Herbal Supplements for Treating PCOS [Podcast]

The natural treatment of PCOS is a passion of mine.  I am happy to share this passion with Dr. Lara Briden, a well respected naturopathic physician.  Dr. Briden is my “period guru.”  Her new book, The Period Repair Manual, was on my list of vacation reading.  For every woman who has ever thought, “I will never have a regular period,” this interview is for you. In our 40 minute interview, she addressed many of the questions I get about herbal supplements for treating PCOS symptoms including insulin resistance, hirsutism and ovulation issues.

In our time together, she explained:

• Why doesn’t the same herb work for all women with PCOS?
• What herbs are best for different symptoms?
• Is it safe to take herbs while you are taking fertility drugs, pregnant or breastfeeding?
• What are the benefits and constraints of herbs  such as vitex, peony, licorice, spearmint, turmeric, saw palmetto, myo-inositol, berberine and more?

I am happy to announce that high-quality berberine (as mentioned in this interview) is now available in the PCOS Diva store!

If you enjoyed this interview, read Dr. Briden’s other articles on PCOS Diva: The Problem with Dairy and Exciting New Treatment for PCOS- Berberine as well as our last interview about the pill.

A complete transcript follows. 

All PCOS Diva podcasts are now

Dr Lara Briden is a board certified Naturopathic Doctor. She qualified from the Canadian College of Naturopathic Medicine in 1997, and currently runs a busy hormone clinic in Sydney, Australia. Lara has worked with PCOS patients for nearly twenty years, and she’s passionate about what natural treatment can do for the condition. Earlier this year, she released her book Period Repair Manual: Natural Treatment for Better Hormones and Better Periods

Lara lives with her husband and teenage step-daughter, and divides her time between Sydney, Australia and Christchurch, New Zealand.

INTERVIEW TRANSCRIPT

Amy:                Hello, this is Amy Medling. I’m a certified health coach, and I’m the founder of PCOS Diva. This is the PCOS Diva podcast. Lately, I’ve been getting a lot of questions about herbals and natural remedies to treat PCOS. I think more and more women are disenchanted with some of the pharmaceuticals or just really want to look for a way to be able to manage their PCOS in a more natural way. I wanted to reach out to a wonderful previous podcast guest, Dr. Lara Briden. If you are interested in learning more about the pill and the pros and cons about the pill in treating PCOS, be sure to check out that podcast. It was from last June. I asked Dr. Lara to join us tonight to talk about some of these herbal remedies for PCOS. Welcome, Dr. Lara. Thanks for being here.

Dr. Lara:          Hi, Amy. Thanks so much for having me again. Always love chatting with you.

Amy:                Let me tell listeners a little bit about you and your practice. You are a naturopathic doctor, and you have a busy women’s health practice in Sydney, Australia. You have a very strong science background, which I love. You’ve worked actually as an evolutionary biologist before qualifying as a naturopathic doctor from the Canadian College of Naturopathic Medicine in Toronto. You are very passionate about hormones and health. That’s why I think we’re kindred spirits. You help many, many patients with PCOS, endometriosis, and a whole host of other period problems. I am just thrilled to say you are also an author of a brand-new book that has just been published called The Period Repair Manual. You live in Sydney with your husband and your teenage daughter.

I have to tell you, I just went on vacation. My relaxation reading is actually books like your Period Repair Manual. I took that. I think I took The Bulletproof Diet book by Dave Asprey and The Adrenal Reset Diet by Dr. Christianson. I have to say, I loved your book. I read most of it on vacation, and I have to tell you a funny story. I was sitting by the pool reading the book, and I was eavesdropping on a conversation that these women were having behind me. They were talking about their teenage daughters and their periods, and all of the problems that they’re having. They were wondering, “Is this normal, or is that normal?”

I couldn’t resist. I turned around. I said, “I can’t help it, but I’m reading this great book. You really should pick up a copy.” I think so many women are just really confused about what is normal and what isn’t. I think your book is a great place to become educated and empowered. Why don’t you tell us, what were your thoughts behind deciding to sit down and write this book?

Dr. Lara:          Yeah. That’s a great story. I often find myself overhearing stories, because women are all the same. What’s happening in our popular culture, and I think it’s great, is that periods are coming out into the open. More and more people are talking about periods. It’s almost like it’s for the first time. We’re really having, as a society, an open conversation about something that is so natural and normal for 50 percent of the population, yet it’s strange that we haven’t really talked about it before now.

In terms of bringing out my book, and why now, and why this year, looking back, I think this is a great year to bring it out, because 2015 is the year of periods. It fits right in with what a lot of people are wanting to know about. For me, I just really wanted to get out, after 20 years of clinical work and work with my patients, that I know, and as you know, I’m sure, with your PCOS Diva work, the natural treatments, the diet changes are so effective for period problems. The message just has to get out there more. Women need to understand they have real options to make real differences to period symptoms, which can otherwise … Periods can seem a little bit mysterious sometimes, I think, but they’re really not. They’re just a natural part of our body. They respond to all the things that our body needs.

Amy:                Yeah. I love how you broke the book up, too. Really the first section of your book is really about learning to dissect and understand what a period is and really understanding what a period should be like and what could go wrong. You have a wonderful section on birth control options looking beyond the Pill. Then you really go into treatment, and then learning how to advance troubleshoot. There’s fantastic information. I was preparing for the interview tonight and thumbing through what I highlighted. I starred this statement, and I thought, “Oh my gosh, this is so treatable.” You said good periods require good nutrition. Tell us about that.

Dr. Lara:          Yeah, the other thing that I talk about in there, I had some feedback from some of my readers that they loved it, was that our periods are essentially our monthly report cards. Our period are not separate, kind of what I was saying before. They’re not separate from the rest of our body. Everything that we need to do to make our body healthy generally is going to have a beneficial effect on periods. In a way, periods are the crowning, the report card. They’re the ultimate finish line in terms of our health. Of course we need nutrition, just because the ovaries are very, they require a lot of energy, a lot of nutrients, high levels of zinc and selenium. They need that. I think when we give them what they need, I think many of my patients and readers are quite surprised. I’m sure some of your readers are quite surprised at what their bodies can do.

Amy:                Yeah. The dietary and lifestyle changes can happen fairly quickly. Like you said, it’s a report card. I know when I was really struggling with PCOS, my periods were absent, or I would have these long periods of this breakthrough bleeding, low-progesterone type cycle. Now, my periods are pretty much like clockwork, which is just amazing to me, but I’ve completely changed my lifestyle and have done a lot of the things that you’re talking about in terms of treatment in your book, is something that I’ve been doing. I see it with women that I work with, too. I think women with PCOS think that they’ll never get a regular period, but I think it’s possible.

I wanted to also ask you, I thought this was really interesting in your book. You have, I think, a unique approach to looking at PCOS. You’re looking at it in terms of different, I don’t know, would you describe it as phenotypes or different categories of PCOS? You have a great little flowchart to help you determine what phenotype you are. Then you give some wonderful therapies for your type. Can you explain for the listeners … I probably didn’t do a great job explaining that … your chapter about PCOS and give us an overview?

Dr. Lara:          Absolutely. No, I’m happy to talk about it. I’ll just share a bit of background. What I put into the book and my approach to PCOS, some of it came from research, what’s out there, the information. Some of it was just from on-the-ground 20 years with PCOS patients. It’s like, “What is happening here? What really works?” I had to just learn by, I hate to almost say, but trial and error with two decades of patients. It’s like, “Okay, let’s just get some things happening here,” because my goalpost for PCOS for most people is they should be able to have regular periods. We should be able to re-establish a normal ovulation. I’d say that happens in the vast majority of patients. Of course, there are always going to be a few women for which it’s just a bit more complicated, but that’s the minority. The majority of women can, I think like yourself, get normal, regular periods, even though they have a past diagnosis of PCOS.

The subtypes that I’m talking about, it really comes down to the fact that PCOS is not a complete diagnosis. It’s quite common in medicine. It’s what’s called an umbrella diagnosis. What that means is that it’s a clinical picture of which the androgens and anovulation, a set of symptoms that occur. They call that PCOS, but within that group of women that have been given this diagnosis, they’ve arrived there for lots of different reasons, for a few main different reasons. They’re actually quite a diverse group. What that means is it can be very confusing for the patient and for the doctor, because you’re reading, for example, PCOS, okay, it’s about insulin. It’s about treating that. What about that group of women for whom it’s not about that? That wasn’t the problem. That’s not why they ended up with a diagnosis of PCOS.

I just try to take a step back and say, “Okay, we have this set of symptoms. We can all roughly agree on what those symptoms are. Ultimately, it’s a problem with, for some reason, ovulation is not occurring. These women are not progressing to monthly ovulation. Let’s take a step back and treat that reason.” Of course, and I do say this in my book, it’s about 80 percent of women who’ve given the diagnosis of PCOS, that reason is insulin resistance. It is a problem with insulin. Of course, that predominates the discussion about PCOS, as it should. Then there’s this other 20 percent of women for whom it’s actually about something quite different. That’s what I try to talk through in the book.

Amy:                In the book, you do talk about herbal remedies for PCOS. I know I’m hearing a lot about vitex lately. It’s definitely an herbal that can help with, supports progesterone. I think that it’s becoming more mainstream. Just from my Facebook page, and I actually have a private group of women who have gone through Jumpstart, women are much more open about what they’re doing and share the pros and cons of some of these therapies that they’re on. There’s a lot of mixed reviews about vitex. Can you tell us a little bit about what it is, and how it helps, and what we should know about it?

Dr. Lara:          Okay. Absolutely. It’s a herbal medicine made from a berry, actually. It’s an interesting herbal medicine in that it’s made the fruit of the chaste tree. The scientific, the Latin name is vitex. It has a long history of use. It’s actually been clinically trialed. Its main use more recently, I know it’s widely used in Germany for PMS and treating premenstrual syndrome and premenstrual depression. Its greatest success is in that area, because it has an effect … We think of it as a progesterone-boosting herb, but basically what it does, its active components act on the communication between the pituitary and the ovaries. It helps to stimulate ovulation and a stronger ovulation. Then that secondarily leads to a higher level of progesterone.

The tricky thing about the herb is it, because of the mechanism, the way it works, the communication, what it does between the pituitary and the ovaries, actually I would say in the majority of PCOS cases, it’s doing possibly the wrong thing. Yeah, I’d like to try to describe that a bit more. Is there anything you want to ask me about what I’ve just said about vitex?

Amy:                Yeah. You were saying that for some women with PCOS, it does the wrong thing. Maybe you could go into more detail about that.

Dr. Lara:          Okay. A lot of it’s to do with a couple of hormones that come from the pituitary. One is called prolactin, and one is called LH. Both of those, they come from the pituitary, but they act on the ovaries. They can either inhibit or stimulate ovulation, depending on the amount of hormone. Vitex suppresses prolactin. That’s basically its main mechanism of action. That allows, by suppressing the amount of prolactin that’s coming from the pituitary, that permits ovulation to occur more strongly. Vitex is most helpful in women that have a slightly elevated prolactin. Absolutely clinically, that’s what we find. I do a lot of blood testing with my patients. Before I ever give vitex, I will usually measure prolactin and LH, is the other hormone we’re going to talk about now, just to get a sense of what the herb is going to do.

The problem with vitex for PCOS is that there’s some evidence that vitex can increase a hormone called LH, which is typically commonly elevated, already elevated, in PCOS, in the classic type of PCOS. This conversation now about PCOS comes back to what we were talking about earlier, about PCOS being an umbrella diagnosis. The reason we’re getting mixed reviews is, there are women out there that have been given the diagnosis of PCOS, but they don’t have elevated LH. They possibly do have a slightly elevated prolactin. Hormonally, they’re actually quite a different picture than the 80 percent that are insulin resistant and have elevated LH.

There’s this subgroup that they have the PCOS diagnosis, but for them, actually vitex is the perfect herb, and it ends up stimulating ovulation and working really well for them. That’s particularly true … I’ll just say the group that works for is the women who have a post-Pill PCOS, who have come off the Pill, they’re not getting their periods, they get slapped with sometimes, I think, mistakenly with a PCOS diagnosis because they’re not having periods. Yet, they don’t have insulin resistance. They don’t have elevated LH, but vitex works for them. Summary, that’s who it works for.

Amy:                That really explains it, because they are such mixed reviews. Some women swear by it and think that it’s been wonderful in terms of regulating their periods, restoring them. Others, it’s just making things worse. It’s just so confusing for us, because there’s really no one-size-fits-all approach. I think that’s what it really comes down to.

Dr. Lara:          Yeah. Sorry to interrupt. I’ll just say, what makes it simpler is I think I’d encourage anyone with PCOS or thinking about vitex to get a baseline LH, prolactin, a baseline FSH:LH, those are the hormones, ratio, and just have a look at that.  If it’s elevated LH, I would say to be very careful. You can not use it, I guess, but I would just say … Straight away, that’s just a screening way, that’s a way people can try to determine if it’s going to be the right herb for them.

Amy:                Okay. Let’s move on to some other herbals. There’s lots of remedies, natural ways to help manage your PCOS symptoms. There’s a lot of nutrients, so things like inositols, and making sure your vitamin D is optimized, and your B vitamins are optimized. In this call tonight, we’re not talking about the nutrients. We’re really focusing in on the herbals. Let’s talk a little bit about … I think two herbals that I don’t see talked a lot about in PCOS circles, but certainly I remember years ago when I went to my first naturopath to be treated for PCOS, it was something that she put me on. That’s peony and licorice. Can you tell us how in your practice do you use those herbals, and maybe what type of PCOS are those best suited for?

Dr. Lara:          Yeah, great question. I use peony and licorice a lot. I think readers will see that on my blog. I speak about it quite a bit. It’s interesting looking at that, because I trained in North America, of course. I trained in Canada, but I never really encountered peony and licorice as a treatment until the last 15 years I’ve been working in Australia. I think Australian herbalists and naturopaths are more influenced by traditional Chinese medicine. Peony is a Chinese herb in a lot of the traditional Chinese formulas. It’s a synergistic combination, the two herbs, peony and licorice. They work together, definitely.

Peony, I think of it as an alternative to vitex, essentially. It’s another herb that works on the communication between the pituitary and the ovaries. Again, it’s an ovulation-stimulating herb, although the difference is that peony has quite a strong anti-androgen effect. It reduces androgens and works directly on the ovary to promote the production of estrogen rather than testosterone. It’s a far better herb for the classic type of PCOS, I think. I do know that it hasn’t been trialed, it hasn’t been clinically studied as much as vitex, but it’s used in a similar way. It’s my herb of choice if I’ve done the blood test for LH and I see that LH is elevated. There’s, I think, at least one study that I quote in the book that talks about peony normalizing testosterone and normalizing LH.

Amy:                Somebody just asked me a question recently about what herbals are best for elevated testosterone and the symptoms like hirsutism. Is peony something that would help there?

Dr. Lara:          Yep. Yep. I’ll just say, in terms of what … Anything like that for PCOS, if someone’s asking you what’s the best treatment for hirsutism and for lowering androgens, ultimately the best treatment is whatever treatment that type of, for that woman, what her type of PCOS needs to be able to ovulate regularly. You’ll know from my book, I just keep coming back again and again and again to ovulation. It’s all about ovulation. If PCOS sufferers can re-establish a normal ovulation, that means they’re making a normal amount of estrogen, a normal amount of progesterone. Those hormones made by the ovaries are the strongest anti-androgen treatment. Progesterone is a natural androgen blocker. It’s ultimately about re-establishing the presence of the female hormones in the body. That will help with hirsutism.

I don’t think of treating hirsutism as a separate … Again, it’s not a separate thing. It’s one of the symptoms. Just back to PCOS, keep in mind 80 percent of sufferers, it’s because of insulin resistance. For those women, I think ultimately the best treatment for their hirsutism is something like myo-inositol. You mentioned the nutrient that sensitizes to insulin. There’s a number of really important nutrients and diet changes that normalize insulin. That’s what’s going to bring androgens down.

Amy:                The peony and the licorice, I know I took it short term to get my cycle on track, and then I stopped using it. What is your protocol for, yeah, prescribing that to your patients?

Dr. Lara:          Very similar. For both vitex and peony, I don’t think of them as a long-term “you’re now going to take this for two years” kind of treatment. It’s essentially stimulating the ovaries. It’s like, “Let’s see if we can get this happening.” I think of ovulation as essentially just getting the ball rolling. Once they’ve ovulated, that puts things in motion for the next ovulation. Once they start going and cycling, you usually shouldn’t need to keep stimulating them every cycle with something like vitex or peony.

I should say here at this point, just for your listeners and just to be really clear as a safety thing, that because both vitex and peony stimulate ovulation and stimulate the ovaries, they should essentially not be used in combination with fertility medication like Clomid or anything, or the IVF-stimulating cycles, because at least for vitex, there’s been at least one clinically documented case of ovarian hyperstimulation or overstimulation of the ovaries. They’re not to be taken lightly. They’re medicines.

Amy:                Yeah. I think it’s really important that you talk to your medical professional before you take any, because they’re powerful agents. I know with licorice, too, and a lot of women with PCOS do have high blood pressure, so that’s something to consider, as well, not to take it if you do have a history of high blood pressure.

Dr. Lara:          Exactly. I agree.

Amy:                I just was going to ask you, another herbal that often you see suggested for high androgens is saw palmetto. Is that something that you use in your practice? It’s I think mixed reviews as to whether it’s really helping or not, but what’s your thought?

Dr. Lara:          I don’t use it. That’s not to say that I’m opposed to it. Certainly I know there are naturopaths out there using it. The idea behind its use is that it blocks, essentially, if I’ve got this right, it blocks androgens or male hormones at the receptor. I think of that as a Band-Aid approach. I’m always looking for treatment that re-establishes ovulation, that normalizes the underlying process, because as I said, that’s how you then get the beneficial estrogen and progesterone that you need. Because I don’t see that saw palmetto is really doing anything to address the underlying process, I tend to focus more on herbs like peony or I guess the other herb, which hopefully we’ll have time to speak about a little bit today, is a herb called berberine, which also helps with PCOS and therefore helps to lower androgens.

Amy:                Yeah. I want to talk about berberine. Just quickly though, I was also curious about spearmint. I know there’s a lot of women with PCOS drinking spearmint tea in hopes of reducing the hair growth. I know that there’s been some positive studies done with spearmint tea. Is that something that you prescribe?

Dr. Lara:          I don’t prescribe it. I am aware of some of those studies. Again, it’s because of it having a general anti-androgen or androgen-blocking effect. I think it’s fine. There’s nothing wrong with taking some mint tea. Obviously, that’s a simple extra thing that women can do. I don’t think it replaces the other work that they need to do in terms of normalizing ovarian function.

Amy:                Yeah. All right. Let’s talk about berberine. For listeners, Dr. Lara wrote a really excellent article on PCOS Diva about berberine. For more in-depth info and links to studies, you can check that out. Why don’t you give us an overview of berberine and how that is becoming an up-and-coming herbal remedy for PCOS?

Dr. Lara:          It’s an up-and-coming herbal remedy for a lot of things. I will try to speak about that and speak about that for PCOS. Berberine refers not to the name of the plant or to one herb, but to the active constituent found in a few different herbal medicines, including goldenseal and a couple of others. It’s actually a herb that’s been in use for a long time. It has different properties. Traditionally, it’s been used as a natural antibiotic.

What it’s doing for PCOS and for other conditions ultimately is that it has quite a strong anti-inflammatory effect. I think that’s why, in terms of PCOS, that’s why it helps to normalize the insulin response or the insulin receptors. Berberine has been trialed for PCOS. It’s done really well, as you’ll see. Listeners can refer to that blog post, which I’m sure we’ll link to, that I wrote back for you in December. It’s done well in terms of normalizing insulin sensitivity, therefore reducing the production of testosterone by the ovaries. Ultimately, it’s done well in terms of fertility trials. It’s a pretty exciting herbal medicine. I use it a lot. Yeah.

Amy:                There are some precautions. If you were going to go and order berberine online, what do you need to know? What do you need to think about?

Dr. Lara:          Yeah. Fair enough. I guess the first thing is it should not be used during pregnancy or breastfeeding. That’s the first thing. Berberine can also, just because of the way it affects the body’s detoxification pathways, it can alter the levels of other medications in the blood stream. If someone’s on something like an immunosuppressant or antidepressants, or medications that the actual dose of their day-to-day medication is tricky to control, then I think they should definitely speak to their doctor before they try berberine. That doesn’t mean you can never take it if you’re taking other medication, but it’s just something to be a little bit more careful about.

I guess the other thing for berberine that I use in my own practice, the other precaution, is that, again, like many herbs, I don’t think it’s the kind of thing you just get on and stay on indefinitely. I tend to use it for a period of time, maybe, say, eight or 12 weeks, just to normalize insulin sensitivity and then take a break from it again. The reason I do that is because it does affect, it alters intestinal bacteria. That’s probably a good thing in the short term, but I think just anything, any medicine that we’re using long term that’s affecting our bacteria, I think we should take breaks from it.

Amy:                Would you suggest making sure that you’re on a probiotic, as well, while you’re taking it?

Dr. Lara:          I don’t usually. Often, I’ll follow it with a probiotic. Probiotics are in the same category, what I just said, any medicine that alters levels of intestinal bacteria. Probiotics or supplements are in that same category, so I would rarely give a probiotic for longer than, one strain or one product of probiotic, for longer than two or three months at a time, as well. I have quite a great deal of respect for intestinal bacteria. I like to give it a chance to find its own balance. Yes, I guess in answer to your question, yes, I do. I think it combines well. A typical protocol I might do is eight weeks on berberine and then four weeks on a probiotic.

Amy:                Oh, okay. I’m going to ask you about another herbal. A lot of women with PCOS are dealing with inflammation. You wrote wonderful section in your book about inflammatory cytokines. I just interviewed Dr. Felice Gersh, and we talked about inflammation in PCOS. She talked about cytokines, as well. I know a lot of women with PCOS now are also taking turmeric. Is that something that you think would be beneficial for us to be adding to our supplement regime, or even just using it in food? It’s a great spice to put in soups and stews. I even sprinkle some on eggs in the morning.

Dr. Lara:          I would say yes. I guess the short answer is yes, I think it’s a great herb. I think in my book I specifically mention it for the inflammatory type of PCOS that I’ve defined. For some PCOS sufferers, it’s highly beneficial. The main thing about turmeric, as opposed to some of the other herbal medicines that we’ve just spoken about today, it can be used long term. It’s ridiculously safe. It’s one of these herbs where it’s almost like, as you read about it, you’re like, “Wow, where is the downside?” It just almost has no toxicity at all, no concerns. Yeah, it’s a great herb.

Amy:                All right. Then I think finally, I just wanted to ask you about herbs that support our adrenals. I think that women with PCOS, we really have to work on our stress levels. I think a lot of the women that I work with tend to have adrenal fatigue. I know that herbs like ashwagandha, rhodiola, what herbs are you using to help with the support your adrenals?

Dr. Lara:          Yeah, those are the two. You just said them, ashwagandha, rhodiola. Licorice is in that category, too, actually. We spoke about licorice earlier. They help to regulate the hypothalamus pituitary. Again, they’re working on the communication between the pituitary and in this case the adrenal glands. Cortisol helps to re-establish a normal cortisol curve. Through the day, we’re supposed have quite high cortisol in the morning to give us energy and then drops down at night so that we can sleep. Absolutely what our adrenal hormones such as cortisol, their pattern of being produced in the body has a huge impact on female hormones.

If you think about it, really, if your listeners don’t … They probably already know this, but I’ll just say. Cortisol is a steroid hormone, just like progesterone and estrogen and testosterone. The two main producers of steroid hormones in our body are the adrenal glands and the ovaries. They’re communicating. They’re actually pushing steroids out into a common pool of hormone. Some of it’s being interconverted. It just intuitively just makes sense that what our adrenal glands are doing is very important for anything to do with female hormones.

Amy:                Yeah. It’s almost like you have to manage your cortisol so that you can manage the rest of your hormones.

Dr. Lara:          Yeah. Sorry to interrupt. Cortisol also has a huge impact on insulin sensitivity, as well, so it ties it into that other insulin part of PCOS.

Amy:                Yeah, and progesterone, too. Can you explain why cortisol steals from progesterone and why it’s so important? Yeah.

Dr. Lara:          Yeah. Progesterone, as well as being its own hormone, … it’s quite an important hormone in its own right … it’s the precursor to other hormones, including cortisol. From the body’s perspective, if it feels like you need more cortisol, more of the life-and-death emergency hormone cortisol, it will just make it, to the detriment of all your … It’s just basically just take progesterone precursor and turn it into cortisol. That’s quite a profound waste in terms of your reproductive health. You’ve made this progesterone, but then it’s just been converted into cortisol. Of course, the body’s doing this, it thinks it’s in a life-and-death situation. It might just be that you’re trying to find a parking spot or got a stressful phone call, or something. Yeah, not really life and death.

I think herbs are helpful for normalizing that stress response, and so is, obviously as I’m sure you speak about on your website in lots of places, but lifestyle and scheduling time for rest. Not just sleep, but downtime. Some of these patients that I work with somehow aren’t able to give themselves permission to just do something fun or just do something for themselves. They either have to be working or looking after their kids. I’m constantly saying and writing on their prescription form, it’s like, “You have permission to go walk in the park, or have a massage, or something.” You need that. It’s not negotiable.

Amy:                I love that. I have to say, people may have already heard this story, but the whole idea of PCOS Diva and the name really came from my husband, because when I started taking care of myself and making sure that I had that downtime, he started calling me a diva. I thought, “You know what? That’s absolutely what it takes for me to be able to manage my health. I have to take time for myself.” I love that you write that as a prescription for your patients, because it’s, gosh, it’s so important. Women have to realize that they’re worth it. They’re worth taking care of.

Dr. Lara:          I love that story about the … I did not know that about the name of your blog. I love that. Yeah. The fact that we have to steal it back for ourselves as women, to steal back that permission, I think maybe says something about how far we’ve been pushed.

Amy:                I know.

Dr. Lara:          Yeah, the way I think … Go ahead. Yep.

Amy:                I was just going to say, and I think it’s asking for what you want. A lot of that was unapologetically. In a restaurant, asking exactly for what you want to eat. It doesn’t have to be a rude thing, but you have to advocate for yourself. It’s okay to want what you want.

Dr. Lara:          It is, and it’s okay to give yourself things. When I’m writing that prescription for downtime, I’ll often say, if my patient looks a bit doubtful, I’ll say, “Okay, think about it as, let’s say you schedule an appointment with an expensive medical specialist or something. You’re going to keep that appointment, because that’s for your health. That takes priority. That’s what it’s like. That’s what your date with yourself should be like. That’s an important thing for your health. It’s not any different, really, than your appointments with your doctors or whatever it is. An investment in your health.”

Amy:                Yeah. That’s such a great message to end our podcast on. Any other words of wisdom for us tonight?

Dr. Lara:          I think just what I said to you earlier. Trust your body. I’m speaking very earnestly from 20 years of doing this. The human body, the female body, is just an amazing thing. I think transformation can happen. I know that’s your message, Amy. I support it 100 percent.

Amy:                I really want to encourage everybody listening to seriously consider picking up a copy of Dr. Briden’s book, Period Repair Manual: Natural Treatment for Better Hormones and Better Periods. Gosh, I highlight books, so as I’m flipping through it, the whole thing’s highlighted, because there’s just so much great information. I walked away learning lots of new information. Great book to have in your reference library. I will post a link to it under this podcast. Thank you again for joining us again, Dr. Briden, and talking about PCOS herbals. I look forward to having you join us again sometime soon.

Dr. Lara:          I would love to come back. Thank you so much for having me, Amy.

Amy:                Thank you, everyone, for listening.