The Ultimate Guide to Women’s Hormones: Use Science to Reset Your Body, Balance Mood, & Feel Amazing

Jessica Shepherd (00:00:05):

Hormonal health represents who we are as women, and the more that we vilify it or kind of fight against it, then that's not ultimately helping who we can be in our best version of ourselves.

 

Mel Robbins (00:00:16):

Today's episode, it is the ultimate guide to understanding and optimizing women's hormones for better health at all ages. Our guest today is world renowned OB GYN, Dr. Jessica Shepherd. She's here with the answers you need if you have really bad PMS. What does that tell you? As a medical doctor,

 

Jessica Shepherd (00:00:38):

When women come in, I always like to

 

Mel Robbins (00:00:41):

Can you speak to a person listening who comes off birth control? What do you want them to know?

 

Jessica Shepherd (00:00:49):

I want them to know that,

 

Mel Robbins (00:00:50):

Wow. Why do so many women in their twenties get hormonal acne?

 

Jessica Shepherd (00:00:57):

There can be stuff that is due to chemicals that top foods you should eat for good skin. Oh, I think that top foods should be blueberries, nuts, but also,

 

Mel Robbins (00:01:07):

Hey, it's your friend Mel, and welcome to the Mel Robbins Podcast. I am so excited that you're here. The conversation that you're about to hear is life-changing, and I want to say it's always such an honor to spend time and to be together with you. And if you're a new listener, I also want to take a moment and welcome you to the Mel Robbins podcast family. And here's one thing I wanted to say because you made the time to listen to this particular episode. Here's what I know about you. You are the kind of person who values information that can help you take control of your health and make you feel your absolute best at every single day, no matter how old or young you may be. And if you're listening to this right now because someone in your life shared this episode with you, I just think that's really cool because here's what that means.

 

(00:01:57):

It means you have people in your life that care about you. They want you to be healthy, and they know that understanding and knowing how to optimize your hormones, that it's critical for your overall health. That's why they sent that to you. And I think that's just really cool that you have people in your life that care about you. So thank you for listening to this. Thank you for being here. I'm so excited because our guest today is going to help us do exactly that, understand our bodies, understand our hormones, and help us optimize them for better health. Dr. Jessica Shepherd is a board certified OB, GYN, who specializes in women's health, sexual wellness, and menopause. Dr. Shepherd completed her medical residency at Drexel University. She also completed a fellowship in minimally invasive gynecological surgery at the University of Louisville where she also earned her MBA. Dr. Shepherd also served as the director of minimally invasive Gynecologic Surgery at the University of Illinois at Chicago before leaving to practice at Baylor University where she's still affiliated today. She sits on the advisory boards for Women's Health magazine, women's health.org, and the Society for Women's Health Research and is the chief medical officer at the healthcare company. Hers, Dr. Shepherd is also the author of the bestselling book, generation M, living Well in Perimenopause and Menopause. So please help me welcome Dr. Jessica Shepherd to the Mel Robbins Podcast, Dr. Jessica Shepherd. I am so excited to meet you. Thank you for hopping on a plane. Thank you for making the time. I cannot wait to have this conversation with you.

 

Jessica Shepherd (00:03:33):

I'm just doubly excited to be here. You are someone who I've listened to for a long time and the ability to be able to share my little slice of life with you and with everyone here, I love it.

 

Mel Robbins (00:03:46):

Well, it's actually a very big slice of life and it's an aspect of life that a lot of us don't understand. And so I cannot wait to learn from you. And where I want to start is I'd love to have you speak directly to the person who is with us right now who has made the time to learn from you, and can you tell them what might be different about their life or the life of a woman that they love, if they really take to heart everything you're about to teach us and share with us today, and they apply it to their life, what could change?

 

Jessica Shepherd (00:04:22):

I would say for everyone who's listening and even myself, I think this is where this really resonates, is I'm going through that journey as well, but why am I here and where do I want to be? And that really is that opportunity of self-care to say, I get to be in charge of myself. And many times we don't take that time to say what is really going on? Because that's when we really start to push away all the narratives and the stories and what society tells us. And that really is this transformation in life, is to take some time, take pause, and say, why am I here and where do I want to be?

 

Mel Robbins (00:04:59):

Wow. And what I'm excited about to learn from you, Dr. Shepherd, is oftentimes when you realize you don't feel how you want to feel or you're not where you want to be in your life in terms of your relationship to your health or how you feel or your energy or all aspects of your life that you're not quite sure what the problem is. And so I think today is going to be life-changing because you're about to teach us about our bodies and about hormones and the vital and transformative role that they can play. Let's start with just talking about what made you interested in medicine and women's health.

 

Jessica Shepherd (00:05:43):

Yeah, it actually started from the OB world, right? Bringing babies into the world. And that was so fascinating to me and it's very exciting. And as I was going through residency, still love OB is when I really, that there is this whole scope of a woman's life outside of pregnancy, but when I really started to see women, whether it was in their adolescence or even later on in life, is that there's still so much to be taken care of, that we really have that ability to interact and build relationship with women. And that's where I really thrived. And so that after residency, I actually did a surgical fellowship. I loved being in the or. I love being able to really take something very complex and transform in a way that's helpful for them in the operating room. And then coming back to who are you and how can I help you there?

 

Mel Robbins (00:06:36):

And how did being a surgeon impact you and lead you to where you are now and the philosophy that you have about medicine and women's health?

 

Jessica Shepherd (00:06:46):

And most of the surgeries that I was doing, a lot of times it had to do with women in their midlife. And so when they would come into me with their diagnosis, whether that was fibroids, endometriosis, I got to sit with them and talk to them about this diagnosis. But what actually came out in the visit was all the other things that were going on in their life. And so that's where I started to see our physical health has so much more to do with the mind body connection.

 

(00:07:14):

So they would come in and have a certain disease or something that was going on, and I was like, I know I can help you there because a surgical thing that I know I'm very skilled to do, but what I'm really paying attention to are the other things that you're telling me that's going on with your life and your career, taking care of your kids, your relationship. And that really has so much more to do with how we show up and what we're able to capacitate, what we're able to take in. And that's when I was like, something's going on in this midlife that I need to pay attention to more.

 

Mel Robbins (00:07:45):

Well, what I'm excited about is that you know, you mentioned pregnancy. You mentioned doing all these surgeries. If you really think about it and in the forward of your book, Dr. Jennifer Ashton writes about the fact that for most women, the first time we truly get proactive about learning about our biology and our body for real is when we either are wanting to get pregnant or we are pregnant. And so we dive into all of it and we track what's happening in our bodies. And then even afterwards, we're tracking what's happening with our bodies as things are changing. When I think about myself and when I first got my period, it sort of came and then I just had to deal. I had to figure out how to use a tampon. I had to figure out how to navigate a swimming pool. I had to figure out that sort of stuff. We didn't have any of the tracking tools or any of that stuff.

 

(00:08:40):

But it is interesting that a woman's body and health is incredibly elegant and intelligent and designed in this system right around the fertility cycle and the menstruation cycle. And honestly, most of us don't understand the role that hormones play at all.

 

Jessica Shepherd (00:09:03):

Not at all. I think pregnancy, you said it perfectly there is that's what society tells us what our worth is in the reproductive years. But even as you said it in your experience, which was similar to mine as far as getting your period, you're just kind of like, okay, I'm going to figure this out.

 

(00:09:17):

But that was something that had to do with just self, right? Yes. But no one was really paying attention to that. But when it came to now you have to take care of someone else, society's like, here's your importance. And then we dive into it because kind of feeding into that, not to say that pregnancy is important that we don't love it, but now we're fascinated and kind of giving more towards, because we have to take care of someone else when we didn't even choose to take care of ourselves earlier when we were going through a transition, which is why I always see this with my patients that come in is that they're like, now that I've kind of finished that phase of my life, no one's really paying attention anymore, and society's kind of deemed me maybe not that important. So that's where I want women to pay attention to their worth.

 

Mel Robbins (00:10:00):

Yeah and I'm so excited to dig into the role that hormones play in your health. And on that point about women really thinking about this. And if you are listening and you're one of the millions of guys that listen to the show, this is a really important conversation to listen to because it's going to help you understand the women and young women in your life, but it's also a resource that you can send to them because women are not little men that what Dr. Stacey Sims loves to say And understanding the unique physiology and biology is critical. And we're going to talk today about how hormones impact your skin and acne and hair and thinning hair and growing hair in places that you don't want, how hormones impact all kinds of health conditions. And what I find to be very exciting is that finally, we're at a moment where there is a lot of attention and education around menopause, but that's like 50 years into a woman's story, truly understanding the role that hormones play what they are. It impacts every aspect of your life. And one other thing that you made me think about is that when I think, for example, just one human being ago, so just think about our moms. How old are you?

 

Jessica Shepherd (00:11:20):

I am 47.

 

Mel Robbins (00:11:21):

Okay, great. So I'm 56. If I think about our moms, they typically grew up in a generation where the messaging, at least in the sixties and seventies, was, okay, you got to do it all. You got to look good. You got to also keep the house together. You got to be able to take care of everybody. There was zero messaging about taking care of yourself.

 

Jessica Shepherd (00:11:47):

Oh, no. That wasn't part of the memo.

 

Mel Robbins (00:11:48):

No. And in fact, if you look at any of the marketing and advertising television shows that our mothers watched, there was no one helping them. They just had to do it all themselves. And so no wonder our moms neglected themselves. No wonder, we don't really understand that putting ourselves first is really a skill that you need to learn. And society has conditioned us to think, oh, no, no, no. Go see a doctor when you're sick. Oh, no, no, no. I have a friend that has prolapse right now. It literally feels like, which is I guess what, when your uterus is falling,

 

Jessica Shepherd (00:12:24):

Yeah, things are kind of coming out.

 

Mel Robbins (00:12:25):

Things are coming. One of my relatives had it. They would literally be like, it's walking around with half a baby coming out of you. And I'm like, you are walking around. You should go see a doctor.

 

Jessica Shepherd (00:12:36):

But that's taking care of self, and we're not trained to do that.

Jessica Shepherd (00:12:45):

I think hormones are these beautiful complex messengers. So it's like we have these little male men that are, or male women going around delivering messages every day. They are consistent. They know what they're supposed to be doing, and our bodies are beautiful machines and they're meant to be. Well, oil machines with these messengers giving off these messages, whether it's to an organ, the brain or the ovaries, hormones are probably one of the most important parts of how our machine runs.

 

Mel Robbins (00:13:15):

So is it like a liquid? What is a hormone? You know what I'm saying? Because as you're thinking messengers, I'm like, wait, is it the wiring is is it liquid? What actually is a hormone?

 

Jessica Shepherd (00:13:24):

Of a, we should go inward and talk about these hormones, but it's actually the delivery of a kind of chemical.

 

Mel Robbins (00:13:32):

Okay,

 

Jessica Shepherd (00:13:32):

Yeah. It's a chemical that's released and from these messages that are being sent, then someone can respond. So it's like I'm giving you a message and you're supposed to be doing this today at this time. And so as we go through our lives, we usually through our younger years and our reproductive life, have these hormones that are giving off these messages and they're just going like clockwork. They're like, I know where I'm supposed to be. I know what time I'm supposed to go off. And then we start to see that the hormones have little glitches. They don't want to show up to work. Some of the messages aren't being delivered. And that's where we start to see those changes in fluctuations, which is why exactly, like you said, we need to be having these conversations about hormones earlier so that we're aware before they just kind of capoot and they're out.

 

Mel Robbins (00:14:16):

Well, you know what's interesting is that if you really think about the experience, whether you are male or female is when puberty hits, the only thing that you hear from adults is, oh, hormones. Oh, the hormones are raging. Oh, here it, and nobody understands what it actually means or what the hormone is doing. When you get to puberty though, and the quote hormones start going crazy, are you not born with this level of hormones? You know what I'm saying? Why are hormones going crazy during puperty?

 

Jessica Shepherd (00:14:52):

Yes. Because they are now getting the response of we now biologically want to start to deliver our follicles. So we're born with the amount of eggs that we'll ever have, but the delivery of when they're going to release every month starts at a certain time because our bodies are, again, beautiful machines, which they know when they're going to start this process. So in the ramping up for this actual delivery of guys, we got a job to do. We got a new design of a job that we have to start. Everyone's running around, where am I supposed to be? Okay, you're there. Okay, wait, am I supposed to be doing this? And over time, which is when you start to see that fluctuation, everyone's getting ready for the job, and then finally they're like, we've got it down. We've done enough rehearsal. We're ready to do the job.

 

Mel Robbins (00:15:38):

Okay, I think I've got, and I hope as you're listening or watching, you kind of have this understanding of messengers number one that are delivering a particular message and that your body has receptors all over it that are designed to receive the message from the hormone.

 

Jessica Shepherd (00:15:54):

Yeah. It's receiving delivery and receiving is the most important part, I would say, of a hormone because they want to get that message across and then the hormones that disassemble. So the job now is kind of falling apart, is what's happening in perimenopause and menopause. What do you disassemble? Well, when we go through a hormone decline, which is the opposite of what we're doing when we're getting towards puberty and adolescence, perimenopause is they're like, biologically, we're not going to be doing that delivery system anymore. We're going to slow down this project now. And people are like, okay, well then I'll come off here. I'm just not going to show up to work anymore. And that's when you start to see the fluctuation of what happens to hormones in the perimenopausal phase. So they're kind of saying, that job that we used to do for 30 plus years of giving off an egg at a certain time every part of the month, we're not really doing that anymore. So that's when you start to see the offloading of what happens with hormones, which is why we now experience all those symptoms in perimenopause.

 

Mel Robbins (00:16:53):

Got it. And does the same thing happen to men if they experience low testosterone?

 

Jessica Shepherd (00:16:57):

They do, but their decline is much slower over a longer timeframe, and so that's why you still can have men who are in their seventies and eighties still being able to have or contribute sperm and you get pregnant, but we no longer can after a certain age, which is why women experience menopause.

 

Mel Robbins (00:17:17):

Gotcha. Okay. So I would love to break down each time period in a person's life and kind of understand exactly what's going on with your hormones and what hormones matter the most during that period of time. What are the key hormones that you need to actually understand are important and play a role in your health?

 

Jessica Shepherd (00:17:49):

Well, all hormones for men and women obviously play that specific role, but when we speak to just women and how they're going to experience life, I think that's the best way to frame it is how are you experiencing life? What's contributing to the factors that really are kind of key and specific to women? I would say estrogen, progesterone, and testosterone as well as our thyroid hormones. But men do have thyroid hormones as well, as well as estrogen and testosterone. We just have it in different levels. But for women, I would say estrogen, progesterone, testosterone, and our thyroid hormones.

 

Mel Robbins (00:18:21):

And can we group the thyroid hormones together or are there a bunch of 'em or?

 

Jessica Shepherd (00:18:25):

We can. They're kind of like cousins, so they're kind of like in separate pods, but they're kind of in the same neighborhood and really contribute towards each other, but estrogen, progesterone, and testosterone.

 

Mel Robbins (00:18:34):

So estrogen, progesterone, testosterone.

 

Jessica Shepherd (00:18:36):

Yeah.

 

Mel Robbins (00:18:37):

Now we hear a ton about cortisol and serotonin, and that's a hormone, right?

 

Jessica Shepherd (00:18:44):

Yeah. Those are hormones.

 

Mel Robbins (00:18:45):

And some other ones who I now can't remember, but are they as important

 

Jessica Shepherd (00:18:50):

They are important.

 

Mel Robbins (00:18:51):

For understanding when it comes to women's health or is it important for us to just start with estrogen, progesterone, and testosterone?

 

Jessica Shepherd (00:18:58):

I usually like to categorize it as maybe if we were to say our menopausal metabolic and mitochondrial hormones. And so cortisol is really, I like to put it in the metabolic kind of family of when we talk about hormones because it has such a broad impact on our entire body system, whereas,

 

Mel Robbins (00:19:15):

And what does metabolic mean?

 

Jessica Shepherd (00:19:16):

So metabolic means the things that function in how we regulate the activity of our entire body. So metabolically, we would say if you have metabolic hormones that are being shifted, that's usually when we talk to insulin and glucose and how our body is able to absorb glucose, utilize glucose as a fuel. So cortisol really has a lot to do with that as far as metabolic functions.

 

Mel Robbins (00:19:39):

Okay. So we're going to shove that to the side.

 

Jessica Shepherd (00:19:41):

You can shove that to the side

 

Mel Robbins (00:19:42):

And we'll stay right here with estrogen, progesterone, testosterone, and let's start with puberty.

Jessica Shepherd (00:20:02):

So I would definitely say what we have started to see over the last few decades is typically when we start our period that age has become younger.

 

Mel Robbins (00:20:11):

Why?

 

Jessica Shepherd (00:20:11):

And so that age has become younger because of environmental factors. A lot of the things that we have in our environment, a lot of the foods that we eat. So it actually is something that we should be researching in a way of why is this happening and is this something that has implications on our life later on? And when I say later on your fifties, and I would think so, absolutely. Why? Because cortisol, which we kind of bring it back into the conversation a little, has a lot to do with, is this the reason why we're starting to see our women or young girls starting to have their periods at a younger age? And so what's happening is you're to have this onboarding, right? We talked about this complexity of our bodies and the systems and how it's being regulated. So the onboarding time is a little bit earlier now, and so what's happening is that estrogen is starting to rev up because our bodies want to release this egg in order to have a menstrual cycle. And so it starts that process earlier in estrogen and progesterone. Are there going to be those key hormones that are going to filter into when am I going to be high? When am I going to be low? Right? We talked about how they're coming into themselves as a system and a bodily function in order to accomplish an event, which is your menstrual cycle.

 

Mel Robbins (00:21:24):

So what is the role of estrogen?

 

Jessica Shepherd (00:21:26):

Estrogen, really, I like to call it our vitality hormone because we really see, when we look at our menstrual cycle, or even when women come to me and they have changes in their menstrual cycle, we typically like to say, how is estrogen functioning and as a vitality hormone, what is it contributing? Maybe it's a little bit too much here or a little too little, and how can we alter it in a way where you can get back to maybe your normal rhythm or your normal menstrual cycle? So it builds up when we're starting our period, and it really is creating your body's in default actually to get pregnant, which is the whole reason for your menstrual cycle is to conceive and to get pregnant.

 

Mel Robbins (00:22:08):

Is it important as a woman to understand that your entire health and the way to think about your health, you really have to embrace that the natural intelligence of your body, the baseline is it is designed as a baby making machine.

 

Jessica Shepherd (00:22:31):

I would say biologically. That's what, if we were to look at it just from key framework,

 

Mel Robbins (00:22:37):

Just I'm just literally just like your tongue is designed to taste.

 

Jessica Shepherd (00:22:41):

Absolutely.

 

Mel Robbins (00:22:41):

Your legs are designed to move in a certain way that you are designed with sort this biological imperative. And I'm only saying that, you know what I mean?

 

Jessica Shepherd (00:22:51):

It's designed biologically to do that function.

 

Mel Robbins (00:22:54):

Yes.

 

Jessica Shepherd (00:22:54):

What I want to make sure that we understand is it doesn't necessarily mean that we have to do that.

 

Mel Robbins (00:23:00):

Oh, of course.

 

Jessica Shepherd (00:23:01):

Right?

 

Mel Robbins (00:23:02):

Of course.

 

Jessica Shepherd (00:23:02):

But I think that society does teach us that that's what you're designed to do and that's what you're supposed to do.

 

Mel Robbins (00:23:07):

Yes. The reason why I'm kind of taking a highlighter to that is because we know that of course, because you have a period that you have to deal with. But if you really start at a baseline and you say to yourself, okay, women are not little men and our bodies all the way down from chromosomes to the way our muscles are to the way the hormones work, our bodies are completely different. Understanding that it is designed to work on this cycle and the cycle is driven by hormones, is the base of all health. Correct?

 

Jessica Shepherd (00:23:44):

And would say that once you understand that, then you can embrace it for what it is and not fight it and work with it and work with it and not work against it.

 

Mel Robbins (00:23:52):

Okay. So before you get your period, this is going to sound like the world's dumbest questions. Do you have estrogen? You know what I'm saying like is this stuff in your body?

 

Jessica Shepherd (00:24:01):

Everyone is born with the amount of hormones or the hormones that we have, how they function changes during the life cycle.

 

Mel Robbins (00:24:08):

Wait, you are born with the amount of hormones you have?

 

Jessica Shepherd (00:24:11):

Well, not the amount, but you have the hormone.

 

Mel Robbins (00:24:13):

Okay, gotcha.

 

Jessica Shepherd (00:24:13):

How they function changes over the course of our lives, which is why we see those changes at adolescence and then perimenopause.

 

Mel Robbins (00:24:21):

Gotcha. So even before you have a period, you still have estrogen, testosterone and progesterone in your system. It's that when you start getting your period, those hormones flood into the system in order to bring this developmental phase online.

 

Jessica Shepherd (00:24:38):

And that's why I love the body. It is so complex, but so elegant because it was always there, but the need for it to do the job that it was designed to do at that time in your life, that's when it knows I need to start doing this. So it's the onboarding, but that's what I love about the kind of basic fundamental part of the body, and that's why we should embrace every part of our lives.

 

Mel Robbins (00:25:01):

So you said that the average age is getting younger and younger, and one of the reasons is the food we eat

 

Jessica Shepherd (00:25:10):

Environmental

 

Mel Robbins (00:25:10):

And ultra process foods

 

Jessica Shepherd (00:25:11):

cortisol and cortisol as well. Stress, and that's where cortisol is our stress hormone and it responds to stress. And so when we have stressors that are showing up early in our lives, a lot of it has to do with the experiences that we have, environmental factors in food. Then that's why we're starting to see that girls are starting to have their periods much younger.

 

Mel Robbins (00:25:33):

Is that because cortisol confuses the design of the body in terms of when it's time to bring this online, or is it the food?

 

Jessica Shepherd (00:25:44):

It's more so that the cortisol is responding to these stressors and then onboarding much too early or much too high of a level than when it's supposed to.

 

Mel Robbins (00:25:54):

Oh, gotcha.

 

Jessica Shepherd (00:25:56):

Yeah. It enters the scene when it shouldn't be, and we're like, you're not really supposed to be appearing at this part of the script, but you're here. And so now we were going to respond to you.

 

Mel Robbins (00:26:05):

Gotcha. So what are some of the issues that happen during that window? Because I can think about, it seems like so many young women also now have complicated cycles, whether it's lots of cramps, and so what are the roles that estrogen, progesterone, and testosterone are playing in that window in the teenage years up to 20?

 

Jessica Shepherd (00:26:29):

So the roles that they're playing is getting the body ready for this now 30 year or maybe 20 year thing that they're going to be doing.

 

(00:26:37):

So that's when you start to see the breasts enlarge. You start to see hair growth, you start to see changes in the external genitalia, and that has a lot to do with how the hormones are responding. It's getting the body ready and also to do the thing that we talked about to get ready for pregnancy, and that's what the body has the capacity to do in your reproductive years. And so that's when women start to see changes in their moods. I mean, how many times have you heard adolescent girls and going through puberty again? Yes, that mood is there because our neurotransmitters, which are also hormones, are responding to these changes when we start to onboard our estrogen, progesterone, and testosterone to do the function of the period.

Jessica Shepherd (00:27:23):

Hormones are at this point, should be functioning very consistently. We know what our job is, we're having a cycle. We may get pregnant, go through the pregnancy, repeat baseline, what we're doing again. So that's when it should be kind of, we should be okay. This is typically when women might start to come in with issues with maybe pain with their cycles or maybe heavier cycles.

 

Mel Robbins (00:27:48):

Yes.

 

Jessica Shepherd (00:27:49):

And so it really should be kind of even keel during this timeframe, but that's not what we always see.

 

Mel Robbins (00:27:54):

So if it's not even keeled, meaning a pretty regular cycle and a pretty predictable kind of route of these are the days I'm kind of moody or grumpy or whatever. This is the days I kind of get those weird cramps. But if you have an irregular period or you have heavy bleeding or you have really bad PMS, what does that tell you as a medical doctor?

 

Jessica Shepherd (00:28:19):

When women come in, I always like to peel the layers back because that's very subjective and subjective, meaning everyone has different experiences.

 

(00:28:29):

What are their tolerance to that experience? What's going on in their life? How do they deal with stressors? And I'll give you an example, and this is where I love the beauty of these conversations is to always recognize that everyone has a different template and everyone has a different experience in life. A lot of my women, especially women of color who come in have different stressors because of what's going on in their environment, whether that's racism, whether that's poverty, whether that's increased stress or that's the cortisol. A lot of what they're experiencing is a lot different to women who are not in those particular environments. And so that's part of peeling the layers back, especially as a physician when women come into me is not looking at just the issue that's going on is saying, what else is going on in your life? And that's the mind body connection. And so when we are able to look at those factors versus maybe it's a food issue, there are a lot of foods that can change how our hormones respond,

 

Mel Robbins (00:29:26):

Like what foods change, how your hormones respond?

 

Jessica Shepherd (00:29:27):

So your processed foods, your foods that have high glycemic index that have a lot of sugar, a lot of soft drinks. I do see a lot of my patients who are in that timeframe when I look at their diet, I'm like, let's start here. For me, that's a lifestyle change that can impact you greatly. And I don't necessarily have to put you on a medication, so that might be a better way of looking at it. And also with exercise. Exercise does have a beautiful way of releasing other chemicals and hormones in our body that can help regulate our period, but we have to utilize that. Then also stressors. What's going on in your life? It's notorious for stressors. Women come in and they'll say, I'm having all these changes in my cycle, whether it's heavy or lighter, irregular doesn't matter. I will always ask them, what's going on in your personal life? What's going on in work life? Again, when we have that session, that's why OBGYNs are actually usually said that they're also psychologists because we absorb a lot of what's going on in their life when they come in for a visit.

 

Mel Robbins (00:30:24):

I think it's fascinating that stress in your life and the food that you're eating impacts the hormones in your body.

 

Jessica Shepherd (00:30:33):

Categorically. And I will say that emphatically because our lifestyle and how we conduct our lives on the outside with those factors of food, nutrition, exercise, really does change the game. And that's why we are starting to see when we get into later life or even in midlife, that is also a very important part of what your body's going to be able to do. Your body can only do what you give it, and if we're not giving it the things that it can thrive, then that's when it's like, I may not be able to perform at my best ability.

 

Mel Robbins (00:31:07):

Where exactly is estrogen made? You know what I'm saying? So I'm starting to think now. Okay, now wait a minute. So I mean, it makes sense that if you're going through a breakup or you're a person who is subjected to chronic bias and racism or you're under a tremendous amount of stress because you're caring for somebody or you're just constantly eating terrible stuff, I think about somebody that I love deeply who had a very big issue with an eating disorder and just destroyed their gut health, and I can't even imagine the kind of stress that they put themselves under. I mean, of course it would impact your, when you explain it that way, Dr. Shepherd, it makes a lot of sense, but why do these things impact estrogen and progesterone and testosterone?

 

Jessica Shepherd (00:31:57):

I'm so glad you asked this question because what does it have to do with the mind? Because the brain usually is the control center for a lot of hormones.

 

(00:32:06):

So it is the one that is going to tell the ovary, I need you to give off a little bit of estrogen today. We're going to give off this much. We're going to dial it down on this day because we're getting ready for ovulation. All those different messages are usually generated from the brain. So imagine what happens with our neurotransmitters when we undergo stressful situations, whether it's something that happens when you're crossing the street and you almost run over by a car versus exactly what you said, a stressor in life that's really taking over all your thoughts, your everyday life, that your brain can respond to that in a way where it's trying to help you cope with that stress. But what happens is when we have stress, the brain can't give off the message to all the other hormones in the way that it could when it wasn't as distracted. And that's why we have to, as physicians get better at mind body connection.

 

Mel Robbins (00:32:58):

It makes so much sense. And what's sad is your period gets irregular or you start having massive cramps, and then you think that you need some medication and you're not looking at the underlying factors because I never understood that stress or eating ultra processed food or basically starving myself to be skinny is going to of course, impact the hormonal functioning of my body, confusing it with all these things.

 

Jessica Shepherd (00:33:28):

Yeah.

 

Mel Robbins (00:33:28):

Why do so many women in their twenties get quote hormonal acne?

 

Jessica Shepherd (00:33:34):

Yeah, hormonal acne. Again, when we think of there's different types of acne, just there can be stuff that is due to chemicals that maybe you're using on your face that are not the best, but usually a lot is hormonal, and you can actually sometimes tell by where it is on your body where you're getting, yes. So most hormonal acne can be mostly in the area right under the eyes or the chin.

 

Mel Robbins (00:33:58):

Why does it go there?

 

Jessica Shepherd (00:34:00):

Because when we're thinking of where the hormones, you have receptors all over your body that respond to hormones, and so the receptors that maybe respond more to estrogen or testosterone's going to be features on or areas on your face that are going to be more prone to the actual area of the breakout. And so when we think of what kind of spurs on these changes in hormones, which will then trigger hormonal, a lot of it has to do with testosterone. Testosterone has a lot to do with sebaceous glands. So a sebaceous glands are the ones on all parts of our body that hold the oil because we need oil, your face, this is how our body functions. We need oil secretion. But when there's a buildup of those areas, and in the glands can be an increase in testosterone as well, which then elicit the buildup of oil, which then you get bacteria and then you have acne.

 

Mel Robbins (00:34:47):

Wow.

 

Jessica Shepherd (00:34:47):

Yeah.

 

Mel Robbins (00:34:48):

And so do you see this a lot with 20 year olds?

 

Jessica Shepherd (00:34:50):

I do. They come in and usually what is the best way to treat them? So it's a great relationship we have with dermatologists because they'll have these patients come into them, and a lot of dermatologists will actually send the patient back to an OB GYN, because typically we will put them on birth control pills to kind of help quiet down this kind of overwhelm of hormones, and it responds to that. And a lot of it has to do with the testosterone feature of what's being elevated, what's creating that message being sent, and then you have the outcome of the hormonal acne.

 

Mel Robbins (00:35:23):

Wow.

 

Jessica Shepherd (00:35:24):

Yeah.

Jessica Shepherd (00:35:38):

I want them to know that the body is really trying to get to homeostasis. And homeostasis is just that kind of perfect balance that the body needs to be able to do the functions that it wants to do. Now when we're on birth control, the goal of birth control is to somewhat suppress or kind of decrease the activity of your hormones that your body naturally produces. And when it does that, it is doing the job of what it's supposed to be doing is preventing pregnancy by decreasing the suppression or rather the release of an egg. Your body's in default to get pregnant every month, so it wants to release an egg.

 

Mel Robbins (00:36:15):

So what happens to all those hormones in your body if it still,

 

Jessica Shepherd (00:36:18):

They're still there, they're still doing what they're supposed to be doing, but the birth control is kind of keeping it a little bit more suppressed so it can't do the function it wants to do. So when you come off now you're lifting off this veil that was always there and suppressing, so now your hormones are like, we can go back to what we were doing. And it's trying to find that homeostasis. And sometimes you might have highs, sometimes you might have lows.

 

Mel Robbins (00:36:44):

So what might somebody expect and what would you say? Dr. Shepherd is a good amount of time to give your body to like, ah, okay, what's happening here?

 

Jessica Shepherd (00:36:58):

Immediate gratification is usually what we want when it comes to our bodies. And I always am coaching my patients to give their bodies grace. And when I say that in a timeframe that may be three to six months,

 

(00:37:11):

I've had some patients who may take nine months to a year to kind of regulate and get back to what they used to be. But just after pregnancy, we always want our bodies to kind of be perfect, bounce back like eight weeks after, but our body doesn't function like that. And so even in the perimenopausal phase, going through these changes, we need to give our bodies more grace and time to do the thing that it's designed to do, but we can't push the agenda as quickly as we would. So three to six months usually I would say give it that timeframe, and when they come back in, I'll be like, well, where are we? Because remember, it's a gradient. They may see that they're improving over three to six months, but maybe not getting all the way back to where they were, and so maybe we can push out time a little bit more.

 

Mel Robbins (00:37:55):

Okay. And it's interesting, I think about the fact that so many young womeng go on birth control and you do it for a number of medical reasons, which I am in full support of. But is there anything that we should be aware of? If you have been on the pill or you're taking one of the coded IUDs for two decades of your life and then all of a sudden you're like, okay, let's stop taking the pill. Let's take out the IUD and you've been doing this hormone suppression for 15 or 20 years.

 

Jessica Shepherd (00:38:33):

Yeah, you are going to see changes. And a lot of that has to do with we were not used to seeing what the body was naturally doing for that long. So now when you're exposed to it, you're like, this is off-put, or this is weird, but really the body may be like, oh, I was kind of doing this all along. We just weren't really aware of it because we had some suppression. So that can be changes in how your cycle comes back. People may experience that it's heavier or maybe they're having longer cycles and duration, and that may be because the birth control is kind of not doing what it wanted to do. You also may see changes in skin. You may also see changes in hair.

 

Mel Robbins (00:39:09):

What changes do you see in hair?

 

Jessica Shepherd (00:39:11):

So hair, you can start to see that maybe they're going to have more thinning or falling out of their hair because it's the shift in the hormones. So it's not that there's something wrong all the time.

 

Mel Robbins (00:39:21):

It feels like it's wrong when literally like a dust ball on the drain.

 

Jessica Shepherd (00:39:25):

When there is a clump of hair in your hands. It does feel so wrong. What the body's trying to do is get back to that homeostasis, right so our,

 

Mel Robbins (00:39:32):

But why are you losing hair?

 

Jessica Shepherd (00:39:34):

Because it's the shift. So you were suppressing your hormones with this birth control, and now that you're lifting it off, it can skyrocket back to what it wanted to be, right? It's like, oh, well, no one's kind of keeping me down. I'm going to come out. And the hair cycle is impacted by hormones. So how our hair goes through cycles and phases of growth, when it falls out, when it's going to be what it wants to be within the cycle, those can all change due to what our hormones are telling it. Right? Hormones are chemical deliverers.

Jessica Shepherd (00:40:12):

Absolutely. There are estrogen receptors all over the body. In generation M, there is this, I was like, this diagram has to go in this book because we have typecast, estrogen and progesterone just to the pelvis. Just to the pelvis.

 

Mel Robbins (00:40:25):

It's true. I think about estrogen, and I'm like, well, it's just talking to my ovaries. What are you talking about? Why do I?

 

Jessica Shepherd (00:40:30):

I know it's talking to your brain. It's talking to your muscle, your heart, which is exactly why we see when estrogen goes down after menopause, what do we have? We have heart disease. Our bones are weaker. Our brain goes through this fog, and that's because estrogen is estrogen, receptors are there. So if it's not able to deliver the message, then that area of your body is like, I'm not going to function the way that I used to or would like to because estrogen is not there.

 

Mel Robbins (00:40:58):

What is a few places in a woman's body that somebody might be surprised to hear has estrogen as a very critical piece of how that part of your body functions?

 

Jessica Shepherd (00:41:12):

You know what I say is the most fascinating is the brain. And why? Because even as an ob, GYN, it's like you know it, but you don't know it. I don't think I realized how much of an impact that estrogen makes on the brain until maybe five, 10 years ago.

 

Mel Robbins (00:41:28):

So what impact does it make on the brain?

 

Jessica Shepherd (00:41:30):

It has an impact on mood. It has an impact on cognition, how we're able to function, how we're able to use our prefrontal cortex. We become more limbic in our responses. What does limbic mean? Limbic means that emotional, right? Oh, yes. That kind of jump to the right. And what do we hear that women who are in their perimenopausal phase are more moody?

 

Mel Robbins (00:41:49):

Well, that's also what we hear about PMS.

 

Jessica Shepherd (00:41:51):

Absolutely.

 

Mel Robbins (00:41:52):

So is PMS like a mini drop in estrogen in your body?

 

Jessica Shepherd (00:41:57):

It's a drop. So it's the fluctuation. It may go down then come up really quick, but unfortunately in perimenopause it's going down, but it's not really coming back up. It's like, I'm really going down and I'm not coming back up. And so that's why you start to see in between the ages of 45 and 55, we have the most diagnoses of anxiety and depression. It makes so much sense.

 

Mel Robbins (00:42:17):

Wait, hold on. You see the most diagnoses of anxiety and depression in women between the ages of and midlife women, 45 and 55?

 

Jessica Shepherd (00:42:25):

Absolutely.

 

Mel Robbins (00:42:26):

Why Dr. Shepherd?

 

Jessica Shepherd (00:42:27):

Because this is when estrogen, our key response, our key hormone in how it interacts with the brain is going to be impacted because our mood, our neurotransmitters are dopamine After menopause. We start to see that dopamine receptors are 30% less, and so if that's our hormone that's going to be around to make us feel good, and now it's not there anymore, what do you think is going to happen? And so this is why it's so crucial that people understand the mind body connection is so important and you are not alone during this journey. You are not the only one who's experiencing this. And the more that we can look inward and say, I'm going through this, I'm going to be okay, but I also understand why wouldn't that make someone feel better?

 

Mel Robbins (00:43:13):

Of course.

 

Jessica Shepherd (00:43:14):

Absolutely,

 

Mel Robbins (00:43:14):

Of course.

 

(00:43:15):

Because you can't solve the problem if you don't know what the problem is.

 

Jessica Shepherd (00:43:18):

You can't.

 

Mel Robbins (00:43:19):

And if you are starting to experience higher states of anxiety or you're feeling depressed and you're not looking at the correlation with your age and understanding that by 45 a lot of the estrogen is gone and your body's going through major changes which impact your brain, which literally can be the cause of this happening in you.

 

Jessica Shepherd (00:43:45):

Do you see how it impacts careers? It impacts relationships,

 

Mel Robbins (00:43:47):

Of course.

 

Jessica Shepherd (00:43:48):

Your personal life, yeah, you're feeling you're going through just like this. And that's what women used to come in and tell me because they couldn't put their finger on it. They would say, I don't feel right. Something's off. I feel like I'm just so emotional. I can watch TV and cry to commercial. Or someone can say one thing to me and I will snap. And they feel as if it's an outof body experience. They're literally watching themselves have these responses.

 

Mel Robbins (00:44:14):

Well, it kind of is because you are out of the body you have been living in for the last 40 some years because the hormones are radically changing, and so your body's probably like, what the hell is going on? Can you explain how estrogen starts to decline in your late twenties and what are the big general age markers, Dr. Shepherd for when you got a hundred percent of this, if things are working well and you're not eating too much processed food and you're managing your stress and you're taking care of yourself, which a lot of us just assume that you're kind of like the one that's doing it right on the planet. What age, Dr. Shepherd, do you start to see estrogen decline or progesterone or testosterone in women?

 

Jessica Shepherd (00:45:06):

Mel, this is why this conversation is so important for a 20 and 30-year-old. So let's bring it back to the reproductive phase, right? Yes. So our body's designed to do this. We know in the reproductive phase as OBGYNs, we start to see a change in a decline in egg quality and the ability to get pregnant spontaneously after the age of 35.

 

Mel Robbins (00:45:23):

Okay.

 

Jessica Shepherd (00:45:24):

Now, why do you think,

 

Mel Robbins (00:45:25):

Oh, because estrogen starts to fall off a cliff.

 

Jessica Shepherd (00:45:29):

Yeah.

 

Mel Robbins (00:45:29):

Is that right?

 

Jessica Shepherd (00:45:29):

Yeah.

 

Mel Robbins (00:45:30):

Does testosterone and progesterone also change in a woman's body at the age of 35?

 

Jessica Shepherd (00:45:34):

Estrogen and progesterone, which impacts what we're able to do with releasing that follicle. So our chemical messenger is not able to tell the ovary we're going to fire off a egg as readily. So it's like, I'm not doing it this month, or the quality of the egg not really going to be that great. Then testosterone is also taking a decline, although it is more subtle, but that's where we start to see that drop in estrogen, which is some women, especially I'm one of them who had kids later on in our age, I think,

 

Mel Robbins (00:46:01):

What is that awful term that they use?

 

Jessica Shepherd (00:46:03):

They use geriatric pregnancy.

 

Mel Robbins (00:46:05):

Yeah what the

 

Jessica Shepherd (00:46:06):

Who came up with that?

 

Mel Robbins (00:46:08):

Clearly not a woman.

 

Jessica Shepherd (00:46:09):

Not a woman. And so even I start to see a lot of my patients having kids later on in their life, what happens is usually after they deliver, they start to experience the perimenopausal kind of symptoms. Hot flashes, night sweats, mood changes kind of entered into that phase just very quickly after delivering their children.

 

Mel Robbins (00:46:29):

Wow. So at 35, do you know the percentage roughly of how much estrogen kind of functioning is left?

 

Jessica Shepherd (00:46:37):

Well, what we do know is looking from a pregnancy perspective in the ability to get pregnant after the age of 35 versus after 40, and then 42 is another marker when we're thinking of fertility of when it really starts to drop off. And so the ability to get pregnant in your twenties is much more than in your thirties. And then after 35, it does take a drop than again, at 40 and 42 is usually when we start to see another decline.

 

Mel Robbins (00:47:03):

Wow. Well, it's so helpful to understand this against the backdrop from an evolutionary perspective, what a woman's body is actually designed to do from a physical and biological standpoint. And when you look at it that lens, and you understand, I was researching something else and was kind of gobsmacked to consider that in the 1920s, the average life expectancy in America was 27 years old.

 

Jessica Shepherd (00:47:33):

Isn't that crazy?

 

Mel Robbins (00:47:34):

And literally, just like a couple people ago, like 50 years ago, the life expectancy was in our fifties and we've gained 30 to 40 more years in the last five to six decades based on improvements in health and sanitation and medical research.

 

Jessica Shepherd (00:47:54):

Do you know what? We haven't accounted for that gap in life expectancy with now estrogen still gone, and that's why we still see women living longer. Yes, that's great. I'm all for that. But we're living life in poor quality of health, and we're seeing these health measures of what women typically, they have more dementia, they have more osteoporosis, they have more heart disease. Number one killer of women is because that estrogen was gone, but we're still living longer.

 

Mel Robbins (00:48:21):

This is so important to understand because I think what we do as women is we throw our hands in the air and say, well, there's nothing. Why is this happening? All this stuff. But when you look at it across the historical perspective and the fairly recent life expectancy jump,

 

Jessica Shepherd (00:48:38):

So when we look at life expectancy, we know that women typically was used to be 57, 58 was the life expectancy, but what is the average age of menopause? 51, 52. So it makes sense biologically that estrogen is kind of tanked and the life expectancy of what the body's able to do because estrogen is not there

 

Mel Robbins (00:48:58):

50 or 60 years ago,

 

Jessica Shepherd (00:49:00):

Is going to be

 

Mel Robbins (00:49:00):

Not a problem.

 

Jessica Shepherd (00:49:01):

Not a problem. Makes sense. But now we have improved with science, technology, nutrition, sanitation to our seventies and eighties, but we have not accommodated the body to function without estrogen.

 

Mel Robbins (00:49:14):

Wow. It's almost like if you have a car and you don't have any gas in it, how is it going to work for you for like 20?

 

Jessica Shepherd (00:49:23):

You just got to keep driving, Mel,

 

Mel Robbins (00:49:25):

Just hit the gas harder and stop complaining and it'll work.

 

Jessica Shepherd (00:49:29):

But isn't that the analogy of what we're told to do? Just keep going. I don't care if you feel crazy. I don't care if your bones are breaking, just keep going. So this allows us, again, to take that step back and have more grace with our bodies, but it's because we now understand the biology of our bodies.

 

Mel Robbins (00:49:45):

Is there things that you can do in your thirties and forties to slow the breakdown of this hormone decline?

 

Jessica Shepherd (00:49:53):

There is not, but there are ways that you can help your body do better things. In other words, optimize the ability for the body to do it. Even in the absence of estrogen and progesterone.

 

Mel Robbins (00:50:06):

Like what are the most important things?

 

Jessica Shepherd (00:50:07):

I would say nutrition and exercise, because those are fundamental things you can do every day or even if it's four times a week. But those are things that are giving our metabolic health and our mitochondrial health, the best ways that they can function, even in the absence or the decline of some of these hormones. So that's going to be paying attention to decreasing your processed foods, your sugar, because your body just doesn't respond to it as readily as it did in twenties and thirties, which I would not advocate for people just because they're 20 and 30 to eat these types of foods. But then also exercise in weight training to be able to build that muscle up so it can utilize the glucose better so that your body's just not sitting with the glucose.

 

Mel Robbins (00:50:47):

Do women that have children after 35 tend to enter perimenopause or menopause earlier?

 

Jessica Shepherd (00:50:55):

It's not necessarily that they're entering it earlier. It's that we do have a significant change of hormones in pregnancy, and what we do see is after pregnancy. So in the postpartum phase, you're going to have that shift again, trying to get back to homeostasis,

 

Mel Robbins (00:51:10):

Which you have taught us, Dr. Shepherd, you got to give your body grace,

 

Jessica Shepherd (00:51:13):

Give your body grace

 

Mel Robbins (00:51:13):

Nine months to a year it could take until you feel like yourself again.

 

Jessica Shepherd (00:51:17):

So if you think that's nine months postpartum, nine months typically for a pregnancy that's almost like a year and a half timeframe. And so in that year and a half is where you start to see that. Now they're entering into the natural kind of fluctuation on the decline towards menopause. And so it does seem a little jarring or quick, but really the body was already on its way, and now we've kind of distracted our body or ourselves from what was happening because we were pregnant. And then after your body's like, well, I was still going in this direction, I'm going to continue to go in that direction.