EPISODE 56: Bettering Women's Health w/ Dr. Aviva Romm

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Show Notes

This week, Anne and Heather are joined by Dr. Aviva Romm, a combined Yale trained MD and a midwife, specializing in all things women's health, with a healthy dose of kids' health, too. Aviva's practice is all about women’s healthcare, reimagined. She helps women reimagine their relationship with their bodies, cycles, hormones, reproductive health, and more—to be the most powerful woman at every stage. On her website you'll find no-BS natural approaches rooted in tradition and backed by science--basically all the tools you need on your wellness or healing journey, with a whole lot of empathy – and no judgment. 

So pour yourself a cup of tea, and enjoy the episode!

Be sure to follow the pod on IG!

From Straw Hut Media

Transcript


Straw media. Everybody. Welcome,
welcome back to better together. Today we

have a wonderful doctor, a Viva
Raum on, who is going to teach

us so much other take it away. Oh my gosh, I'm so excited

about our guests today. Today we
have Dr Viva Rom she's a midwife and

an internal medicine and board certified family
physician with specialties and Integrative Gynecology, obstetrician

and pediatrics, with the focus on
endrocnology. She's also a world renowned herbalist

and author of textbooks botanical medicines for
women's health, which she's going to give

us lots of scoop on that today, as well as seven other book she's

a practitioner, a teacher and activist
and an advocate of both environmental health and

women's reproductive rights. She has been
bridging the best of traditional medicine, total

health, ecology and good science for
over three decades. I mean it's so

special that people on like this is
what exactly what we said better together is

going to be about this year.
We want to learn about our health.

We want to understand how we can
do it with herbs and not only taking

and we're going to learn about this
to today, not taking the medicine that

is prescribed necessarily. There are a
lot of remedies that help us and help

every generation. She's going to teach
us about each one of those things.

I think it's a total cliff notes
episode. If you want to listen.

Yes, absolutely find out what herbs
to take for if you're struggling with fertility,

if you're struggling with men pause,
or if you're just a thirty year

old who wants to be healthy.
It's all in there and it's not only

about herbs. You know I don't
just take herbs. I talked about chasing

my Melatonin with my Lunasta to sleep. So we talked about all the reddies

that she's really it's it was.
It's a fascinating conversation. We hope you

enjoy it. Were better dig with
and so please outs what kind of doctor

you are and and and where you
began your study and why we're lucky enough

to even interesting path to in your
in your professional life. It's a little

different, isn't it? So's practice
family medicine. I have an internship in

internal medicine and residency and Family Medicine
and I treat women primarily and also children,

because I always feel like, you
know you're someone once said to me

you're a mom, is only as
happy as her unhappy as child. So

I have to make sure the mom's
are happy by taking care of the case.

Say that all the time. I
don't really good rule to live by.

Yep, I grew up in a
housing project and New York City,

a single mom in the I was
born in sixty six. I'm fifty five,

and my way to get out of
that housing project was to use my

intelligence to apply to college really early. I was always kind of a science

geek and a Word Geek. So
I got into college en I was fifteen,

left New York City found myself.
It was like Doogie House or yeah,

right, but before Dougie I was
pretty Du and I found myself in

western Massachusetts, in like Hippie town
basically, and within a few months I

got exposed to herbal medicine and midwiffery
and organic food, before there was really

even a thing called organic food.
It was. This was in one thousand

nine hundred and eighty one right.
My family wow literally asked me if I

had joined a cult because I went
vegetarian and went started studying these things and

I left school at Sixteen, apprenticed
myself to a midwife, started studying or

will medicine in earnest and before long
I was in my early S. I

was practicing having my own kids.
And then kind of earth fast forward a

whole bunch of years. Really wanted
to bridge the gap between what was then

extremely fringe. I mean this was
before it was cool to do her herbal

things and eat healthy, and decided
to go back and do med school,

which is what I originally went to
college for in the beginning. So now,

fast forward a bunch of years.
I'm in my mid s doing my

Prerex, going to med school with
four kids and toe at Yale and along

the way had written a bunch of
books, did a lot of leadership work,

policy work for nonprofits. And here
I am. How are we so

lucky to that amazing people on this
planet? I think it's just so lucky.

Right now I'm better together that we
get to talk amazing people. You

have four children and you went to
college. Did you have a partner at

the time helping you out of you? I have had the same but I

met my partner when I was fifteen
and we have been together for wow,

thirty eight years. Come well,
that deserves a congratulations. That kind of

of itself, isn't an easy thing
to do, no matter what you study,

as we all know. That what
do, what a relationship? How

old are your kids now? They
are turning thirty seven, thirty four,

thirty, thirty and twenty eight.
And I have a fashion for people.

People listening, the doctors looking learning. Oh my gosh, thank you,

thank you, I will and I
have. The fun part is I have

two grand babies. Okay, stop
it, okay, no, I do,

and they're seven and ten. And
it's really fun because my daughter in

laws a pediatrician and my son is
kind of a public health Unicorn company Creator,

but they decided to have their babies
at home and I got to be

the midwife for my two grandkids.
So of all my credentials and accolades,

that's what I love the most.
Oh Wow, wow, that's okay.

We have so many. Twenty get
because, say, died about their motherin

law that they delivered. They delivered
their grandchildren by themselves. That's incredible.

I don't even know where to begin, because there's so much we want to

talk to you about. What's your
favorite part of the study of herbs,

I would and and what are you
focused on right now? Can we start

there? With Women's health? Yeah, so with women's health. Right now

I'm really looking into how to bridge
the scientific evidence, which is often quite

lacking because there's not a lot of
financial incentive for pharmaceutical companies and medical institutions

are not studying botanicals because you can't
patent them and make a trillion dollarney off

of selling those right like you can
with pharmaceuticals. So there's kind of a

dearth of research. So how do
we use botanicals in a way that we

can feel really good about, really
smart about, know that they're really working

for us and that they're safe,
sometimes even in the absence of this higher

level scientific evidence? So I'm really
interested in that. And then what is

my favorite part? You know,
honestly, with Spring coming, this is

so kind of Nerdy, but I
love when I find on a hike or

just out in nature, on my
yard, wherever, the herbs that I'm

actually using medicinally. It just gives
me this incredible sense of connection to women

going back generations and eons that these
same plants have been part of our healing,

our diet, are medicine for so, so long, and it's just

magical to find them. If you
could give us, I know that it's

a very difficult question, but if
you could pick maybe three herbs or a

few herbs that would be the most
beneficial to women, could you? Why?

Yes, yeah, so there's one
herb called vitext, or chaste Berry,

and that one I love because it's
really universally beneficial. So it can

help with period pain, it can
help when you're not ovulating or having regular

cycles. In studies looking at VITEX
and women's Hormone Balance, the biggest quote

unquote I'm doing are quotes, y'all, for you can't see me right,

is getting pregnant and dropping out of
study because you've gotten pregnant. So it's

great for fertility, but now the
latest studies on it also show that it's

really beneficial for perrymenopause and menopause symptoms, so sleep problems, mood problems,

hot flashes, irregular cycles that start
to happen when we're in our S and

you know, half of all of
us, half of all women in United

States right now are already in menopause. So we're a force to be we're

a force of nature. So having
a botanical we can rely on throughout our

life cycles and use for our daughters, use for ourselves, us for our

sisters, etcetera, etc. Throughout
our lifestimes, I love that. So

that's one earth when you say that
one more time for the people who went

to go get a pan. What
is it called? The end, it's

called VITEX vix or chaste berries the
same, or chase tree, vitex Chase

Berry. Another herb is really a
simple one and most people are familiar with

this from cooking, and that's ginger. And you can use ginger in your

cooking. You can use it as
a tea. I love making it into

ginger juice, just putting it through
a juicer or making it in an into

a juice with like pineapple and apple
and carrots. But it is incredibly anti

inflammatory. It can be pain relieving. So a couple of studies have shown

that just taking up to two grams
of ginger a day, like encapsules as

a powder is equal to IB profant, which is amazing because I'd be Bo

havoc on your gut and the other
thing with ginger is so it can help

with menstrual pain, it can help
with heavy menstrual bleeding, it can help

with chronic pain, chronic inflammation,
but also about half of all women struggle

with some gut problems, IBS,
gas bloating, and Ginger can help with

that too. So I love Ginger
in everything. Plus it taste great.

So whenever we're reading Sushi, get
that ginger into our bodies, because totally

for us. Get the ginger that
you like to and then I would say

my third favorite or for women is
something called Ashwaganda and a lot of people

have probably heard of it by now, and it's in a class of herbs

called Adaptagens, and adaptagens have a
history that goes back thousands of years and

what they do is actually help our
stress response system adapt to stress and prevent

all the physical and emotional and cognitive
effects that can happen when we're overwhelmed,

chronically stressed a little bit on the
edge of Burnout, and kind of who

isn't right now? And it also
helps right Leep and some General Musculo skeletal

pain and inflammation. So those three
are might go to nice good question.

Okay, and one think about kids. are what herbs would you suggest for

children? Yeah, so with kids
you can definitely use herbs with them.

I actually have a whole my first
book was naturally healthy babies and children,

Nice crunchy Hippie book, but it's
a beautiful book with a lot of different

botanicals that you can use for kids, both preventatively but also just when they

have common, run of the mill
symptoms. And it's actually quite important because

antibiotic overuse, before Covid Antibiotic Overuse
and resistance was actually considered the biggest global

public health threat that we had,
and it's from overusing antibiotics and part of

it's overusing them in the food system
because they're given to animals to prevent them

from getting infection but also to make
them grow faster like meat, but also

they're widely overusing kids. So probably
seventy percent of the anibiotics prescribed to kids

are unnecessary. It's like a viral
impression or we should wait and see.

So that's when I lean into things
like echinasia. If your child has a

cold or an earache, sometimes we
can use something like echinasia to help with

that. Elder for a flu and
of course it's important to get conventional medicine

if you need it for all the
things, but if you've gotten the AOKA

from your pediatrician to wait and watch
on that earache or wait and watch on

that cough and cold, those are
some of the things you can lean into.

Another thing is called sort of the
classic name is Naturopathic eardrops, and

that's just what they were called in
this big study that was done on them.

But for kids who do have ear
aches or ear infections, you can

actually use these ear drops made with
a few different herbs. One is called

Mullen, another is Garli. It's
actually the same garlic we eat, and

another is called St John's. For
it there's some cautions around it, like

you want to make sure there's no
ruptured ear drum, but that has been

shown to be really effective in reducing
pain and helping shorten the length of the

air infection. So you can avoid
antibiotics when they're not necessary. Interesting.

I know with my kids I would
always get get the prescription, but then

I would always wait and it turned
out probably tend I didn't need to give

it to them. You know you
I would get the piece of pint because

you know you don't want to give
it to them if you don't need to.

So. So don't rush, you
know, if you're going that route

of get exactly Western medicine, just
don't don't rush his wait for a second.

Yeah, give it a minute and
see and let their bodies react and

change and and if that's like new
to someone or they're uncomfortable with it,

there are good guidelines that you can
use and your pediatrician should be able to

know. You can just go right
to the setters for disease control and they

have a whole list of how to
know when to give the antibiotic or when

you can wait. So if you're
nervous about it, there's guidelines there.

Can you help me with them?
Going to go back to menopause, since

I'm now considered what part of your
force of nature? So I'm going to

go right with that. I'm one
of those ones that's a force of nature.

Is there anything for losing your keys
every single day? I swear to

God. Is this something that is
really true? The forgetfulness that goes on

once you hit men and pause?
I it sounds like an old lady.

It sounds like an old lady thing. And I know for me as a

kid, I was always like the
menopause, that's never going to happen.

And the fact is, heather and
I talked about all the time, we

feel like we're in the best is
stage of our life or in a very

open, more more loving, free
place. So it's the opposite of what

I thought when my mom, you
know, or whatever whatever body, anybody,

talked about something like this. It
was it's not old lady, but

it does start to feel like we
don't know times we don't know whether to

blame it on. For us,
we don't know whether to blame it on

menopause or Covid, because we both
had covid and it's and so we're both

like, what is happening to our
bodies? And Yeah, especially with forgetfulness.

Yes, yeah, Covid can definitely
do a number on we look,

we know it affects cognitive functions.
So it may be that you don't need

more recovery time, but I have
to tell you, and when you said

like can can you tell me anything
about where to put your keys, I

jokingly always help my paramount of Pausele
and menopausea women, while the first place

to look is in the freezer because
you were probably having a hot flash.

You Open the Freezer and put your
keys down. My God, that is

so funny. I looked in the
refrigerator this morning. Now I I mean

I just have to say it seems
my logic, I'm a very logical person,

and I mean I'm I created person, but I'm also very logical.

The I seem to have been a
race of some of my my logic can

well, let's talk about menopause.
So you like you really you like you're

right. So I want to add
a caveat here for anyone who's listening,

particularly who might think, oh,
I just heard a doctor say menopausea women

are losing their memory. That's not
what I'm saying. But there are some

hormonal changes that happen as estrogen goes
down. One of the things is that

Eshergon does shape the way our brain
works. So there's a transitional period where

you can actually be more forgetful of
where you put things. It doesn't mean

your intelligence or your IQ or your
ability to do anything has gone down,

but there can be those momentary hmm, why did it just walk into this

room? And a lot of them
and get worried like, oh, at

my having on early onset of Alzheimer's, and that's extremely rare. So unless

it's happening frequently with other things,
like you can't remember were basic words,

you know, like you look at
an apple and you can't remember what it's

called, it's not likely to be
ment Alzheimer's or dementia, it's just likely

to be Menopaus. So that's one
thing. The other thing that happens is

sleep gets really affected a lot of
times for menopazzle and hair amount apauzle women.

So when you're not sleeping as well, that can affect your sort of

sharpness during the day, and so
that's another big piece of it. So

one of the things is just you
know, you know, it's like when

you get called on in class and
you know the answer for then the teacher

calls on you and you freeze.
Yes, like when you're worried about forgetting

the word or when you're worried about
where you put your keys. It adds

kind of like a layer of more
stress that makes it even worse. So

just take a zep breath, give
yourself a moment to get quiet and you

know, where you put the keys. Just kind of backtrack a little bit

and then trust that this will resolve. It will kind of write itself.

Once your hormones start to level out, and that for most women is around

fifty four. Like you, most
people are going to go into menopause around

fifty two. Per amountopause can happen
for even six or eight years ahead of

that. But once your hormones reach
that new steady state, they tend to

be fine. And then doing everything
you can to work on sleep, keeping

your blood sugar steady, making sure
you're getting plenty of good quality protein and

good quality fats, the things that
feed our brain, and exercise and hydrate.

Yeah, EXC'S gonna say? What
about the weight gain? That's just

the worst. Yeah, it's really
annoying, I know. So here's what

I'm going to say about that.
What happens when we go into menopause is

that our ovaries are done. They're
just like, we don't need to make

estrogen anymore because she's not going to
get pregnant. We don't need to do

this game anymore. So your body
stops making most of its estrogen in your

ovaries, but it has to make
estrogen somewhere, because estrogen is critical for

your bone health, your brain health, your heart health and a lot of

other things. So what it starts
to do is makes estrogen from your fat,

the fat that's on your hips and
your butt and your thighs, and

so your body starts to put on
a few pounds to have those extra fat

reserves to make Estrogym so or fifteen
pounds. I think it's really important,

and it I mean this is not
any easier for me than it is for

anyone else, because I've definitely gained
five pounds in menopause, is to remember

that your body's doing it for a
reason and that that extra few pounds is

actually really important to actually, I
heard, I think it was tear banks,

she said something when she went into
menopause. It was she said it's

my face or my ass, basically, and that's another thing to remember with

menopause is you may gain a little
bit of extra fat, but that little

bit of extra fat is also what
keeps you from having more wrinkles. It

keeps your face more supple, your
tissue more supple. So figuring out how

to find a little bit of piece
with it and at the same time doing

all the Diet things and the exercise
things that keep it from being like ten

pounds of twelve pounds and fifteen pounds
and twenty pounds. Don't go down the

rabbit hole going like I really need
the SASTER JD, so I'm gonna have

that fit. Do think to Tier's
point, I had a friend WHO's grandma

would say, you know, you
got to fill in the cracks so she

would eat ice cream. But but
I do think that as we age,

we do I you know, I
lost, I had gained a lot of

weight during covid because covid kind of
coincided with turning fifty and all this for

me. And and I just lost
most of the weight that I gained during

covid. But I didn't lose all
of it because I think that we,

I had to wait. You get
any skinner, I'm gonna get away more

as we're older than we did when
we were younger. That that it doesn't

you know, I think as we
get older and if you look too thin,

you just look frail. I'm calling
it mental pause. Doctor. By

the way, I'm I feel like
my my brain is on up the mental

pauses sometimes and I do the way
to you know, weve been kind of

a different society where what we look
at. His body type is very different,

I think, in the USA compared
to most, say, European countries,

where a woman's body, in the
curves of her body are preferred and

celebrated and totally we don't do that
here. We have these, you know,

this supermodel mentality, and it honestly, it's like outdated. Like I

don't like seeing women that look like
they haven't had a cheeseburger, yeah,

the last week. I know.
I always love it when I'm watching like

an Italian film or a French film
and I'm just like Oh yeah, right,

not all botoxed, they're not all
facelifted and they've got bellies and they've

got bodies. It's reassuring about that. I was just talking of just quoting

sophiel around this morning in in a
talk I was giving, saying how she's

on my hearing her in interview saying
she credited everything she had to Pasta God.

I love it. So one more
thing I want to say about menopause

and weight gain and and, as
you said, mental pause is, and

this is not going to be super
popular, but probably one of the best

things we can do for ourselves when
we're in those menopauzzle imparamentopuzzle years is eighty

six alcohol and I don't know any
patient of mine who was having metopazzle sleep

problems who, like when she quit
the red wine, didn't get better sleep.

It's and it's weird, like you
think of red wine as healthful right,

but it's just red wine. We
could still have white wine, any

wine, any alcohol. It seems
to just make hot flashes worse. It

adds to weight gain and it makes
us look puffier and it screws up our

circadian rhythm in our sleep. So
I always tell my patients, look,

if you do want to have a
drink, and I get it because,

like by the time we get tip
fifty, you know, that glass of

wine or two at the end of
the day it feels like a really nice

reward and we're relaxing and especially in
covid you know, we all know what

that felt like. So if you're
going to have some alcohol, keep it

to look one or two nights a
week and lean into vodka or Tequila or

gin because those white alcohols are actually
a little bit less disruptive. They're not

I'm not endorsing them. I'm just
saying I'm sure you gave me the solution

to wine, because I was worried
there for a second. I can be

I can push it on guard Jean. Thank you. Dr That is not

what she's saying. Vodka. But
but if that's interesting, because I I

will have wine because I think it's
less harsh than like a hard alcohol,

right. But it's not. I
think it's more sleep disruptive and more emotionally

disruptive for some reason. Of course, everyone knows their own body. Right.

If you have a vodka and it's
not working for you, then have

what works for you. But the
bottom line is just have a little less,

have it earlier in the evening because
it's less likely to disrupt your sleep,

have it with food, stick to
one glass instead of two or three,

but anything too close to bedtime that
is so disruptive and just says well,

I have noticed that out. You
know and and and my drinking has

change raged as I've gotten older.
Because you it is disruptive, but for

me it's mostly disruptive when I wake
up the next day because I feel it

if I've had a couple glasses of
one more than I used to. I

feel I've taken to having like you
know, if I am going to have

more than two glasses of wine,
I will have a like electrolytes in my

water, you know, before bring
me Peda light just in case. Like

if we were traveling together, you
she would bring little packets of PD.

Like what I would like to ask
about is is sleep and I'm but we

love the tips that you're saying and
in some of them will following some of

them I want. I'm ready to
pout of vodka right now. Okay,

so let me. You said go
earlier. Huh, don't tap me with

a good time. So here's what
I would like to ask about. Sleeping

and I and it's because I've had
some confusion with the herbs and overtaking them

with with Melatonin, which just because
it's herbal. and is it herbal or

herbal? That's another question. I
happened if you're from the UK or not.

If you're from the UK it's herbal. Everywhere else it's herbal. Okay.

So when herbal remedies and you go
into health in store and then you

look at the packets, I happen
to not have on my glasses and down.

I'll pop a couple of pills like
the hey, they're they're herbal.

My sleep was so disrupted and it
was because I didn't I didn't look at

the directions or or whatever. But
is Melatona. Did you odeed on Melatonin?

Yeah, I mean I was like
I took three bills or something,

thinking, Hey, they're just serves
and I just want to I mean,

it's a cautionary tale really, and
I want you to explain the importance of

a the amount we should take and
why that's important to to look at,

because I do the same with weed
sometimes, so I want to ask you

about weed too. But first things
first. What is a good sleep herbal

sleep remedy? Are The sleep teas
good? I like the sleep tease,

but to just calm and also help
us not drink so much wine to because

they're really gummy. Yeah, Melatonin
is kind of an interesting one because it

acts as a hormone in our body
and some people just do great with it

and other people are just like that
was not for me. So my recommendation

with Melatonin is always start with the
lowest amount, so point three milligrams and

then work your way up. Oh
God, see I take twenty milligrams.

Well, see, that's what I'm
saying. That's why it gets confusing.

Could not to not to know?
Yeah, so start with a low amount

and see and just like slowly work
your way up and find the dose that

works for you. And you can
go up like every few nights and if

you wake up the next morning and
you feel groggy or even a little blue,

you might just back down your dose. If you're at the lowest dose,

just push through for a few days
if you feel like you can.

Like it may take about three days
to where you're like, Oh, I

actually feel great when I wake up
in the morning and I'm sleeping. Well,

a lot of people have really intense
dreams on Melatonin. That so and

again a few nights at the lowest
dose. The other trick is taking it

an hour or so before bet.
Don't take it right before bed. Oh,

that's said. Okay, that's good
to know. Yeah, and that

might make a difference for you.
As far as botanicals, as you know,

herbs, I love the one I
mentioned earlier, Ashwaganda. Again,

it isn't just about helping you sleep, it's really about helping you reset that

whole stress response system, so helping
you have healthier cort as all levels,

healthier adrenaline levels. So it has
much more systemic benefits than just let me

Zonch you out, and it doesn't
Zonk you out, which is nice.

You can take that with Melatonin.
You can use simple herbs like passionflower,

even came emeal and Lemon Balm,
which are so gentle. And then,

of course, so many people are
using CBD, with really good results for

a lot of people. But again
it's not for everyone and you want to

make sure that you get a CBD
that really isn't psychoactive, because a lot

of CBD products do have some thhc
in them. So again, start with

now, start with a half a
gummy or a quarter of a gummy.

Right, how you do? And
then work your way up. And really

all of those can be combined.
You just want to start with one,

see how you do. Add another, and that's not so much for safety.

But let's say you take five things
at once and you don't feel great

with it. You're like, I
didn't sleep great. Now you don't know

which one it was. Right,
right, you have to be your own

chemist. Now, yeah, I
mean I've had sleep problems for a long

time. So I I take I
mean I take Melatonin and I'd also have

found that I also chase it with
a Lunesta, if I'm going to be

honest, and then I don't even
know what that is, but is so

it's a sleep aide. Okay,
it's a pharmaceutical. I love they call

it a Chaser, like I like. I chase with that gold. Have

found taking magnesium has been helpful for
my sleep. Magnesium is one of my

favorites, probably my first goat.
I take it every day. Wow,

yeah, so what it? So
can you speak of those benefits? Yeah,

so magnesium you can start at like
two hundred and fifty milligrams. You

can go up to five or six
hundred milligrams. The thing you need to

know is there's there many kinds,
but there are two basic kinds. The

great one for sleep that's really easy
to absorb is called Magnesium glysonate. There's

another one called magnesium side rate.
That works for sleep also, but it

also gets your balls moving. So
if you're constipated, you can take the

side trate before bet and have a
nice benefit of better ball movements in the

morning. But too much of it
can make you have loose poops, which

isn't fun. So figure out that
balance between the glysenate or the side trait.

If you're not constipated, just take
the glysonate. But Magnesium is critical

for calming down our nervous system and
it just nourishes the nervous system. It

also helps nourish the adrenals, which
are part of where the stress response is

happening. And we also know from
studies that a lot of women are low

in magnesium. So adding a little
bit, even above what might be in

your Multivitamin, if you take a
multi can be helpful. Taking it before

sleep again, maybe an hour half
hour before sleep. Just a couple hundred

milligrams can really help you relax into
sleep much more easily. Yeah, I

really noticed the benefit of the magnesium. What what about going back to menopause?

I know that, like I had
a whole panel of you know,

my blood work and all of this, and one of the things that I

started taking that I noticed that a
lot of my friends and talking to everybody's

taking dthree, Vitamin D. Yeah, is that is that? Can you

talk to us about what sort of
vitamins supplements people you know going through or

anyway and demons and shine is the
sunshine, right, right, yes,

only that's get let's talk about what
vitamins we should be taking at what age.

So maybe let's talk about vitamins for
four people our age and then talk

about vitamins for people fertility age,
you know. And you know what,

honestly, it's really not that different. So, okay, for all of

us throughout most of our lives,
taking a multivitamin is a great idea.

It's always optimal to get everything we
need from our food, but most of

us aren't getting everything we need more
food. Either we're on the run and

we're not getting all of our meals
or we're not getting all we need in

our meals. But also the reality
is is modern agriculture. We know that

an orange today has about one six
of the vitamin C of an orange that,

let's say, our grandmothers would have
eaten. Right, I didn't know

that. Sad. Yeah, our
food is is not actually as nutritious as

it was. So a multi vitamin
is kind of like an insurance policy that

you're going to get all the little
vitamins and minerals that we really need for

optimal health met. But most multi
vitamins don't have enough calcium for women our

age. So once we had about
forty eight fifty. We want to get

about a thousand one hundred milligrams of
calcium a day. You can, again

get it from your food, but
most of us don't. And also so

many of us were following different diets
where we might be dairy free or this

or that free. So we're also
cutting back on some of the foods that

may have had those things in it. So I like to add a calcium

in about a thousand milligrams, and
then vitamin D three. Vitamin D three

is really interesting because, like Melatonin, vitamin D is actually a hormone.

It's not even just a nutrient or
it's not a botanical it is when we

take it, our body forms it
into a hormone that is essential for metabolism,

healthy way, healthy blood sugar,
but also critical for bone health,

as we might imagine the sunshine vitamin, and also immune health. So during

Covid for example, studies, really
robust studies, showed that people who had

low blood levels of vitamin D were
actually more likely to get more severely sick

with covid wow and giving vitamin D
didn't help help reverse that once people were

sick. But it's a preventive.
These vitamins that you're saying, calcium and

D three. Is that for four
people of any age? Yes, for

any age, although if you're younger
you can use a little bit less calcium,

like maybe eight hundred milligrams. But
but dthree would apply to somebody in

their S. yes. I'm just
curious about the gender of it all and

and I'm is, are these the
same for both male and female? I

know at this point probably most men
who are listening and they're like, okay,

this is a menoplause conversation, but
I want to know because I feel

like men go through a similar thing. They just don't have a name for

it or something. But are the
vitamins that you're saying the preventative medicines,

just the dthree? Is that it? Is that a good, good preventative

for both men and women? It
is actually, you know it, these

do affect women a little bit more
in the senset, for example, a

really big study just came out,
and it was a really good quality study,

looking at the impact of low vitamin
D on autoimmune disease. Now,

eighty percent of all autoimmune disease affects
women. So women are much more likely

and autommune disease is serious, like
one of the top eight causes of death,

and women it's not. You know, it's not just like Oh,

who has that automnansea? That's weird. Can you explain to us on auto

layman's level, what that actually is? AUTOMN IMMUNE DISEASE? So autoimmune disease

is a collection of different conditions that
affect US differently, but the common denominator

in all of them is that it's
our own immune system attacking our own body.

And the different autoimmune diseases have to
do with the different parts of the

body that are getting attacked or the
different types of cells that are doing the

attack. So one really common one
is Hashimoto's Thyroiditis, where people have hypothyroidism.

Another really common one is rheumatoid arthritis. Could crowns disease is another really

common one, and these mostly affect
women and the study show that women who

had better vitamin D levels actually were
less likely to get these autoimmune conditions.

So everything we're saying. Men Can
get osteoporosis, men can get sleep problems.

They don't really go through manopause so
much. They do have right their

testosterone levels do go down, but
really it doesn't affect their estrogen or anything

significantly. So they do go through
changes, but it's much more subtle.

It's later in their lives and that
and it more affects their libido than anything,

whereas we go through these massive overhaul
changes that affect our bones, are

brain, our heart, our hormones. Let's let's finish our supplement. So

we're on where we talked about taking. What did we talk about? D

Vitamin D. Yeah, so,
okay, is I'm multi vitamin, vitamin

D, Calcium. I usually recommend
a small amount of magnesium also, because

the vitamin D, calcium and magnesium
is a great combination for our bone,

but also the magnesium for stress.
And then if I have patients who are

or just women I'm working with who
are Vegan or vegetarian and don't get any

fish in their diet, then I
usually recommend fish oil as well. If

you're getting a few ounces of salmon
or sardines in your diet two or three

times a week. If they're if
they're wild caught, then you don't need

it. If their farm rays you're
not getting those a mega threes, and

so a fish oil is a great
idea. Also, what about I know

that is we age our hair fins, and so I know I take by

Atin is. Do you recommend taking
by Atin? I don't, only because

the research on Byatin doesn't really show
that it helps that much. Yeah,

I would follow that too. So
I usually recommend us a multi vitamin because

it had. They usually have some
byatin in them. It's in the Bee

vite. Okay, so you usually
get enough from that. Some of it

is an I like just a really
frustrating function of menopause for a lot of

us. But some of it is
stress and not sleeping as well. And

you know, some of it we
can buffer with some of the hormone chain,

the hormone support that we're talking about
and the multi vitamins and nutrients that

we're talking about right. So I
like to some it. First of all,

we're so I we just could not
be more grateful to to have the

help and subbing up with the preventative
medicine that we've been talking about, the

herbal medicine that we've been educated about, to really help our sustainability as we

go through the changes and did not
look so negatively at those changes, but

embrace onto something we're going through,
get the help that we need, and

and and and and listen to the
wisdom of our people on this show.

Thank you very much for making us
better together. Welcome. You know what

you said and is really important and
powerful about how we embrace it. There's

some really interesting research that looks at
different cultures and how different cultures how women

experience menopause. And what has been
found is that, and I don't want

to have this sound like I'm blaming
women, that somehow our attitudes cause menopause

to suck, because it can just
really suck for some women. But in

cultures that do embrace menopause it seems
that women have fewer disruptive symptoms. Some

of that maybe that there are other
aspects like people eating more plants and their

diet or walking more or just living
more healthfully, but some of it does

seem to be how we feel about
it ex kind of shapes our experience of

it. So how can we and
I like to look at role models.

You know, I remember seeing Michelle
Obama, she was like fifty eight,

on a nighttime talk show and she
was wearing a cutout shirt with her her

ladies all pushed up and just looking
smoking hot. Or I think about yeah,

Helen Mirren or Yoko Oh no,
and I'm like these women are redefining

sexy, smart, effing awesome,
and so yeah to that. And you

know, I was I was about
to be on an interview recently and I

was talking to to a video interview
and I was talking to to young women

who work with me and they're in
their s and I said, you know,

it's really hard sometimes to be on
video and be fifty five and you

know I haven't done the face work
and stuff, and they looked at me

and they were like, a viva, it's really hard to be on video

in your s and s like we're
all struggling. That is where how we

look and all the many points where
we see ourselves on zoom and on Instagram,

and it was such a sobering reminder
that it's it's affecting women at all

of our ages. This how we
look, and I think in menopause it

becomes so sharp for us when we
look at ourselves and we see those elevens

or whatever the changes are. But
how do we like? How do we

love that? How do we embrace
it or do the face work? If

that's what you want, you know, okay, whatever makes you feel good.

What is there any herbs that you
would recommend for depression and anxiety,

because there's so much of that in
our world at this moment? Yes,

so for its depression, the best
known, best studied, truly most effective

herb is called St John's war and
probably tons of people have heard of it

and it really, really really can
work equal to PROZAC and other pharmaceuticals without

the side effects, including, you
know those other pharmaceuticals. For exam ample.

They can just kill your sex drive, they can kill your motivation.

So they make you feel calm and
quieter, but then all that other stuff

is affected. So St John's were
three hundred milligrams, three times a day.

That's the dose. You could take
it in capsules, so that's probably

my favorite for that. And then
for anxiety, my favorite is lavender oil.

It's in capsules. There's actually I
don't usually mention brands, but this

brand is actually the best one because
it was the one that was in the

studies showing that it worked, and
it's called La Vella. La Vela and

you can just take one capsule right
before bad and it helps with sleep anxiety,

but also helps with like performance anxiety, test anxiety. So I love

that one. So that could work
for teenagers. It can work for teenagers

definitely. And then CBD. You
know, there's a lot of things that

are attributed to cbd that are completely
bs like it doesn't help with all the

things that people say it helps with, but anxiety is one that it really

can't help with. Great. Well, go go with Libido, because that

was going to be my question to
yeah, we want to add on a

second and on a sex note.
Is there any is? Well, I'm

curious about Libido and fertility, both, like what? What? What would

you recommend for either of those oysters? Yeah, you know, Labino is

so interesting because it there are so
many factors that affect our sex drive.

Like for men, you know,
it's almost like a joke or a meme,

you know, kind of like men
won't ask for directions and it's,

you know, like these tropes that
we have. But with men they don't

need a lot for the most part
to get aroused. But right just like

a physical thing, they can see
somebody and they're like that does, she

doesn't, for me, boom,
or being I should say. And then

for us, for most women,
it's like we want more. We want,

and this is really evolutionary, right, we don't want to just do

it and then have the person be
irresponsible and walk away, because we biologically

want the partner who's going to also
stick around and be the Good Dad,

right, like that's how we're wired, even if that's not the motivation for

having sex, even if we're past
that age. So we want connection,

we want something physical that turns us
on, we want touch, we want

gifts, we want all the things, dinner and champagne come on. Or

do we just want to go to
bed and watch Netflix and be left the

fuck alone? Will now that is
the others even for women in relationships with

other women. It doesn't change our
biological drive. We still want those things.

So a lot of things happen.
Right, we're tired at the end

of the day, we do want
to just get in bed and watch Netflix.

Or maybe you've been with someone like
for ten or fifteen or twenty years

and now they're not twenty or thirty
anymore. They're like fifty five and you

know he doesn't or she doesn't look
quite the same, so that physical cues

aren't quite the same. So there's
a lot to unpack and I think it's

really important, when our libidos low, not to just run and take the

thing right, whether it's the pharmaceutical
or the herb, but to really get

honest in what we can do in
the relationship. And sometimes it may be

your partner doesn't look the same way, so you're like mentally fantasizing, and

that's okay. You're thinking of what
your partner used to look like or you're

thinking about what someone else looks like, but you're still there with your partner.

Or maybe you need more stimulation or
imagination or whatever the things are that

make you get aroused. There's one
study that looked at long term relationships that

found that in this was done in
heterosexual partners, but that for women who

are in their s and above in
long term relationships, were not necessarily as

actively or proactively filled with desire.
But we're receptively filled with desire. So

it might not be like let me
jump your bone and just so let me

jump here whatever, but it may
be like if you bring me a little

gift or you stroke my back,
and give me a little massage, I'm

all fired up and ready to go. So learning those things for yourself is

important and it's a lot of these
things to and conjunction. I mean,

we were looking at as we get
all the different things changes, different things

shift. But when when you talk
about men a pause and the point of

view on it, finding the self
esteem and the way that we look at

in the perspective that we look at
and being able to communicate about it,

when you could communicate without your which
is dry. Want to dry church.

That doesn't help. You don't have
sex. I mean there's a given.

But also when we look at whether
it's a whether it's a heterosexual relations ship

or board, it's either way,
the other is going through changes and shifts

in their life and looking at it
with the perspective that says the growth of

us can also be enjoyed and embraced. It doesn't necessarily mean like you're saying,

like I want to jump your bones
like I did when I was twenty,

but acknowledging and being able to work
through that difficult I feel like once

you get into your s were working
you know late forward is you're working through

a different part of your life and
that embrace of that shift and change,

if communicated about, can become what
sensual. Maybe it's less I want to

jump your bonds, but a can
you appreciate like I have a little tired,

but I do want something a little
bit different other than I talked about

this a lot and being able to
we had a good joke about it last

week with Ryan talking about our needs
and our wants and our desires, and

something I want to remind them with
the doctor on, it's to say you,

when you tell the truth about what
it is that you're going through,

it embraces the other or another in
your experience and that's a turn on.

It it's a turn on on different
levels and in different arenas, but it

brings in intimacy and that intimacy could
reflect in I don't know why I'm saying

this. I don't I haven't had
sex and forever, but you know.

But but I think there are different
ways that we communicate when we when we

become adults, and we have different
things that feed us and I just want

to I love with you to look
at the shifts in your life. It

doesn't matter if you're t your thirty
or forty doesn't matter and embrace them in

a way that doesn't. It's not
embarrassing to change your life. It's actually

life growth and evolvement. I have
to feel Larette on my wall, I

eat some Boston and feel your tests
like, let's let's say, you know.

But embrace it and enjoy yourself and
that change and it will allow others,

because we get embarrassed, to talk
about what we are. Changes are

instead of shared, and that's what
we're doing on better together. So true,

and it's so gorgeous to be at
an age where I remember Helen Mirren

saying, look, if she could
tell at seventy, if she could tell

her younger self anything, it would
be to give a lot less fucks about

things, right, zero facts.
Yeah, preaching to the choir. Yeah,

part of it is like that.
is about being able to say this

is what I want, this is
what I need, and the beautiful thing

is we are at an age where
we're so much more empowered to be like,

I want to tell all the twenty
and thirty olds, don't wait till

you're fifty to do that. That's
right and it's our responsibility. Yeah,

and the thing is, too,
it's funny, like right now, twenty

and thirty year olds are apparently having
less, less sex than several generations prior

because they're all on their devices before
bad or in bad and women in their

s and s are having better sex
than ever fast. Listen to that,

kids. So, because we know
what we want right and we're not afraid

to say I want this, I
want that. We're not embarrassed about our

bodies in the same way, and
if you have them with a partner and

for a long time, you're you
know, I mean, you pee in

front of them, you do all
the things in front of them. Right,

like, right, whatever. Can
you have me a tamp on all

the things? Well, if you're
a menopause, you don't need that anymore.

But yeah, it's a beautiful thing
to embrace that and I wish we

could all embrace it even earlier.
M that's what we do better to get

it for so that the twenties and
three years Google listen. We know the

joy. So embrace it earlier.
I've got you. I just think it's

great advice to deal with you know, to look at your relationship rather than

go straight to a quick solve.
Yes, yeah, because that's important.

and that's really the clues behind why
you're not feeling you know, I'll I'll

takeically look at yourself and the distance
that you're putting between first of all yourself

and then your partner. And how
are we judging ourselves? You know,

and you said earlier about, you
know, our body image, right,

and that can really change. So
I mean women are struggling with body image

postpartum, you know, they've had
a baby, their body looks different.

That can affect their self esteem and
that can affect their desire but also affect

their willingness to sort of be intimate
and naked on every level. And then

post part I mean in PARMENOPADS and
menopads. We maybe we are, we're

going through that same shifting self identity. We, as friends and partners,

can help with that, because I
know that we can talk about for days

like embrace yourself, embrace and and
and and when you're in it, you

just don't you just don't feel gray
eight and I think that that friends and

partners can do a lot to be
aild people like us to and say,

like, you look fantastic, you
have courage and your current Comma to Nice.

That's a nice thing to do,
especially when you know somebody's struggling with

with body images. Just remind them
how beautiful and fantastic they are in they

great goes alidivation. That goes a
long way. It does. And for

the twenties and year old it's fun
to be able to have this conversation.

It's funny. It's like, Oh
my God, now I'm going to feel

bad when I'm pregnant. Now the
fact of the matter is you're never going

to be younger than you are today, so you might as well embrace that

as a truth and go all have
the hell's bells. It is not going

to get better tomorrow, so why
don't I enjoy what I am today?

But for those generations, there are
always that's what we're called. We are

we are evolving creatures and there are
things that are going to continue to challenge

us. When you say that your
assistance or the girls who the young women

who work with you, they're like
wait, we don't have it any user.

Looking at our image and shoot,
you're struggling at twenty, you're worried

about yourself. At thirty, your
post, you know your your post baby,

at forty, and then at fifty
you got menopause. So enjoy what

you are today. Is huddles your
friends to enjoy it, share what it

is and activate the part of you
that is involved with the self selfinvolved in

activating your self esteem and doing that
for others. I think that would be

our active participation this week. Totally, because I ain't gonna get any better.

You know, I was in the
shower. I was in the shower

not too long ago and I remember
how being this judgmental thought about my changing

body, but and my buddies and
change's like it's like I've change that much

either. But I remember having this
sort of like self judging thought and I

remember thinking, Oh, like,
I judge myself when I was thirty and

if I were seventy right now I'd
be wishing I were fifty five, right,

and that's exactly right. I just
remember having this thought in the shower

of like when does it stop?
When does this self judging thoughts stop?

And I just remember that day thinking, okay, it stops right now,

like I'm just I need to yeah, just shift these thoughts to like I

am in love with my gorgeous self. Well, we're in love with your

gorgeous self. By guys. Is
that? You know what? Let's take

it to heart. We can't leave
without talking about fertility, because I brought

it up and I just want to. I just I know that there's people

listening waiting for that. So,
self is esteem and fertility. Let's let's

talk about people either struggling with fertility
or thinking about it's time and and what

would you recommend for those people?
Lifestyle orbs? I feel like the most

important thing is getting all the nourishment
that our bodies need, especially the nourishment,

not to be too reductionist, but
like what are your ovaries need to

be optimally nourished and healthy to allow
you to ovulate and allow you to grow

a baby. And so it really
comes down to getting a really optimally healthy

diet. So we know that we
need eggs for poline once we're pregnant,

for our baby's brain growth. We
know that we need essential fatty acids to

support baby's brain. Worth getting all
the things now that you need when you're

pregnant and all the things now that
you need to nourish healthy ovulation. So,

if you're a Vegan or a vegetarian, do you have? Are they're

different with ways that you can supplement
what those you joked about fish oil,

but is that? Does it become
necessary? Yeah, I mean Vegetarians actually

have great most of the time vegetarians
have great hormone balance and really healthy fertility.

It's not usually a problem. I
personally was vegetarian for my first for

till I got pregnant with my fourth
baby, so I had for vegetarian,

three vegetarian pregnancy of the force when
I eat me, so I can personally

say I know you can totally do
it. The main thing with being vegetarian

or Vegan is just to get the
betwelve and just get adequate protein. It

can be really easy to start eating
a lot of brown rice and other carbs

and not get enough protein. So
just make sure that you're getting the beans,

the legooms, the nuts, the
seeds. If you need to use

like p protein powder and smoothies,
that's fine. If you're willing to eat

some eggs, that's great, because
eggs are really beneficial for fertility. We

know that having some fish in the
Diet can enhance fertility, and you really

don't have to worry too much about
coffee and alcohol because the studies don't show

that it interferes with fertility. I
mean to excess, of course, but

you're you know, occasional glass of
wine. Well, that's how you get

pregn it. You'RE gonna pregnant,
but that's you know, the main thing

is, are you ovulating? And
the best thing to do is use an

ovulation tracker. Either you can use
a basal body thermometer and check it yourself

or you can get an APP and
track your ovulation and if you're not ovulating,

that's what you really want to work
on and figure out what is going

on that's keeping that from happening.
And often that's you can just really shift

that amazingly with Diet, some simple
supplements, some botanicals. Again, I

mentioned vitext that chase very earlier has
been shown to be great for fertility,

and there's some other things you can
use. There's a supplement called Coqu ten

which actually has been shown, even
with fertility treatments, to enhance the outcomes

of fertility treatments and as much as
you can just get good sleep, exercise

and of all the basic things.
Some people that I've known that have had

a hard time getting pregnant were,
you know, very thin and constantly diet

conscious? Yeah, and you have
to kind of let that go and make

sure you're eating enough so that your
body is is ready. I've worked with

a lot of women over the years
and if they're underweight, the first thing

I do is try to help them
get to a healthy body weight, because

you have to have, again,
that fat to produce the hormones right,

yes, to support the pregnancy,
but to even just get pregnant, you

have to have fat to make cholesterol, to make estrogen and progesterone and all

the good stuff, and that's really
scary to women. With this body conscious

thing. I like to do well, I like our audience very everybody,

everybody's listening, to do what you
did in the shower and say I'm getting

embraced today who I am. I'm
tied, I'm not. I'm not not

in that judgment anymore because in trying
to get pregnants really hard to do,

very difficult thing to do. When
you say fat, even if you even

if you say that to anybody,
would imagine a table full of okay,

the tennis ladies and anybody says you
you need healthy fat. When you hear,

when ladies here that they're like,
don't tell what you can say olive

oil and Avocados and not almond's right. That's all. That's what I want.

I want the healthy fats and to
embrace that part of us that needs

that. One thing I want to
say, too, is that we live

in a time when all of us
are being exposed to a tremendous amount of

environmental chemicals that can and do interfere
with our hormones. We're all exposed to

a tremendous amount of stress, and
these are things that are somewhat beyond our

control. And it's so easy whenever
I ask women this question, and I'll

ask you all, what when you
have something going on, either with your

own body or with your kids,
like if your kid is facing a challenge

of any kind, what's probably one
of the first questions you ask yourself?

One am I going to do?
How do you feel? How do you

fix it? Like now, like
what am I doing wrong or what's wrong

with me? And I really want
funny, I don't ask that. Yeah,

US to stop thinking that way when
we have a hormone and elent's,

when we have a fertility challenge,
to remember that a lot of these things

are bigger than just us and there's
nothing wrong with you, you're not broken,

you're not a lemon. And then
from there like, okay, what

can I do to support myself to
be as optimally healthy as possible so that

I can try to do this through
my own steam, you know. But

then there's also like there's no shame
in the game if you need to use

fertility treatments. There are still all
these things are still important, like all

the fertility diet, the healthful eating. Out Love the word Diet, but

all the healthful way of eating for
fertility. You still need that if you're

going to do IVF. You're still
going to need that to be pregnant and

have a healthy baby. So it's
just a simple, low hanging fruit that

we can all turn to. Yes, and put our health first. Put

our health first, our happiness comes
with it and we just be answered a

beautiful question. And what we can't
thank you enough. This has been fantastic.

You've given our listeners so much great
a great advice and it was so

fantastic to meet you. So everybody
to do to activate the nonjudgment of ourselves.

Look at our bodies, look at
our mental health, our physical health

and our friendship and our love health
and say I'm done with judgment and I'm

going to continue forward being better in
reminding my friends and complimenting my friends.

I love that. I love it. I know now. Now you've written

seven books, and let us let
our listeners know. I'm sure they're going

to want more from you. Where
and they find you, of Eva Romcom,

just set my website, or over
at doctor a viva on instagram.

I hang out there quite a bit
too. All right, sick, ohrful

speaker and well, here who you
are. Thank you so much for being

together, bettering us. Thank you. Thank you for chatting with me today.

Were better together withsten and wow,
I was impressed by that. She

was, by the way, fifteen
and going off to college. I'm believe

you're just such a braid and either
talk about that, I mean, and

like for kids whatever. I'm going
to Yale. Yeah, right, but

I think what she did is is
break it down, to be able to

break it down and understand the things
that you can go to to get that

much help, all of the different
the education on the earth. We really

take a doctor's appointment. We were
able that, and neither did y'all.

I started to feel very lucky that
I'm better together. We can have all

these. That's exactly what we're doing
right is for I mean I can,

we can order so all the college
that she gave us. You just I

was like, Oh, I'm gonna
have to listen to this myself, and

I hope everybody did. Bring it
bet into paper. Right, get all

that, get all the good scoop
on I. We're just going to get.

We're gonna get so health we're going
to get so healthy and happy.

It's in, but nobody's going to
be and with our Labidos, are going

to be served by, hopefully,
our self esteem and everything else that we

have going on in complimenting our friends. I love how you activated that.

If we give positive energy to our
friends, make that your activations. We

say something nice to somebody. Thank
you, Dr for being on our Shell

and for everybody who is listening.
That was so u my godther just get

better together. I hate it all
right, and a big, big thanks

to our better together team, Ryan
Tillotson, Silvana, Alcohola, Daniel Ferrara

and, of course, and in
Heather. If you haven't already, please

subscribe on whatever device or platform you're
listening to this song and, as always,

see you next week.
Better Together w/ Anne Heche and Heather Duffy
Anne Heche's BETTER TOGETHER w/ Anne & Heather is a space where guests introduce us to the person that makes them better. For me, that's my friend, Heather, and t... View More

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