#25: Hormones & Fertility with Sarah Swanberg

Michelle:
It's time to stop being the victim of your over-scheduled life and become the most powerful version of yourself. Welcome to, she's got power. I have a question for anyone who has a period. How was it this month? I'm asking because after, you know, five, six weeks in quarantine, you may have noticed a significant difference. It could have been better, could have been a better period, an easier period, more regular than usual. If you've been able to use this time as a break, like if you're someone whose life has slowed down and your resting more could have been better or your period could have been much, much worse if you've been sort of eating a lot of things that you normally wouldn't eat if you've been stressed to the gills. Busier than usual. Yeah. You may have had more symptoms than you normally would in this episode. We're talking about the many ways that our hormones and our fertility in particular are impacted by stress and how our cycle can act as a report card that lets us know how we're doing every month.

We recorded this a while ago, but I think it's super relevant right now because our lives have changed so dramatically with COVID and it's more important than ever to check in with your report cards, and by the way, your period is not the only report card that your body gives, and we talk about this during the episode, but if your digestion is sluggish, if your sleep is disturbed, if your skin has been breaking out, if you feel bloated, lethargic, listen, listen, in a couple of weeks I'm going to be offering an easy free version of my five day lift program. It's going to help us all feel so much better. It's going to start correcting any imbalances that have started to go haywire during quarantine, and I'm going to be announcing it here on the podcast, so keep listening for details because that's coming, but for now, let's talk fertility and hormones. Hey Sarah, thanks so much for being on the show today.

Sarah:
Thank you so much for having me.

Michelle:
This is going to be a great conversation. I know a lot of women in my audience are thinking about thinking about, thinking about maybe getting pregnant or maybe they're even further along that path or have other fertility period type issues. So we're so glad you're here. Yeah. And since we're always talking about chronic stress and burnout here on the podcast, let's just start right there. Like when you think about a woman's hormonal health, fertility, how does chronic stress and burnout play into that?

Sarah:
Yeah, that's a great question. Well, I think one of things that really stresses people out about trying to get pregnant is that they just don't have all the information about like how it all works. I mean, I don't know. I went to Catholic school. My sex education was like, don't look at a boy, you'll get pregnant. And I didn't understand my cycle at all. Even when I started to think about thinking about trying, I did not understand that like day one of my cycle was this day and that ovulation signs look like this. So I think a lot of women end up kind of stressed out because they start trying and maybe they're even like missing the fertility window. It just can get really stressful and I think the, the main piece of that puzzle is not having the information. Of course there are other medical issues that can play into this too, but stress is real too. Women are getting pregnant or trying to thinking about families later in life and they have stressful careers already. So the stress plays a lot of roles here.

Michelle:
Yeah. Let's talk about getting ahead of things and especially getting ahead of the way that stress can impact your fertility because I'm thinking back to an episode that we did with Andrea Nakayama last season, all about digestion and how digestion is impacted by your stress levels and how energy is sort of shunted away from your digestive organs when your body's under stress. Could you just outline for us kind of how that works when it comes to our fertility and being?

Sarah:
Well, when you think about fertility, I mean our bodies want to be in a safe place to bring another human into the world. And so if your body's sending all of these signals that you know there's a tiger that's going to attack, which is what we were kind of designed to respond to, then that's not a safe time and a safe place and your energy and our resources are not going to go to your reproductive system. So yeah, that, that type, that proverbial tiger now exists in the form of, you know, life stress and work stress and all of these things that are coming at us that we are, we are getting stuck in these fight and flight responses that really do impact our fertility and our hormones. And I think we're sort of taught in our culture that like hormone health is not like, I see a lot of women that will come in to see me for acupuncture and they'll say, yeah, everything's great. My hormones are a mess. But like, everything's great. And you know, hormones are big piece of the puzzle. If they're not great, then everything isn't great. So like what, what can we look at? And sometimes it means it's not just about the hormones, sometimes there's a root cause that's deeper and it's digestion or sleep. But often stress is a major component there.

Michelle:
Major, yeah. Because I can think of so many ways that a woman can optimize her fertility. You know, starting with the food that she's eating and eliminating toxins from her environment. But if you had to put like a percentage on it, and I won't hold you to this, this is not scientific, but like what percentage of infertility problems would you say are like very, very related to the stress that the woman's under?

Sarah:
I think stress is a huge part of it. I mean by the time, well, so as an acupuncturist I'm usually seeing women come in who have been trying for awhile and it's not successful. We usually become, instead of like a getting ahead of the game thing, it's usually like a last resort thing when I would love to change that. But that is the reality. A lot of women come in and they've been trying and they've been to their doctors and everything looks fine, but it's still not happening. And that is usually stressful. I'm seeing a lot of women that like they just don't want to have that conversation and that's really stressful. This external pressure, you know, if you've been married for a few years or if you're getting older, people want to know. So I mean, I don't know. Stress is coming at us in a lot of ways. I would say it's a big piece, but the other big piece is the information piece. Like you really, you need to know the basics of your cycle to figure out when the optimal time to get pregnant is. And I am, I'm finding more and more that we just don't know. We're not really educated on that. A lot of women just go on the pill thinking it's going to regulate their cycle. And sadly it doesn't. It suppresses symptoms. Um, and it makes you feel like you have a regular cycle, but once you come off of it it's not always, that's not always the case.

Michelle:
Yeah. Let's talk about the pill a little bit. Cause I would say, you know, most women that I work with have been on the pill for at least 10 years of their life. I know that was the case for myself as well and we didn't think anything of it. You just go, you get that prescription, you know, through college or your twenties or whatever it is. You don't think anything of it. But what are your thoughts on the pill and what are of the ramifications of having been on it for a period of time?

Sarah:
Yeah. I always find myself kind of in the gray zone in these conversations that are often very black and white out there on the internet, especially in the health and wellness world. There are some people that are like, the pill is the worst. I mean let's be real for a second. The pill has been amazing for women. Like back in the day you had to be thinking about getting pregnant or not getting pregnant all the time. And it's provided a lot of freedom for women. But I do think that there are side effects to it that we are not told or we didn't know until more recently. And one of the things I see a lot is women who went on the pill, not specifically for birth control purposes, but to suppress some sort of symptom that they were probably having in their teenage years, like terrible acne or really irregular periods or really heavy periods. The solution was like, just go on the pill, it will fix things. And what we now know is it absolutely does not fix those things. It just suppresses your hormones so that, that those symptoms aren't there. But when you come off the pill, those symptoms can sometimes come back and come back with a vengeance, especially women that suffered with acne. Or they could have had PCOS and that's not, that's why they weren't getting regular cycles and they had no idea that like, but that could be impacting their future fertility. So again, that's the education piece. It's or the information piece. We just aren't always aware of things like this. I mean I think that's shocking to a lot of people is that that problem that they originally went on the pill for 20 years ago has not been fixed.

Michelle:
Yeah, it sure is. And you know what, our period is almost as a, it's a measure of like how things are going in our body, right? Like you know like digestion or your skin or you know, we have, if we were robots, I always say like lines. Imagine you were a robot and you had like a little gauge on the front of your body to tell you how things were going inside. Well we don't have one of those, but we do have our bowel movements. We do have our cycle. You know, we do have certain things we can look at as indicators of how things are going on in there.

Sarah:
I love it. I read a, I can't remember who, it's a book called the period repair manual. She talks about your period getting your monthly report card and it can change from month to month. I know we just, before we started recording, we were talking about my life recently and I just moved. I moved the week before Thanksgiving. Then we hosted Thanksgiving like during the move week, I have to say I ate like garbage. I mean there was a lot of pizza. There was just a lot of like quick and easy meals. I have two little kids and I was like you know what, I will be fine, I will get back on the horse like once we have a kitchen again. But this last report card was not a pretty one let's just say. And I was like Oh my gosh I never get PMS or crampiness anymore and it was just a really clear sign that like my hormones were pretty wacky this last month probably due to the stress and the diet and all of those are definitely due to those things as we know. But I think yes your period and your poop. The two things that we like really don't like to talk about cause we think it's so gross are to me so fascinating and they're one of the things I really love to talk about with patients and in the fruitful program we're talking a lot about like changing that conversation from ew to wow. Because how cool is it that we women, especially with our periods, like we can really have a pretty good gauge of what's going on. Although I will say like the period that you get if you were on the pill, that does not count as a report card because that's not a real period. That is not so impacted by what's going on.

Michelle:
So and I guess that's where I was kind of going with that, which is if you've been on the pill, you are not, you're not getting that report card. You don't really know what's going on. So things can be way out of whack for years and years and years and then you go off the pill then it's like what?

Sarah:
Yeah, exactly. You thought you were like, wait, I thought I was getting straight A's all this time and I wasn't at all. Yeah. And that's that. I don't mean to terrify people either. Like some women get off the pill and they resume a normal healthy cycle right away. And sometimes that issue, like the heavy periods that you had in your teen years because your hormones weren't balanced. Sometimes those had time to regulate sort of behind the scenes with the way everything else works. But, but not always. And that's what I think it's better to be prepared knowing that might be the case than to be shocked when it happens. Cause that's stressful. We don't need that.

Michelle:
It is, Oh my goodness. And then so then we're in a cycle. How many women do I know who, by the way, while they're going through infertility treatments, rarely talk about it. It's very difficult and embarrassing or scary, all the things, right? So there's like no support around it. It's so, so stressful. And then you're stressed about being stressed. I'm too stressed, can't get pregnant, but now I'm stressed so I can't get pregnant stress.

Sarah:
And then somebody tells you to just stop stressing and that just kicks that ball further down the Hill. Well tough luck. I always tell people like, I know it's stressful. I'm not going to tell you not to stress cause that doesn't help. But like what are the actionable things that we can do to help pull that stress level down a little bit and you know, it's lying on the acupuncture table, which some women find so helpful but it's also not eating foods that might be causing some additional inflammation and stress on the body. Avoiding you know, too much alcohol, getting a little more exercise. Those things you can actually like make some real changes other than or, or I guess, um, instead of just trying to like tell yourself not to stress out.

Michelle:
Right. You just don't have to meditate all day long. You can go about your normal life, but with a couple of tweaks here and there that you can make a big difference. Why don't you tell us, Sarah, the woman who just moved before Thanksgiving and then hosted Thanksgiving, why don't you tell us how you incorporate some of these things into your life?

Sarah:
You know, I feel like sometimes I can roll my eyes out there in the world too with all of these things that we're supposed to be doing and meditating and like I am a busy mom, I have two businesses, I have two kids. We just, I can't do it all, but I try to keep my eye on what I call my, my fuel tank and like whether the things that I'm doing are depleting my tank too quickly or whether they're filling them. Things that might really deplete your tank might fill mine and that's okay. I just need to like always have a little bit of awareness about how I'm doing and that doesn't mean I don't end up in the red zone. Sometimes I just then know like I can't let that go too far. I have what I call the Roadrunner syndrome where I like think I feel great if I'm not really checking in. And then all of a sudden we'll look down and be like, where the F is the floor. Because I, to be honest, I like to have a lot of balls in the air. I like get, I like that kind of adrenaline of doing a lot of things that I'm excited about. So, um, I have learned over time to not take my, take my eye off like how I'm feeling and now that I'm more aware of my report cards, like I can check in on that a little more quickly than I used to be able to. If I notice my digestion's really off or I noticed that my periods kind of wonky or I'm having more cramps, then it's time to like make some changes and rest and do things. And I don't mean like a weekend long retreat somewhere cause that's not a possibility for me right now. It's taking a half an hour walk where I'm not even listening to a podcast or trying to learn something new, just clearing my head. So, you know, I'm all about like practical steps and nothing, uh, nothing too extreme.

Michelle:
That sounds very familiar. What you said, and I'm sure many of our listeners are kind of nodding their head like for women like us, like we like to have a lot of wonderful things going on. We don't want to not do those things that make us so happy. It's like it's fun and there is that like little adrenaline that goes along with it and the projects and the job and the best and the that. But yeah, it's that checking in like really how are you managing on the inside?

Sarah:
Yeah. I was reading something like earlier this last year that was like, you know, if you're so busy it's because you are trying to avoid something in your life and you should check in on that. And so like stop me in my tracks. I sort of like felt bad and guilty. I'm like, why am I adding all of these things to my life? Like what am I trying to ignore? But I realized like I ended up in this weird kind of guilty and shame spiral about it, that I don't know that that didn't really speak to me. That wasn't, that isn't what's going on for me. And I mean, I'm glad that I did take that moment to check in, but I really do like doing a lot of different things. It's, it keeps my like creative spark going and I feel like I actually am better in my whole life when I, I feel fulfilled in that, I don't know, like creative way. So, you know, it's different for everybody and I think that's what makes us also so cool and unique.

Michelle:
So how did you get into all of this anyway? You're originally an acupuncturist and then you started seeing women for fertility treatments. Like just give us a little background.

Sarah:
Yeah. So yes, I'm an acupuncturist and I guess when I was first getting my practice going, I wasn't sure the beauty of Chinese medicine is you can sort of treat any condition by looking for these group cause patterns. And so I didn't want to niche down too much. I really wanted to see people that were going through fertility struggles, but also that had anxiety and insomnia and back pain and digestive issues. It's, you know, again, my, my brain that kind of likes to be busy and doing a lot of things enjoyed that. But over time I started to realize that women's health specifically was something that I was really interested in and that's how I met you actually through a Viva ROMs program that we both did that was more specific on women's health.

Speaker 3:
And we touched in that course a lot about the like women that fall through the crack a little bit where nothing is specifically red flag wrong with them when it comes to their labs, but they're not feeling great. And those are a lot of women that would end up in my office. They're like, I've had every test and everything looks okay, but I'm still tired, I'm still whatever. I'm still having a hard time getting pregnant. And I just found like that population was really, I don't, I felt really inspired to sort of work with that group of women. And then when I was seeing a lot more fertility patients, I really started keeping this mental list in my head of the things that women would say. Like, Oh, I wish I knew this. Like, Oh, I wish I knew that just because the internet says I ovulate on day 14, like that might not be the case or I wish I knew that somebody told me that like day one of my cycle is the first day that I bleed, not the day that I started. You know, when you look at those, um, the pill packs, it really does make it seem like your periods that last part of the month because it's the last part of the pack. But that really throws a lot of women off and if you don't have that information, it gets really hard to get pregnant. So I guess that's sort of where the idea for this program came. And then my sister Carolyn Brown, who is a registered dietician, she did the same program of Eva Rahm's program the year after me because I just was like, you have to take this. There's so much information that could be helpful to the women that she was seeing too who were coming in with digestives issues but really had a lot more going on. And so we just love to like nerd out on this together and problem solve and talk about cases. And I don't remember exactly when it happened, but at some point we thought like let's do something like this together cause we just love both. Loved to share information and thought a program like this was necessary.

Michelle:
I love how you, how you phrase that, that idea of women who are falling between the cracks. That was definitely my experience and how I landed in health and wellness was this. And I know so many of our listeners right now will agree, your doctor says you're fine and you're like, I'm not fine. And the conversation goes nowhere, right. Until they find a practitioner who's like willing to hear you and hear like, Oh, that really does sound like you're not too exhausted.

Sarah:
Does it not go nowhere? It also creates this kind of like mistrust about our bodies. You're like, why am I feeling this way? But everybody else tells me I'm fine. Like I think that creates the stress and I don't think we're talking about that part of it a lot. But yeah, no, it's a tough place to be because we don't, our medical system doesn't really have all of the answers if you're not obviously sick.

Michelle:
Right. And bringing it back to fertility, how many, you know, women are just given the diagnosis of unexplained infertility.

Sarah:
Yes, it's nice to know that something isn't like majorly wrong, but it also can, I can leave you with this sense of like what is going on with my body? And those are the women who probably do need help somewhere else. And they're not connecting the dots between what they're eating or the products they're using or the fact that they're not sleeping or that they'd never poop. That's a, that's something that I think about a lot, but, and people are usually like, well, why are you asking about that when I want to talk about hormones?

Michelle:
And you said again before we started recording, you said something and I wrote it down. He said it's all part of the same puzzle. So is this what you're talking about like digestion and other things going on in your body? It's all part of fertility.
Sarah:
Yeah. We are not this like compartmentalize robot where things, you know that's the sort of machine model like let's just look at that part and fix that part. It all works together and you have to be sort of looking at the bigger picture and the root causes of things sometimes to figure out what's really going on. So a lot of those women with unexplained infertility come see me and when I think about what's going on from a Chinese medicine perspective, they have these like really clear patterns of what we call disharmonies. Maybe they have like blood deficiency or maybe they have cheese stagnation, but they're usually pretty obvious to me when nobody else has been able to like figure out what's going on. And then we work on those things and boom, they get pregnant and it's really fun.

Michelle:
Boom. There you go. Okay. For everybody. Sarah has a free gift, it's a guide to foods for hormone health. You want to just tell us a little bit about that?

Sarah:
Sure. That actually is the brain child of Carolyn, my, my dietician sister partner in the program and she so into the specific foods and what you can get out of them. We don't want you to overhaul your life cause we know you're not going to do that. To be honest, like a we have to make small changes in our lives and get rid of certain foods while introducing better ones. I never liked to tell people like get rid of all of this until we've replaced it first or thought about what we're going to replace it with. So this is all about um, just the healthiest foods and sort of how they impact your hormones and where to focus your energy. And uh, I guess I could give a spoiler alert. Berries are always going to be up there. They're high in antioxidants and yeah, junk food does play a role. So wherever we can limit that.

Michelle:
So important. And Hey, again, it's all part of the same puzzle. So the same foods that are going to, you know, improve your hormonal health, are going to improve just about everything. So we're going to put a link to that free gift in the show notes. So if you're listening you can go to, shesgotpower.com/podcast and find this episode to download this free guide to foods for hormone health. And then you have, first of all, we should mention that you have your acupuncture clinic in Stanford, Connecticut. That's right. Yeah. And then, but your course is virtual. So tell us a little bit about that.

Sarah:
Yeah, so, um, my practice in Stanford is called Indigo acupuncture and wellness. And we're actually expanding too, you have some other wellness options coming soon, which is really exciting. But the program is an online program. So it's a six week program. It's broken out into, uh, like three modules really with two lessons each. So the first two weeks are really like the sex ed 101. Uh, here's how your cycle works, here's how each phase of your cycle, here's what's going on. And then a recap of all the hormones cause they're the things you're going to hear a lot about if you're thinking about or trying to get pregnant. Like what does estrogen do, what does progesterone do? What is luteinizing hormone? These are the things that I remember like if you did cover in sex class, sex ed class back in high school probably just sounded gross and now they're like wow this is so our bodies are so cool, really fascinating. And each week we're also going to have like an expert chime in. And then the last part of the program is what we're calling the fruitful five and it's all the things we've been talking about in this conversation. The five fundamentals for overall health, which then lead to fertility. So diet, sleep, stress, supplements, and then what sort of chemicals and endocrine disrupting chemicals you want to be thinking about and trying to avoid. And throughout the whole course we're going to be just weaving in like actionable things that you could do because I think that's what's really important for so many women and we'll be spending the last week of the program together practicing some of those things.

Michelle:
So I know that you know your stuff because we did study together and I love the perspective that you bring to all of this. Um, before we wrap, I just have one thought that I keep going back to because I read this earlier in the year and it has really stuck with me that although there's so many reasons for infertility problems, which let's face it, it's really becoming a huge rampant problem in the population. One of them being we're just not having as much sex.

Sarah:
That is a big thing and we are going to touch on that. Put your phones down people. I mean, to make a baby you have to be getting busy and we aren't. Yeah, I've seen that statistic too. So yes, that is sort of one of the, the more fundamental things that will catch on.

Michelle:
Yeah, that was just fascinating to me. Like of all the factors, the most obvious one being like Netflix, you know?

Sarah:
Yeah. And you know, this is a kind of funny anecdote from back when I was in Chinese medicine school, the parasympathetic nervous system is what controls erections in men. And so they're stressed out like if they're going to have a harder time to the parasympathetic is the the rest and digest mode. And I remember learning that because the sympathetic grows into the parasympathetic if you want to think about it that way when it comes to the male baby making parts. But yeah, like stress, we're keeping ourselves busy and we're not, we're not having enough sex, which also isn't helping our, bodies decompress. So definitely think about stress reliever everybody.

Michelle:
Alright. Thank you so much for sharing with us today and for anyone who is interested in learning more about foods for hormone health and the fruitful program. Again, head over to, shesgotpower.com/podcast where you can find this episode and connect with Sarah there. Thanks again.

Sarah:
Thank you so much for having me.

Michelle:
Oh, I love that last part. It seems that with quarantine we should be expecting a baby boom next year, but I guess it depends what we're doing with our time. And as I mentioned at the top of the show, if you've been feeling sort of down and out, sluggish, bloated, if your period's been wonky, I'm offering a free version of my five day lift program in a couple of weeks to get you back to feeling like yourself. It's something I've had to do for myself recently, and I can't wait to share it with you. I'll be announcing dates soon. So keep listening for details and I'll see you next time.