Hormone Repair- Menopause Edition [Podcast with Dr. Lara Briden]
We all know women in that age group, into menopause, after perimenopause, where they just get a lot of stuff done. They’re running volunteer organizations, doing a PhD, or traveling the world. So that really flies against this idea that somehow, menopause is the beginning of the end and it’s over now. It’s completely the opposite. – Dr. Lara Briden
Dr. Lara Briden is a naturopath doctor, women’s health activist, and best-selling author of two books which I and countless others use as a foundation for natural management of hormones. She is a long-time friend of PCOS Diva and has contributed her uniquely accessible wisdom in many ways. Her new book, The Hormone Repair Manual, is for those of us born before 1984 though it’s food for thought for all of us. Dr. Briden’s advice can help us approach perimenopause/menopause or “second puberty” with grace and ease. She describes this time as a hormonal recalibration and an opportunity to thrive in all new ways. Listen in or read the transcript as we discus how to approach menopause as well as:
- How to talk to your doctor about possible treatments
- Why progestins of hormonal birth control are NOT the same thing as progesterone
- Benefit of keeping your cycle going as long as possible
- Insulin resistance management tips
- Why a vegetarian diet may not be the right choice
All PCOS Diva podcasts are available on:
Mentioned in This Podcast:
- The Period Repair Manual
- Hormone Repair Manual
- larabriden.com
- Intermittent Fasting
- The Problem with Dairy for PCOS (Guest post by Dr. Briden)
- PCOS Diva Podcast #80: PCOS & Ovulation: The How and Why [with Dr. Lara Briden]
- PCOS Diva Podcast #48: 4 Types of PCOS and How to Treat Them- Which type are you? [with Dr. Lara Briden]
- PCOS Diva Podcast #19: Herbal Supplements for Treating PCOS [with Dr. Lara Briden]
- The central role of ovulatory disturbances in the etiology of androgenic polycystic ovary syndrome (PCOS)—Evidence for treatment with cyclic progesterone
Complete Transcript:
Amy:
Today, I am going to welcome back, one of what I think, she’s really a thought leader, a pioneer in women’s hormone health and I’m so excited to have her back on the PCOS Podcast. Welcome, Dr. Lara Briden.
Dr. Lara Briden:
Thanks Amy. Thanks for having me. We were just reminiscing about our previous interviews. This is my third time with you now, I think?
Amy:
Yeah.
Dr. Lara Briden:
And we go way back, which is nice.
Amy:
I know. We were talking about how, when I was really searching for other experts who felt the pill was not a great therapy for PCOS, and there was other ways to manage it. You were one of the other voices out there, 10 plus years ago-
Dr. Lara Briden:
Yeah.
Amy:
… really talking about it. You were the first person that I think, was really talking about types of PCOS, based on what you were seeing in your practice. And you talked about that in your… It’s really a groundbreaking book, The Period Repair Manual. You’re a naturopath doctor, you’re the best-selling author of now, two books.
Dr. Lara Briden:
Yeah.
Amy:
The Period Repair Manual, and the brand new, Hormone Repair Manual. And they are really, both practical guides for treating period problems, women’s hormones, with nutrition supplements, and bio identical hormones. And although you studied in Canada-
Dr. Lara Briden:
Yeah.
Amy:
… you moved down under and you were in, I think when we first started chatting, you were in Sydney, Australia, but now you’re in Christchurch, New Zealand and you have a practice there where you treat women with PCOS, PMs, endometriosis, perimenopause. And you are really active on social media and have some great social media. Your Instagram is fantastic, and I learned so much from you. So I’m so glad that you’re going to be here and I’m sure I’m going to learn a lot more today.
Dr. Lara Briden:
Good.
Amy:
So I’ve been reading your Hormone Repair Manual. It’s your brand new book out, and it’s really geared for women over 40-
Dr. Lara Briden:
Yep.
Amy:
… as we enter perimenopause and menopause. But if you’re listening and you’re younger than that, I encourage you to keep listening because you’re going to get a lot of information that’s going to be really important to safeguard your future and your future health. What you do now really makes a huge difference. But I wanted you to, first of all, explain why you wrote this book and I love how you frame the stage in a woman’s life. So, if you could share that with us?
Dr. Lara Briden:
Yeah. Sure. Similar to Period Repair Manual, for me, the writing of this book was to fill what seemed like a gap in the information. Obviously, there are lots of books about menopause, but a lot of it seemed to be perpetuating this idea that it all happens later, menopause is in our ’50s or something, it’s off in the future. When clinically and in the research, every place, we know that the process of perimenopause, which is the 2 to 12 years before the final period and the first year after the final period, that is when symptoms occur.
So actually, by the time you get to the early ’50s, a lot of it’s behind you. When women really need help, is in their ’40s and even late ’30s. So one of my messages is, if you were born before 1984, you need to think about this book for you, because the changes start then. And you put it quite well when you said, preparing for it and stabilizing our health, as we head into what I call, second puberty, can make the whole process a lot easier.
It’s a hormonal recalibration. It’s not about aging. This is one of my key messages too. It’s happening alongside aging, but perimenopause and menopause, the second puberty and the stopping of ovulation, is not because of aging. Some women go through it earlier than others. It’s not because they did something wrong and they aged more quickly, it’s nothing about that. It’s actually, largely in our genetic blueprint as to when we’re going to start to go through these changes. Whereas, I explained in the book, I think we evolved to have menopause, it’s not just an accident of living too long. It’s something we do and it’s important, it’s an important life phase.
Amy:
Yeah. And just quickly share your anecdotal information about hunter-gatherer’s societies.
Dr. Lara Briden:
Yeah.
Amy:
And the role, women this age play. It’s a very important role.
Dr. Lara Briden:
It’s not just anecdotal, so this is in the research-
Amy:
Yeah.
Dr. Lara Briden:
… of existing- the few foragers groups that still exist in the world. Obviously, there’s not many of them and from that, we can try to infer what prehistorically, might’ve been happening. But women in their ’50s and ’60 and even ’70s in those groups, are highly productive. So they’re no longer reproductive, they’ve stopped having their own babies, but they are gathering a lot of food. They’re doing a lot, they’re holding it all together for the group. In fact, they gather more food per capita than any other demographic, which I love.
I’m just imagining because they know what they’re doing, right? They’ve got skills. So they’re bringing in more food, calories for the group, than the young people, than the teenagers or certainly than, reproductive women because women of reproductive age are busy having babies and breastfeeding. So they’re looking after everyone, they’re bringing in more than men of the same age. So I love that.
And something about that, we all know women in that age group, into menopause, after perimenopause, where they just get a lot of stuff done, right? Even in our modern world, they’re running volunteer organizations, they’re doing a PhD or traveling the world, there’s just a lot going on and I think we intuitively understand that. So that really flies against this idea that somehow, it’s the beginning of the end and it’s over now, that’s completely the opposite.
Amy:
The other thing that you had mentioned is, there’s a lot of symptoms in perimenopause, a lot that are driven by estrogen dominance, which seems to be the hot, new hormonal topic these days, everybody’s writing about estrogen dominance. But the way that you feel right now, if you are in that stage, doesn’t necessarily mean that, that’s how it’s always going to be.
Dr. Lara Briden:
Exactly. Yeah.
Amy:
So maybe you could speak to that a little bit more?
Dr. Lara Briden:
Yep, the symptoms are temporary, so that’s one of the most important messages in my book, I talk about that straight away in chapter one. This is temporary, this too shall pass, this is part of the recalibration process. It’s second puberty, right? I give the analogy, when you watch kids go through first puberty and they’re having skin breakouts and mood changes and they’re struggling, but you don’t think, “Oh, that’s how they’re always going to be now.” Right? You know they’re going to move through that. That’s just part of the recalibration process. So yeah, that’s definitely the case for perimenopause.
And on the topic of estrogen dominance because it’s interesting. I don’t actually use that term, although I certainly understand what is meant by that. But it does speak to, one of the other things I’m trying to get across, is that especially, the earlier phases of perimenopause, I talk about the four phases. But in phases one and two, estrogen is not lower than before, it’s the opposite, it’s higher. It’s up to three times higher than it was in women’s ’30s. So it’s spiking up and down, it’s fluctuating, it’s the estrogen rollercoaster.
And when estrogen spikes up really high, it’s quite stimulating, it can cause irritability and mood symptoms, but also, it can cause a histamine or mass cell release, so our mass cell activation. So you get a lot of headaches and rashes and hives and nasal congestion and things like that and heavier periods. Actually, a lot of that’s from that whole estrogen, histamine side of things, that I describe in the book. And at the same time, of course, progesterone is quietly leaving the scene because the only way to make progesterone is to ovulate and ovulation becomes harder to do in second puberty.
That’s the whole basis of it, which is we’re starting to ovulate less often. And for some women, I mean, ovulation is always hard do because we’re on a PCOS Podcast, obviously. Being able to maintain regular ovulation is a challenge for other reasons as well, but it becomes even triply challenging during our ’40s.
Amy:
Yeah. And thank you for reminding me. I just want to tell listeners that we did a podcast, podcast number 80, on ovulation and PCOS.
Dr. Lara Briden:
Right.
Amy:
So dig in deeper, there’s a transcript for that as well. So, one of my very first podcasts, podcast number 7, we did one on healthy hormones and PCOS.
Dr. Lara Briden:
Right.
Amy:
So yeah, check those out. So when I started my PCOS Diva journey, blogging about it. I had a baby, my baby girl, and I remember telling my husband, “Oh my gosh, you’re in for it.” Because I’m calculating it in my head, because I had her at 37 and she’s 12 now, and she’s starting to go through puberty.
Dr. Lara Briden:
Yeah.
Amy:
And we see the little mood swings and I’m going to be 50 this year and I’m in the throes of perimenopause.
Dr. Lara Briden:
Yep.
Amy:
I said, “Oh, you’re going to want to move out by then.” But I would love for you to… And I know that every woman with PCOS, it’s a unique situation, but there’s some common themes for women with PCOS, as they enter this space in life. And I was wondering if you could go through some of those scenarios and maybe even share a story of one of your patients? Her name was Julie, in the book.
Dr. Lara Briden:
Yeah. Yeah. Let’s talk about that. So I’ll just preface it. There’s a few things going on, in terms of the overlap between PCOS and perimenopause and menopause. And one is a good thing. We were talking a little bit off air, how I have observed, and I think is a little bit of the science. That women who have that calibration to their hormonal system, that is PCOS basically, the longer cycles, the higher androgens that picture. Some of that’s genetic, as you know, tend to, I would say on average, have a longer-lasting fertility or potentially a later perimenopause, menopause, than women who are calibrated more normal.
I hate to use the word normally, because I think a lot of PCOS is partly, it’s just a difference in calibration. But so some women might find they’re going through, maybe going into perimenopause a bit later than their friends because of PCOS and actually cycles. Some women in their ’40s might say, “Wow, this is the most regular my cycles have ever been. I went from a long cycle to now, I’m having a 29 day cycle.” And their friends are having 21 day cycles, because our cycles shorten as we get older. So that’s one piece of overlap.
The other, there’s a couple of other things going on and then we’ll talk about Julie’s story. But one is that, especially in the later phases of peri-menopause, all of us, PCOS or not, experience a shift in insulin resistance and that is something we just all need to be aware of. Obviously, if there’s a background of insulin resistance already, then that is potentially going to be even more challenging. So it’s not like you had insulin resistance when you were younger and you got that under control. It’s always potentially, going to be something you need to be thinking about and try to optimize your insulin sensitivity, especially as you head into the later phases of perimenopause.
And another area of overlap which is related, is that with the later phases of perimenopause around the time of the final period, just leading up to that, we get a shift to, all of us, to what I call in this book, testosterone dominance. So we do get a lot more of the testosterone shining through, as our estrogen and progesterone drop away. And again, if you have a history of high-ish androgens, then that can become more pronounced and that’s all happening against the background. I have to acknowledge that for all of us, androgens are on a slow decline. They’re going down through our life.
Young women have more androgens than older women. That’s just true, whether you have PCOS or not, but we do get this temporary, little uptick in androgens and then we get this relative androgen picture, which would be testosterone in relation to estrogen and progesterone. And all of that can make PCOS and menopause look similar in some ways. They’re obviously different things, but there’s some overlap and I’ve seen that a lot with my patients. And then there can also be, in the case of Julie’s story, which is in chapter, something of the book. I think I forget. Yeah, chapter three. Yeah. This is chapter three, where I’m talking about cycle while you can.
Amy:
Yeah.
Dr. Lara Briden:
The value of knowing that cycling is going to end, knowing that observation is going to end, but keeping it going for as long as you can, there’s definitely benefits to that, whole body benefits for our health. And in Julie’s case, she was only 42 and her cycles had been getting longer and then they disappeared for a while. And her doctor did an ultrasound and saw that she had a thickened uterine lining, which is quite classic, PCOS at this point, but yet, her FSH was normal, that’s a test for menopause.
So, he said, “Well, it’s not menopause.” Because she was assuming she was in menopause. It’s not that, of course he said, “I don’t know what’s going on, take the pill.” But in her case, I perceived or I really felt that she had that PCOS picture, that she’d had it really, all her life and had not really been picked up on or described properly. But as she was moving into her ’40s, the insulin resistance had reached the point where it was strong enough to stop her periods for a while.
So, in her case, what she had to do to get her periods back in her ’40s, was to reverse insulin resistance and work on it that way. The interesting thing about Julie’s case and certainly women in their ’40s… I can’t remember. Yeah, she didn’t have the classic polycystic ovary appearance because she’s older. Right? So you know my view on the whole polycystic ovaries and PCOS, is a very messed up, confusing thing.
Amy:
Term, I know.
Dr. Lara Briden:
Yeah, because young women tend to have more follicles. So younger women will often show up with so-called polycystic ovaries, even when they don’t have PCOS. Conversely, older women can have a full blown androgen and ovulatory insulin resistance picture and not show polycystic ovaries.
Amy:
Yeah. And that’s why I think it’s so important that you educate yourself. I’m hearing from more women, as they enter their ’40s, that their doctors are telling them that, “Oh, now, I don’t think you ever had PCOS because you don’t have cysts on your ovaries.” And it’s so confusing. So it’s really important that we know what’s going on.
Dr. Lara Briden:
Yeah.
Amy:
And we can advocate for ourselves. So it’s really still important at this age, to manage insulin.
Dr. Lara Briden:
Yeah.
Amy:
And I know in Joy’s case, she needed some cyclical progesterone, natural progesterone therapy to help things along, as well.
Dr. Lara Briden:
Yeah. Well, one of the main reasons she needed that in her case, because of the thickened uterine lining, you’ve got to do something about that, right? So either she’s being offered the pill, women might be offered the hormonal IUD. It is true, that you can’t go on and on with a uterine lining that is thickened like that. So the advantage of cyclic progesterone therapy is that, it induces a bleed, but it also works to promote ovulation.
So Amy, I’ve probably sent it to you. I just published a peer review paper with Professor Jerilynn Prior, the Canadian Endocrinology Professor about, we called it the central and ovulatory aspect of PCOS and how that can be improved by cyclic progesterone therapy. So we can put that in the show notes. Yeah.
Amy:
Yeah. I would love to do that. And I think that to me, that is where physicians need to be educated. I think that there’s just not enough knowledge about how to use progesterone to help women with PCOS.
Dr. Lara Briden:
Yeah.
Amy:
So I guess, how can you bridge that subject with your doctor? You know, bring a copy of your paper to the doctor’s office?
Dr. Lara Briden:
Yeah.
Amy:
Yeah.
Dr. Lara Briden:
Well, there’s the paper, there’s also a protocol put together by Professor Prior for cyclic progesterone therapy, for ovulatory cycles, for PCOS, in particular. So in these both books, but in particular, this Hormone Repair Manual, as you know, I have sections called, How to Speak With Your Doctor, and a few talking points, in what I think is doctor speak, to be able to communicate what you need. And one of them is, “This is protocol put together by an endocrinologist for PCOS, with cyclic progesterone therapy, brand name Prometrium in the US or Utrogestan in some other countries.”
And say to the doctor, “I’d like to try it for a few months.” A lot of the times, when you’re talking with a doctor, just as a tip, they don’t necessarily need to be 100% convinced that it’s going to work. I mean, that’s a high bar to clear, convincing them, it’s going to work. They more, a lot of the time, just need to know that it’s safe to try.
Amy:
Yeah.
Dr. Lara Briden:
Do you know what I mean? That there’s some evidence that it’s not going to be harmful. And so with progesterone, it’s very safe, so that’s part of it. It’s like, “I’d like to try this, some women get results. Could I do this?” And often, if the doctors skeptical, what you can then say is, “Look, you know what? I’ll leave it with you for a couple of weeks. I’ll come back for another appointment.” Give them some time to think about it and regroup and then have another second conversation. And often, that will go better that time.
Amy:
Oh, that’s good advice. A lot, it seems like doctors are more comfortable prescribing synthetic, like Provera.
Dr. Lara Briden:
Yeah.
Amy:
Yet, they won’t prescribe Prometrium.
Dr. Lara Briden:
Which is crazy because, just in terms of risk and safety, this is very simply, progestins, all progestins are associated with a slight increase in risk of breast cancer and progesterone is the opposite. It may help to decrease the risk. So just purely from a safety perspective, progesterone is a win. Now potentially, something else for your show notes. There was recently a presentation by the International Menopause Society, so this is more around menopause, but it would apply to anything that you’re trying to use progesterone for.
A couple of scientists talking about how progesterone the real hormone, is not the same thing as progestins, it’s very distinct in its effect in the brain and the breast tissue, so that’s another resource, potentially. It’s quite long, I mean, it’s a 30 minute presentation. So doctors may not necessarily want to watch all of that, but at least it’s something to know that exists and is starting to make headway, in terms of debunking this idea that the progestins of hormonal birth control, are the same thing as progesterone, because they’re not.
Amy:
Yeah. And I remember doing research on this, eons ago, and it was Dr. John Lee, was the one that pioneered progesterone and didn’t Dr. Prior, pick up his torch, in a way?
Dr. Lara Briden:
I think she’s been going along independently, all along. She’s been doing it for 40 years.
Amy:
40 years, okay.
Dr. Lara Briden:
Yeah. But yeah, she would have overlapped with him.
Amy:
Okay.
Dr. Lara Briden:
I’ve never heard her mention him.
Amy:
Okay.
Dr. Lara Briden:
She’s a primary, she’s a research scientist. So yeah. But that’s something that other people have been out there talking about, the value of real progesterone.
Amy:
Yeah. So you mentioned the importance of maintaining your cycles as long as you can.
Dr. Lara Briden:
Yeah.
Amy:
But I just wanted to dive a little bit deeper into that. So why is that important?
Dr. Lara Briden:
Because regular ovulation is how we make estrogen and progesterone, back to progesterone. Really, it all comes back to progesterone and we benefit from those. There was actually, I have to find the research. I want to say British Medical Journal, but I’d have to fact check that. A recent study about how they correlated lifespan with menstrual history and found that women who have a history of many years or decades of natural, ovulatory menstrual cycles, live longer.
Now there could be lots of different reasons for that. So, they weren’t necessarily saying that’s a causation, but I would say, there’s a factor of causation in that. That getting under your belt, if you can, some decades potentially, of regular ovulations, real menstrual cycles, builds up metabolic reserve. And certainly, in terms of bone density and health, that’s going to then, serve you well through all of your menopausal years, the three or four decades that you spend after you’ve finished menstruating.
Amy:
So I think, I want to finish up with talking a little bit more about insulin resistance, because that is a huge factor for women with PCOS and it remains to be.
Dr. Lara Briden:
Yeah.
Amy:
I think when there’s this misnomer that, PCOS goes away after your reproductive years are gone.
Dr. Lara Briden:
No.
Amy:
And in my mind and in your book, really solidified that for me, is that, it’s so important to manage the insulin resistance over the course of the lifetime, I mean, that’s really the key. And I would love for you to share some of your key tips on doing that?
Dr. Lara Briden:
Yeah, I will do that. I’m just going to preface it with just a little part, one of the many times in the book, that I talk about insulin resistance. But one of them, I think the most important, is the way maintaining good insulin sensitivity, is good for the brain. Because we go through this major brain rewiring, brain recalibration, what I call an energy crisis in the brain when we lose estrogen, with the final phases of perimenopause. Not lose it entirely, but when estrogen drops.
And that energy crisis, or basically drop in metabolic energy in the brain, can have long-term consequences. So it causes symptoms while it’s happening and if you don’t navigate that… Basically, your brain is having to switch from burning, not exclusively, but more burning glucose for energy, to being able to burn more ketones for energy. This is something we have to do with menopause and that’s a lot harder to do if there’s insulin resistance. And if your brain can’t gain that metabolic flexibility and ability to burn ketones, that could potentially, in some situations, sounds scary, but anyway, set you down the path to dementia, right?
There’s a bit of research about, that for some women, dementia begins in menopause, it doesn’t manifest for 15 or 20 years later, but that’s when it starts, it starts with this energy crisis. So I’m just mentioning all this because the stakes are high, right? This is not just about abdominal weight gain and some of the other things, this is about your brain and other aspects of health that are affected by insulin resistance. So what are my top tips? Well, the ones I talk about is firstly, I want to start with reaching satiety.
I just think that has to be the starting place. I give a patients story later in the book about, step one, with a lot of my patients is, let’s just get you feeling good. Let’s get you eating enough protein in particular, because protein is our primary appetite to feel full. None of this should be about suffering and feeling hungry all the time because you can’t keep doing that. So I’m a big fan of a protein breakfast. This has been, even I, over the last 10 years, I’ve come to understand how effective that can be. So my general advice, especially if women want to interface it with a little bit of gentle intermittent fasting.
This is my approach. You can tell me Amy, whether you agree with this. But with my patients, especially in their ’40s and beyond, don’t eat in the morning until you’re hungry. Now, I don’t mean stretch that all the way through till the afternoon. I mean, try to read your body, but by waiting till you’re hungry, that means you have stomach enzymes happening, so you’re going to be able to digest some protein. So let’s say, 9:00 or 10:00 AM, something like that, might be pretty common and then eat protein. And by that, I do I mean meats, it could be eggs. So it’s that more typical protein breakfast, but it could be leftover meat or chicken or fish from the night before. There’s no rule that says you can’t have that for breakfast.
Amy:
I loved your favorite breakfast.
Dr. Lara Briden:
Chicken soup.
Amy:
Yes.
Dr. Lara Briden:
Yeah, it’s true. And I give the example of my husband. He’s like, “I can’t remember the time in my life when I wasn’t constantly making chicken soup for your breakfast.” In fact, I had chicken soup this morning, so yes, that’s my favorite, because it’s a bit lighter, I guess, to take it.
Amy:
Yeah.
Dr. Lara Briden:
If we have less stomach acid in the morning than we do later in the day, which is why a lot of women say, “Oh, I can’t face protein in the morning.” I guess I would say an answer to that, start with lighter protein and maybe as you get healthier, you might find your stomach acid kicks in and you can actually take in some protein.
Amy:
Yeah. I’m a big believer in intermittent fasting. I didn’t even know that is what it was.
Dr. Lara Briden:
Yeah.
Amy:
But I just stopped eating after dinner and as soon as I stopped the nighttime snacking and I would have at least, that 12 hour window, I noticed that I just became more balanced.
Dr. Lara Briden:
Yeah.
Amy:
I just felt I had more control over cravings and obviously now, is telling me my insulin resistance was improving.
Dr. Lara Briden:
Yeah.
Amy:
So yeah, I agree and I agree that protein is really important. I’m a little bit alarmed because I’m hearing from a lot of women, they’re asking me, if I have vegetarian meal plans, which I don’t sell. I have meal plans, they do have meatless options, but I am a believer, that you need to have some animal protein in your diet to keep hormones functioning well. And would love to know what your thoughts are on protein and vegan and vegetarianism and animal protein?
Dr. Lara Briden:
Yeah.
Amy:
OAB.
Dr. Lara Briden:
Oh, you just opened the Pandora’s box.
Amy:
I know, I know.
Dr. Lara Briden:
But we’re going to end in about five minutes so we’ll have some people, hopefully not pressing stop on this, but they might have to. Look, my background is, I’m an evolutionary biologist, so I do see things through that lens. Homo sapiens are omnivores. I don’t know how to say it. Our body is expecting to have animal protein, not just for protein, but for all the other accessory nutrients that brings along-
Amy:
Amino acids.
Dr. Lara Briden:
… including taurine, which I talk about. Amino acids which I talk about a lot in the book, choline, vitamin B6, B12. Our body’s expecting to have those foods and animal foods are very nutrient dense. I just don’t know what to say. My clinical experience is, this is my clinical experience, I talk a little bit about it in the book. But very often, when people first go on a vegan diet, they feel great because they’ve stopped dairy, basically, period. And I would argue, you could get the same benefits by just stopping dairy or stopping A-1 dairy.
But then, they might feel great for a while, they get a honeymoon period, but 6, 12, 18 months into it, and there are problems. What I say, truly hand on heart, when I’m with patients, if they tell me they’re vegan, I feel a little drop in my heart. I say to them, “Okay, well, I’ve just had to lower my expectations of how healthy you can be. We’ve now hit a limit, as to what’s possible here.”
And I know that goes against, I know there’s people out there saying how they’re thriving long-term on a vegan diet. All I can tell you is, I’ve never seen them in my practice, which could be because they don’t come to see me, which is fine. They’re so healthy, they don’t even need me, which I guess I have to allow as a possibility. But I have talked to thousands of women over the years and I’ve never seen someone on an exclusively plant-based diet that was doing well.
Amy:
Well, it’s just, I’ve been in this PCOS space for so long now, that I’ve seen so many different coaches and folks come and go and there have been some vegan PCOS folks out there and they’re not around anymore.
Dr. Lara Briden:
No. That’s interesting, yeah.
Amy:
I remember I was talking to one and she said, “Oh, I just couldn’t do it. I’m not a vegan anymore.” But that’s interesting. And in the show notes, we’ll also put a link to an article that you wrote several years ago for POCS Diva, about A-1 and inflammatory issues with it. So if you want to read more about that, check out the show notes.
Dr. Lara Briden:
For sure, yeah.
Amy:
So yeah, intermittent fasting, more protein. I think sleep is so important and getting good quality sleep and reducing stress, which you talk about in your book and how important that is too, for women.
Dr. Lara Briden:
Yeah, for sure. Maintaining a healthy gut. I think you might’ve said that already, but the gut microbiome plays a role in insulin resistance, which is where some of the argument for plant-based foods are beneficial for the microbiome, so that’s where some of that comes in, but we also need then, the animal based foods for the nutritional. And I guess the other thing around insulin resistance, I don’t feel we can leave the topic without me saying, after all of those things, after protein for satiety and helping with circadian rhythm, we didn’t mention.
But all of those things and feeling good, and then really at some point, there has to be identifying and addressing a sugar problem because it’s not the only thing that’s going on with insulin resistance. But high dose fructose and I’m talking about, in the form of sweet drinks and desserts, like proper dessert foods. I’m definitely not, I’m 100% not saying that fruits is bad. Whole fruit is okay, but fruit juice and soft drinks and pop-
Amy:
And cocktails.
Dr. Lara Briden:
… yes, cocktails, and ice cream and brownies and date squares, even if it’s a so-called natural sugar, I guess my view is, if it’s a lot of it and if it’s high dose of fructose, that is going to make it harder to reverse insulin resistance.
Amy:
Yeah. And you have some nice thoughts on how to manage sugar cravings in your book. It’s really a dense book, there’s 300 pages of pure content. It’s excellent and again, I really highly recommend it. Not just women that are over 40-
Dr. Lara Briden:
Yeah.
Amy:
… but really, if you’re a younger woman as well, it’s important to know how you can safeguard your health. I do feel like I am blessed, that I started my journey early in my ’30s-
Dr. Lara Briden:
Yeah.
Amy:
… on switching to a healthier lifestyle because I’m so much better off now, in this phase of life.
Dr. Lara Briden:
Sure.
Amy:
It’s been an investment in me, which I’m so glad I made.
Dr. Lara Briden:
It’s a really good way to think about it, but yeah, the healthier you are heading into perimenopause, the easier it’s going to be.
Amy:
So I just wanted to ask you to tell listeners again, where we can find you? How can women learn more about your work?
Dr. Lara Briden:
For sure. I’m easy to find. So as you’ve said, my two books are, Period Repair Manual and Hormone Repair Manual. Period Repair Manual is for any age, Hormone Repair Manual for I’ll say, 35 and up. Then my blog is, larabriden.com, which is now, yeah, we were just talking about it, it’s 10 or 11 years old. You read some of my blog posts decade ago, which is just crazy to think about. All my social media is at Lara Briden. So I’m pretty easy that way.
Amy:
Well, you are a busy lady these days, so I’m so grateful you took the time to come on the show-
Dr. Lara Briden:
Yeah.
Amy:
… and share your wisdom with us.
Dr. Lara Briden:
Thanks so much for having me.
Amy:
And thank you everyone for listening. I look forward to being with you again soon. Bye-bye.
