aromatherapy
  • The dark side of alcohol

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Complete Transcript:

Amy:

In today’s podcast, I welcome back Dr. Felice Gersh. She’s a multi award-winning physician with dual board certifications in OB/GYN and integrative medicine, which is fairly rare. She is the founder and director of the Integrative Medical Group of Irvine. It’s a practice that provides comprehensive healthcare for women by combining the best evidence-based therapies from conventional, naturopathic, and holistic medicine.

She is the bestselling author of PCOS SOS and her brand-new book PCOS SOS Fertility Fast Track. She is also a regular contributor to PCOS Diva, which I feel very blessed to have her on the podcast again today. So welcome, Dr. Gersh.

Dr. Felice Gersh:

Oh, Amy, I’m so happy to be joining you again today.

Amy:

As I mentioned we’re going to be… You have a new book, PCOS SOS Fertility Fast Track, and we’re going to be basing our podcast today off of your new book, which is really fantastic. I’ve read over the last couple of days and learned many new things that you’re going to be sharing with our audience today.

But first, I would love for you to just talk about women with PCOS and why taking control of your lifestyle even before you think about getting pregnant is so important. You were talking before we got on the podcast about how just going along with your standard American diet and then maybe taking an ovulation inducing drug to try to get pregnant really isn’t the optimal way to try to approach fertility.

Dr. Felice Gersh:

Well, it turns out that fertility is a basic sign, a vital sign of the health status of a woman. In ancient times they actually knew this, they would worship fertility Gods. They knew that fertility was a vital essence of health and happiness. Now, we have forgotten that. In fact, we spend most of our efforts to try to squash and destroy fertility temporarily, hopefully, but we forget that when a woman has fertility problems and has to really work hard to get pregnant, it means that there’s some underlying issues.

It seems so obvious when you say it, that if you have fertility problems, there’s something going on in the body. So what we don’t want to do is just go on fertility drugs and then trick the body into ovulating, you want to be healthy and hopefully spontaneously get pregnant. But if that doesn’t happen, and sometimes no matter how hard we try we do have to use some assisted reproductive technologies, but even if we go that route, we want to make sure the woman is optimally healthy before actually conceiving.

We now know that what happens in pregnancy if we just focus on the baby it sets really the path for that child for their entire life. How the genes are expressed, the underlying health of that child is really very based on what happens in the pregnancy. Which seems also obvious when you think about it because really we know from so much data that if an unhealthy woman somehow achieves pregnancy through luck or through different techniques and gets through that pregnancy, that child is more likely to have a whole slew of issues; whether it’s ADHD or even increased risk of autism, or things like metabolic syndromes, diabetes and weight gain at younger ages, cardiometabolic issues, mood problems.

All those things are actually set because now we understand that during pregnancy, that’s when all the endocrine system is occurring and developing, the brain is developing. It’s also very important to be aware, and I know we’ll talk about this more, about the level of toxins that you have in your body because those also can bioaccumulate in the fetus and affect how the very endocrine system is developed; the hormone receptors, their functionality, and so forth.

As for the mother, she is much more prone to having pregnancy complications, gestational diabetes, pre-term labor and pre-term delivery, preeclampsia, all of these different problems; even placental abruption, growth-restricted babies, all these problems are more prominent in women who are unhealthy at the time they conceive. So being healthy before you conceive is to help you to be healthy through your pregnancy, reduce complications, have a healthier baby, and be more successful in terms of getting pregnant in the first place.

Amy:

Well, I love that you have written this book. It’s a follow up to your first book PCOS SOS, which is excellent. We did a podcast on that a while back, and I will link it in the show notes. But what I love about this book is if you are thinking about trying to conceive, this is a 12-week plan to optimize your chances of a successful pregnancy and a healthy baby.

You really take us week by week with action items and to-dos of how to really get on track. We’re going to talk about some of the nuts and bolts of the what to-dos in a little bit, but reading the book, I was sensing an overarching theme of taking care of three areas in your health. One was circadian cycle, and getting that on track. You’re one of the few experts out there I think that have been really talking about the importance of circadian cycle and PCOS, so I’d love for you to address that.

The other piece is creating a healthy microbiome and then finally as you alluded to, endocrine disruptors and trying to eliminate those as best you can. So maybe you can walk us through a little bit deeper those three steps?

Dr. Felice Gersh:

Well, sure. When it comes to metabolic health, emotional health, immune health, it all links to circadian rhythm. As we’ll see, all these things intertwine. There’s no standalone in the body, they’re all beautiful interlinking systems, and all of it comes into play particularly when you’re dealing with fertility.

It turns out the ovaries are very circadian. Most people don’t know that. Circadian is based on the 24-hour rotation of earth. We are all earthlings. I know I love science fiction, I grew up with Star Trek and Star Wars, and all of that; but we are actually evolved to be on planet earth, and planet earth has many beautiful rotations. One of the primary rotations is on its axis, the 24-hour rotation that gives you the day and night variation.

We humans are what are called diurnal, that means we’re day creatures. Now an owl is nocturnal, and mice and rodents are nocturnal, so they’re very active during the night, they sleep during the day. As we are diurnal, we are active during the day, and then we are supposed to sleep at night. Of course, in our society, that isn’t always the case. We have something like 20, 30% of all employed people work into the night in some fashion, so they’re some form of shift workers.

I was one of them because I did deliveries, and it turns out that many women and this is actually programmed by our genes, go into labor at night. That makes sense, they labor through the night when it’s dark and it’s safer because what’s a pregnant woman in labor going to do to defend herself in the middle of labor? So it’s safer at night under the cloak of darkness, and then she delivers in the early morning hours. So I was up at night with my patients and delivering them in the early morning hours.

But some people are in a circadian dysfunctional state even though they don’t work at night. They may intentionally stay up at night because they just feel more alert, and we’ll talk about that. They feel more energized at night, they call themselves night owls, which actually I hate to tell you, you’re not an owl. So if you feel more energized at night, that’s a sign of a circadian rhythm problem in your body. Then there are some people that just can’t seem to fall asleep at night, they just have so much trouble with sleep issues, and that is very common in women with PCOS.

So now that we understand that the ovaries, actually every cell in our bodies with maybe the exception of red blood cells, but they all have clock genes. They’re all on the timer. In our brain there’s a group of cells, group of neurons, called the suprachiasmatic nucleus, this is the master clock. It sits atop the optic nerve and actually has connections to the eye, to the retina where there are special censors of light and dark and send a signal to these special neurons in the master clock, which then sends out signals throughout the entire body to synchronize all the organs together.

As we’ll talk about, there’s a secret back doorway through the microbiome to help us to regulate our rhythms even when our master clock is a little bit off-kilter, which is what happens in women with PCOS. So because we now have plenty of data that women who do work at night and have the night shift issues, they have much greater incidents of infertility, irregular cycles, mood problems, weight gain, insulin resistance, all the things that women with PCOS are fighting. It’s really that we can reframe PCOS as really a circadian rhythm disorder.

So essentially women with PCOS are living a life of jet lag. They’re crossing across major timezones all the time, or they’re up at night very commonly and so forth. So the ovaries which have clock genes and have receptors to melatonin, that critically important hormone that’s produced at night, and they don’t get enough of it. If you don’t get proper circadian rhythm and proper sleep, the ovary will not function properly, will not ovulate on cue.

Recognizing this, it’s changed a lot of my approach to treating PCOS to help women align with their circadian rhythm. That’s what a lot of the book is about, getting to bed at the right time, eating at the right time, and helping because it turns out our microbes in our gut, the microbiome like every living creature on this planet they too have clock genes. I call that the back doorway to help set our circadian rhythm is through timed eating. When you eat is just as important as what you eat.

So by harnessing this new knowledge we have amazing new tools with lifestyle, not drugs, to help women with PCOS to get back on the beat and to get back into the rhythms that our beautiful bodies were evolved to have to enable and facilitate ovulation and fertility.

Amy:

I just want listeners to know you wrote two great articles for our site, a part one and part two on circadian cycle a few years back, and it really gives you some specific details on how to hack your circadian cycle. We will link those in the show notes as well. I was wondering if you could just speak to supplementing with melatonin. I’m seeing a lot more women taking melatonin at night to help with their circadian cycle. Do you think that’s a good idea?

Dr. Felice Gersh:

It can be but I’ll tell you, sometimes with melatonin less is more. You know how that is, that sometimes people overdose. So what I always like to start with is the more natural approach, and enabling the body to make its own melatonin. We want to harness our innate mechanisms to heal, and melatonin has its own rhythms like everything, everything is rhythmic. Melatonin should naturally peak around 2:00 AM, and that’s when our cortisol should actually be at its lowest point.

It’s sort of like they’re at opposites in terms of ups and downs, so we really would be best off if we could have our natural melatonin rhythms and peaking naturally at 2:00 AM. So I always try to start with encouraging the body to do its thing naturally. I encourage women to watch the sunset, it’s so amazing. Like I said, we’re earthlings, we are designed to be outside. Now, we tend to be inside so much of the time, so it turns out that being outside is very beneficial, like watching the sunrise.

Well I know everyone isn’t going to get up early enough to watch the sunrise, but that is actually a wonderful thing to do. But watching the sunset, pretty much everybody could manage that one. The colors of the sunset, I know we can talk about this a little bit, people know that blue light that comes off of our screens, the television screens, the computer screens, that they are very bad for really enabling sleep. That’s why they have the amber, which I recommend, amber blocking glasses that help block the blue light.

Of course, my preference is to avoid screens for as many hours as possible. I’ll start with one hour, I’ll go to two hours, I prefer three hours, but I’m always a realist about what people are doing, and then they could wear the amber glasses, change the apps on their devices to try to block out the blue light. Well it turns out that looking at the sunset and the beautiful colors of the sunset actually start to suppress our cortisol. Our cortisol levels will start to drop and will start to increase the production of melatonin and prepare our bodies.

It’s like we know when we see the sunset that night is coming, and our bodies will prepare for it naturally so that our melatonin will start to rise, our cortisol will start to drop. We’ll start to feel sleepy and hopefully calm and peaceful. So just taking a drop of melatonin a while before actually you’re going to go to sleep. Could be two to four, even as much as six hours, and people could experiment a little bit with this, to take .5 milligrams. It’s just a touch of melatonin to say to the body, to give it a cue. So like, “Hey, guys, we’re going to go bed in a few hours. Let’s start winding down.”

That along with all of the other things like winding down and having a sleep routine, we call it sleep hygiene, to get the body into that pathway to facilitate sleep, which is sometimes so difficult for women with PCOS to do that, to actually feel tired and go to bed when they should because they often have this flipped circadian rhythm where they actually have high cortisol at night and low in the morning. So they have to drink a lot of coffee in the morning, they feel kind of groggy, they don’t really get going for a while, and then at night it’s like, “Whoa, I’m feeling more alert than ever.” It’s like, “What’s with that?” That’s not good so-

Amy:

Yeah. I was just going to say the coffee in the morning, you drink that until it’s time for wine in the evening.

Dr. Felice Gersh:

That’s right, and that’s the worst thing you can do is drink alcohol at night. We can talk more if people are interested in that topic. But basically so taking just a little bit of melatonin and then maybe towards bedtime, when maybe in the last half hour to hour before bed, you can have one milligram.

Now, I will go up higher if I need to, so that’s where I work with what I call with personalized precision medicine. If I’m going to give blanket advice to people, I would say go with the half a milligram two to four hours before you go to bed. Then half hour to an hour, and experiment a little bit, go to one milligram. But when I work individually with patients, I may go up to two milligrams, I may go to three, I may use a sustained release. That’s where I have to use the interaction with the patient and what’s happening with her and finesse it.

When people travel across time zones, I usually give them something like five or six milligrams of melatonin but just for three days. On occasion, I might even do that, but this is where I’m working one-on-one with each patient where I have to personalize what I’m doing.

Amy:

So let’s move on to microbiome. You’ve written a great article about taming the flames of PCOS, and we know that inflammation is a root factor. If you are looking to have a healthy pregnancy and to conceive, just tell us more about the role microbiome plays and what else we could do, or maybe talk a little bit more about timed eating around-

Dr. Felice Gersh:

Oh, absolutely.

We now know that we are super organisms, so our DNA is not all we are. We are working in this beautiful synergy with these microscopic creatures, and we focus primarily on bacteria, but we know it’s actually more complicated than that. There’s other things involved, but we’ll focus primarily on the bacteria, and we call it the microbiome.

It turns out that we were wrong, medical people, that many organs we thought were sterile are actually filled with bacteria, different amounts. So every single structure in our body has its own unique microbiome. The largest collection, the largest microbiome consists of trillions of bacteria in the large intestine, the colon. The other areas of the intestinal tract also have microbes, but lower numbers. The biggest number like I said, is in the colon, and this is what we typically refer to as the gut microbiome.

It turns out that this interplay between them and us is just profound, it’s changed our view of what it means to be a human being because it turns out that these microbes inside of us are actually like busy little factories. They actually make neurotransmitters, they make hormones, they produce what are called short-chain fatty acids; butyrate, acetate, propionate.

Butyrate, which has gotten a lot of attention, actually can travel through the body and go to the brain and reduce inflammation in the brain. It actually has receptors on a big finger of the brain called the vagus nerve which actually controls the autonomic nervous system, particularly the parasympathetic or the calming arm of the autonomic nervous system. If you don’t have the right microbial population, you don’t make the right short-chain fatty acids.

These also do tremendous amounts of signaling with the liver to keep the liver functioning properly, and these microbes like I mentioned also have their own clock genes, and they have different populations that develop and become prominent at different times of the day or night. The nighttime ones that swarm in the presence of melatonin and there are particular cells in the gut lining that can actually make melatonin. Many people have heard this that the gut makes at least as much melatonin as the brain and the melatonin actually is interacting and altering how the gut microbial populations are functioning.

It’s just this amazing, complex interaction that sets everything into correct or incorrect motion in our bodies. So having the right microbial populations and having the food that comes in at the right time because our little microbes, they don’t know what time of day it is. The way that they set their own clocks is by the time that food comes into them, and then they feed off of primarily fiber. So we want to have a wonderful array of different fibers in our diets because different microbes like different types of fibers.

We want to have a beautiful array of types of vegetables because the vegetables have what I call the secret sauce, the magic sauce, the polyphenols that are getting so much attention in research these days, and they actually align differently with different microbes. So it’s a like a dance between the polyphenols and the microbes, and the microbes are feeding off the fiber.

Then the right fats also matter. If you have a diet that’s really high in saturated fat, that actually suppresses a lot of the beneficial microbes and you get an altered or dysbiotic gut microbiome and you’re going to have altered production of the protective mucus, then and you can get impaired gut barrier, which we call leaky gut. When you have the wrong gut microbes they make particles that are really harmful. They’re called lipopolysaccharides, but we also call the endotoxins.

So think of it as toxins from within the lumen of the gut that can actually pass through between cells of the lining of the gut, and we call that leaky gut, and inside the body just lining the gut are all of these immune cells. When they see this toxic stuff coming in, they explode with their inflammatory content creating, like you mentioned, that inflammation that underlies so many of the problems with PCOS have.

Much of that inflammation that is so destructive to female health and the ovaries and the brain and all the different organs is actually coming from this dysbiotic abnormal gut microbial population that we can actually remedy through getting our timing of our eating. That we get a big breakfast, which is when we’re most receptive to food and eating the right food, and then stop snacking, so we eat on the beat.

If we don’t have the right signals coming from our master clock because we have this sort of drunk master clock, it’s a little bit off the beat, we can help reset things in the body and in the liver; the critical metabolic organ that does detoxification that is so critical to so much of the body. The liver doesn’t get its due. All of that can be actually fixed and actually just amazingly reset by eating at the right time, eating to what I call nurturing the gut microbiome and then resetting the clocks of the different organs because of the signals that come from the short-chain fatty acids, these metabolic byproducts that are made by fermenting the food we eat.

So it is complex but that’s why I did it in the book with a week-by-week, step-by-step, here’s your shopping list, here’s what you do so that it really makes it into a manageable thing. But I want all of your listeners, I’d like all of patients to really understand, I encourage reading and learning. I don’t just say do what I say, I say understand what you’re doing. That’s how people get motivated, that’s how people take control really of their health is by understanding what’s the process that’s going on in their body and how we’re trying to repair it and get them back to a state of what we call metabolic homeostasis where things are really aligned with the way nature intended.

Amy:

I love how you framed that all for us. You’re right, knowledge is power, and having that knowledge is really empowering. It really makes you want to eat more fiber and want to eat more plant food to bring this homeostasis into play. I think that it’s very disempowering when we go to our doctor, and they say, “Lose some weight, go on a low carb diet, and take this pill.”

Dr. Felice Gersh:

Yes, it’s very disempowering in the extreme. You and I talk all the time, Amy, about how the conventional medical approach ignores what’s really going on in the body and just seeks to come up with some way to cover up some of the symptoms while never addressing the real root causes of what’s going on in the body to heal from within. That is so disturbing to me, that’s why I always love our conversation.

Amy:

Oh, me too. I’m so grateful for you. I want to give listeners a tip that you talk about in your book for adding in more fiber. You are a big proponent of beans and lentils. I love beans too. Bean dips like hummus, and I love a white bean dip with, I can never say it right, cannellini beans and garlic and rosemary. It’s just so delicious and a great way to add fiber into your diet. They also have a lot of phytonutrients. So tell us how many beans we should be eating daily and maybe a few more of the benefits.

Dr. Felice Gersh:

Well, I just love beans as well. There’s so many amazing recipes you can get them from so many books and also from online. Beans come in a variety of types, and there’s actually been quite a bit of research on beans and their relationship to improving the health of the gut microbiome. One of the ones, garbanzo, which are also known as chickpeas, there’s actually a lot of research.

It’s amazing that healthcare professionals don’t know this that there’s data to show that you can dramatically improve the gut microbiome by eating beans. They have different types of fibers, some of it is soluble fiber, and it’s just amazing how the microbes just love eating it up. Like you said, of course it has other vital nutrients, it’s not just a piece of fiber, which is why I don’t like just giving some kind of synthetic fiber supplement.

There’s always magic in food, and I do use plenty of supplements, but that’s why I like word supplement, it’s supplemental to the diet. You can’t just live off of supplements, you need to get the beautiful combination of all the blends of fibers, and nutrients, and polyphenols, and vitamins, and everything that come from things like beans. Now I also want to mention soy because soy is a bean, and poor soy. I’m always having to defend estrogen, I have to defend soy, I have to defend fiber because a lot of people don’t understand it.

Soy, when eaten whole as the bean, which is often known as edamame, so the soybean and also its unprocessed types of forms like the tofu, the miso, the tempeh. When you eat soy that’s whole and organic and I emphasize, and emphasize, and emphasize organic because we do not want to have the herbicides, the GMO, the glyphosate that comes on the conventional type soy or processed soy like soy pretending to be something it isn’t like a hotdog or a burger or some other cheese or something. We want soy only in those whole forms. It’s actually a fertility food.

It’s like a phytoestrogen. It helps work in the gut on the beta estrogen receptors, and it actually helps to align with the microbes and actually is beneficial, as are flaxseeds as a phytoestrogen. These are really important things to know, so don’t think that soy is a problem. Now, like any food, some people have allergic reactions or something, so I’m talking once again in generality.

Just like I say eat across the colors of the rainbow with vegetables, I like to say eat across the different types, it’s not colors, but eat across the whole variety of beans. Try them all out, like black beans, pinto beans, cannellini, garbanzo, try all these different types of beans that each one of them has its own special, unique benefits.

People who don’t have the healthiest gut microbiome sometimes they don’t have the right guides there to ferment properly, and so sometimes they get GI distress when they eat really healthy foods. That doesn’t mean the food is disagreeing with you permanently or you have no ability to eat this food, it means that you have to nurture your gut microbiome to grow in the right directions and populations so that it can then actually ferment these wonderful foods.

If you have been living on what we call the SAD diet, the standard American diet with very, very low fiber… Like in ancient societies, people ate 100 to 150 grams of fiber a day. Often Americans eat less than 10, and the government says, “Well, eat 25 or 35,” and that’s really not enough really to give your healthy microbes what they need. But you may have to go slowly, so start with if you really eat some beans, and you just say, “Whoa, I’m having so much GI distress,” then take a couple of tablespoons, work up to half a cup.

I would love for people to have at least one cup of beans every single day. Personally, I could eat probably a salad bowl full because I’m so used to them and to me, they taste like candy because I love them. When you put them with some really high-quality vinegar and oils and all those herbs that you mentioned, it’s like they are fabulous. But work your way up, and that’s why we start slow. Sometimes that motto, “Start slow, go slow.”

See how your own body reacts, and that’s why we start with less and then go up. But I would love for people to incorporate as much as they can every day. It’s also, by the way, a wonderful source of protein, and a lot of people don’t realize that there’s a lot of protein in beans and lentils. What they have found is that the musculoskeletal system like bones that actually you have less osteoporosis from eating proteins from plant-based sources than from animal sources. How amazing great news is that?

You’re actually going to be healthier when you have a predominantly plant-based diet. You get so much fiber and so much protein from these beans.

Amy:

I had mentioned endocrine disruptors, I think that I’m going to let people pick up your book. They could check out my Sparkle program, we talk about endocrine disruptors there because we’re running low on time and I wanted to hit a couple other topics that I thought would be interesting to listeners.

Aromatherapy, I thought that some of the studies that you had listed about the benefits of aromatherapy was really interesting because I think of aromatherapy as something that’s so easy and enjoyable, and it’s a great way to help with PCOS. I’m going to let you share how that can help.

Dr. Felice Gersh:

Well, it’s once again harnessing the beautiful innate healing properties of plants. I’ve actually even since the book, I’ve actually gone and tried to learn more about aromatherapy. I’m so fascinated with it. If you know about how the oils are made and there’s the other side, the water side, the hydrosol, so I just want to explain that a little bit. A lot of the newest knowledge is that when you create essential oils it’s traditionally a distilled process. So on the one side, you get the oils, and the other side you get the water which is called the hydrosols.

Now the oils are very powerful medicine because they are very concentrated. So when you use essential oils, you only want to use a very few drops, and there are some wonderful different recipes that we know that you can blend different types of essential oils. If you’re just starting out the most, we’ll call it the universal essential oil is lavender. Lavender has so many benefits. It’s calmative, it helps people with sleep, it’s actually antimicrobial. You can put it on infections, it actually can help with skin, with acne. You can put some in a bath, and you can soak, and you can be so calm and relaxed.

The hydrosols, the water portion, you can just spray it on anything. You can spray it on your hair, you can spray it on your pillow, and it also has all these wonderful benefits. They have these little side benefits like it’s good for if you get a rash, it’s good if you get a mosquito bite, so all of these different types of things. Then you have all of these other essential oils like neem which is very antimicrobial. You can put that in a mask if you do a clay mask and instead of using water, like if you have acne, which of course is a prevalent problem for women with PCOS, you can mix in with neem oil, which is an Indian plant and that can really help with acne. So I think becoming proficient in some of the basics, and you can also get blends.

In my office I have some blends that are calming that you can dab on, you can roll so that you can sleep better. So essential oils have been shown that they can help with libido, they can help with stress, and tension, and insomnia, and depression. One of my favorites now is bergamot, which is a Mediterranean citrus fruit. You can put just a few drops on a handkerchief, put it in a Ziploc baggy, and anytime you’re feeling blue, you just open up that Ziploc baggy and just take a few sniffs of your bergamot essential oil handkerchief, and you’ll feel better. We know that-

Amy:

Or drink some earl gray tea like I’m doing right now.

Dr. Felice Gersh:

Oh, absolutely and you can get bergamot in you earl gray tea, exactly.

Amy:

Yeah.

Dr. Felice Gersh:

Exactly. What we know about the olfactory system of the body has never really been appreciated by conventional medicine. That particular sense has been kind of forgotten, it’s like we don’t pay much attention. But we know that when people get old, often when they smell something it actually brings back memories, even people with dementia, that we have amazing memories for smells. When you smell something, when it goes in through sniffing these wonderful scents, that it goes right into the limbic system of the brain which deals with emotion. So you can actually really affect emotions tremendously through these essential oils.

I hope that when you read the book you’ll see I just wanted to add things because I have become so enamored with essential oils. I’m on my own personal journey to keep learning more about it and more ways to use it because it just also came out with COVID that a lot of people lose their sense of smell, so our sense of smell has come back a little bit into the forefront of how important it is. So everyone should take a little side journey into learning about essential oils and how we can harness these amazing properties in our brain through the limbic system to affect our emotions.

We now know that emotions affect everything. You can’t underestimate how powerful emotions are in terms of how every organ in the body functions. In fact, women have this condition, it’s mostly in women, 80%, that’s called broken heart syndrome where a big powerful emotion can actually trigger vasoconstriction. Narrowing of the small blood vessels in the heart that can actually trigger an arrhythmia, it can actually trigger heart failure, or it can trigger what looks just like and actually functionally is just like a heart attack, and has nothing to do with plaque in the arteries, it’s purely an emotion-based reaction in the heart.

When you talk about the heart and the heart as the center of the emotions of a woman, it actually is. So essential oils are a fabulous tool to help basically everyone and particularly women with PCOS.

Amy:

Well, thank you for that. I will point out that I developed an essential oils course with Dr. Meaghan Kirschling. She’s a-

Dr. Felice Gersh:

Wonderful.

Amy:

Yeah. So if you are interested in more about how to use essential oils for specific PCOS systems, check that out. But Dr. Gersh, I want to just address one more topic before we have to go. We giggled about using caffeine and coffee to get us through the morning and mid-day until it’s time for wine. I think a lot of us enjoy a glass of wine with dinner or relaxing with friends or other types of alcohol.

You have been somebody that has really opened my eyes to maybe the dark side of alcohol, especially if you’re using it on a regular basis. You share that in your book, and I was wondering if you could just share that information to enlighten and empower us to make informed decisions for ourselves?

Dr. Felice Gersh:

Sure. Well, they’ve now shown that in pregnancy there’s actually no safe minimum amount of alcohol. We need to rethink alcohol. When they’ve talked about the health benefits, they’re talking about resveratrol, that magical polyphenol that comes in red grapes in particular, but it could be other grapes as well. But when they did a study, it was actually in Spain where they actually compared non-alcoholic wine to alcoholic wine, they found that wine with the alcohol was universally harmful in a variety of ways. All the benefits that derived from wine that people talked about really did not come from the alcohol, it came from the portion that is non-alcoholic from the grapes and the resveratrol.

There’s no benefit to alcohol. Alcohol is a direct neurotoxin that means it harms neurological tissue, that’s what the brain is; and also our gut, sometimes they talk about that as the second brain, the enteric nervous system. So alcohol is directly toxic to the neurological system of our gut, which is so critical for how the gut works. It’s a direct toxin to the liver, and women with PCOS have very high rates of fatty liver, so this is the last thing they need.

It’s also toxic to the gut microbiome. It’s like they’re running around dizzy like, “I’m a drunk little microbiome.” We do not want that. I love to picture things because I love guided imagery, so I’m always getting these images in my head. So I see all these little one-celled organisms, and they’re all drunk inside of our gut. It’s like do you want that picture inside of you? How are they going to know what to do? They’re not going to do their jobs right. We just have to let go of alcohol as PCOS women.

That said, if you get everything under control and you’re ovulating regularly, and your weight is right, and you’re not insulin resistant, you’ve gotten everything together, then you have a celebration. You can have your little glass of champagne or a special occasion. But when you’re trying to get healthy because you’re really coming from a place that’s still health challenged, when you are interested in optimizing your fertility, please find other ways to celebrate.

Now one of the things that I have found is really amazing is that you can take sparkling water like Pellegrino, which has a lot of wonderful minerals in it, and then you can add a fruit vinegar. Of course, you can do apple cider vinegar, that always gets a lot of press, but you could also do blueberry vinegar or strawberry vinegar, these are specialty vinegars. You put maybe a tablespoon in this glass of sparkling water, you could put it in a wine glass. It looks pretty.

Amy:

That’s a really great idea. I have an obsession with flavored vinegars so I’m thinking-

Dr. Felice Gersh:

Oh, me too.

Amy:

I’m thinking right now in my cabinet I have peach vinegar, I have pineapple vinegar, I have a cranberry-pear. All of those sound good. You know what I’ve been doing lately because I got into a little habit of having my 5:00 glass of wine to unwind, and I needed to get off of it, but I still needed to feed the habit I guess in some way. So I’ve been drinking, I dilute kombucha tea with mineral water. You definitely get… It has that fermented taste like vinegar, and I still feel like I’m having a little celebratory drink because I got through the day.

Dr. Felice Gersh:

I think that’s so wonderful with these is that if you put it in a pretty wine glass, if you have the Waterford, put it in the crystal and make it look so pretty because presentation really changes how we perceive things. But when you do it with these wonderful vinegars like you mentioned, and I want to try, I haven’t had the pineapple vinegar, but when you do that they actually are improving your… They’re like aperitifs in that they improve your appetite, and they actually start getting your digestion going because they’re wonderful, and they help regulate blood sugar. All the side effects are benefits that’s what I love about natural things.

Amy:

Oh my gosh, this is the best tip that I’ve come across in a long time, so I can’t wait to try that. Thank you so much for taking the time out of your… I know you’re such a busy woman, you’re jet setting all over the place giving talks about women’s hormones, but you also have a practice. I was wondering if you could tell our listeners more about how they might be able to work with you.

Dr. Felice Gersh:

Well, I am still an old-fashion doctor, that’s my main job. I have a practice, it’s called The Integrative Medical Group of Irvine in Southern California; Irvine, California. I see patients five days a week in my office. I do physical exams, I do everything that typical gynecologist does but then we do more. In my office we actually have a gym, we actually do fitness classes, we do fitness assessments. I have vascular ultrasounds so that we can assess in the appropriate people what the state of their health of the cardiovascular system. We have massage therapy, we do essential oils, we do bio-feedback. We do a lot with bio, we call it mind-body medicine. So we do all these different things.

Then for patients who can’t really make the journey to Irvine, then we do telemedicine, and we can do a lot. If I can’t prescribe because it’s across state lines, I can create a treatment plan that you can then take to your own doctor, I can order labs. We can do a lot with telemedicine. In California, I can actually treat you 100% in terms of I can prescribe, I can do all the different things, but across state lines, I can do everything except prescribe pharmaceuticals.

But since I try to avoid prescribing pharmaceuticals, that usually isn’t a big problem because we can talk about it another time, we were talking about all the negatives of pharmaceuticals. That’s a huge, huge area of interest for both of us, so that’s not my first line of treatment for the vast majority of my patients anyway. With telemedicine, I can accomplish a great deal with people in the US or even now on any continent on the planet.

Amy:

Oh, that’s so fantastic because I know in years past when I’ve talked to you, you were so limited. You’re such a trailblazer for women with PCOS, and just to let people know that you have PCOS too, so you know the struggles and you have overcome them. You’ve written about it in your two books, PCOS SOS, and again PCOS SOS Fertility Fast Track, and I really encourage you to pick up a copy of those books. They’re available on Amazon and Kindle as well. Thank you, Dr. Gersh, for joining us again and sharing your wonderful wisdom with us.

Dr. Felice Gersh:

It’s always a pleasure, and it’s just a joy to have this time to talk to you and to talk to all of your very avid and devoted listeners.

Amy:

To all of my listeners, thank you for tuning in again. I look forward to being with you again soon. Bye-bye.

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